A brief review of technology-based antecedent training procedures

This brief review summarizes recent research on technology-based antecedent staff training procedures, highlights key methodological components, and concludes with potential directions for future research.     

Back to sleep: Teaching adults to arrange safe infant sleep environments

There are over 3,000 sleep related infant deaths each year in the United States. Attempts to teach medical personnel and parents safe infant sleep practices in the infant sleep training literature have demonstrated mixed results. Thus, strategies to teach arrangements of safe infant sleep environments warrant further investigation. Behavioral skills training (BST) is an evidence-based teaching strategy shown to successfully teach various safety skills to children and adults. The current study evaluated the effectiveness of behavioral skills training to teach safe infant sleep practices to typically developing adults. Specifically, differential responding was assessed across multiple environmental arrangements typical of contexts parents may be exposed to when putting an infant to sleep. BST significantly improved appropriate arrangement of a safe sleep environment for infants for all 8 participants.     

A comparison of isolated and synthesized contingencies in functional analyses

Recently, researchers have compared the utility of isolated versus synthesized contingencies in functional analysis (FA) methodology (e.g., Fisher et al., 2016; Slaton et al., 2017). A limitation of these studies is that there were other differences across FA methodologies (e.g., design, contingency) that did not allow for isolation of the influence of isolated versus synthesized contingencies. Therefore, the current study compared outcomes of FAs that involved isolated versus synthesized contingencies for problem behavior of 5 children while controlling for these other differences across FAs (Experiment 1). Next, the current study compared the effects of interventions based on the functions identified in the isolated and synthesized contingencies for each participant (Experiment 2). Results indicated isolated contingency FAs produced differentiated responding for 1 or both functions for all 5 participants, and there were little to no differences between treatments informed by isolated and synthesized contingency FAs.     

Providing noncontingent,alternative, functional reinforcers during delays following functional communication training

Functional Communication Training (FCT) involves arranging extinction for problem behavior and reinforcement for a more desirable, functionally equivalent, communicative response (FCR). Although effective under ideal arrangements, the introduction of delays to reinforcement following the FCR can result in increased problem behavior. Austin and Tiger (2015) showed that for individuals whose problem behavior was sensitive to multiple sources of reinforcement, providing access to alternative, functional reinforcers during delays mitigated this increase in problem behavior during delay fading. The current study replicated the procedures of Austin and Tiger with 2 individuals displaying multiply controlled problem behavior. Providing alternative functional reinforcers reduced problem behavior during 10-min delays for both participants without requiring delay fading.     

Utilizing in-vivo feedback for caregiver training of pediatric feeding protocols

Researchers have used multicomponent behavioral skills training packages including written and verbal instructions, modeling, rehearsal, and feedback when teaching caregivers to implement pediatric feeding treatment protocols (e.g., Anderson & McMillan, 2001; Seiverling et al., 2012). Some investigators have shown that fewer behavioral skills training components may be necessary for effective training (e.g., Mueller et al., 2003; Pangborn et al., 2013). We examined the use of in-vivo feedback following written instructions to train caregivers to implement pediatric feeding treatment protocols using a multiple baseline design across 3 caregiver dyads. Correct implementation of the feeding treatment procedures was low during baseline (written instructions only), increased with only the addition of in-vivo feedback, and remained high during follow-up sessions for all caregivers. Results are discussed in terms of clinical implications and caregiver satisfaction.     

An evaluation of parents as behavior change agents in the Preschool Life Skills program

Parental involvement in intervention can support intervention efficacy, improve generalization, and increase accessibility. The Preschool Life Skills (PLS) program is designed to teach 13 preschool life skills and prevent problem behavior. The current study explores the utility of the PLS program as delivered by parents. In Experiment 1, 6 parents were taught to use the PLS program at home with their typically developing children (3 years 3 months to 4 years 11 months). This application of the PLS program led to an increase in preschool life skills and a decrease in problem behavior and supported some generalization of the target preschool life skills from the home to preschool settings. In Experiment 2, 7 parents were taught to use the PLS program with their children with autism spectrum disorder (ASD; 3 years 11 months to 6 years 9 months). Results overall supported the parent implementation of the program and highlighted modifications required to support positive outcomes for children with ASD.     

A preliminary evaluation of treatment duration on the resurgence of destructive behavior

Quantitative models of resurgence (e.g., Behavioral Momentum Theory, Resurgence as Choice) suggest that resurgence is partly a function of the duration of extinction exposure, with longer histories of extinction producing less resurgence. This prediction is supported by some laboratory research and has been partially supported by clinical translations that did not isolate the effects of extinction exposure prior to testing for resurgence. The degree to which different histories of extinction impact the likelihood of treatment relapse in therapeutic applications of differential reinforcement is of great interest to the clinical community, including insurance carriers and other financial providers. In the present study, we isolated the effects of extinction history for severe destructive behavior across 6 participants referred for treatment services and examined resurgence of destructive behavior when alternative reinforcement terminated. Our within-subject evaluation showed no difference in the level of resurgence or persistence of destructive behavior following short and long exposures to differential reinforcement with extinction. We discuss our failure to replicate in relation to experimental-design considerations for investigating this and other relapse phenomena in future research with clinical populations.     

Relative effects of breastfeeding intention and practice on maternal responsiveness

Our objective was to examine the differential effects of antenatal breastfeeding intention (BI) and breastfeeding practice (BP) on maternal postnatal responsiveness. We conducted a secondary analysis of longitudinal data from a subsample of 962 mother–infant dyads from a U.K.-based birth cohort study the Avon Longitudinal Study of Parents and Children. Exposures were BI and BPs measured at 32 weeks of gestation and 18 months’ postpartum. The outcome was maternal responsiveness assessed at 12 months’ postpartum. We used logistic regression analyses unadjusted and adjusted for confounders. Intention to breastfeed was associated with increased odds of postnatal maternal responsiveness independent of BP, adjusted odds ratio (OR) = 2.34, 95% CI [1.42, 3.86]. There was no evidence that BP was an independent predictor of maternal responsiveness, OR = 0.93, 95% CI [0.55, 1.57]. Life-course epidemiology analyses demonstrated that maternal responsiveness is most positive when both BI and BP are present. This is the first population-based study to provide evidence that BI during pregnancy is more strongly associated with maternal postnatal responsiveness than is BP. Further research is needed to understand the determinants of BI in pregnancy and its relationships with maternal responsiveness.     

Assessing the impact of a family nurse-led intervention on young mothers’ references to internal states

A mother's propensity to refer to internal states during mother–child interactions is important for her child's developing social understanding. However, adolescent mothers are less likely to reference internal states when interacting with their children. We investigated whether young mothers’ references to internal states are promoted by the Family Nurse Partnership (FNP) intervention, an intensive home-visiting programme designed to support adolescent mothers in England. We also investigated family, maternal, and child factors associated with young mothers’ references to inner states during interactions with their children. Adolescent mothers (n = 483, aged ≤ 19 years when recruited in pregnancy) and their children participated in an observational substudy of a randomized controlled trial investigating the impact of FNP compared to usual care. Mother–child dyads were video-recorded during free play, and mothers’ speech was coded for use of internal state language (references to cognitions, desires, emotions, intentions, preferences, physiology, and perception). We found no differences in mothers’ use of internal state language between the FNP and usual care groups. A sample-wide investigation identified that other features of mothers’ language and relationship status with the child's father were associated with internal state language use. Findings are discussed with reference to targeted interventions and implications for future research.