A component analysis of behavioral skills training with volunteers teaching motor skills to individuals with developmental disabilities

This study included a component analysis of behavioral skills training (BST) for teaching volunteers how to use this training method to support individuals with developmental disabilities in a physical education program. In an alternating treatment design embedded within a multiple baseline design across five participants, the number of BST steps that volunteers completed correctly while teaching four motor skills was measured. In the initial training phase, each motor skill was taught to volunteers using a specific component of BST (i.e., instructions, modeling, rehearsal, or feedback). In subsequent training phases, BST components were combined to teach the volunteers the motor skills for which they did not reach a predetermined mastery criterion (a score of four correct responses across two consecutive trials). Maintenance was assessed. Results indicated that individual components of BST alone were sufficient for volunteers to meet the mastery criterion; however, the full BST framework was necessary for skill maintenance. Strengths, limitations, and recommendations for future research are discussed.     

Computer-Presented Video Prompting for Teaching Microwave Oven Use to Three Adults with Developmental Disabilities

We evaluated the use of a video prompting procedure for teaching three adults with developmental disabilities to make popcorn using a microwave oven. Training, using a 10-step task analysis, was conducted in the kitchen of the participant’s vocational training program. During baseline, participants were instructed to make popcorn, but were given no further instructions or prompts. Video prompting consisted of first watching a video clip of a step being performed and then giving participants the opportunity to imitate that step. This prompting procedure was introduced in a delayed multiple-probe across subjects design. Following acquisition, video prompting was removed and maintenance in the absence of video prompting was assessed at 2, 6, and 10 weeks. Two of the three participants acquired the task when video prompting was introduced and performed at 80–100% correct during follow-up sessions. These data suggest that video prompting may be an effective instructional strategy for teaching daily living skills to adults with developmental disabilities.     

Using telehealth to teach valued skills to adults with intellectual and developmental disabilities

Telehealth uses electronic information and telecommunication technologies to deliver long-distance clinical services. It has successfully been used by clinical professionals to teach family and staff members to provide evidence-based assessment and treatment procedures. There is no research to date, however, evaluating the use of telehealth to directly teach individuals with intellectual and developmental disabilities (IDD). Thus, we evaluated the efficacy of a telehealth intervention using total task chaining with least-to-most prompting delivered via videoconference to 2 adults with IDD. Both participants demonstrated low independent responding during baseline with enhanced written instructions present. During intervention, which included vocal and model prompting, both participants met the mastery criterion for each skill in fewer than 15 sessions, which maintained after 2 weeks. Finally, both participants expressed satisfaction with the goals, procedures, and effects of the intervention. We discuss the broader scope of the intervention for individuals with disabilities when face-to-face services may not be feasible.     

Evaluating backward chaining methods on vocational tasks by adults with developmental disabilities

Backward chains are widely used to teach complex skills to individuals with developmental disabilities. Implementation of chaining procedures may vary regarding untaught steps and there is little to guide practitioners in the selection of chaining procedures. Moreover, there is a dearth of research evaluating effectiveness and efficiency of procedural variations of behavior chains. The purpose of this study was to extend previous research by evaluating the effectiveness, efficiency, and preference for four procedural variations (i.e., teacher‐completion, participant‐completion, no‐completion, and a control condition) of backward chains across vocational tasks with adults with developmental disabilities. Although procedural variations effectively established vocational skills, the participant‐completion procedure (in which the instructor implemented a least‐to‐most prompt hierarchy during all untrained steps in the chain) was the most efficacious backward chaining procedural variation and efficient in terms of sessions to mastery. The no‐completion procedure (in which the instructor completed all untrained steps in the chain out of view of the participant) was least efficient across trials, sessions, errors, and total duration to mastery. One participant preferred the no‐completion condition while the other two participants showed an initial preference for the teacher‐completion condition that changed to preference for the no‐completion condition. Vocational skills maintained 1‐ and 4‐weeks postmastery. Stakeholders rated goals, procedures, and outcomes as socially valid.     

Effects of decreasing intersession interval duration on graduated exposure treatment during simulated routine dental care

Reports suggest that individuals with developmental disabilities often engage in behavior during dental visits that precludes regular dental care. Graduated exposure therapies are an effective treatment for avoidant behavior in people with developmental delays, and some studies show that the duration of the intersession interval (ISI) can impact the effectiveness of graduated exposure treatments for typically developing individuals. The current study examined the effects of decreasing ISI on outcomes of a graduated exposure treatment during simulated routine dental care for 3 individuals diagnosed with autism. Treatment consisted of graduated exposure and extinction for disruptive behavior. Initially, sessions were conducted once per week. In subsequent conditions, treatment sessions were conducted 3‐5 times per week. A nonconcurrent multiple baseline across subjects design was used to demonstrate experimental control. Results suggest that decreasing ISI durations can produce improved treatment outcomes.     

Using video modeling to teach a domestic skill with an embedded social skill to adults with severe mental retardation

We assessed whether three adults with severe mental retardation would acquire a domestic skill (making coffee) with an embedded social skill (serving coffee to and sitting down beside a peer) via video modeling procedures. Training was conducted in a classroom in the participants' day treatment setting. The intervention consisted of (i) watching a video of an adult with a developmental disability making coffee and initiating a social interaction with a peer; and (ii) receiving verbal praise for each step of the task that was performed correctly. All three participants mastered the task and demonstrated generalization across settings, stimuli, and people. Two participants performed with 100% accuracy on maintenance probes conducted 1 month following mastery, and one participant did so following booster training. Copyright © 2004 John Wiley & Sons, Ltd.     

Token‐economy‐based contingency management increases daily steps in adults with developmental disabilities

Adults with developmental disabilities are less likely to meet physical activity guidelines than typically developing counterparts. Contingency management (CM) interventions increase physical activity in sedentary adults. The current study systematically replicated previous research among sedentary adults diagnosed with developmental disabilities living in a residential group home, using a token economy in the context of a CM intervention. Using a changing criterion design, participants (N = 4) were given tokens contingent on meeting increasing step goals over 8 weeks, tracked via a Fitbit Flex?. CM increased the number of steps substantially for three of four participants. These findings extend previous research supporting the use of token‐based CM interventions for increasing daily steps among individuals with developmental disabilities. Because the current study was conducted in a residential group home setting, it may offer a long‐term sustainable approach to improving the health of some individuals living with developmental disabilities.     

The Application of Mastery Criterion to Individual Operants and the Effects on Acquisition and Maintenance of Responses

Instructors assess the acquisition of new skills by delivering blocks of trials containing multiple operants. Mastery is evaluated as percentage correct across all operants in the block. The purpose of the current study was to investigate this traditional mastery criterion arrangement compared to an analysis of mastery at the level of individual operants. In both conditions, mastery criterion was 100% accuracy in one session. In the Set Analysis (SA) condition, accuracy was evaluated as average correct responding across all 4 target operants, or sight words, in a set. In the Operant Analysis (OA) condition, we taught 4 sight words simultaneously, assessed accuracy per sight word, and substituted new sight words into the set each time a single sight word was mastered. Overall, all 4 participants learned textual responses to sight words quicker in the OA condition, the reliability of maintenance was similar across conditions for 2 of 4 participants, and 4 of 4 participants maintained a higher or same number of responses from the OA condition compared to the SA condition. Implications for skill acquisition are discussed.

     

EXTINCTION OF SELF-INJURIOUS ESCAPE BEHAVIOR WITH AND WITHOUT INSTRUCTIONAL FADING

Three individuals with developmental disabilities participated in a study of the treatment of self-injurious behavior (SIB) maintained by negative reinforcement (escape from educational tasks). Treatment was implemented in a multiple baseline design across subjects, in which two treatments were compared in a multielement format. Both treatment conditions included an escape-extinction component in which SIB no longer produced escape. One of the conditions also included a fading component in which the frequency of instructions was initially reduced to zero and then was gradually faded back in across sessions until the instructional rate matched that of the original baseline. Results indicated that extinction alone reduced SIB to the end-of-treatment criterion in fewer sessions than did extinction plus fading for all 3 subjects. For 2 of the 3 subjects, however, there was an initial increase in the frequency of SIB at the outset of treatment with extinction (an extinction burst) that was not observed when extinction was combined with the fading component.     

ESTABLISHMENT OF NONDELUSIONAL RESPONSES IN A SOCIALLY WITHDRAWN CHRONIC SCHIZOPHRENIC1

Multiple treatment interventions including instructions, modelling, timeout, avoidance of repetition, and reinforcement were successful in establishing factual answers to personal background questions in a withdrawn and socially unresponsive chronic schizophrenic. The subject had previously persisted in giving only delusional responses to these questions. A multiple-baseline design across verbal replies to personal background questions demonstrated that the changes in behavior were brought about by the treatment interventions. During baseline, the subject was reinforced for any response to four questions. The experimental interventions were then introduced for the first question and moved sequentially to an additional question when the subject's responses reached the criterion of at least 80% correct for two consecutive sessions. Introduction of the experimental interventions produced an increase from a baseline level of zero to at least 80% correct for each question. The use of the token reinforcement procedure was faded out after the subject was able to answer all four questions correctly at least 80% of the time for two consecutive sessions. Fading of the token reinforcement procedure was accomplished by using increasingly intermittent schedules of token reinforcement during the last seven sessions. In the final session, no tokens were used to reinforce the subject's responding. Nine-, ten-, and 12-month followup interviews were conducted to evaluate the maintenance of treatment gains. Maintenance was found to be complete at the nine- and 10-month followups, but at the 12-month followup interview, the subject answered one question incorrectly. This study replicates an investigation previously reported in this journal.     

Assessing long‐term maintenance of staff performance following behavior skills training in a home‐based setting

We used a multiple baseline across participant design to evaluate the effects of behavior skills training on teaching three behavior therapists to implement discrete trial teaching (DTT) and evaluate the long‐term maintenance of skills acquired through behavioral skills training. For participants whose skills did not maintain, the authors evaluated an independent self‐evaluation procedure on their performance. Following DTT implementation training, maintenance probes were assessed at 2‐, 4‐, 6‐, and 8‐week follow‐ups. The results demonstrated that one participant maintained 100% procedural integrity (PI) through all follow‐ups, one participant decreased below mastery criterion at the 2‐week follow‐up, and one participant dropped below mastery criterion at the 4‐week follow‐up. Those participants that demonstrated decreased accuracy of implementation of DTT programs and were taught to implement a self‐evaluation procedure. Following self‐evaluation, PI maintained for up to 7 weeks for one participant. Our results suggest that if PI does not maintain, self‐evaluation may be a supplementary intervention to increase and maintain PI of new employees.     

Effects of mastery criterion on the emergence of derived equivalence relations

In this study, we manipulated mastery criterion form (rolling or block) and stringency (across 6 or 12 trials) and measured the emergence of derived relations. College students learned neuroanatomy equivalence classes and experienced one of two rolling mastery criteria (6 or 12 consecutive correct responses) or a block mastery criterion (12 trials in a block) during training. The study found that block and rolling mastery criteria produced similar outcomes. Effectiveness was hampered when the criterion was less stringent.     

Preference assessment training via self‐instruction: A replication and extension

We examined the effects of a self‐instructional and feedback package on participants’ implementation of a paired‐stimulus preference assessment. Specifically, in Experiment 1, we used a multiple baseline design across participants to replicate and extend the results of Graff and Karsten (2012) by evaluating the effectiveness of their self‐instructional manual. A majority of the participants (i.e., 5 of 7 undergraduate students and 4 of 5 in‐home behavior technicians) achieved mastery with the self‐instructional package. The remaining participants met the mastery criterion after brief modeling and feedback sessions. In Experiment 2, we identified the most effective component of the feedback condition from Experiment 1 when a self‐instructional package was not sufficient. Brief feedback sessions in which participants received a list of the targeted responses plus information regarding accuracy of emitted responses was sufficient for 5 of 6 participants to achieve mastery.     

Evaluating the Effectiveness of an Abduction Prevention Program for Young Adults With Intellectual Disabilities

The purpose of this study was to evaluate the effectiveness of behavioral skills training (BST) and in situ training (IST) for teaching abduction prevention skills to young adults with intellectual disabilities. Four individuals, ages 18–24, participated. Five BST sessions were conducted for each participant. Following BST, in situ assessments took place at the participants’ school to assess acquisition of the skills. The data show that none of the participants reached criterion level following BST although some of the participants improved their score from baseline. IST was then implemented with two of the participants achieving criterion level and two participants exhibiting two of the three safety skills.     

Establishing and maintaining treatment effects with less intrusive consequences via a pairing procedure

The generality and long-term maintenance of a pairing procedure designed to improve the efficacy of less intrusive procedures were evaluated for the treatment of problem behavior maintained by automatic reinforcement exhibited by 2 individuals with developmental disabilities. Results suggested that a less intrusive procedure could be established as a conditioned punisher by pairing it with an effective punisher contingent on problem behavior. Generalization across multiple therapists was demonstrated for both participants. However, generalization to another setting was not achieved for 1 participant until pairing was conducted in the second setting. Long-term maintenance was observed with 1 participant in the absence of further pairing trials. Maintenance via intermittent pairing trials was successful for the other participant.     

A post hoc analysis of multiple‐stimulus preference assessment results

Fifteen individuals with developmental disabilities participated in multiple‐stimulus without replacement preference assessments (seven assessment sessions, seven trials each). Twelve of 15 individuals completed a second set of preference assessments 6 months later. Post hoc analyses indicated that in 25 of 27 cases, the same most preferred stimulus was identified in the first three trials as the full seven trials. Additionally, five sessions of three trials each were sufficient to identify the most highly preferred stimulus in 22 of 27 instances. Copyright © 2002 John Wiley & Sons, Ltd.     

Examination of relative reinforcement effects of stimuli identified through pretreatment and daily brief preference assessments.

Several brief preference assessments have recently been developed to identify reinforcers for individuals with developmental disabilities. One purported advantage of brief assessments is that they can be administered frequently, thus accommodating shifts in preference and presumably enhancing reinforcement effects. In this study, we initially conducted lengthy paired‐choice preference assessments and identified a hierarchy of preferred items for 5 individuals with developmental disabilities. Subsequently, brief multiple‐stimulus‐without‐replacement assessments using the same items were completed each day prior to work sessions. On days when results of the daily brief assessment differed from the one‐time lengthy assessment, the relative reinforcing effects of the top items from each assessment were compared in a concurrent‐schedule arrangement. The results revealed that when the two assessments differed, participants generally allocated more responses to the task associated with the daily top‐ranked item.     

Teaching a simple meal preparation skill to adults with moderate and severe mental retardation using video modeling

We evaluated whether adults with mental retardation in the moderate or severe range would acquire simple meal preparation skills via video modeling. Training was conducted in the kitchen of the participants' day treatment setting. The intervention consisted of (i) watching a video of an adult with a developmental disability making a peanut butter and jelly sandwich and (ii) receiving verbal praise for each step of the task that was performed correctly. All three participants mastered the task and demonstrated generalization across settings. All three participants also demonstrated maintenance of the skill one month following mastery. Copyright © 2003 John Wiley & Sons, Ltd.     

A COMPARISON OF NONCONTINGENT REINFORCEMENT AND SENSORY EXTINCTION AS TREATMENTS FOR SELF-INJURIOUS BEHAVIOR

We compared the effects of two treatments, noncontingent reinforcement (NCR) and sensory extinction (EXT), on the self-injurious behavior (SIB) exhibited by 3 individuals with developmental disabilities. Results of a functional analysis indicated that their SIB was not maintained by social reinforcement, as indicated by undifferentiated responding across assessment conditions or higher rates of responding in the alone condition. Prior to treatment, leisure probes were conducted to identify highly preferred items for use in the NCR condition, and equipment probes were conducted to identify devices that produced the greatest behavioral suppression for use in the EXT condition. Following baseline, treatment was implemented in a multiple baseline across subjects design, and the effects of NCR and EXT were compared in a multielement format. During NCR sessions, participants had continuous access to a highly preferred item. During EXT sessions, participants wore equipment (gloves or protective sleeves) that seemed to attenuate stimulation directly produced by their SIB, while still allowing the behavior to occur. Results indicated that both procedures were effective in reducing SIB, although NCR was associated with either more rapid or greater overall response suppression.     

Some determinants of changes in preference over time

Results of longitudinal studies suggest that the stability of preferences varies across individuals, although it is unclear what variables account for these differences. We extended this work by conducting periodic assessments of preference for leisure activities over 3 to 6 months with 10 adults with developmental disabilities. Although previous research has collectively shown that preferences identified via repeated assessment are highly variable, our results showed that preferences were relatively stable for the majority (80%) of participants. In an attempt to identify some environmental determinants of shifts in preference, we provided extended daily access to high-preference items (preference-weakening manipulation) and paired access to low-preference items with social and edible putative reinforcers during brief sessions (preference-strengthening manipulation). Preference assessments continued over the course of these manipulations with 2 participants. Results showed that changes in preference across time could be produced systematically and suggest that naturally occurring changes in establishing operations or conditioning histories contribute to temporal shifts in preference. Implications for preference assessments, reinforcer usage, and planned attempts to change preferences are discussed.