Increasing compliance with wearing a medical device in children with autism

Health professionals often recommend the use of medical devices to assess the health, monitor the well-being, or improve the quality of life of their patients. Children with autism may present challenges in these situations as their sensory peculiarities may increase refusals to wear such devices. To address this issue, we systematically replicated prior research by examining the effects of differential reinforcement of other behavior (DRO) to increase compliance with wearing a heart rate monitor in 2 children with autism. The intervention increased compliance to 100% for both participants when an edible reinforcer was delivered every 90 s. The results indicate that DRO does not require the implementation of extinction to increase compliance with wearing a medical device. More research is needed to examine whether the reinforcement schedule can be further thinned.     

An assessment of differential reinforcement procedures for learners with autism spectrum disorder

Differential reinforcement procedures may promote unprompted correct responding, resulting in a quicker transfer of stimulus control than nondifferential reinforcement. Recent studies that have compared reinforcement arrangements have found that the most effective arrangement may differ across participants. The current study conducted an assessment of differential reinforcement arrangements (i.e., quality, schedule, and magnitude) and nondifferential reinforcement to identify the most effective arrangement for each participant. The assessment phase showed that the quality arrangement was the most efficient for all participants during auditory‐visual matching. Next, a validation phase was conducted to evaluate whether the assessment would predict the most effective arrangement across multiple skills. The results from the assessment phase were validated for all participants for the same skill. However, the results were only validated for one participant during the other skills (i.e., tact and intraverbal). The results are discussed in light of previous research and future areas of research.     

Evaluation of a telehealth parent training program in teaching self-care skills to children with autism

The present study used synchronous video conferencing to remotely deliver a behavioral skills training-based (BST) parent training program to 3 parents of children with autism in the family home. Parents were taught to implement graduated guidance to teach their children several important self-care skills. Parents did not correctly implement graduated guidance after receiving detailed written instructions only. After parents received the BST parent training package, however, all parents implemented graduated guidance with near-perfect levels of fidelity, and all children completed the targeted self-care skills with substantially higher levels of accuracy and independence. Furthermore, parents reported high levels of satisfaction with graduated guidance, the telehealth BST training package, and their children's ability to complete self-care skills.     

Effectiveness of video modeling in teaching earthquake and postearthquake evacuation safety skills for children with autism

The purpose of the present study was to investigate the effectiveness of video modeling to teach safety skills during earthquakes and postearthquake evacuation to children with autism. Three male children with autism, aged 9–10 years, participated in the study. The results indicate that video modeling was effective at promoting the acquisition of “drop, cover, and hold on” and evacuation skills for all three students. Furthermore, the skills generalized to a new setting for all three participants and maintained up to 4 weeks after video modeling for the two participants for whom maintenance was evaluated. Social-validity data were also collected from participants, their parents, and a teacher, and the findings were positive overall. Implications for instruction and future research are discussed based on the results of the study.     

Further analysis of modifications to the three-step guided compliance procedure to enhance compliance among children with autism

Three-step guided compliance (vocal prompt, vocal plus model prompt, vocal prompt plus physical guidance) is a commonly used procedure to increase compliance among children with intellectual disabilities. Previous research has suggested that under some conditions, slight modifications to the three-step procedure may enhance its effectiveness. These modifications include omitting the model prompt and decreasing the interprompt interval. In the current study, we evaluated another modification to the procedure: the delivery of a high-preference item contingent upon compliance with the first vocal prompt (i.e., differential reinforcement). For 2 participants with autism, compliance remained low when we implemented differential reinforcement and the guided compliance procedure in isolation. However, compliance improved when we combined differential reinforcement and the three-step guided procedure, suggesting that for at least some children, the combination of contingent access to a high-preference item and the guided compliance procedure is more effective than either intervention alone.     

Outcomes of a practical approach for improving conversation skills in adults with autism

Many individuals with autism spectrum disorder (ASD) have deficits in conversation skills that can interfere with the development of personal and professional relationships. Further research is needed on efficient interventions for targeting conversation skills in adults with ASD and for evaluating the social validity of the outcomes. In this study, 2 practitioners implemented a 4‐week training program for 5 adults with ASD that combined individualized computer‐based instruction (CBI) and practice with peers to promote the acquisition, maintenance, and generalization of conversation skills. Training was associated with improvements in 12 of 13 skills across participants. These findings, along with peer ratings of the participants' conversation skills, suggest that this model is a promising, socially valid approach for improving conversation skills in adults with ASD.     

Teaching social play skills to adults and children with autism as an approach to building rapport

Adults with autism spectrum disorder (ASD) and no intellectual disabilities were taught to increase the social play skills of children with ASD as part of a vocational training program. Participants included 3 adults, aged 21 to 27 years, and 6 children with ASD. Probes conducted throughout the study evaluated whether play skills training affected a measure of rapport between the adult and child. Results demonstrated the effectiveness of behavioral skills training for teaching the adult participants the appropriate play skills. In addition, the children's social engagement increased. Finally, rapport probes showed that play skills training increased levels of proximity, our measure of rapport, between the adults and children.     

Teaching spontaneous responses to young children with autism

Using a multiple probe design across responses, we demonstrated the effectiveness of intensive intervention in establishing spontaneous verbal responses to 2 3-year-old children with autism with generalization to novel settings involving novel persons. Intervention involved discrete-trial instruction (i.e., repeated instructional opportunities presented in close proximity to high rates of reinforcement), specific prompts, and error correction. Spontaneous responses were defined as specific verbal utterances (e.g., the child says "bless you") following discriminative stimuli that did not involve explicit vocal directives (e.g., adult sneeze). The development of effective interventions to address the social-communicative needs of very young children with autism is discussed.     

An evaluation of photographic activity schedules to increase independent playground skills in young children with autism

We used photographic activity schedules to increase the number of play activities completed by children with autism during unstructured time on the playground. All 3 participants engaged in more playground activities during and after training, and they continued to complete activities when novel photographs were introduced.     

Evaluation of behavioral skills training for teaching abduction-prevention skills to young children

This study examined the effectiveness of individual behavioral skills training in conjunction with in situ training in teaching 13 preschool children abduction prevention skills. Children's performance was measured during baseline, training, and at 2-week, 1-month, and 3-month follow-ups using in situ assessments in which abduction prevention skills were measured in naturalistic settings. Results revealed that all the children learned the skills and all the children available at the 2-week and 1-month follow-ups maintained the skills at criterion level. All but 3 children's criterion-level performances were maintained at the 3-month follow-up as well.     

Treatment of resistance to change in children with autism

“Resistance to change” represents a core symptom of autism that we conceptualized and assessed as resulting in part due to factors known to govern free‐operant choice. During a free‐choice baseline, participants chose between problematic, resistive responses and an appropriate alternative response. During the asymmetrical‐choice condition, we delivered their most highly preferred item if the participant chose the alternative response (i.e., differential reinforcement of alternative behavior [DRA]). During the guided‐ (Experiment 1) and singular‐ (Experiment 2) choice conditions, we prompted participants to choose the alternative response and then delivered their most highly preferred item (i.e., DRA with escape extinction). All participants learned to tolerate (Experiment 1) or choose (Experiment 2) the alternative response when we combined DRA with escape extinction. After exposure to escape extinction, two participants showed strong maintenance effects with DRA alone. We discuss these finding relative to the effects of DRA and escape extinction on resistance to change.