Treating liquid expulsion in children with feeding disorders

In the current investigation, we compared and evaluated the effects of two intervention procedures, a modified chin prompt and reclined seating, on the liquid expulsion of 2 children with feeding disorders. For both participants, expulsion decreased to clinically meaningful levels when we added the modified chin prompt or reclined seating to a treatment package consisting of differential reinforcement of acceptance, nonremoval of the cup, and re‐presentation. We discuss possible mechanisms underlying the effects of the 2 interventions and areas for future research.     

Increasing the vocal responses of children with autism and developmental disabilities using manual sign mand training and prompt delay

The purpose of this study was to determine the effect of manual sign mand training combined with prompt delay and vocal prompting on the production of vocal responses in nonvocal children with developmental disabilities. A multiple baseline design across participants verified the effectiveness of this intervention. All participants showed increases in vocal responses following the implementation of the independent variables.     

Evaluation of a finger prompt variation in the treatment of pediatric feeding disorders

Children with feeding disorders often engage in refusal behavior to escape or avoid eating. Escape extinction combined with reinforcement is a well-established intervention to treat food refusal. Physical guidance procedures (e.g., jaw prompt, finger prompt) have been shown to increase food acceptance and decrease inappropriate mealtime behavior when more commonly employed escape extinction (e.g., nonremoval of the spoon) procedures are ineffective. The finger prompt, however, has not been extensively evaluated as a treatment adjunct to target food refusal, thus necessitating further examination. The purpose of this prospective study was to assess a variation of a finger prompt procedure to treat food refusal and to assess caregivers' acceptability of the procedure. Three children age 1 to 4 years admitted to an intensive feeding disorders program and their caregivers participated. The finger prompt was effective in increasing bite acceptance across all participants and decreasing or maintaining low levels of inappropriate behavior for 2 participants. The procedure was also acceptable to all caregivers.     

Effects of textual prompts and feedback on social niceties of adolescents with autism spectrum disorder in a simulated workplace

Previous research demonstrates the efficacy of behavioral skills training with a textual prompt to establish greetings and conversational skills. This study examined the efficacy of a brief intervention of textual prompts with performance feedback for increasing social niceties of adolescents and young adults with autism spectrum disorder in a simulated workplace. Target social niceties included “Do you have a minute?” when a participant initiated an interaction and “Thank you for your time” when a participant ended the interaction. Results revealed this intervention was effective for 7 of 9 participants. This study expands upon previous studies by showing the efficacy of a resource-efficient training on acquisition and generalization of social niceties by people with autism spectrum disorder.     

The effectiveness of function‐based interventions to treat sleep problems,including unwanted co‐sleeping,in children with autism

This study investigated the effectiveness of functional behavioral assessment (FBA)—informed interventions for sleep problems, particularly co‐sleeping, in children with autism spectrum disorder (ASD). Seven children, who exhibited multiple sleep problems including unwanted co‐sleeping, participated. FBA, based on information derived from interviews and parent‐recorded sleep diaries, was used to develop individualized case formulations upon which multicomponent, parent‐implemented interventions were based. These were evaluated using a single‐case, non‐concurrent multiple‐baseline‐across‐participants design. Improvements were observed across all sleep problems, including the elimination of co‐sleeping. Gains were maintained at follow‐up for five out of seven children, though two children did not complete intervention. Parents reported high levels of satisfaction with the program. FBA‐based interventions for sleep problems in children with ASD and their clinical implications are further discussed.     

Further investigation of increasing vocalizations of children with autism with a speech-generating device

We replicated and extended the findings of Gervarter et al. (2016) by using prompting and reinforcement to produce increased vocal speech with 3 young children diagnosed with autism spectrum disorder (ASD) who used a speech generating device (SGD). We extended Gervarter et al. by adopting a more robust experimental design, conducting session-by-session preference assessments, and measuring the emergence of novel vocalizations. The frequency of vocalizations increased for all 3 participants after the introduction of an echoic prompt. These results suggest that SGD-based interventions may lead to increased vocal output for children with ASD.     

Assessment to identify learner-specific prompt and prompt-fading procedures for children with autism spectrum disorder

Few studies have evaluated the use of assessment to identify the most efficient instructional practices for individuals with autism spectrum disorder. This is problematic as these individuals often have difficulty acquiring skills, and the procedures that may be efficient with one individual may not be for others. The experimenters conducted instructional assessments to identify the most efficient prompt type (model, partial physical, full physical) and prompt-fading procedure (progressive delay, most-to-least, least-to-most) for teaching auditory–visual conditional discriminations for individuals with autism spectrum disorder. Each assessment was conducted at least twice, and a final generality test combined the most and the least efficient prompt type and prompt-fading procedure for teaching novel auditory–visual conditional discriminations. The results demonstrated learner-specific outcomes for the prompt type assessment, whereas the least-to-most prompt fading procedure was most efficient for all participants.     

A randomized clinical trial of three prompting systems to teach tact relations

Prompts are commonly used during discrete trial teaching for individuals diagnosed with autism spectrum disorder (ASD). Three commonly used prompting systems include constant time delay, most-to-least prompting, and flexible prompt fading. Most of the research demonstrating the effectiveness of these three prompting strategies have been completed through the use of single subject experimental designs. Some within the field of behaviorally based approaches to ASD interventions have called for more randomized clinical trials of these approaches. The purpose of the present study was to compare these 3 prompting systems to teach tact relations for 27 individuals diagnosed with ASD through a randomized clinical trial without a control group with respect to pre–post responding, generalization, sessions to mastery, and responding during teaching. Overall, minimal differences were observed across the 3 systems. The results are discussed with respect to future research and clinical application of the methods evaluated.     

An Investigation of Student-Selected and Parent-Delivered Reading Interventions

In this study, we examined whether individualized, student-selected, parent-delivered reading interventions would produce generalized oral reading fluency improvements. Three 3rd-grade students received reading fluency interventions (repeated readings, modeling, error correction, and flashcard instruction) 1 at a time and were shown the results that each intervention produced. The students then selected the intervention strategies they wanted their parents to use. We trained parents in the student-selected reading intervention package who delivered the interventions for 4–5?weeks, and students were given the opportunity to earn rewards for generalized performance improvements at the end of each week in school. Using an alternating treatments design, results of parent tutoring were compared to a control condition that included a reinforcement contingency for generalized performance improvements to control for reinforcement effects across conditions. Generalized improvements in oral reading fluency (to high-word-overlap passages) were found for all participants. Results are discussed in terms of how educators can improve parent-tutoring outcomes by influencing students’ motivation to engage in tutoring procedures.     

Evaluation of two physical guidance procedures in the treatment of pediatric feeding disorder

Children with pediatric feeding disorder may refuse to consume an adequate variety and/or volume of food to maintain expected growth. They can consume food but may actively or passively refuse, resulting in escape or avoidance of eating. Behavioral interventions like positive reinforcement with escape extinction can increase consumption. However, sometimes these interventions are insufficient, especially in treating passive refusal. In these cases, physical guidance may be used to prompt an open mouth to deposit food. Research indicates open-mouth prompts are effective and rated as acceptable. This study replicated an existing physical guidance procedure, the finger prompt, and compared its efficacy and acceptability with that of a spoon prompt. This study extended research by defining and measuring passive refusal as a dependent variable and assessing social validity among different stakeholders and times. Both prompts were effective in treating food refusal, and caregivers rated the finger prompt as more preferred.     

Relative Efficacy of Behavioral Interventions in Preschool Children Attending Head Start

This study tested the relative efficacy of two interventions for children referred for consultation services due to problem behavior in the classroom. Teachers nominated children for participation due to frequent disruptive behaviors, such as inappropriate vocalizations and off-task behavior. Four Black males from 3 to 4 years old who attended Head Start centers served as the participants. Each child received a functional assessment that included a teacher-completed functional assessment rating scale and a brief functional analysis. Following functional assessments, an alternating treatments design was used to test the relative efficacy of an intervention matched to function and the Mystery Motivator intervention, not matched to function. Results indicate that both the intervention matched to function and the Mystery Motivator intervention were superior to a no-intervention control condition, but the function-matched intervention was more effective than the Mystery Motivator intervention for reducing problem behaviors and increasing appropriate engagement for all four children. Results are discussed in terms of learning principles potentially responsible for differential efficacy, as well as implications for applied practice.     

The unique impact of parent training for separation anxiety disorder in children

This investigation examined the preliminary efficacy of an integrated cognitive-behavioral parent-training protocol for six families of separation-anxious children (7 to 10 years of age) using a multiple baseline design across participants. Although families were assessed on child, parent, and clinician ratings at pre- and posttreatment as well as 6-month follow-up, only parents received education and training. Although the parent-training protocol was largely effective and treatment gains were maintained at 6-month follow-up, only those child participants whose parents experienced clinically significant improvement on parental process measures (i.e., enhanced efficacy or satisfaction, reduced stress) achieved high end-state functioning. Implications regarding the importance of individualized family-based interventions for treating anxious youth are discussed.     

A comparison of computer‐assisted and therapist‐led instruction for children with autism spectrum disorder

The current investigation applied a model of assessment‐based instruction to an evaluation of the efficacy and efficiency of computer‐assisted and therapist‐led instruction on skill acquisition for 3 participants with autism spectrum disorder. We also evaluated the participant's attending during instruction and the social validity of each format of instruction. The results showed that computer‐assisted instruction was most efficient for 2 of the 3 participants, although attending varied across instructional formats. In addition, the social validity of instructional formats varied across participants.     

Using Psychological Skills Training to Develop Soccer Performance

The present study examined the effects of a soccer, midfielder-specific psychological skills intervention comprising relaxation, imagery and self-talk on position-specific performance measures. Using a multiple-baseline-across-individuals design, five participants had three per-formance subcomponents assessed across nine competitive matches. The results of the study indicated the position-specific intervention to enable at least small improvements on the three dependent variables for each participant. Social validation data indicated all participants to perceive the intervention as being successful and appropriate to their needs. The findings provide further evidence to suggest the efficacy of sport, and position-specific interventions. Suggestions for future research are provided.     

SEPARATE AND COMBINED EFFECTS OF METHYLPHENIDATE AND A BEHAVIORAL INTERVENTION ON DISRUPTIVE BEHAVIOR IN CHILDREN WITH MENTAL RETARDATION

We investigated the separate and combined effects of a behavioral intervention and methylphenidate (Ritalin®) on disruptive behavior and task engagement in 3 children with severe to profound mental retardation. The behavioral intervention involved differential reinforcement of appropriate behavior and guided compliance. All 3 children demonstrated decreased disruptive behavior and improved task engagement in response to the behavioral intervention. Two of the 3 children demonstrated similar improvement in response to methylphenidate. Although both interventions were highly effective for these 2 participants, the relative efficacy of the interventions varied between the 2 children. There was no evidence of an additive or synergistic effect of the two interventions, but the high efficacy of each intervention alone limited our ability to detect such effects.     

Evaluation of multiple‐alternative prompts during tact training

This study compared 2 methods of fading prompts while teaching tacts to 3 individuals who had been diagnosed with autism spectrum disorder (ASD). The 1st method involved use of an echoic prompt and prompt fading. The 2nd method involved providing multiple‐alternative answers and fading by increasing the difficulty of the discrimination. An adapted alternating‐treatments design showed that both procedures were more effective than a no‐intervention control condition. Providing multiple alternatives did not increase error rates or teaching time, and better maintenance was shown for tacts taught with the multiple‐alternative prompt.     

Effects of video modeling on treatment integrity of behavioral interventions

We examined the effects of individualized video modeling on the accurate implementation of behavioral interventions using a multiple baseline design across 3 teachers. During video modeling, treatment integrity improved above baseline levels; however, teacher performance remained variable. The addition of verbal performance feedback increased treatment integrity to 100% for all participants, and performance was maintained 1 week later. Teachers found video modeling to be more socially acceptable with performance feedback than alone, but rated both positively.     

Evaluating preference for and reinforcing efficacy of a therapy dog to increase verbal statements

The purpose of this study was to evaluate preference for and reinforcing efficacy of a therapy dog to increase verbal statements across different contingencies. Five children with autism spectrum disorder ages 3-8 years participated. Alternating treatments and reversal designs were used to compare conditions in which (a) a therapy dog was not present, (b) access to a therapy dog was noncontingent, (c) access to a therapy dog was contingent on interacting with a therapist, and (d) access to another preferred item was contingent on interacting with a therapist. Results varied across participants. Noncontingent access to the therapy dog slightly increased verbal statements for 1 participant. Contingent access to the therapy dog increased social interactions for 2 participants; however, this was the most effective intervention for only 1 participant. Practitioners should be aware that some clients may be better suited for interventions including therapy dogs than others.