Stimulus fading and differential reinforcement for the treatment of needle phobia in a youth with autism

Stimulus fading in the form of gradually increased exposure to a fear-evoking stimulus, often combined with differential reinforcement, has been used to treat phobias in children who are otherwise normal and in children with autism. In this investigation, we applied stimulus fading plus differential reinforcement with an adolescent with autism and diabetes whose needle phobia had prevented medical monitoring of his blood glucose levels for over 2 years. Results showed that the treatment was successful in obtaining daily blood samples for measuring glucose levels.     

Shaping exhale durations for breath CO detection for men with mild mental retardation

Roll, Higgins, and Badger (1996) used a carbon monoxide (CO) detector to determine whether participants smoked in a smoking-cessation study. We sought to replicate their work with adults with mild mental retardation. However, verbal instructions were inadequate to establish stable exhalations of sufficient durations for reliable and accurate CO evaluation. This report describes a shaping procedure that enabled 3 of 4 participants to achieve 20-s exhalation durations.     

Establishing compliance with liquid medication administration in a child with autism

Children with autism often display difficulty with swallowing pills and liquid medications. In the current study, stimulus fading and positive reinforcement established compliance with liquid medication administration in a young boy with autism. The boy's mother eventually administered liquid medication on her own.     

Teaching spontaneous responses to young children with autism

Using a multiple probe design across responses, we demonstrated the effectiveness of intensive intervention in establishing spontaneous verbal responses to 2 3-year-old children with autism with generalization to novel settings involving novel persons. Intervention involved discrete-trial instruction (i.e., repeated instructional opportunities presented in close proximity to high rates of reinforcement), specific prompts, and error correction. Spontaneous responses were defined as specific verbal utterances (e.g., the child says "bless you") following discriminative stimuli that did not involve explicit vocal directives (e.g., adult sneeze). The development of effective interventions to address the social-communicative needs of very young children with autism is discussed.     

Outcomes of a practical approach for improving conversation skills in adults with autism

Many individuals with autism spectrum disorder (ASD) have deficits in conversation skills that can interfere with the development of personal and professional relationships. Further research is needed on efficient interventions for targeting conversation skills in adults with ASD and for evaluating the social validity of the outcomes. In this study, 2 practitioners implemented a 4‐week training program for 5 adults with ASD that combined individualized computer‐based instruction (CBI) and practice with peers to promote the acquisition, maintenance, and generalization of conversation skills. Training was associated with improvements in 12 of 13 skills across participants. These findings, along with peer ratings of the participants' conversation skills, suggest that this model is a promising, socially valid approach for improving conversation skills in adults with ASD.     

Coping and care-related stress in parents of a child with autism spectrum disorder

Background and Objectives: Parenting a child with Autism Spectrum Disorder (ASD) is challenging and can result in elevated levels of parenting stress. This study investigated the relationship between parent-ratings of their child’s ASD symptoms and two conceptually different measures of parenting stress: One specific to the ASD context and the other a general stress measure applicable to the broader caregiving context. Additionally, the influence of coping style on the relationship between child’s ASD symptoms and parenting stress was investigated.

Design and Methods: Using an internet survey, parents (N?=?178) caring for a child with ASD reported on coping strategies, completed two measures of parenting stress, and assessed their child’s ASD symptoms.

Results: Parenting stress increased with severity of the child’s ASD symptoms, but the strength of this relationship depended on whether a general or disorder-specific measure of parenting stress was used. Regression analyses indicated that some coping strategies moderated the impact of ASD symptom severity on the parent’s care-related stress, but moderation depended on how stress was conceptualized.

Conclusion: This study reinforces the importance of identifying the coping strategies of parents of children with developmental disorders, and highlights the consequences of using different conceptual approaches to measure parenting stress.     

Direct and distal effects of noncontingent juice on rumination exhibited by a child with autism

Previous research has demonstrated the efficacy of the noncontingent delivery of foods and liquids at suppressing rumination, the repeated regurgitation and rechewing of partially digested food. However, it is unclear how long this reduction is maintained after caregivers terminate this procedure. The current study examined the direct and distal effects of noncontingent juice on rumination by measuring the duration of rumination during juice delivery and immediately following the termination of juice delivery. Noncontingent juice suppressed rumination, but this suppression was not maintained after delivery termination.     

Using a combined blocking procedure to teach color discrimination to a child with autism

A combined blocking procedure was used to teach a child with autism to select two colors on request. First, two color cards were placed at fixed locations on a table and the experimenter repeatedly requested the child to touch one of the colors. After 10 consecutive correct selections, the child was asked to touch the other color. Blocks of trials with each color were systematically thinned until requests were presented randomly with few errors. Subsequently, the location of the selection cards was systematically alternated until the child was able to touch the correct card when both requests and card positions were presented in random fashion.     

An evaluation of a multi-component intervention for loud speech among children with autism spectrum disorder

Idiosyncratic patterns of speech are common among individuals with autism spectrum disorder (ASD) and can greatly affect their ability to participate successfully in various social and educational settings. We evaluated a treatment package with three children with ASD and a history of loud speech. A multiple baseline across participants design and a decibel meter application were used to evaluate whether the multi-component intervention (i.e., a rule, differential reinforcement, and in vivo feedback) would effectively reduce participants' rates of loud speech. The results showed that the intervention decreased rates of loud speech for all participants. Results are discussed in terms of (a) their extension of the literature regarding speech prosody in ASD by demonstrating an effective intervention for loud speech, (b) clinical implications, and (c) potential future research regarding this nuanced, yet crucial aspect of social communication, including appropriate methods for addressing loud speech in individuals with ASD.     

Evaluation of stimulus intensity fading on reduction of rapid eating in a child with autism

This study assessed the effects of a vibrating pager on reduction of rapid eating. The study also evaluated two strategies for fading the pager, by intensity and by frequency. The pager was successful in decreasing the pace of eating to an appropriate level and the pager prompt was successfully faded. Fading by frequency was ineffective in maintaining an appropriate pace of eating while intensity fading was successful.     

Telehealth parent training for a young child at risk for autism spectrum disorder

The global pandemic has highlighted the importance of telehealth to access behavioral interventions. Face-to-face parent training improves the development and behaviors of young children at risk for autism spectrum disorder (ASD). We evaluated a telehealth parent training intervention for a child at risk for ASD. Two parents identified possible early ASD symptoms in their 30-month-old son (lack of imitation, pointing, and vocal manding). Both parents simultaneously received telehealth behavioral skills training on the Parent Intervention for Children at Risk for Autism program for 1 hour per week over 29 weeks. Multiple baseline designs across parent and child behaviors showed that both parents improved their parent teaching fidelity above 80% and the child improved on all trained behaviors. This study expands the utility of telehealth behavioral parent training to young children at risk for ASD to mitigate early symptoms of ASD.     

A Social Stories intervention package for students with autism in inclusive classroom settings

A Social Stories intervention package was used to teach 2 students with autism to read Social Stories, answer comprehension questions, and engage in role plays. Appropriate social behaviors increased and inappropriate behaviors decreased for both participants, and the effects were maintained for up to 10 months. This intervention package appears to be useful in inclusive classroom environments and does not require intensive supervision of the child's behavior.     

Establishing a generalized repertoire of helping behavior in children with autism

The present study used a multiple baseline across participants design to assess whether 4 children with autism could learn a generalized repertoire of helping adults with different tasks through the use of a multicomponent teaching package. Different helping responses were taught in the presence of multiple exemplars of discriminative stimuli drawn from experimenter-defined categories of helping behavior (e.g., locating objects, putting away items, setting up an activity). During the training condition, video models, prompting, and reinforcement were used. The results showed that all 4 children learned to emit appropriate helping responses in the presence of discriminative stimuli from the helping categories used during training. Generalization of helping responses was observed in the presence of untrained discriminative stimuli during additional probe conditions. Additional pre- and postintervention generalization trials showed that the frequency of helping responses also increased in the presence of novel stimuli, in a novel setting, and with a novel instructor.     

Emergent control for play responses following instructive feedback for children with autism spectrum disorder

Play provides children learning opportunities in the natural environment to acquire communication skills. While working to establish skills that may lead to additional leisure and social opportunities of children with autism spectrum disorder (ASD), procedures need to be both effective and efficient. One way to increase efficiency of teaching is through the use of instructive feedback (IF). Therefore, the purpose of the current study is to systematically replicate and extend previous research by examining if play behaviors emerge when using IF to teach conceptually related primary (i.e., tacts) and secondary targets (i.e., play skills). The results of the present study extend previous research by demonstrating the effectiveness of teaching tacts to individuals with ASD, and that using IF during tact training can help promote the acquisition of play skills.