An evaluation of video-prompting procedures via telehealth to teach first aid skills to children with intellectual and developmental disabilities

Unintentional injuries are one of the leading causes of morbidity and mortality among children with intellectual and developmental disabilities (IDD). First aid training involves teaching critical first aid skills, some of which are designed to treat unintentional injuries. To date, no study has (a) evaluated the effects of a video-prompting procedure to teach first aid skills to children with IDD or (b) attempted to teach these skills to children by using a telehealth delivery format. We used a concurrent multiple-baseline-across-skills design to evaluate the efficacy of a video-prompting procedure via telehealth to teach five children with IDD to perform first aid on themselves for insect stings, minor cuts, and minor burns under simulated conditions. For all participants, our procedure produced large improvements that maintained for a minimum of 4 weeks. Furthermore, the effects of the training generalized to novel confederates for all participants, and these effects maintained for a minimum of 4 weeks.     

Young adults with intellectual and other developmental disabilities acquire vocational skills with video prompting

Students with intellectual and other developmental disabilities often require substantial support to acquire the skills needed to secure work experience and paid employment. Prior findings suggest that video prompting is likely to be an effective and feasible strategy for establishing such skills. To evaluate this possibility in a special education transition program, we examined the effectiveness of a video prompting procedure in teaching 8 young adults with developmental disabilities to perform job-related tasks (doing laundry, checking in to work, vacuuming, stripping bed). The intervention was effective with all participants. The skills maintained over 3 months, and the participants performed the tasks accurately in a new setting with different materials. Participants were reportedly satisfied with the intervention and deemed it easy to use.     

A quantitative review of overjustification effects in persons with intellectual and developmental disabilities

The overjustification hypothesis suggests that extrinsic rewards undermine intrinsic motivation. Extrinsic rewards are common in strengthening behavior in persons with intellectual and developmental disabilities; we examined overjustification effects in this context. A literature search yielded 65 data sets permitting comparison of responding during an initial no‐reinforcement phase to a subsequent no‐reinforcement phase, separated by a reinforcement phase. We used effect sizes to compare response levels in these two no‐reinforcement phases. Overall, the mean effect size did not differ from zero; levels in the second no‐reinforcement phase were equally likely to be higher or lower than in the first. However, in contrast to the overjustification hypothesis, levels were higher in the second no‐reinforcement phase when comparing the single no‐reinforcement sessions immediately before and after reinforcement. Outcomes consistent with the overjustification hypothesis were somewhat more likely when the target behavior occurred at relatively higher levels prior to reinforcement.     

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.     

Using token reinforcement to increase walking for adults with intellectual disabilities

The purpose of this study was to evaluate the effectiveness of token reinforcement, using an ABAB reversal design, for increasing distance walked for adults with mild to moderate intellectual disabilities at an adult day‐training center. Five participants earned tokens for walking 50‐m laps and exchanged tokens for back‐up reinforcers that had been identified through preference assessments. Token reinforcement resulted in a substantial increase from baseline in laps walked for 4 participants.     

Response to bullying (RTB): Behavioral skills and in situ training for individuals diagnosed with intellectual disabilities

This study evaluated behavioral skills training (BST) and in situ training (IST) to teach a response to bullying (RtB) to four adults with intellectual disabilities who were victims of bullying. The RtB consisted of refraining from retaliating, stating disapproval, walking away, and telling a staff member. In situ assessments were conducted in the natural setting to assess the effects of BST and IST. BST alone was successful in teaching the RtB to two participants. When BST did not result in the use of the RtB, IST was effective for one participant, and IST plus an incentive was effective for the other participant. The results of this study are consistent with previous BST and IST research.     

Life skills instruction for children with developmental disabilities

The Preschool Life Skills program is an intervention package designed to teach functional skills to prevent problem behavior in typically developing children. The purpose of the current study was to evaluate the effects of the instructional package (renamed “Life Skills”) with children with developmental disabilities. The program involved teaching 12 life skills to nine participants across four instructional units. The units were instruction following, functional communication, tolerance of denial and delay, and friendship skills. Teachers provided instruction through a three-tiered instructional approach, starting with class-wide instruction followed by small group and one-to-one instruction as necessary. We extended previous research by using visual prompts during all three tiers and progressively increasing intertrial intervals during one-to-one instruction. Results indicated that the intervention led to skill acquisition with all nine participants. The skills maintained 4 weeks after instruction ended.     

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.     

Interventions for inappropriate sexual behavior in individuals with intellectual and developmental disabilities: A brief review

Although prevalence rates vary, 6% to 28% of individuals with intellectual or developmental disabilities (IDDs) engage in inappropriate sexual behavior (ISB), ranging from public masturbation to sexually aggressive behavior. Along with increased risk for contacting the criminal justice system, people with IDDs who display ISB may encounter negative social consequences, restricted community access and barriers to independence, and a variety of counter-therapeutic outcomes. The purpose of the present review is to highlight recent, efficacious behavior-analytic treatments for ISB in individuals with IDDs. Ethical considerations and areas for future research will be discussed.     

A review of behavioral procedures to teach motor skills to individuals with severe disabilities

Behavioral procedures are one approach to teaching or improving the fluency of motor skills of individuals with severe disabilities. This article provides a review of behavioral procedures by highlighting antecedents, consequences, and multifaceted techniques. Investigations are reviewed in each area according to (a) replicability of the intervention, (b) experimental control, (c) maintenance, (d) generalization, and (e) social validation. Practitioner implications address selection of reinforcers, reinforcement schedules, and teaching within meaningful routines. Future research recommendations highlight the need for documenting that stimuli are actually reinforcers. Additional research needs emphasize targeting maintenance, generalization, and social validation.     

Comparison of prompting procedures to teach internet skills to older adults

The Internet and information and communications technologies (ICTs) have been found to produce meaningful social interactions and greater social support among older adults (White et al., 2002 ). Despite these benefits, the Internet and ICTs are not widely used among the older‐adult population (Cresci, Yarandi, & Morrell, 2010 ). The purpose of the current study was to compare the effectiveness and efficiency of video prompting and text‐based instructions on the acquisition of three tablet‐based tasks: emailing, video calling (FaceTime® application), and searching for a YouTube? video. Both video prompting and text‐based instructions were effective for all three participants, with text‐based instructions being slightly more efficient for one participant and video prompting being more efficient for two participants, suggesting that both prompting procedures can be used to teach older adults Internet and ICT skills.     

Training play behavior in a 5-year-old boy with developmental disabilities

The purpose of the current study was twofold: (a) to investigate if it was possible to train three different games (both as a leader and as a participant) to a child with developmental disabilities through interaction with 4 typically developing peers, and (b) to examine if correct responding would be maintained after the training was faded. A multiple probe design across three games was used. The results showed that the child learned both skills as a leader and as a participant in all three games, and that skills were maintained for a period of 3 weeks after the training had stopped.     

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.     

Replications and extensions in arousal assessment for sex offenders with developmental disabilities

Three adult male sex offenders with developmental disabilities participated in phallometric assessments that involved repeated measures of arousal when exposed to various stimuli. Arousal assessment outcomes were similar to those obtained by Reyes et al. (2006). Additional data-analysis methods provided further information about sexual preferences, thus replicating and extending previous research. The results provide preliminary data for establishing a preference gradient by age. Implications for the use of repeated measures and preference gradients in arousal assessments are discussed.     

Effects of direct instruction on the acquisition of prepositions by students with intellectual disabilities

Some students with intellectual disabilities require explicit instruction of language skills, including preposition use; however, little is known about effective ways to teach preposition use to this population. This study examined direct instruction (DI) to teach students to use and respond to prepositions. Results indicated that DI was an effective way to teach prepositions. Limitations and directions for future research are discussed.     

A further comparison of external control and problem‐solving interventions to teach social skills to adults with intellectual disabilities

We compared the effectiveness of a problem‐solving and an external control intervention to teach social skills to two adults with mild intellectual disabilities. Each participant received the problem‐solving intervention with one social skill and the external control intervention with another social skill. The comparative effectiveness of the social skill training protocols was evaluated using individual participant alternating treatment designs. Overall, there seemed to be little difference between the interventions in terms of acquisition, generalization, or maintenance of social skills with either participant. Limitations of the current study and issues for future research are discussed. Copyright © 2004 John Wiley & Sons, Ltd.     

Comparison of arousal and preference assessment outcomes for sex offenders with intellectual disabilities

We compared outcomes of arousal and preference assessments for five adult male alleged sexual offenders with intellectual disabilities. Arousal assessments involved the use of the penile plethysmograph to measure changes in penile circumference to both deviant (males and females under the age of 18) and nondeviant (males and females over the age of 18) video clips. Paired‐stimulus preference assessments were arranged to present still images from the video clips used in the arousal assessments. Results showed correspondence between the assessments for four out of the five participants. Implications are discussed for the use of preference assessment methodology as a less intrusive assessment approach for sexual offender assessments.