Assessment and treatment of elopement maintained by access to stereotypy

We evaluated a treatment for elopement maintained by access to stereotypic door play. First, we conducted a functional analysis of elopement that produced undifferentiated results. Next, we conducted an assessment in which we evaluated the relation between elopement and door play. Results suggested a functional relation between the 2 behaviors (i.e., elopement was maintained by contingent access to door play). Finally, we implemented functional communication training as a treatment for elopement in which access to door play was made contingent on a target appropriate communication response.     

Parent‐implemented brief functional analysis and treatment with coaching via telehealth

We evaluated the use of parent‐implemented brief functional analyses in the home with coaching delivered via telehealth. Parents of 7 children with autism conducted functional analyses of their child's challenging behavior. For 4 participants, the brief functional analysis provided information regarding the function of the child's challenging behavior. A full functional analysis indicated a social function for 1 participant. The brief functional analysis yielded false positive results and subsequent assessment indicated an automatic function for another participant. The final participant did not engage in sufficient rates of challenging behavior to provide information regarding the function of the child's challenging behavior. Treatment evaluations occurred with 4 participants; these evaluations provided support for the results of the functional analysis. Together with previous research, the results indicate that parent‐implemented brief functional analyses, followed by additional assessment as needed, may be an effective method for assessing and treating challenging behavior via telehealth.     

The stability of function of automatically reinforced vocal stereotypy over time

Although prior research has suggested the function of socially reinforced problem behavior can change across time, the stability of the function of automatically reinforced behavior is largely unknown. Further, some authors have suggested automatically reinforced behavior is likely to enter into socially mediated contingencies. The present study compared 2 functional analyses conducted on the same target behavior at least 1 year apart. Participants were 6 individuals diagnosed with an intellectual or developmental disability displaying automatically reinforced vocal stereotypy. Results indicated the function of each participant's vocal stereotypy remained stable over time (i.e., no new functions were acquired); however, future research on functional stability for automatically reinforced behavior of other topographies is needed.     

Superimposition and withholding of edible consequences as treatment for automatically reinforced stereotypy

The delivery and subsequent withholding of tangible consequences has been previously investigated as an intervention for stereotypic behavior. The current investigation sought to extend previous research by evaluating its effectiveness and durability as treatment for stereotypy of 2 children who had been diagnosed with autism. Nonsocial functions for stereotypic behavior were identified via functional analysis. Edible items were then delivered contingent on stereotypy and were withheld in a subsequent condition. When the superimposition procedure failed to reduce stereotypy, environmental enrichment was implemented and was found to reduce the stereotypy of both participants.     

Parent‐implemented behavioral skills training of social skills

Impairment in social skills is a primary feature of Autism Spectrum Disorders (ASDs). Research indicates that social skills are intimately tied to social development and negative social consequences can persist if specific social behaviors are not acquired. The present study evaluated the effects of behavioral skills training (BST) on teaching four parents of children with ASDs to be social skills trainers. A nonconcurrent multiple baseline design across parent–child dyads was employed and direct observation was used to assess parent and child behaviors Results demonstrated substantial improvement in social skills teaching for all participants for trained and untrained skills. Ancillary measures of child performance indicated improvement in skills as well. High levels of correct teaching responses were maintained at a 1 month follow‐up. This study extends current literature on BST while also providing a helpful, low‐effort strategy to modify how parents can work with their children to improve their social skills.     

Evaluating a treatment without extinction for elopement maintained by access to stereotypy

Elopement is a common and potentially dangerous form of problem behavior. Results of a functional analysis found that the elopement of a child with autism was maintained by access to stereotypy in the form of door play. We implemented functional communication training and contingency-based delays dependent on the absence of elopement and increased the amount of time the participant waited prior to engaging in stereotypy. We also conducted treatment-extension probes, with the participant waiting up to 10 min without elopement.     

A comparison of differential reinforcement procedures for treating automatically reinforced behavior

Children diagnosed with autism spectrum disorder (ASD) often exhibit stereotypy, which can be socially stigmatizing, interfere with daily living skills, and affect skill acquisition. We compared differential reinforcement of alternative behavior (DRA) and differential reinforcement of other behavior (DRO) when neither procedure included response blocking or interruption for (a) reducing stereotypy, (b) increasing task engagement, and (c) increasing task completion. DRA contingencies yielded superior outcomes across each measure when evaluated with 3 individuals with autism spectrum disorder.     

Parent‐conducted rapid assessment of attention types for the treatment of attention‐maintained problem behavior

When praise is not a reinforcer for alternative behavior in the treatment of attention‐maintained problem behavior, further pretreatment assessments are warranted to develop an effective treatment. The current study reports a replication of the pretreatment rapid assessment of attention types (RAAT) procedures, implemented by the parents of a 19‐year‐old female with attention‐maintained problem behavior. After administering staff and parent‐conducted RAATs, a parent‐implemented treatment, (a) produced clinically significant decreases in problem behavior, and (b) confirmed that the RAAT identified an attention‐type that served as a reinforcer for appropriate alternative behavior. This study extends the findings of Strohmeier et al. by reporting results of a parent‐conducted RAAT and treatment evaluation. The findings highlight the practical importance of pretreatment assessment of attention‐types, with emphasis on caregiver involvement, to develop effective treatments for attention‐maintained problem behavior.     

Developing a treatment for hand‐clapping maintained by automatic reinforcement using sensory analysis,noncontingent reinforcement,and thinning

Two subjects diagnosed with autism spectrum disorder and related disabilities who engaged in hand‐clapping maintained by automatic reinforcement participated in this study. We conducted a sensory analysis to evaluate matched stimuli that functioned as an abolishing operation or extinction for different sources of sensory reinforcement. Finally, we implemented noncontingent reinforcement (NCR) using the stimuli found to compete in the assessment to reduce the target behavior, and we thinned item availability. Results showed a decrease in hand‐clapping, and hand‐clapping remained low when we thinned the schedule of reinforcement. This research further elucidates how NCR can treat problem behavior maintained by automatic reinforcement.     

Artificial intelligence for the measurement of vocal stereotypy

Both researchers and practitioners often rely on direct observation to measure and monitor behavior. When these behaviors are too complex or numerous to be measured in vivo, relying on direct observation using human observers increases the amount of resources required to conduct research and to monitor the effects of interventions in practice. To address this issue, we conducted a proof of concept examining whether artificial intelligence could measure vocal stereotypy in individuals with autism. More specifically, we used an artificial neural network with over 1,500 minutes of audio data from 8 different individuals to train and test models to measure vocal stereotypy. Our results showed that the artificial neural network performed adequately (i.e., session-by-session correlation near or above .80 with a human observer) in measuring engagement in vocal stereotypy for 6 of 8 participants. Additional research is needed to further improve the generalizability of the approach.     

Response interruption and redirection for vocal stereotypy in children with autism: a systematic replication

This study systematically replicated and extended previous research on response interruption and redirection (RIRD) by assessing instructed responses of a different topography than the target behavior, percentage of session spent in treatment, generalization of behavior reduction, and social validity of the intervention. Results showed that RIRD produced substantial decreases in vocal stereotypy. Limitations of this study were that behavior reduction did not generalize to novel settings or with novel instructors and that appropriate vocalizations did not improve.     

Effects of socially appropriate singing on the vocal stereotypy of children with autism spectrum disorder

This study evaluated the effects of children with autism spectrum disorder engaging in socially acceptable singing on their vocal stereotypy. A multiple‐baseline across four participants with embedded multielement designs was used to assess the effects of the singing intervention upon later occurrence of vocal stereotypy for each participant. Results showed that fewer instances of vocal stereotypy occurred during and after singing intervention sessions. Additionally, two children began to emit appropriate singing after intervention, which suggests that the topography of their vocal stereotypy (e.g., monosyllabic or screeching sounds) was altered to some extent. Overall, results suggest positive implications for teaching appropriate vocal behaviors as functional replacements for vocal stereotypy.     

‘An Association for All’—Notions of the Meaning of Autistic Self‐Advocacy Politics within a Parent‐Dominated Autistic Movement

In this paper, we seek to explore the tensions between advocacy and self advocacy autistic movements in a Swedish context with a special focus on the meanings that enable the production of particular understandings of autism and the autistic subject. Drawing on articles written for the Swedish advocacy magazine Empowerment written for and by people with autism, the discourse analysis explores two competing discourses: a reformist and a radical. The reformist discourse underlines a goal of (political) representation expressed in Empowerment. It may be understood as an important part of producing a legitimate autistic political subject–positioned as a full member, with a full membership–within a parent‐dominated autistic advocacy movement. The reformist discourse can be viewed as a result of a negotiation, where full membership is conditioned on the parents' terms and granted on specific terms. These include working together (neuro‐inclusively), advocacy based on interest rather than identity/position as a specific target/member group, agreement upon a definition of autism as a disability (a deficit) a person has rather than an identity. In relation to this, an alternative legitimate autistic subject is produced through invoking the counter‐hegemonic radical discourse. Such a narrative produces the ‘Asperger’ or ‘Aspie’. Here, the ‘full membership’ refers to a sense of identification with sense of belonging to and being at home with other people with autism. It contains a certain amount of autistic solidarity within the group of adults with autism. Copyright © 2014 John Wiley & Sons, Ltd.     

Assessing and treating vocal stereotypy in children with autism

Previous research implies that stereotypic behavior tends to be maintained by the sensory consequences produced by engaging in the response. Few investigations, however, have focused on vocal stereotypy. The current study examined the noncommunicative vocalizations of 4 children with an autism spectrum disorder. First, functional analyses were conducted in an attempt to identify the function of each child's behavior. For each of the participants, it was found that vocal stereotypy was likely not maintained by the social consequences. Following assessment, response interruption and redirection (RIRD) was implemented in an ABAB design to determine whether vocal stereotypy could be successfully redirected. RIRD involved a teacher issuing a series of vocal demands the child readily complied with during regular academic programming. Vocal demands were presented contingent on the occurrence of vocal stereotypy and were continuously presented until the child complied with three consecutively issued demands without emitting vocal stereotypy. For each child, RIRD produced levels of vocal stereotypy substantially lower than those observed in baseline. For 3 of the children, an increase in appropriate communication was also observed. The children's teachers were trained to implement RIRD. Brief follow-up probes and anecdotal information implied that the treatment had a positive impact in the natural environment.     

Decreasing motor stereotypy in leisure contexts: Analysis of stimulus control with response interruption and redirection

Noncontingent access to preferred stimuli and activities may decrease stereotypic behavior in individuals with autism or other developmental disorders. However, prompted engagement, response interruption and redirection (RIRD), and/or contingent access to stereotypy may be required to achieve clinically significant reductions in stereotypy. Antecedent stimuli may also be manipulated during intervention to establish stimulus control by signaling when stereotypy will receive programmed consequences. The purpose of the current project was to replicate prior research in this area by a) evaluating the effectiveness of RIRD on motor stereotypy in an adolescent with autism and b) providing contingent access to stereotypy as a function of successively longer intervals without stereotypic behavior. We also assessed the extent that these procedures gained acceptable stimulus control. Results from this project suggest RIRD and contingent access to stereotypy may effectively decrease motor stereotypy in leisure contexts, though consistent inhibitory stimulus control may be difficult to establish.     

Effects of music on vocal stereotypy in children with autism

We examined the effects of manipulating the intensity (i.e., volume) of music on engagement in vocal stereotypy in 2 children with autism. Noncontingent access to music decreased immediate engagement in vocal stereotypy for each participant, but it produced only marginal effects on subsequent engagement in the behavior (i.e., after withdrawal). Manipulating the intensity of music did not produce differential effects on immediate engagement in vocal stereotypy. The implications of the results and applications for future research are discussed.     

Differential reinforcement to decrease stereotypy exhibited by an adult with autism spectrum disorder

Motor and vocal stereotypies are behaviors commonly exhibited by individuals with autism spectrum disorder (ASD). Stereotypy may impede and interfere with learning new skills and decrease work performance in employment settings. Previous research has evaluated effective interventions for stereotypy; however, they have typically focused on treating stereotypy exhibited by children in structured settings. We evaluated the practicality of implementing a simple differential reinforcement of other behavior procedure with an adult with ASD in multiple, naturalistic environments. Results showed rapid decreases in motor and vocal stereotypies upon implementation of the intervention and maintenance of low levels of behavior. These data highlighted the successful treatment of stereotypy exhibited by an adult with a long history of exhibiting these behaviors. Treatment effects were replicated across multiple, naturalistic environments.     

Abatement of intractable vocal stereotypy using an overcorrection procedure

We conducted a series of reversals to compare the effects of four different treatments on vocal stereotypy emitted by a 7‐year‐old boy with autism. The results showed that (1) the level of vocal stereotypy decreased during exposure to matched stimulation but returned to high levels immediately upon its removal; (2) stereotypy did not significantly decrease during differential reinforcement of other behavior; and (3) contingent withdrawal of movies and music (i.e., response cost) was only moderately effective. However, positive practice overcorrection decreased vocal stereotypy by clinically significant levels. Further, when differential reinforcement of engagement in a Lego^® building task was implemented, the level of engagement was significantly higher when positive practice overcorrection was in place than when overcorrection was withdrawn. Copyright © 2011 John Wiley & Sons, Ltd.