Further evaluation of response interruption and redirection as treatment for stereotypy

The effects of 2 forms of response interruption and redirection (RIRD)-motor RIRD and vocal RIRD-were examined with 4 boys with autism to evaluate further the effects of this intervention and its potential underlying mechanisms. In Experiment 1, the effects of motor RIRD and vocal RIRD on vocal stereotypy and appropriate vocalizations were compared for 2 participants. In Experiment 2, the effects of both RIRD procedures on both vocal and motor stereotypy and appropriate vocalizations were compared with 2 additional participants. Results suggested that RIRD was effective regardless of the procedural variation or topography of stereotypy and that vocal RIRD functioned as a punisher. This mechanism was further explored with 1 participant by manipulating the schedule of RIRD in Experiment 3. Results were consistent with the punishment interpretation.     

When do errors in reinforcer delivery affect learning? A parametric analysis of treatment integrity

Treatment integrity is the extent to which components of an intervention are implemented as intended (Gresham, 1989). Recent behavior-analytic literature has begun to evaluate the effects of reduced-treatment integrity on the efficacy and efficiency of skill-acquisition interventions. This study extended the current literature on the effects of errors of omission and commission of reinforcer delivery by replicating and extending Hirst and DiGennaro Reed (2015). Using a randomized-control group design, we compared undergraduate student participants' acquisition of conditional discriminations in a parametric analysis of different error values. A computer program erred in reinforcer delivery on 0%, 5%, 10%, 15%, 20%, 25% and 50% of trials. The purpose of the current study was to identify which levels of reduced integrity slowed or prevented acquisition. Our data replicated the findings of Hirst and DiGennaro Reed, and extended parametric analyses by identifying that errors in reinforcer delivery occurring on 15% or fewer trials (i.e., 85% integrity) were unlikely to prevent participants' responding from meeting the mastery criterion. These results could inform future research on how treatment-integrity errors change behavior-analytic procedures and the effects on skill acquisition for consumers of applied behavior analysis.     

Comparison of task interspersal ratios on efficiency of learning and problem behavior for children with autism spectrum disorder

The current study extends the literature on task interspersal (TI) by comparing the effects of four different TI ratios on the efficiency of skill acquisition and on levels of problem behavior in children with autism spectrum disorder and related disorders. The four ratios of TI were 3:1, 1:1, 1:3, and 0:1 mastered‐to‐acquisition tasks. An adapted alternating treatments design was implemented to compare the cumulative number of stimuli mastered, mean training time to mastery, rate of acquisition, and the level of problem behavior. The results showed that the 0:1 condition was the most efficient intervention procedure for all four participants. In addition, TI did not lead to a greater reduction in levels of problem behavior.     

Incorporating multiple secondary targets into learning trials for individuals with autism spectrum disorder

The current study examined the outcome of presenting multiple secondary targets in learning trials for individuals with autism spectrum disorder. We compared conditions in which (a) a secondary target was presented in the antecedent and consequence of trials, (b) two secondary targets were presented in the consequence of trials, (c) one secondary target was presented in the consequence of each trial, and (d) no additional targets were presented trials. The participants acquired the majority of secondary targets. Presenting one or multiple secondary targets per trial, regardless of the location of these secondary targets, increased the efficiency of instruction in comparison to a condition with no secondary target.     

Embedding an identity-matching task within a prompting hierarchy to facilitate acquisition of conditional discriminations in children with autism

Least-to-most prompting hierarchies (e.g., progressing from verbal to modeled to physical prompts until the target response occurs) may be ineffective when the prompts do not cue the individual to attend to the relevant stimulus dimensions. In such cases, emission of the target response persistently requires one or more of the higher level prompts, a condition called prompt dependence (Clark & Green, 2004). Reinforcement of differential observing responses (DORs) has sometimes been used to ensure that participants attend to the relevant stimulus dimensions in matching-to-sample (MTS) tasks (e.g., Dube & McIlvane, 1999). For 2 participants with autism, we embedded an identity-matching task within a prompting hierarchy as a DOR to increase the likelihood that the participants attended to and discriminated the relevant features of the comparison stimuli in an MTS task. This procedure was compared with a traditional least-to-most prompting hierarchy and a no-reinforcement control condition in a multielement design. Results for both participants indicated that mastery-level acquisition of spoken-word-to-picture relations occurred only under the identity-matching condition. Findings are discussed relative to the use of DORs to facilitate acquisition of conditional discriminations in persons with autism or other conditions who do not attend to the comparison stimuli.     

Reinforcement magnitude: an evaluation of preference and reinforcer efficacy

Consideration of reinforcer magnitude may be important for maximizing the efficacy of treatment for problem behavior. Nonetheless, relatively little is known about children's preferences for different magnitudes of social reinforcement or the extent to which preference is related to differences in reinforcer efficacy. The purpose of the current study was to evaluate the relations among reinforcer magnitude, preference, and efficacy by drawing on the procedures and results of basic experimentation in this area. Three children who engaged in problem behavior that was maintained by social positive reinforcement (attention, access to tangible items) participated. Results indicated that preference for different magnitudes of social reinforcement may predict reinforcer efficacy and that magnitude effects may be mediated by the schedule requirement.     

The effects of intertrial interval and instructional format on skill acquisition and maintenance for children with autism spectrum disorders

We replicated and extended the study by Koegel, Dunlap, and Dyer (1980) by examining the effects of 3 intertrial‐interval (ITI) durations on skill acquisition in 2 children with autism spectrum disorders. Specifically, we compared the effect of short (2 s), progressive (2 s to 20 s), and long (20 s) ITIs on participants’ mastery of tacts or intraverbals presented in massed‐trial and varied‐trial instructional formats. We also measured (a) stereotypic and problem behavior during the ITI, (b) maintenance of skills, and (c) responding to novel adults and settings. Results showed that short ITIs in a varied‐trial format produced the most efficient acquisition of skills; however, most ITI durations produced more efficient skill acquisition in a varied format compared to a massed format. The trial format and ITI duration associated with the lowest levels of stereotypic and problem behavior during the ITI and responding during maintenance and novel adult and setting probes differed across participants.     

Expansion of Genetic Services Utilizing a General Genetic Counseling Clinic

We established a general genetic counseling clinic (GCC) to help reduce long wait times for new patient appointments and to enhance services for a subset of patients. Genetic counselors, who are licensed in Tennessee, were the primary providers and MD geneticists served as medical advisors. This article describes the clinic referral sources, reasons for referral and patient dispositions following their GCC visit(s). We obtained patients by triaging referrals made to our medical genetics division. Over 24 months, our GCC provided timely visits for 321 patients, allowing the MD geneticists to focus on patients needing a clinical exam and/or complex medical management. Following their GCC visit(s), over 80 % of patients did not need additional appointments with an MD geneticist. The GCC allowed the genetic counselor to spend more time with patients than is possible in our traditional medical genetics clinic. Patient satisfaction surveys (n?=?30) were very positive overall concerning the care provided. Added benefits for the genetic counselors were increased professional responsibility, autonomy and visibility as health care providers. We conclude that genetic counselors are accepted as health care providers by patients and referring providers for a subset of clinical genetics cases. A GCC can expand genetic services, complement more traditional genetic clinic models and utilize the strengths of the genetic counselor health care provider.