A blueprint for general‐case procedures illustrated by teaching adolescents with autism spectrum disorder to use a chip‐debit card

Individuals diagnosed with autism spectrum disorder (ASD) often respond poorly to novel stimulus combinations and may have difficulty discriminating across critical and noncritical stimulus dimensions without direct teaching. General‐case procedures and multiple‐exemplar training have been effectively used to address this deficit. In the current study, the experimenters outlined general‐case procedures with video modeling, prompting and reinforcement to teach three adolescents with ASD a generalized repertoire of using a chip‐debit card. A multiple‐probe across participants design demonstrated the effectiveness of these procedures. All participants acquired the skill, responding generalized from simulated teaching materials to four novel automatic payment machines, and maintained 4 weeks following teaching. Implications of using these general‐case procedures as a blueprint for future researchers to reference when teaching individuals with ASD a generalized repertoire of any skill are discussed.     

Analysis of Live Modeling Plus Prompting and Video Modeling for Teaching Imitation to Children with Autism

Previous researchers have demonstrated that training in imitation can significantly improve the learning capabilities of children diagnosed with autism spectrum disorder (ASD) and that children within this population show a preference for video presentations. Video‐based instruction has been used to teach a variety of behaviors to individuals with ASD. However, only a small number of studies have examined the use of video modeling to teach initial imitation. Furthermore, there are limited and conflicting data on the effectiveness of a video modeling procedure that does not incorporate prompting when used to teach imitation to young children with ASD. Thus, the purpose of this study was to evaluate a video‐modeling‐alone procedure and a live‐modeling‐with‐prompting procedure for teaching imitation to young children with ASD. The results suggest that the live modeling with prompting procedure was more effective, and implications related to this finding are discussed. Copyright © 2015 John Wiley & Sons, Ltd.     

DISCRIMINATION TRAINING FOR PERSONS WITH DEVELOPMENTAL DISABILITIES: A COMPARISON OF THE TASK DEMONSTRATION MODEL AND THE STANDARD PROMPTING HIERARCHY

A comparison was made between two procedures for teaching persons with severe handicaps: (a) the task demonstration model, which is based upon a fading procedure and general case programming, and (b) the standard prompting hierarchy, a least-to-most intrusive prompting procedure commonly used to teach these individuals. Five phases were used in comparing the procedures: pretesting, training, two generalization tests, and a 6-month maintenance test. Eight students learned two discrimination tasks by each procedure, with each task involving two- or three-digit numbers. Results showed that under the task demonstration model all 8 subjects had more unprompted correct responses (about 1.5 times as many) in training, all 8 subjects had fewer errors (about 0.6 times as many) in training, all 8 subjects had more correct responding in the generalization test with untrained stimuli in the training room, 6 of 8 subjects had more correct responding with untrained stimuli in another room, a 7th had equivalent amounts, and 7 of 8 subjects had more correct responding on a 6-month maintenance test. Thus, the task demonstration model proved superior to the standard prompting hierarchy in 29 of 32 tests of correct responding. Results are discussed in terms of implications for stimulus control training strategies.     

Effects of modeling rote versus varied responses on response variability and skill acquisition during discrete‐trial instruction

Despite its advantages, discrete‐trial instruction (DTI) has been criticized for producing rote responding. Although there is little research supporting this claim, if true, this may be problematic given the propensity of children with autism to engage in restricted and repetitive behavior. One feature that is common in DTI that may contribute to rote responding is the prompting and reinforcement of one correct response per discriminative stimulus. To evaluate the potential negative effects of rote prompts on varied responding, we compared the effects of modeling rote versus varied target responses during the teaching of intraverbal categorization. We also evaluated the effects of these procedures on the efficiency of acquisition of any one correct response. For all four children, any increase in varied responding was fleeting, and for two participants, acquisition was slower in the variable‐modeling condition.     

Operant discrimination training to establish praise as a reinforcer

Social deficits are a hallmark feature of autism spectrum disorder (ASD). Consequently, socially mediated consequences (i.e., praise) may not function as reinforcers for individuals with ASD. Given the frequency in which praise is used as a programmed consequence in empirical research and in clinical practice, it is necessary to explore procedures that could condition praise to function as reinforcers. Operant discrimination training has emerged as a potential procedure to condition stimuli to acquire reinforcing properties. This study aimed to utilize the operant discrimination training procedure to condition a praise statement to function as a reinforcer. Four children diagnosed with ASD participated in the study. A nonconcurrent multiple baseline design across participants was used to evaluate this emerging pairing procedure. Findings suggest that immediate effects were observed across all participants, but responding did not maintain, suggesting that reinforcing value of the praise statement diminished.     

Teaching mands for information using speech generating devices: A replication and extension

Approximately 30% of individuals diagnosed with autism spectrum disorder (ASD) fail to develop vocal communication and, therefore, use some form of augmentative or alternative communication system. The current study replicates and extends previous research on teaching “Who?” and “Which?” mands for information to 3 young children diagnosed with ASD using a speech generating device. Procedures were evaluated using a multiple baseline across participants design. All participants learned to mand for information and, subsequently, used the information to access preferred items.     

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.     

Exploring Exceptions and Discovering Solutions: A Case Presentation of Autism and the Family

As the prevalence of autism spectrum disorder (ASD) continues to rise, there is a rapidly increasing need for treatment services among individuals diagnosed with ASD and families. Currently, the majority of the evidence-based treatments, such as Applied Behavior Analysis, overlook the notable systemic effects of ASD and maintain a problem-focused lens. There is a growing body of research calling for strength-based, relational interventions that build on existing resources to enhance coping, efficacy, and well-being among families affected by ASD. Solution-Focused Brief Therapy (SFBT) is a widely practiced clinical approach that is increasingly being used among clinicians to address the systemic effects of developmental disabilities in the family. However, particular modifications to specific interventions may better accommodate autism-associated deficits in executive functioning (e.g., goal development and impulsivity), perspective taking, or restricted interests when using an SFBT approach. This article offers recommendations for adapting a solution-focused approach by modifying commonly used SFBT interventions to address family-driven treatment goals using a collaborative stance with families of children with ASD. A case presentation is included to demonstrate SFBT as informed by the unique challenges and inherent resources of families affected by ASD that have been identified in the extant literature.     

Acute Stress Disorder: Conceptual Issues and Treatment Outcomes

Acute stress disorder (ASD) was included as a diagnosis to the 4th edition of the Diagnostic and Statistical Manual (American Psychiatric Association, 1994) as a way of describing pathological reactions in the first month following a trauma. Since that time, ASD has been the focus of some controversy, particularly regarding the theoretical basis and practical utility of the disorder. Despite this controversy, ASD has demonstrated usefulness in identifying individuals experiencing a high level of distress in the acute aftermath of a trauma as well as those at risk for developing posttraumatic stress disorder (PTSD). This paper reviews the clinical application of ASD, the current controversy surrounding its conceptual basis, and then discusses the dilemmas regarding this diagnosis that might occur in clinical practice. A review of the randomized control trial treatment outcome literature for ASD is also included in an effort to assist clinicians selecting interventions for clients recently exposed to traumatic events. Throughout this paper, the relationship between research and applied clinical practice is highlighted.     

The effects of receptive and expressive instructional sequences on varied conditional discriminations

Many Early Intensive Behavioral Intervention (EIBI) curricula recommend teaching receptive responding before targeting expressive responding (Leaf & McEachin, 1999; Lovaas, 2003). However, a small literature base suggests that teaching expressive responses first may be more efficient when teaching children with ASD and other developmental disabilities (Petursdottir & Carr, 2011). The present study employed an alternating treatments design to compare the effects of three instructional sequences to teach feature, function, and class to three children diagnosed with ASD: (a) receptive–expressive, (b) expressive–receptive, and (c) mixed. The results suggested that expressive–receptive was the most efficient training sequence for all three participants. Additionally, greater emergent responding was observed with the expressive–receptive training sequence.     

Teaching children with autism to request help with difficult tasks

We taught three children diagnosed with autism spectrum disorder to request help using an interrupted chain procedure during which we manipulated task materials such that the child was either incapable or capable of independently completing a link of a behavior chain. We initially observed undesirable generalization of requests for help during capable trials when teaching was introduced during incapable trials for two participants and to a lesser extent for the third participant. However, with repeated exposure to differential prompting and reinforcement across incapable and capable trials, differential responding was observed across EO‐present and EO‐absent trials for all three participants during both teaching sets and one generalization set that was never exposed to teaching procedures. These findings suggest that it is important to consider the antecedent conditions under which the response should occur when teaching children to request help.     

Participation bias among suicidal adults in a randomized controlled trial

Although individuals who attempt suicide have poor compliance rates with treatment recommendations, the nature and degree of participation bias in clinical treatment research among these individuals is virtually unknown. The purpose of this study was to examine participation bias by comparing the demographic and diagnostic characteristics of adult suicide attempters who participated in a randomized controlled trial to a sample of nonparticipants. Results indicated that males and individuals with a diagnosis of substance abuse or dependence were more likely to be participants in the randomized controlled trial. The implications of these findings for suicide intervention research are discussed.     

自闭症谱系障碍个体的注意解离

注意解离是注意定向网络的重要组成部分, 指在注意转移过程中对原来刺激进行注意分离的过程。自闭症个体注意解离的早期受损会直接影响其它重要功能的发展, 尤其是唤醒调节和共同注意发展。采用间隙重叠范式的研究发现, 自闭症个体注意解离能力是否异常还存在争议, 被试年龄及取样、测量指标和刺激特征可能是影响的因素; 其神经机制可能涉及额叶、顶叶、小脑和胼胝体等脑区。未来应从脑机制研究入手, 综合考虑被试特征、研究方法和刺激特征对注意解离结果的影响, 明确其在自闭症早期预测和识别中的作用。     

An extension of commonly used toilet-training procedures to children with autism spectrum disorder

The current study evaluated a toilet-training treatment package described by Greer et al. (2016) with children diagnosed with autism spectrum disorder (ASD). Most of the current research on toilet-training interventions for children with ASD are replications and modifications of Azrin and Foxx (1971) or (more recently) LeBlanc et al. (2005). However, these procedures are composed of components that are not included in studies with typically developing (TD) children. For example, Greer et al. evaluated the effectiveness of three typical components within a toilet-training package, mostly with TD participants: a 30-min sit schedule, placing participants in underwear, and differential reinforcement. The primary purpose of the current study was to replicate and extend the treatment package described by Greer et al. to children with ASD. A secondary purpose was to evaluate modifications necessary for individualized toilet training when the commonly used components were ineffective. The results of Greer et al. were replicated for 11 participants with ASD in the current study, suggesting that intensive toileting interventions (e.g., interventions requiring overcorrection, reprimands, and dense sit schedules) may only be necessary for a subset of individuals with ASD.     

Using the teaching interaction procedure to train interventionists to implement the Cool versus Not CoolTM procedure

The teaching interaction procedure is a behavior analytic procedure that has been used to target the development of social skills. The teaching interaction procedure consists of labeling the target skill, providing a meaningful rationale, describing the steps of the target skill, modeling the skill, role‐play, and providing feedback throughout the interaction. Although the teaching interaction procedure has been used to teach a variety of social skills for individuals diagnosed with autism spectrum disorder (ASD), it has only been used to train staff in two studies. The purpose of this study was to evaluate the use of the teaching interaction procedure to teach three interventionists to implement the Cool versus Not Cool? procedure to target the development of social skills for children diagnosed with ASD. The results of a multiple baseline design demonstrated that the teaching interaction procedure was effective for all three interventionists. Results of the child participants' skill acquisition are also provided.     

The Effectiveness of Using a Video iPod as a Prompting Device in Employment Settings

The purpose of this study was to evaluate the effectiveness of using a video iPod as a prompting device for teaching three job-related tasks to a young man with developmental disabilities in a community-based employment setting. The effectiveness of the prompting device was evaluated using a multiple probe across behaviors design. Results indicated that the introduction of the video iPod was associated with immediate and substantial gains in independent correct responding with an associated decrease in the number of prompts given from a job coach. In addition, the participant used the video iPod independently. Instructional implications and future research will be discussed.     

Zur Therapie von ADHS bei komorbiden Autismus-Spektrum-Störungen

Until recently, research on the co-occurrence of ADHD with autism spectrum disorder (ASD) has been limited by the fact that current classification systems did not allow a dual diagnosis of these two neurodevelopmental disorders. Since the DSM-5 permits a double diagnosis of ADHD plus ASD, research on their comorbidity has substantially increased. In addition to shared and distinct etiological factors, studies have revealed a high clinical impact of the combined symptomatology on affected individuals. This article provides a selective overview of evidence-based, mainly pharmacological treatment strategies in ADHD/ASD phenotypes.     

Establishing a normal peer as a behavioral model for developmentally delayed toddlers.

The present investigation demonstrated a systematic teaching procedure for establishing a normal toddler as a peer-model for three children showing delayed development, each one under 27 mo. of age. For each delayed subject, training consisted of adult-directed prompting and social reinforcement contingent upon the delayed children's imitations of material use and motor responses emitted by a normal peer. Within-subjects multiple-baseline designs across responses were used to demonstrate intrasubject control over imitative responding. Indices of stimulus and response generalization were assessed through having the peer-model present the trained responses along with untrained responses in a situation free of adult prompting and social reinforcement for imitative responding. Results indicated that the training in peer-imitation was successful for establishing the peer-model's behavior in a stimulus control relationship with the imitative responding of the delayed children. Moreover, the findings generally demonstrated transfer of training across stimulus situations and responses. Implications for educational programming with developmentally delayed children are discussed.     

Teaching Pedestrian Skills to Individuals with Developmental Disabilities

The purpose of the present study was to examine the effectiveness of most to least prompting on teaching pedestrian skills to individuals with developmental disabilities. Five individuals with developmental disabilities were taught three different pedestrian skills, all related to crossing the streets, using simulation activities on a road model in the gym of their school. A multiple probe design across behaviors was used to evaluate the effects of most to least prompting. The results of the study revealed that most to least prompting was effective in teaching pedestrian skills. The subjects learned each of the skills and managed to generalize these skills to the actual city traffic.