A Meta-Analysis of Behavioral Interventions for Adolescents and Adults with Autism Spectrum Disorders

Evaluation of evidence-based treatments is important for adolescents and adults with autism spectrum disorders (ASD) given the increasing number of interventions available and the prevalence of ASD. In this study, we sought to evaluate the effectiveness of behavioral interventions for this population by conducting a meta-analysis of published single-case research studies. A new metric for calculating effect size in single-case research, nonoverlap of all pairs, was utilized. In addition, the certainty of evidence, a system to evaluate research methodology, was applied to the reviewed articles. Forty-three articles were identified in the study. Results suggested that the behavioral interventions in the areas of academic skills, adaptive skills, problem behavior, phobic avoidance, social skills, and vocational skills have medium-to-strong effect sizes. Medium-to-high confidence in findings was noted for 81 % of the studies in the meta-analysis; however, three-fourths of the reviewed studies did not include treatment integrity, which may affect the ability to draw conclusions about the effectiveness of the interventions. Overall, the evidence is promising for the use of behavioral interventions for this population; however, additional research and dissemination are needed to fill the gap between research and practice in order for practitioners to meet the increasing demand as individuals with ASD age.     

Social skill assessment and training for children: an evaluative review

Techniques employed in the behavioral assessment and treatment of socially deficient children are reviewed. General definitions and components of assertion and social skill in children are presented. While considerable data attest to the potential efficiency of behavioral approaches with this population, several methodological problems prevent any definitive conclusions from being drawn at this time. Some of these include: (1) lack of an accurate classification system of socially isolated children, (2) need for an empirical determination of skill components, and (3) the paucity of data concerning generalization and maintenance of treatment effects. The utility of incorporating developmental and social psychological methods into behavioral programs also is discussed. Suggestions for future directions of research are offered.     

Bernard Berelson: Behavioral scientist

Bernard Berelson (1912–1979) was trained as a librarian and wrote two important books on reading and readers, but his major contributions to the behavioral sciences were in the fields of communications research, voting studies, and population. He virtually created the term “behavioral sciences” and he was principally responsible for the establishment of the Center for Advanced Study in the Behavioral Sciences in Stanford, California. His energy and intelligence and his belief both in the importance of behavioral empiricism and the ethical and moral dimensions of behavioral research have left an enduring legacy.     

A Qualitative Exploration of Sleep Habits and Intervention Needs Among Youth with Cystic Fibrosis

Evidence suggests that individuals with Cystic Fibrosis (CF) experience difficulties with sleep architecture and hygiene, although research is limited. There are currently no behavioral sleep interventions for youth with CF. The current study used qualitative methods to understand sleep needs and concerns among youth with CF, as well as to obtain feedback about potentially useful behavioral sleep intervention strategies. Semi-structured interviews were conducted with youth with CF between the ages of 11–17 and their parents. Themes were extracted from the data and will be used to inform the development of a brief behavioral sleep intervention for youth with CF. Youth and their parents described several CF-specific sleep concerns, often related to respiratory symptoms, and a number of strategies used to manage these concerns. They also described concerns that apply to the general population, including pervasive use of technology around bedtime. Many evidence-based behavioral sleep intervention strategies are acceptable to youth with CF, although modifications are appropriate to reduce time burden and address CF-specific needs. Youth with CF experience a number of disease-specific and more generalized sleep concerns which are likely amenable to behavioral intervention. Results from this study will be used to inform the development of a brief behavioral sleep intervention for youth with CF.

     

The Mexican American in Higher Education: An Example of Subtle Stereotyping

This article focuses on four major weaknesses that are prevalent in behavioral science articles on Mexican Americans: (a) overgeneralization from a small subgroup to the total Mexican-American population; (b) misuse and misinterpretation of data; (c) adherence to a culture-blame syndrome; and (d) inappropriate treatment suggestions. In order to facilitate discussion, examples are drawn from an article published recently in the Personnel and Guidance Journal. Suggestions for improving counseling research and practice relative to Mexican Americans and other minorities are presented.     

We Are the World—and They Are Not: Prototypicality for the World Community,Legitimacy, and Responses to Global Inequality

The relation between developed and developing countries is characterized by inequalities that sometimes hinder actions against worldwide problems. The current research presents an intergroup approach, based on the ingroup projection model, towards an analysis of psychological processes that perpetuate global inequality on a social group level. Precisely, we argue that people from developed countries perceive their group as more prototypical for the world population than they perceive people from developing countries. These perceptions of ingroup prototypicality should in turn relate to legitimacy beliefs and predict unfavorable behavioral intentions towards developing countries. We present two studies that corroborate our hypotheses: In Study 1, participants from a developed country perceived their ingroup as more prototypical for the superordinate group (i.e., world population) than the outgroup (i.e., developing countries), which in turn was related to beliefs that global inequality is legitimate. This finding was replicated in Study 2, and the predicted effect of ingroup prototypicality on behavioral intentions was mediated by legitimacy beliefs. These findings demonstrate that intergroup processes can contribute to perpetuating global inequality.     

Jeab at 50: coevolution of research and technology

Evidence of how behavioral research and technology have evolved together abounds in the history of the Journal of the Experimental Analysis of Behavior (JEAB). Technology from outside the discipline (exogenous), from such disciplines as electronics and computer science, has been adapted for use in behavioral research. Technology from within the discipline (endogenous) has developed from both basic behavioral research and existing apparatus. All of these sources of technology have contributed to the corpus of behavioral research as it has evolved in JEAB. Such research, in turn, has provided the environmental pressure necessary for continuing technological evolution both within and outside the discipline. The new technology thus evolved further spurs research along in novel directions. This dynamic coevolutionary interplay between research and technology is an important variable in the past, present, and future of JEAB.     

Behavior-analytic research on dementia in older adults

It is estimated that 1 in 10 adults aged 65 years and older have been diagnosed with dementia, which is associated with numerous behavioral excesses and deficits. Despite the publication of a special section of the Journal of Applied Behavior Analysis (JABA) on behavioral gerontology (Iwata, 1986), there continues to be a paucity of behavior-analytic research with this population. This review compares the research published before and after the behavioral gerontology special section and evaluates the most recently published aging articles in JABA.     

A comparative outcome study of behavioral social-skills training, interpersonal-problem-solving and non-directive control treatments with child psychiatric outpatients

The purpose of the present study was to compare the short- and long-term efficacy of behavioral social-skills training and interpersonal-problem-solving with a control condition (non-directive treatment) with a clinical population of 61 socially-maladjusted outpatient boys. Treatment consisted of 12 weekly 1-hr sessions, with follow-up conducted at 12 months. A comprehensive assessment strategy was employed which included direct behavioral observations, parent, teacher, peer, self-report and academic performance measures. The results of this social-skills comparative outcome study indicated that the behavioral and interpersonal treatments resulted in changes on parent, teacher, self-report and peer sociometric ratings at post-treatment. At the 1-yr follow-up, the behavioral treatment maintained it's gains and continued to show modest improvement. Conversely, the interpersonal treatment manifested significant declines, as did the control group. These findings and implications for future research are discussed.     

A Review of Behavioral Interventions for Anxiety‐Related Behaviors in Lower‐Functioning Individuals with Autism

Anxiety is highly prevalent in persons with autism and affects individuals with higher‐functioning autism (HFA) and lower‐functioning autism (LFA). Although there is emerging support for the efficacy of cognitive‐behavioral therapy (CBT) in treating anxiety in autism, these findings are largely based on HFA samples. Moreover, CBT may be inappropriate for individuals with LFA who may struggle to grasp the cognitive components of the therapy because of their more limited verbal abilities. Behavior analytic interventions may be better suited to treat anxiety in this population; however, the quantity and quality of the extant literature have yet to be reviewed. Toward this end, the extant behavioral intervention literature was reviewed. Seven studies met the inclusion criteria and were evaluated against quality indicators for within‐subject design research. Next, the efficacy of each treatment component was assessed using established criteria for defining empirically supported therapies. Results revealed behavioral interventions to be efficacious, with desensitization and reinforcement emerging as efficacious treatment components, while prompting, modeling, and antianxiety stimuli were established as possibly efficacious. However, given that some of the quality indicators were not met, these results should be interpreted with some caution. Additional research is needed to form a more conclusive evidence base for the treatment of anxiety in individuals with LFA. Copyright © 2016 John Wiley & Sons, Ltd.     

Cognitive and Behavioral Contributions to Depression Severity,Quality of Life,and Functioning Among People Living With HIV in South Africa

Cognitive-behavioral treatments for depression typically address both behavioral (e.g., activation) and cognitive (e.g., rumination) components, and consequently improve quality of life (QOL) and function in high-resource settings. However, little is known about the cross-cultural applicability and relative contribution of these components to depression symptom severity, QOL, and functional impairment in South Africa and other resource-limited global settings with high HIV prevalence rates.Persons with HIV (N = 274) from a peri-urban community outside Cape Town, South Africa, were administered multiple measures of depression (Hamilton Depression Scale, Centre for Epidemiological Studies Depression Scale, South African Depression Scale), cognitive and behavioral components related to depression (Ruminative Response Scale, Behavioral Activation for Depression Scale), and measures of QOL and functioning (Sheehan Disability Scale, Quality of Life Enjoyment and Satisfaction Scale—Short Form). Multiple linear regression models were fit to assess the relative contribution of behavioral and cognitive components to depression severity, QOL, and functional impairment in this population.Models accounting for age and sex revealed that lower levels of behavioral activation (BA) were significantly associated with all measures of depression, as well as with QOL and functional impairment (all ps < .01). Rumination was associated with all measures of depression (all ps < .01), but not with QOL or functional impairment.The consistent and unique association of BA with depression, QOL, and functional impairment bolsters its importance as a treatment target for this population.     

Using national survey data incorporating the theory of planned behavior: Implications for social marketing strategies in physical activity

Abstract

This paper illustratesthe potential use of the Theory of Planned Behavior (TPB) as a guiding fiamework for the conduct of population based survey research to develop strategies to promote physical activity involvement in various market segments. The Campbell's Survey of Well-Being (1988), a nation-Wide representative study of the Canadian population incorporated a modified operationali- zation of the TPB Pertainingto intended involvement in regularphysical activity. The theory was found to be generally effitive in munting for intentions in the general population (Rz= .32)as well as in various age and gender subgroups. Whereas, neither the model's direct predictors of intentions (e.g., attitudes, sub jective normdsocial support, perceived behavioral control) nor the indirect predictors (e.g., the beliefs underlying these predictors) varied consistently across gender, a number of age-related differenceswere observed. These differencesare used to exemplify how population-based data utilizing the TPB can be utilized to develop promotional and programming implications for fostering greater physical activity involvement in various ag-ender market segments.     

The Effectiveness of an Occupational Therapy Program for Chemically Dependent Adolescents

This research study, conducted at a residential treatment center for chemically dependent and emotionally disturbed youth, was designcd to answer the following questions: is occupational therapy effective in producing behavioral change in the adolescent chemically dependent population and, if so, what are the factors producing the change? An assessment tool was designed and used in conjunction with observations to determine each resident's behavioral status before and after involvement in occupational therapy groups. All residents admitted to James- town wcre involved in a Work Skills Group (focusing on pre- work skill development) and/or a Relationship Skills Group (fo-cusing on interpersonal skill development). The behavioral status was measured by the therapist using a defined rating scale in an interview format. The changc in ratings from pre- to post-treatment was used as the basis for the data analysis. Groups of residcnts were compared to each other on the, variables of age, sex, attendance, rate of goal completion, group membership, and completion and type of occupational therapy goals. The results of the study indicate that rcsidents who attended occupational therapy, were involved in both groups, completed their occupational thcrapy goals, and completed the occupational therapy program demonstrated significant behavioral change, especially in relationship skills. Age and sex variables alone did not produce significant behavioral change.     

Engineering technology and behavior analysis for interdisciplinary environmental protection

Engineering strategies for saving environmental resources have been widespread. However, many of those engineering advances have not been widely accepted nor generally applied by large segments of the general population. This paper considers the need to examine behavioral/environmental variables in the application of engineering technology, with particular reference to specific behavioral strategies for encouraging the use of engineering technology from an interdisciplinary perspective. A model for the study of factors contributing to the solution of ecological/environmental problems is presented and examples of interdisciplinary research are described. The model implies a need for the examination of the effects of antecedent and consequent manipulation of a variety of variables including: behavioral, physiological, environmental, technical and legal conditions. It is concluded that while interdisciplinary research efforts between engineering technologists and behavioral analysts are necessary, they have not received sufficient attention in the literature nor have they focused on the comprehensive study of antecedents and consequences as they relate to ecological/environmental problems. Thus, an extended "family" of research efforts is important for the success of these efforts.     

Social facilitation

Video-recording procedures have been used in previous research as a motivational manipulation. The present study investigated the permanent recording of behavior as a manipulation of evaluation apprehension and its effects upon behavioral performance and upon autonomic arousal. Twenty-four subjects (12 males, 12 females) were randomly assigned to one of four conditions formed by completely crossing two levels of audience status (peer or authority) with two levels of behavioral record (non-permanent or permanent). Another 24 subjects were assigned to an external control group to the 2×2 design. Subjects' performance on a hidden-word task and their arousal level (as assessed by the Palmar Sweat Index) were measured. Analyses of variance results showed a significant performance (p<.05) and a significant arousal (p<.05) difference between the behavioral record conditions as predicted. The control group was also found to be significantly (p<.05) different from the experimental groups on the behavioral performance measure. The results were related to previous research findings and interpreted within the context of the evaluation apprehension notion presented within social facilitation research.The author would like to thank Angelia Mellors, Valerie K. Golish, and Judy Cohen for serving as experiments, and Susan L. Doman and Cheryl Primmer for scoring the PSI measures.     

婚姻关系、亲子关系对3～6岁幼儿心理行为问题的影响

采用CBCL量表、自编的婚姻关系和亲子关系问卷调查了6所城市幼儿园的457名3～6岁幼儿,结果发现：(1)本研究中3～6岁幼儿心理行为问题的检出率为15．10％;(2)3-6岁幼儿的心理行为问题主要表现为交往不良、攻击性等外部行为问题;(3)没有心理行为问题的幼儿家庭其婚姻关系在性格相容、问题解决和性生活方面显著优于有心理行为问题的幼儿家庭,但在经济条件方面则相反;(4)婚姻关系和亲子关系则呈显著的正相关,并共同影响幼儿的心理行为问题。     

Single-case experimental designs for behavioral neuroscience

Single-case experimental designs (SCEDs) are commonly used in behavior analytic research but rarely used in behavioral neuroscience research. The recent development of technologies that allow control of the timing of neurobiological events such as gene expression and neuronal firing enable the fruitful application of SCEDs for the study of brain–behavior relations. There are at least 3 benefits expected from applying SCEDs to study how neurobiological events affect behavior. First, SCEDs entail direct within- and across-subject assessments of reliability, likely increasing the probability of replication across studies and encouraging a search for the causes of replication failure when they occur. Second, SCEDs focus on behavior in individual organisms producing a body of knowledge that applies to individuals rather than population parameters. Finally, SCEDs require fewer animals, decreasing costs and effort and addressing the ethical obligation to reduce the number of animals used for research. Examples are provided using hypothetical data generated based on published research. Collaborations between behavior analysts and behavioral neuroscientists will bring the world within the skin under direct experimental control and broaden our understanding of the determinants of behavior.     

Behavioral distraction by auditory novelty is not only about novelty: The role of the distracter’s informational value

Unexpected events often distract us. In the laboratory, novel auditory stimuli have been shown to capture attention away from a focal visual task and yield specific electrophysiological responses as well as a behavioral cost to performance. Distraction is thought to follow ineluctably from the sound’s low probability of occurrence or, put more simply, its unexpected occurrence. Our study challenges this view with respect to behavioral distraction and argues that past research failed to identify the informational value of sound as a mediator of novelty distraction. We report an experiment showing that (1) behavioral novelty distraction is only observed when the sound announces the occurrence and timing of an upcoming visual target (as is the case in all past research); (2) that no such distraction is observed for deviant sounds conveying no such information; and that (3) deviant sounds can actually facilitate performance when these, but not the standards, convey information. We conclude that behavioral novelty distraction, as observed in oddball tasks, is observed in the presence of novel sounds but only when the cognitive system can take advantage of the auditory distracters to optimize performance.     

Sudden Gains in Depressed Cancer Patients Treated With Behavioral Activation Therapy

Many patients who receive cognitive-behavioral therapy experience sudden gains that are associated with improved treatment response and decreased risk of relapse. Extending prior research, this study examined sudden gains among depressed cancer patients receiving brief (9-session) behavioral activation therapy. Fifty percent of patients experienced sudden gains of large magnitude (M = 11.8 BDI-II points), with sudden gains associated with improved treatment response and maintenance of gains at 3-month follow-up. Relative to those without sudden gains, at pretreatment assessment, cancer patients with sudden gains were more likely to present with less severe depression, less somatic anxiety, fewer coexistent anxiety disorders, as well as less bodily pain, better overall physical functioning, and fewer problems with daily activities as a result of emotional problems. These findings provide increasing support for behavioral activation with a difficult-to-treat population but raise important questions regarding mechanism of change. Clinical implications for treating depressed cancer patients are discussed.