‘A kaleidoscope of themes’: intensive psychotherapy with a girl on the autistic spectrum

This paper is an account of the intensive psychotherapy of a young girl on the autistic spectrum. It describes her confusing presentation and how this suggested a tendency to oscillate between mainly unintegrated states of mind. Important themes that emerged included the phantasy of inhabiting a claustrum; the use of adhesive identification to defend against the bodily felt terror of separation; and fear of damage to the maternal object. The paper also discusses the trans-generational aspects of her difficulties and considers how her therapy helped growth to take place.     

TEACHING FUNCTIONAL COMMUNITY SKILLS TO AUTISTIC CHILDREN USING NONHANDICAPPED PEER TUTORS

In this study, two autistic children were paired with normal peers who, after pretraining sessions, taught community skills to the autistic children. Data were collected during three conditions: baseline, modeling, and peer tutoring. Results demonstrated that no identified skills were acquired during the baseline and modeling conditions. However, direct instruction of each child by a peer tutor resulted in the learning and maintenance of functional community skills.     

PROMOTING AUTISTIC CHILDREN'S PEER INTERACTION IN AN INTEGRATED EARLY CHILDHOOD SETTING USING AFFECTION ACTIVITIES

Group affection activities were used to increase the interaction of three autistic children with their nonhandicapped peers in an integrated early childhood setting. Peer interaction increased during free play when the affection activities were conducted, but not when similar activities without the affection component were used. This interaction included initiations by both the autistic and nonhandicapped children, with reciprocal interactions occurring more frequently with nonhandicapped peers who had participated in the affection activities.     

THE TRAINING AND GENERALIZATION OF SOCIAL INTERACTION SKILLS WITH AUTISTIC YOUTH

Two experiments were conducted to increase the initiations and duration of social interactions between autistic and nonhandicapped youths. Experiment 1 taught two autistic youths to initiate and elaborate social interactions with three age-appropriate and commonly used leisure objects; a radio, a video game, and gum. The students were first taught to use the objects and subsequently instructed in the related social skills. The youths generalized these social responses to other nonhandicapped peers in the same leisure setting. A second experiment trained a third autistic youth to emit similar social leisure skills. The use of the leisure objects and the related social skills were taught at the same time. The autistic youth learned these skills and generalized them to other handicapped peers in the same leisure setting. The importance of teaching generalized social responding in particular subenvironments was emphasized.     

SENSORY EXTINCTION AND SENSORY REINFORCEMENT PRINCIPLES FOR PROGRAMMING MULTIPLE ADAPTIVE BEHAVIOR CHANGE

The role of sensory reinforcement was examined in programming multiple treatment gains in self-stimulation and spontaneous play for developmentally disabled children. Two phases were planned. First, we attempted to identify reinforcers maintaining self-stimulation. Sensory Extinction procedures were implemented in which auditory, proprioceptive, or visual sensory consequences of self-stimulatory behavior were systematically removed and reintroduced in a reversal design. When self-stimulation was decreased or eliminated as a result of removing one of these sensory consequences, the functional sensory consequence was designated as a child's preferred sensory reinforcer. In Phase 2, we assessed whether children would play selectively with toys producing the preferred kind of sensory stimulation. The results showed the following. (1) Self-stimulatory behavior was found to be maintained by sensory reinforcement. When the sensory reinforcer was removed, self-stimulation extinguished. (2) The sensory reinforcers identified for self-stimulatory behavior also served as reinforcers for new, appropriate toy play. (3) The multiple treatment gains observed appeared to be relatively durable in the absence of external reinforcers for play or restraints on self-stimulation. These results illustrate one instance in which multiple behavior change may be programmed in a predictable, lawful fashion by using “natural communities of sensory reinforcement.”     

GENERALIZATION BY AUTISTIC-TYPE CHILDREN OF VERBAL RESPONSES ACROSS SETTINGS

Generalization of verbal behavior by autistic-type children across physically different settings was assessed. Four boys learned responses to common questions in two settings at school and were probed to determine transfer of learning to home. Three of the children demonstrated little generalization to home when trained in a cubicle. Greater generalization was indicated when they received training at varied locations. The fourth child generalized most responses to his home regardless of training setting. Simple manipulations of the school environment to more closely simulate home conditions may facilitate transfer of training to the natural environment.     

EFFECTS OF A PROCEDURE DERIVED FROM THE OVERCORRECTION PRINCIPLE ON MANIPULATED AND NONMANIPULATED BEHAVIORS

Positive practice overcorrection has been shown to be effective in reducing stereotypic self-stimulatory behaviors displayed by retarded and autistic individuals. In addition, the procedure also may increase the occurrence of appropriate behavior through intensive practice. In the present study, several stereotypic and one appropriate behavior (appropriate toy play) displayed by two autistic children were measured before and during treatment by a positive practice in appropriate toy play overcorrection procedure. Overcorrection was introduced for each of the targeted inappropriate behaviors in succession for both children. Results showed that overcorrection reduced all stereotypic behaviors displayed by both children. In addition, one subject displayed marked increases in the behavior practised during overcorrection, appropriate toy play, relative to its baseline rate of occurrence. The results indicate that for some individuals, overcorrection may be effective in teaching and motivating appropriate forms of behavior as well as in reducing stereotypy.     

SOME DETERMINANTS OF THE REINFORCING AND PUNISHING EFFECTS OF TIMEOUT1

Some determinants of the reinforcing and punishing properties of timeout were investigated in two experiments. Experiment I began as an attempt to reduce the frequency of tantrums in a 6-yr-old autistic girl by using timeout. Unexpectedly, the result was a substantial increase in the frequency of tantrums. Using a reversal design, subsequent manipulations showed that the opportunity to engage in self-stimulatory behavior during the timeout period was largely responsible for the increase in tantrums. Experiment II was initiated following the failure of timeout to reduce the spitting and self-injurious behavior of a 16-yr-old retarded boy. Using a multiple-baseline design, the nature of the timein environment was shown to be an important determinant of the effects of timeout. When the timein environment was “enriched”, timeout was effective as a punisher. A conception of timeout in terms of the relative reinforcing properties of timein and timeout and their clinical implications are discussed.     

RESEARCH ON THE DIFFERENCE BETWEEN GENERALIZATION AND MAINTENANCE IN EXTRA-THERAPY RESPONDING1

Many authors have reported that the development of programs for producing durable extra-therapy responding lags behind the development of programs for producing initial behavior change. In Experiment I, responding was recorded continuously in both the therapy and extra-therapy settings. The results showed that one child did not generalize to the extra-therapy setting, but that other children did. However, for the children who generalized, extra-therapy responding was not maintained. Therefore, in Experiment II two variables affecting the durability of extra-therapy responding were assessed and found to be influential: (a) the use of partial reinforcement schedules in the original treatment environment; and (b) the presence of noncontingent reinforcers in the extra-therapy environment. The results suggest that there are two distinct parameters of extra-therapy responding: generalization and maintenance. A technology for producing durable extra-therapy responding is discussed in terms of different treatment procedures required for different deficits in extra-therapy responding.     

THE DEVELOPMENT AND FUNCTIONAL CONTROL OF READING-COMPREHENSION BEHAVIOR1

Reading comprehension, indicated by motor behavior and multiple-choice picture selection called for in written instructions, was taught to an autistic child using verbal prompts, modelling, and physical guidance. The child was rewarded for correct behaviors to training items; nonrewarded probes were used to assess generalization. Probable maintaining events were assessed through their sequential removal in a reversal design. Results showed: (a) following acquisition, performance was maintained at a near-100% level when candy, praise, attention, and training were removed, (b) absence of other persons was correlated with a marked decrease in performance, whereas their presence was associated with performance at near 100%, and (c) performance generalized to probes and across experimenters. Rewards, which may have been reinforcing during acquisition, did not appear necessary to maintain later performance. Instead, presence of others (a setting event) was demonstrated to have control over maintained performance.