Behavior Modification最新文献

During the COVID-19 pandemic, many insurance companies approved the funding of telehealth-based behavior analytic services for both training and direct-care purposes. Activity schedules are a simple and effective intervention that can be used in the home environment to improve independence for children with ASD. Recent efforts have shifted the format of activity schedules from paper-based schedules to digital platforms that make the schedules more portable and provide easier access for both the caregiver and the Board Certified Behavior Analyst (BCBA). Google Slides^® is a readily available web-based platform that has been used to design and deliver behavior analytic instruction during the COVID-19 pandemic. A non-concurrent multiple baseline design across three child-caregiver dyads was used to evaluate the effectiveness of a caregiver-implemented digital activity schedule intervention on the independent play behaviors of children with ASD. The activity schedule was created and shared on the Google Slides^® platform and caregivers received bug-in-ear (BIE) coaching from practitioners to implement the intervention. Regardless of some minor treatment implementation difficulties attributed to the remote service delivery and the digital format, the digital platform and coaching intervention were effective in increasing independent schedule following with minimal training on the part of the caregiver. We hope that the results of this study provide BCBAs with additional guidance on effective interventions and procedures for remote service delivery.

Behavioral problems, such as noncompliance and aggression, are a common referral reason to mental health services for young children. Behavioral parent training (BPT) is the leading intervention for addressing behavioral problems and leads to benefits in a variety of parental factors (e.g., parenting efficacy and parenting stress). While the COVID-19 pandemic dramatically shifted service delivery toward telehealth services, limited work has evaluated the effectiveness of BPT when delivered in a brief, group format through telehealth. The current retrospective chart review study evaluated the engagement to and preliminary effectiveness of a brief version of BPT delivered through telehealth to 64 families of 3- to 7-year-olds referred for behavioral problems. Families attended an average of 4.55 of 6 sessions and most families had two caregivers who engaged in the intervention. Significant reductions in caregivers' report of children's behavioral problems and improvements in parenting self-efficacy resulted. Future research and clinical implications are discussed.

Research on the delivery of behavioral assessment and treatment via telehealth has focused largely on child outcomes and parent procedural fidelity. By contrast, the behavior of the therapists coaching parents to conduct assessment and treatment has garnered little research consideration. In this study, we conducted a retrospective analysis of behavior therapists' coaching behaviors when directing parents to conduct functional analysis (FA) and functional communication training (FCT) with their young children with autism via telehealth. Coaching behaviors for five experienced behavior therapists across seven parent-child dyads were scored using a combination of standardized and novel behavior codes. Therapists displayed more social engagement behaviors than any other type of behavior throughout the study, and rates of antecedent and consequence behaviors shifted across the FA and FCT phases. Results are discussed in relation to therapists' goals during behavioral assessment and treatment and the implications for training behavioral therapists to coach parents via telehealth.

Assuring treatment plan implementation following consultation is critically important because implementation is strongly related to outcomes. Treatment implementation has been hypothesized to be influenced by both the nature of the follow-up support provided and contextual variables. However, studies to date have not examined both issues while directly measuring implementation. This study examined treatment implementation following consultation for 48 teachers in public schools who had referred a student for intervention services in a randomized clinical field trial. Participating teachers in the experimental group received Integrated Support (IS). IS includes social influence, planning, and performance feedback elements. IS was compared to weekly follow-up meetings alone. Treatment implementation and child outcomes were markedly superior for IS as compared to weekly follow-up. Three school climate factors were found to be correlated with treatment implementation for the IS group, but not the weekly follow-up group. Participants rated treatment implementation, treatment acceptability, and consultant effectiveness positively and similarly across conditions. The implications of these findings for future work examining school culture, consultation and intervention are discussed.

Anxiety is a cluster of responses that can involve both operant and respondent behavior, which can be both public and/or private in nature, and occurs when an upcoming aversive stimulus is signaled. Despite the reported high comorbidity of autism and anxiety, there has been very limited research on how to directly assess and treat anxiety, especially with individuals who have limited communication skills. In Study 1, anxiety was assessed in five individuals with autism, ranging in age from 10 to 19 years old. Anxiety was assessed by measuring behavior during (1) a baseline (with no putative anxiety-provoking stimuli present), (2) signals for an upcoming aversive event, and (3) exposure to that aversive event. Anxiety presented in several different ways, as both conditioned activation and suppression, and both with and without problem behavior during the aversive event. In Study 2, individualized treatments involving differential reinforcement of alternative responses and stimulus fading were used to successfully reduce anxious responding in all four participants who displayed anxiety. These studies demonstrated a potentially useful means of assessing anxiety in individuals with autism which may not only help to measure anxious behavior and identify anxiety-provoking events, but may also lead to effective treatment.

Token economy systems have been widely used as an evidence-based classroom management strategy to reinforce and improve prosocial responses. While token economies have been widely applied to educational settings, there have been mixed results regarding the effectiveness depending on the classroom type. To better understand the components contributing to the effectiveness, the researchers analyzed 24 token economy studies conducted in general and special education classrooms from kindergarten to fifth grade between 2000 and 2019. Eight token economy components and effect sizes were identified for each study and compared across different classroom types. The results showed that the token economy intervention yielded large effect sizes for both general and special education classroom types. There were differences in the usage of token components including backup reinforcer types, token production rate, and exchange production rate based on classroom types. Implications for future research and practice for educators and clinicians are discussed.

Maximizing the discrepancy between expected and actual outcomes during exposure (i.e., expectancy violation) is thought to optimize inhibitory learning. The current study examined Craske et al.'s suggestion that engaging in cognitive restructuring (CR) before exposure prematurely reduces expectancy and mitigates outcomes. Participants (N = 93) with claustrophobia were randomly assigned to either 15 minutes of CR before exposure (CR Before) or 15 minutes of CR after exposure (CR After). Although the CR Before condition experienced greater expectancy reduction before exposure than the CR After condition, both groups experienced similar overall expectancy reduction by the end of the intervention. Groups experienced similar gains, with large significant improvement at posttreatment and follow-up. Results suggest that both cognitive therapy and exposure therapy lead to expectancy reduction, but that the order of these interventions does not impact outcome. Clinicaltrials.org registration #NCT03628105.

The purpose of this study is to provide a brief introduction to effect size calculation in single-subject design studies, including a description of nonparametric and regression-based effect sizes. We then focus the rest of the tutorial on common regression-based methods used to calculate effect size in single-subject experimental studies. We start by first describing the difference between five regression-based methods (Gorsuch, White et al., Center et al., Allison and Gorman, Huitema and McKean). This is followed by an example using the five regression-based effect size methods and a demonstration how these methods can be applied using a sample data set. In this way, the question of how the values obtained from different effect size methods differ was answered. The specific regression models used in these five regression-based methods and how these models can be obtained from the SPSS program were shown. R² values obtained from these five methods were converted to Cohen's d value and compared in this study. The d values obtained from the same data set were estimated as 0.003, 0.357, 2.180, 3.470, and 2.108 for the Allison and Gorman, Gorsuch, White et al., Center et al., as well as for Huitema and McKean methods, respectively. A brief description of selected statistical programs available to conduct regression-based methods was given.

Mindfulness-based programs are a promising intervention modality for reducing disruptive behavior, and Soles of the Feet (SOF) is one program that teaches internal awareness of personal events (e.g., unpleasant emotions) and a self-regulation strategy to decrease disruptive behaviors. This study conducted a meta-analysis of single-case research design (SCRD) studies that implemented SOF to decrease disruptive behaviors. Existing SOF studies were evaluated using high-quality SCRD standards, resulting in 15 studies included in the analysis (49 participants; mean age 23.12 years (SD = 15.87); highly heterogeneous backgrounds). Studies were analyzed to calculate effect sizes using Tau-U, an innovative non-parametric statistical approach for estimating effect sizes in SCRD studies. The aggregated weighted Tau-U effect size of SOF across all studies was -0.87. Moderator analyses indicated SOF's effectiveness was robust across participant characteristics and delivery formats. This meta-analysis suggests that SOF is a moderately effective evidence-based practice for reducing disruptive behavior.

Socially anxious adolescents often endure anxiety-provoking situations using safety behaviors: strategies for minimizing in-the-moment distress (e.g., avoiding eye contact, rehearsing statements before entering a conversation). Studies linking safety behaviors to impaired functioning have largely focused on adults. In a sample of one hundred thirty-four 14 to 15 year-old adolescents, we tested whether levels of safety behaviors among socially anxious adolescents relate to multiple domains of impaired functioning. Adolescents, parents, and research personnel completed survey measures of safety behaviors and social anxiety, adolescents and parents reported about adolescents' evaluative fears and psychosocial impairments, and adolescents participated in a set of tasks designed to simulate social interactions with same-age, unfamiliar peers. Relative to other adolescents in the sample, adolescents high on both safety behaviors and social anxiety displayed greater psychosocial impairments, evaluative fears, and observed social skills deficits within social interactions. These findings have important implications for assessing and treating adolescent social anxiety.