Instructive feedback embedded within group instruction for children diagnosed with autism spectrum disorder

The present study evaluated the effects of instructive feedback embedded within a group discrete trial teaching to teach tact relations to nine children diagnosed with autism spectrum disorder using a nonconcurrent multiple‐baseline design. Dependent variables included correct responses for: primary targets (directly taught), secondary targets (taught via instructive feedback), primary observational targets (directly taught to other members of the group), and secondary observational targets (taught via instructive feedback provided to other members of the group). Results showed that all nine participants reached the mastery criterion for the primary targets, as well as acquired the secondary and observational targets without direct teaching. Clinical implications and areas for future research are provided.     

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.     

Teaching children with autism spectrum disorder to tact olfactory stimuli

Research on tact acquisition by children with autism spectrum disorder (ASD) has often focused on teaching participants to tact visual stimuli. It is important to evaluate procedures for teaching tacts of nonvisual stimuli (e.g., olfactory, tactile). The purpose of the current study was to extend the literature on secondary target instruction and tact training by evaluating the effects of a discrete‐trial instruction procedure involving (a) echoic prompts, a constant prompt delay, and error correction for primary targets; (b) inclusion of secondary target stimuli in the consequent portion of learning trials; and (c) multiple exemplar training on the acquisition of item tacts of olfactory stimuli, emergence of category tacts of olfactory stimuli, generalization of category tacts, and emergence of category matching, with three children diagnosed with ASD. Results showed that all participants learned the item and category tacts following teaching, participants demonstrated generalization across category tacts, and category matching emerged for all participants.     

The effects of transition to technician‐delivered telehealth ABA treatment during the COVID‐19 crisis: A preliminary analysis

Telehealth delivery of applied behavior analysis treatment has focused on supervision or staff and parent training, rather than the direct delivery of treatment to clients. The novel coronavirus (COVID‐19) crisis had the potential to significantly disrupt access to direct treatment for individuals with autism. We report a sample of 17 cases that transitioned from in‐person to telehealth delivery of treatment when shelter‐in‐place orders were issued. Of these cases, 76% of participants transitioned to technician‐delivered telehealth services whereas the rest transitioned to a caregiver‐implemented telehealth model. Participants continued to access a similar dosage of treatment hours per week in spite of the treatment model transition (in‐person M = 12; telehealth M = 11) and maintained or improved correct independent responding across all targets from in‐person treatment (M = 75%) to telehealth treatment (M = 80%). These findings provide initial evidence that some clients with autism benefit from technician‐delivered telehealth services.     

Exposure to a specific prompt topography predicts its relative efficiency when teaching intraverbal behavior to children with autism spectrum disorder

Comparisons of the relative efficiency of different prompt topographies (visual or auditory), when teaching intraverbal behavior to children with disabilities, have yielded idiosyncratic results. Recent research has shown that previous exposure to a specific prompt type may affect its efficiency when teaching intraverbal behavior to preschool children. The current study was an attempt to replicate these results with 3 children diagnosed with autism spectrum disorder. For all participants, increased exposure to one prompt topography was sufficient to make it relatively more efficient as measured by number of trials to criterion. These results suggest that previous history with a prompt type may predict its efficiency.     

Using multiple-tact training to produce emergent visual categorization in children with autism

Previous research has shown that children with autism spectrum disorder (ASD) can categorize visual stimuli without direct training when they can also tact these stimuli using a common name and behave as listeners in relation to this name. However, children usually learn to assign objects specific names prior to learning the category to which they belong. The current study replicated previous research and evaluated whether multiple-tact training would establish visual categorization (measured by a picture sorting test) and listener behavior. We used a nonconcurrent multiple baseline design across 2 children with autism spectrum disorder. After multiple-tact training, we assessed whether participants would visually categorize stimuli based on their common category name. Both participants categorized and engaged in the corresponding listener behavior.     

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.     

Incorporating multiple secondary targets into learning trials for individuals with autism spectrum disorder

The current study examined the outcome of presenting multiple secondary targets in learning trials for individuals with autism spectrum disorder. We compared conditions in which (a) a secondary target was presented in the antecedent and consequence of trials, (b) two secondary targets were presented in the consequence of trials, (c) one secondary target was presented in the consequence of each trial, and (d) no additional targets were presented trials. The participants acquired the majority of secondary targets. Presenting one or multiple secondary targets per trial, regardless of the location of these secondary targets, increased the efficiency of instruction in comparison to a condition with no secondary target.     

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.     

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.     

Teaching a perspective‐taking component skill to children with autism in the natural environment

We evaluated procedures for teaching three children diagnosed with autism spectrum disorder the perspective‐taking component skill of tacting what others are sensing across all five senses: see, taste, feel, hear, and smell. Using a multiple baseline across participants design, we evaluated a training package consisting of multiple exemplar training, reinforcement, and error correction. The treatment package was implemented in the natural environment and was effective for teaching participants to tact what others sensed. Generalization across untrained stimuli and people was observed from baseline to posttraining for all participants. We discuss how this component skill may be related to teaching further skills related to perspective taking such as tacting what others know, predicting future behavior based upon one's beliefs, and creating false beliefs in others for the purpose of adaptive deceptive behaviors such as keeping secrets, surprises, and bluffing during games.     

Comparing skill acquisition under varying onsets of differential reinforcement: A preliminary analysis

The purpose of the current study was to evaluate the effect of implementing differential reinforcement at different times relative to the onset of teaching new skills to learners with autism spectrum disorder. Specifically, we first determined the most efficient differential reinforcement arrangement for each participant. Using the most efficient arrangement, we evaluated if differential reinforcement from the immediate onset, early onset, or late onset is the most efficient for learners to acquire a new skill. Three children diagnosed with autism spectrum disorder who have a history of receiving intervention based on the principles of applied behavior analysis participated in this study. The immediate onset of differential reinforcement resulted in the most efficient instruction in 6 of 7 comparisons. The results are discussed in light of previous studies and suggestions for future research are provided.     

Increasing meal consumption in individuals with competing protective equipment

Individuals diagnosed with autism spectrum disorder may engage in self‐injurious behavior that can cause tissue damage. Protective equipment is sometimes used to decrease the severity of tissue damage when self‐injury occurs. However, wearing protective equipment may be incompatible with some forms of adaptive behavior, such as meal consumption. The purpose of the present analysis was to identify a treatment for increasing meal consumption in two adolescent males diagnosed with an autism spectrum disorder who wore protective equipment that interfered with self‐feeding. Three interventions were evaluated: modifying the protective equipment, manipulating the reinforcing efficacy of the meal, and arranging additional positive reinforcement for meal consumption in the absence of protective equipment. Modifying protective equipment and manipulating the reinforcing efficacy of the meal were effective for both participants. Additional positive reinforcement was evaluated and effective for one participant.     

Telehealth mask wearing training for children with autism during the COVID‐19 pandemic

SARS‐CoV‐2 is the virus causing COVID‐19 and is spread through close person‐to‐person contact. The use of face masks has been described as an important strategy to slow its transmission. We evaluated the effects of coaching caregivers via telehealth technologies to teach face mask wearing to children with autism spectrum disorder. Six participants with a history of challenging behavior associated with mask wearing were recruited from different parts of the world, and trained using graduated exposure, shaping, and contingent reinforcement. By the end of the intervention, all participants wore a face mask for a period of 10 min without exhibiting challenging behavior. The skills generalized to a novel mask or a community setting. Mask wearing did not affect the percentage of oxyhemoglobin saturation of participants, and caregivers found the intervention useful. The findings support previous tolerance training treatment evaluations in children with developmental disorders exhibiting resistance to healthcare routines.     

Discrete‐trial training performance of behavior interventionists with autism spectrum disorder: A systematic replication and extension

Further research is needed on strategies to improve employment outcomes for individuals with autism spectrum disorder (ASD). We replicated and extended prior research by examining the acquisition, maintenance, and generalization of discrete‐trial training (DTT) performance of adults with ASD who were interested in careers as behavior technicians. Three participants received training on how to implement DTT with children and we assessed the maintenance and generalization of DTT performance in the absence of feedback. Results indicated that procedural integrity generalized across children and targets and maintained for 6 to 17 session days without feedback. Results have implications for the successful employment of individuals with ASD as behavior technicians and for future research on strategies to enhance their performance on the job.     

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.     

The influence of instructive feedback presentation schedule: A replication with children with autism spectrum disorder

Instructive feedback (IF) is a modification to discrete trial instruction that may increase instructional efficiency for individuals with autism spectrum disorder. Several variations of IF have recently been evaluated in the literature; however, few studies have assessed the effectiveness and efficiency of presenting secondary targets on continuous versus intermittent presentation schedules. The current study evaluated the effectiveness and efficiency of various presentation schedules of secondary targets during discrete trial instruction. Specifically, we replicated and extended Griffen et al. (1998) by comparing a condition in which secondary targets were presented during each trial of a session, a condition in which secondary targets were presented every other trial, and a condition in which secondary targets were presented about every 4 trials. Within-subject replications were included for both participants. One of the intermittent presentation schedules was associated with the most optimal outcomes in all 4 comparisons.     

Teaching with Massed Versus Interspersed Trials: Effects on Acquisition,Maintenance, and Problem Behavior

The current study evaluated the effects of teaching three programs using massed‐trial teaching (MTT) versus interspersed‐trial teaching (ITT) for three participants diagnosed with autism. Specifically, we compared the (i) rate of response acquisition, (ii) percentage of trials per session with problem behavior, and (iii) number of acquisition targets maintained following mastery. For all three participants, the rate of acquisition was higher under MTT than ITT, and levels of problem behavior were similar in both conditions for each participant. Perhaps the only advantage of ITT over MTT was maintenance of targets at the follow‐up probes for two participants; however, neither approach yielded consistently high levels of correct responding across 2‐, 4‐, and 6‐week follow‐up probes. Collectively, results for these three participants provide some evidence for the additive benefit of MTT over ITT. Copyright © 2014 John Wiley & Sons, Ltd.     

A comparison of teaching tacts with and without background stimuli on acquisition and generality

We evaluated whether teaching tacts of images with or without backgrounds would affect acquisition during teaching and generality across untaught targets with four children diagnosed with autism spectrum disorder. Including backgrounds could slow acquisition but bolster generality across other media containing backgrounds, whereas removing backgrounds may improve acquisition but result in poorer generality. Overall, acquisition rates were similar across conditions for three children, although one child displayed consistently slower acquisition during the background condition. We rarely observed generality to untaught targets when programming extinction, but embedding differential reinforcement or teaching additional images with backgrounds led to equally successful outcomes irrespective of initial teaching conditions. Teaching with or without backgrounds may result in marginal differences in acquisition of teaching and untaught targets, especially when arranging supplemental procedures during tests for generality. We discuss the importance of intrasubject replication, considerations when testing for generality, and implications for practice.     

Generality of the practical functional assessment and skill‐based treatment among individuals with autism and mental health disorders

A practical functional assessment format was recently developed that informed a skill‐based treatment for the problem behavior of children diagnosed with autism spectrum disorder. Since its inception there have been multiple replications of the procedures; however, the comprehensive model has rarely been applied to populations with more complex comorbid disorders and severe problem behavior such as those diagnosed with anxiety or depression. We conducted the current study to systematically replicate the entire practical functional assessment and skill‐based treatment model with two participants diagnosed with multiple mental health disorders admitted to a severe behavior outpatient unit. The practical functional assessment identified reinforcers that were provided contingent on increasingly complex forms of communication. Problem behavior remained low for both participants after reinforcement was thinned by increasing a response requirement of completing difficult tasks. Furthermore, the results were socially validated by the parents and teachers and the treatment was extended to the home setting.