Teaching behavior analysts in an early intensive behavioral intervention setting to conduct a structured mealtime protocol

Children with autism spectrum disorder often display feeding problems, such as consumption of a limited variety of foods. It is also common for these children to be enrolled in early intensive behavioral intervention (EIBI) services for comprehensive treatment. Combined, these factors make it possible that behavior analysts will have a role in a child's clinical care related to feeding. However, given that the etiology of pediatric feeding disorders is complex and multifactorial, clinicians should ensure they have sufficient training and a setting that is appropriate for assessment and treatment. Therefore, we evaluated the effects of behavioral skills training in an EIBI setting to conduct a structured mealtime protocol. Training resulted in increases in procedural integrity, and we replicated these effects for all participants.     

A preliminary evaluation of two behavioral skills training procedures for teaching abduction-prevention skills to schoolchildren

Although child abduction is a low-rate event, it presents a serious threat to the safety of children. The victims of child abduction face the threat of physical and emotional injury, sexual abuse, and death. Previous research has shown that behavioral skills training (BST) is effective in teaching children abduction-prevention skills, although not all children learn the skills. This study compared BST only to BST with an added in situ training component to teach abduction-prevention skills in a small-group format to schoolchildren. Results showed that both programs were effective in teaching abduction-prevention skills. In addition, the scores for the group that received in situ training were significantly higher than scores for the group that received BST alone at the 3-month follow-up assessment.     

Randomized controlled evaluation of an early intervention to prevent post-rape psychopathology

A randomized between-group design was used to evaluate the efficacy of a video intervention to reduce post-traumatic stress disorder (PTSD) and other mental health problems, implemented prior to the forensic medical examination conducted within 72 h post-sexual assault. Participants were 140 female victims of sexual assault (68 video/72 nonvideo) aged 15 years or older. Assessments were targeted for 6 weeks (Time 1) and 6 months (Time 2) post-assault. At Time 1, the intervention was associated with lower scores on measures of PTSD and depression among women with a prior rape history relative to scores among women with a prior rape history in the standard care condition. At Time 2, depression scores were also lower among those with a prior rape history who were in the video relative to the standard care condition. Small effects indicating higher PTSD and Beck Anxiety Inventory (BAI) scores among women without a prior rape history in the video condition were observed at Time 1. Accelerated longitudinal growth curve analysis indicated a videoxprior rape history interaction for PTSD, yielding four patterns of symptom trajectory over time. Women with a prior rape history in the video condition generally maintained the lowest level of symptoms.     

Implementation of a brief early intervention in times of socio-economic crisis: effects on parental stress

The paper investigates the effect of brief early intervention on parental stress in the midst of a socio-economic crisis, such as the one that struck Greece in the past decade. During this period, a psychoanalytically oriented prevention programme with parents and their infants/young children, named ‘Early Intervention Programme’, was designed and implemented in the Department of Child Psychiatry at ‘Aghia Sophia’ Children’s Hospital in Athens, Greece. The families that attended the programme were asked to participate in a research study regarding its effectiveness; data were collected from 102 mothers and 73 fathers. This paper presents the statistical findings regarding parental stress, mainly because it is a factor that has systematically been shown to negatively influence several aspects of a child’s development, but also because our hypothesis was that parental stress would be influenced by the negative external conditions. The results showed that both mothers’ and fathers’ stress levels were high before their participation to the programme (with fathers’ Total Stress scores falling within the clinical range), while they decreased to a statistically significant level after the completion of the programme. These findings are discussed in conjunction with some illustrative clinical material. Based on these, it is argued that the implementation of a psychoanalytically oriented brief early intervention programme with parents and infants/young children can alleviate parental stress, and thus support the parental capacity to efficiently deal with the high demands of early development, even in periods of economic crisis where the tensions for young parents are significant and the available mental health resources are scarce.     

A review of recent studies on differential reinforcement during skill acquisition in early intervention

Although the use of differential reinforcement has been recommended in previous investigations and in early intervention curriculum manuals, few studies have evaluated the best method for providing differential reinforcement to maximize independent responding. This paper reviews previous research on the effectiveness of differential reinforcement as treatment and describes important areas of future research.     

Prevention of anxiety disorders: A model for intervention

Anxiety disorders are among the most prevalent of all psychological disorders and are potentially amenable to early intervention and prevention. In this article, we review the various costs associated with anxiety disorders that make early prevention a valuable endeavor. Also, we considered extant data regarding risk factors for anxiety disorders, as knowledge of risk factors permits the targeting of a select group of the population considered to be most likely to develop anxiety disorders. Existing efficacy research on prevention for anxiety disorders is promising, but an overarching model to guide further research and development is lacking. We propose such models to guide high-risk sample selection including the content and format of prevention efforts.     

行为干预情绪记忆再巩固：从实验室到临床转化

重新激活已经储存的记忆会重返暂时不稳定的状态, 需要经历重新稳定, 称为记忆再巩固。在这期间可以通过多种行为手段破坏、强化或更新原始记忆痕迹, 这为开发一种革命性的情绪记忆障碍治疗方法开辟了道路。然而, 即使在简单的实验模型中引发记忆再巩固的条件也是复杂的, 这给临床转化带来了困难与挑战。未来研究可以设置更具生态效应的基础模型, 寻求引发以及干预再巩固的最佳方式, 从神经生理、细胞分子层面进一步深化其内在机理研究。     

Newborn behavioral observations system in rural Pakistan: A feasibility and acceptability study

The Newborn Behavioral Observations (NBO) system is a relationship-based tool that helps parents recognize their infant's competencies and learn their behavioral cues, with the goals of enhancing parental responsiveness and satisfaction in the infant-parent relationship. In our study, a pediatrician integrated the NBO into 44 pediatric health care visits of infants in rural Pakistan villages, under the remote guidance of two U.S.-based child psychiatrists. A clinician then gave the mothers a survey about their experience of the NBO and found that the mothers were highly satisfied, reporting greater appreciation of their infant's strengths, greater understanding of their infant's behavioral cues, stronger attachment to their infant, and greater self-confidence as a mother. In their consideration of these results, the authors explore cultural reasons for the mothers’ responses and generate hypotheses to inform an outcome study of a similar intervention. This was a feasibility and acceptability study and was not randomized, had no control group, and did not use objective measures of outcome.     

‘Play skills’ for shy children: development of a Social Skills Facilitated Play early intervention program for extremely inhibited preschoolers

The aim of the present study was to develop and provide a preliminary evaluation of a social‐skills‐based early intervention program specifically designed to assist extremely inhibited preschoolers. Participants were a sample of n=22 extremely inhibited preschool‐aged children, who were randomly assigned to either the Social Skills Facilitated Play (SST) or Waitlist Control (WLC) condition. As compared to wait‐list controls, extremely inhibited children who participated in the SST‐facilitated play program sessions demonstrated a significantly greater post‐intervention decrease in observed socially wary behaviours and a significantly greater increase in social and socially competent behaviours at preschool. Results are discussed in terms of the importance of developing and refining early intervention programs for extremely inhibited young children. Copyright © 2010 John Wiley & Sons, Ltd.     

Association of prenatal attachment and early childhood emotional,behavioral, and developmental characteristics: A longitudinal study

This study examines the associations between prenatal attachment and child development, socioemotional behavioral problems, and competence at early childhood. It also inquires whether maternal depression and anxiety at the prenatal period and at early childhood are associated with child outcomes. The study consisted of 83 mothers and their children. Data regarding the prenatal attachment, depression, and anxiety were collected during Weeks 28 to 40 of gestation. When the children were 21 to 31 months old, the Brief Infant and Toddler Social Emotional Assessment (BITSEA) and the Ankara Developmental Screening Inventory (ADSI) were applied to children along with Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI) administered to mothers. Results showed that prenatal attachment scores significantly correlated with BITSEA-Competency subscale scores and ADSI total scores at early childhood, r(83) = 0.246, P = .025, and r(82) = 0.316, P = .004, respectively. Prenatal attachment levels were found to be the predictors of both behavioral and emotional competence and development at early childhood, b = 0.081, t(83) = 2.273, P = .014, and b = 0.281, t(83) = 3.225, P = .002, respectively. In addition, prenatal attachment was shown to be even a stronger predictor of development than was worsening maternal depression at early childhood, b = −0.319, t(83) = 2.140, P = .035. Our results indicate that fostering prenatal attachment may be beneficial for better infant outcomes at early childhood.     

Prediction of treatment outcomes and longitudinal analysis in children with autism undergoing intensive behavioral intervention

Outcome prediction is an important component of treatment planning and prognosis. However, reliable predictors of intensive behavioral intervention (IBI) have not been clearly established. IBI is an evidence-based approach to the systematic teaching of academic, social, verbal, and daily living skills to individuals with autism spectrum disorder. Incorporating longitudinal analysis to IBI outcome studies may help to identify outcome predictors of clinical value. Twenty-four children with autism underwent on average two years of IBI and completed language, daily living skills, cognitive, and motor assessments (Early Learning Accomplishment Profile and the Learning Accomplishment Profile-Diagnostic, 3rd edition) every six months. We used multilevel analysis to identify potential longitudinal predictors including gender, age, intervention intensity, intervention duration, total intervention time, and pre-intervention functioning. Results indicated that total intervention time, pre-intervention functioning, and age caused the greatest increase in goodness-of-fit of the longitudinal multilevel models. Longitudinal analysis is a promising analytical strategy to identify reliable predictors of the clinical outcome of IBI.     

Modified Comprehensive Behavioral Intervention for Tics: Treating Children With Tic Disorders,Co-Occurring ADHD,and Psychosocial Impairment

Our objective was to evaluate the feasibility and acceptability, and preliminary efficacy of a modified comprehensive behavioral intervention for tics (MCBIT) therapy for youth with chronic tic disorders (CTDs), co-occurring attention-deficit hyperactivity disorder (ADHD), and associated psychosocial impairment. Seventeen youth ages 10–17 with CTD and co-occurring ADHD were randomly assigned to the MCBIT group (n = 9) or to a control group where they received traditional comprehensive behavioral intervention for tics (CBIT) therapy (n = 8). Both groups received ten 55-minute weekly treatment sessions, and two 55-minute biweekly relapse prevention sessions. Sixteen of the 17 participants completed the study, and acceptability ratings in both treatment groups were high with no significant differences in expectation of improvement. The MCBIT and CBIT groups in combination showed significant improvement in tic severity, ADHD symptom severity, and tic-related impairment. Group differences were not significant. The results indicate that MCBIT treatment is feasible and acceptable for youth with CTD and ADHD, and is similarly well tolerated relative to traditional CBIT. Results were not sufficiently superior to recommend MCBIT over CBIT for this population. However, given the demonstrated benefit of behavioral treatments that target co-occurring conditions concurrently, continuing to examine novel behavioral approaches that can target tics and related conditions simultaneously and successfully is recommended.     

Toward quantifying the abuse liability of ultraviolet tanning: A behavioral economic approach to tanning addiction

Many adults engage in ultraviolet indoor tanning despite evidence of its association with skin cancer. The constellation of behaviors associated with ultraviolet indoor tanning is analogous to that in other behavioral addictions. Despite a growing literature on ultraviolet indoor tanning as an addiction, there remains no consensus on how to identify ultraviolet indoor tanning addictive tendencies. The purpose of the present study was to translate a behavioral economic task more commonly used in substance abuse to quantify the "abuse liability" of ultraviolet indoor tanning, establish construct validity, and determine convergent validity with the most commonly used diagnostic tools for ultraviolet indoor tanning addiction (i.e., mCAGE and mDSM‐IV‐TR). We conducted a between‐groups study using a novel hypothetical Tanning Purchase Task to quantify intensity and elasticity of ultraviolet indoor tanning demand and permit statistical comparisons with the mCAGE and mDSM‐IV‐TR. Results suggest that behavioral economic demand is related to ultraviolet indoor tanning addiction status and adequately discriminates between potential addicted individuals from nonaddicted individuals. Moreover, we provide evidence that the Tanning Purchase Task renders behavioral economic indicators that are relevant to public health research. The present findings are limited to two ultraviolet indoor tanning addiction tools and a relatively small sample of high‐risk ultraviolet indoor tanning users; however, these pilot data demonstrate the potential for behavioral economic assessment tools as diagnostic and research aids in ultraviolet indoor tanning addiction studies.     

A meta-analytic approach to the association between inhibitory control and parent-reported behavioral adjustment in typically-developing children: Differentiating externalizing and internalizing behavior problems

Impairments in inhibitory control (IC) are traditionally seen as a vital aspect in the emergence and course of maladaptive behavior across early childhood. However, it is currently unclear whether this view applies to both the externalizing and internalizing domain of parent-reported behavioral adjustment. Furthermore, past (meta-analytic) developmental research and theory characterizing this association have largely neglected the vast heterogeneity of IC measures and conceptualizations. The present meta-analyses examined the association of IC with parent-reported externalizing (N = 3160, 21 studies) and internalizing (N = 1758, 12 studies) behavior problems, assessed with the Child Behavior Checklist (CBCL), in non-clinical populations of children aged 2–8 years. They further investigated the moderating effects of a priori IC categorization, according to a recently proposed two-factor model of IC (“Strength/Endurance” account, Simpson & Carroll, 2019). In line with previous research in the clinical domain, the current results corroborate the notion of a robust, but small association between IC and externalizing behavior problems (r = ?0.11) in early childhood. However, although frequently proposed in the literature, no significant linear association could be identified with internalizing behavior problems. Furthermore, in both meta-analyses, no significant moderating effects of IC categorization could be revealed. These findings enhance our knowledge about the cognitive underpinnings of early-emerging maladaptive behavior, indicating that different subtypes of IC are statistically related with externalizing, but not internalizing behavior problems. Overall, the small association of IC ability with behavior problems in non-clinical populations provokes broader questions about the role of IC in behavioral adjustment.