Improving accepting and giving compliments with individuals with developmental disabilities

Individuals with developmental disabilities, such as autism spectrum disorder, typically exhibit conversation skill deficits, with two prevailing deficits including giving and accepting compliments. The current study used an individualized approach to assess and teach accepting and giving compliments specific to performance, possession, and appearance with three adolescents and young adults with developmental disabilities. We taught these skills using behavioral skills training and prompting during conversations utilizing a multiple-baseline design across participants. We also observed generalization and treatment extension of the participants' skills in conversations with adults not associated with teaching and in the absence of any teaching procedures. The results support the efficacy of the procedures used toward improving giving and accepting compliments within the context of a conversation. We discuss considerations to improve the social acceptability of and refinements to the teaching procedures and acquired skills.     

Assessing indices of happiness and unhappiness in individuals with developmental disabilities: a review

The behavioral deficits of individuals with profound multiple disabilities (PMD) make it difficult to assess their satisfaction and quality of life. To address this problem, researchers have recently evaluated affective behavior (i.e., indices of happiness and unhappiness) to document the effects of therapeutic interventions and to assist with clinically relevant decisions. We review the recent literature on indices of happiness and unhappiness and discuss its major themes. In addition, potential concerns with this technology are discussed and clinical recommendations are provided. Copyright © 2007 John Wiley & Sons, Ltd.     

Regulatory and ethical principles in research involving children and individuals with developmental disabilities

Children and individuals with developmental disabilities (DD) compared to typical participants are disadvantaged not only by virtue of being vulnerable to risks inherent in research participation but also by the higher likelihood of exclusion from research altogether. Current regulatory and ethical guidelines although necessary for their protection do not sufficiently ensure fair distributive justice. Yet, in view of disproportionately higher burdens of co-occurring physical and mental disorders in individuals with DD, they are better positioned to benefit from research by equitable participation. Greater elucidation of this ethical dilemma is called for by researchers, institutional review boards, and funding agencies to urgently redress the imbalance. This article discusses many of the regulatory principles to ensure better research participation of children and individuals with DD: human rights, validity, distributive justice, beneficence/nonmaleficence, and autonomy.     

Placebo effects in developmental disabilities: implications for research and practice

Recent clinical trials of secretin in children with autism showed robust placebo effects and no benefit of secretin over placebo. This article explores the reasons for the observed placebo effects, focusing on the heightening of positive expectancy by media attention and by the sensory experiences associated with intravenous injections. Comparisons are drawn with research involving other novel treatments and other clinical populations of children with developmental disabilities and neurobehavioral disorders. Research regarding mechanisms of placebo effects is reviewed, including patient and clinician attributes, expectancy effects, participation effects, changes in caregiver behavior, and conditioning. New evidence regarding the biological basis of placebo effects is briefly presented. Since placebo effects are ubiquitous and may operate by a variety of mechanisms, research design is critical in designing clinical trials and in evaluating other outcomes research. Measurement issues important for research in developmental disabilities are emphasized. Ethical concerns have been raised regarding the use of placebo in clinical research, but current analysis suggests that placebo controls are necessary and defensible on ethical grounds, if certain conditions are met. The study of placebo effects ("placebology") holds great promise as a new area of research in therapeutics. The author's research in the potential augmentation of stimulant effects in children with attention deficit/hyperactivity disorder (ADHD) by adding placebo in open label is briefly presented. The placebo has always been integral to the practice of medicine, but advances in scientific medicine and medical ethics have diminished the role and use of placebo in practice. An innovative approach to the ethical use of placebo is proposed.     

Staff support strategies to increase the involvement of individuals with disabilities in meal preparation

In recent years, residential services for persons with disabilities have changed radically, reflecting a shift from custodial care to habilitation and community participation. This has resulted in a significant shift in the roles of direct-care staff. Improvement of staff performance is recognized as a major objective of agencies providing residential support to persons with disabilities. This study examined the gap between existing technologies of support and performance of direct-care staff, and focused on participation in an important activity of daily living, meal preparation. This study compared initial, baseline levels of participation to levels of involvement observed during three experimental intervention phases introduced sequentially within a multiple-baseline design: staff prompting by interventionists, staff self-management, and staff training. Increases from baseline levels of participation were observed for all five participating staff-resident dyads. High levels of variability were observed in some dyads and amounts of increase differed across dyads. Findings are explained in terms of dyad-specific information. A model of staff performance is presented along with implications for high-quality residential service.     

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.     

Functional analysis and treatment of low rate problem behavior in individuals with developmental disabilities

Extensive research has validated the standard functional analysis as a useful technology for identifying the function of problem behavior in individuals with developmental disabilities. The assessment of low rate problem behavior is one area that has yet to receive a significant amount of research. Some problem behaviors may occur at rates too low to be observed during a standard functional analysis, despite the fact that they may be highly destructive behaviors. The current study evaluated the effectiveness of initiating functional analysis sessions contingent on the occurrence of bursts of problem behavior for producing interpretable functional analysis results. While a standard functional analysis did not produce definitive results with respect to behavioral function, the ‘low rate’ functional analysis produced interpretable results for all three participants. Two of the three participants were available for the evaluation of treatments based on their functional analysis results. Function‐based treatments suppressed rates of problem behavior for both participants. Copyright © 2004 John Wiley & Sons, Ltd.     

Long‐term stability of edible preferences in individuals with developmental disabilities

Multiple stimulus without replacement (MSWO) preference assessments were used to examine the stability of preference hierarchies in eight individuals with developmental disabilities. In Study 1, preference assessments using edible items were conducted 6 months apart; in Study 2, assessments were conducted 12 months apart. As in previous studies analyzing preference stability, individual differences in stability were found in both studies. However, mean rank order coefficients across participants revealed interesting findings in both comparisons. Generally, preference for edible items, particularly the most and least preferred stimuli, was more stable across time than has been found in other research conducted with leisure items. Stability was greater when only 6 months lapsed between assessments. Moreover, for three of the eight participants, rank order coefficients were significant across both studies indicating the possibility that some individuals may tend toward more stable preferences. Copyright © 2007 John Wiley & Sons, Ltd.     

Assessing preferences of individuals with developmental disabilities using alternative stimulus modalities: A systematic review

The purpose of this systematic review was to identify investigations comparing the efficacy of alternative modality (e.g., pictorial, verbal, video) stimulus preference assessments for individuals with developmental disabilities. We identified articles by searching peer‐reviewed journals using the PsycINFO and ERIC databases, conducting table of contents searches of common behavioral outlets, and conducting ancestral searches of recent reviews and practitioner summaries of preference assessment methodology. A total of 32 articles met our inclusion criteria. These studies were then coded across a variety of features to gain a better understanding of the efficacy of alternative format preference assessments for individuals with developmental disabilities. In addition, we reviewed this literature for the use of prerequisite‐skill assessments and contingent‐reinforcer access to further investigate the relation between these variables and the accuracy of pictorial, verbal, and video preference assessments. A variety of methodological concerns are discussed as well as suggestions for future research.     

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.     

Functional analysis and treatment of low‐rate problem behavior in individuals with developmental disabilities

Extensive research has validated the standard functional analysis as a useful technology for identifying the function of problem behavior in individuals with developmental disabilities. The assessment of low‐rate problem behavior is one area that has yet to receive a significant amount of research. Some problem behaviors may occur at rates too low to be observed during a standard functional analysis, despite the fact that they may be highly destructive behaviors. The current study evaluated the effectiveness of initiating functional analysis sessions contingent on the occurrence of bursts of problem behavior for producing interpretable functional analysis results. While a standard functional analysis did not produce definitive results with respect to behavioral function, the ‘low‐rate’ functional analysis produced interpretable results for all three participants. Two of the three participants were available for the evaluation of treatments based on their functional analysis results. Function‐based treatments suppressed rates of problem behavior for both participants. Copyright © 2004 John Wiley & Sons, Ltd.     

Reducing the serious behavior problems of people with developmental disabilities living in the community

Trends and issues regarding the community-based support of people with developmental disabilities who exhibit severe behavior problems are discussed. Living in the community provides a unique framework within which behavior change programs are developed, implemented, and monitored. Support models for people with challenging behavior need to: (a) program for diversity across people, settings, and activities; (b) plan for high levels of integration in community settings among typical community members; and (c) meet guidelines regarding restrictions in intervention typologies. Increasingly, behavior analysts are conducting analog and in vivo assessments prior to intervening in order to develop an understanding of why behavior problems are occurring. Along with the increase in assessing the functions of behavior, is a greater attention to the contexts in which interventions are applied. The rearranging of contexts, communication training, choice-making, matching people's competence to their settings, the use of novelty, and proactive programing reflect these concerns.     

Contributions of positive behavior support amid lingering questions over its relationship with behavior analysis: A review of Positive behavior supports for adults with disabilities in employment,community, and residential settings by Storey and Post

Positive Behavior Supports for Adults with Disabilities in Employment, Community, and Residential Settings by Keith Storey and Michal Post (2019) presents valuable information for support providers and clinicians working with adults in inclusive settings who display challenging behavior. Numerous examples of challenging behavior encountered in such settings are provided along with a multitude of interventions for addressing the behavior in ways that comport with the values of positive behavior support (PBS). This review highlights contributions of the Storey and Post book and considers the content in regard to the controversial relationship between PBS and applied behavior analysis (ABA). The authors specify ABA as the foundation of PBS, but questions linger about the exact PBS–ABA relationship that will likely affect the book's ultimate contribution. Concern over the relationship is illustrated in regard to qualifications of behavioral professionals whom the authors often refer to as being necessary to help support providers develop and implement PBS interventions.     

Stress,coping, and resources in mothers of adults with developmental disabilities

This study examined the relationship of various stressors, coping resources, and coping strategies on the level of stress reported by 147 mothers of adults with delayed development. A sense of mastery and the mother's health as well as financial well-being were significantly negatively related to stress. Coping behaviours of reframing of the problem and acquisition of social support were also significantly negatively related to stress. Implications of the results of this study for service providers are discussed.