|Advances in the Assessment and Treatment of Repetitive and Ritualistic Behavior in Individuals With Autism and Related Disorders
|Sunday, May 28, 2017
|3:00 PM–4:50 PM
|Convention Center Mile High Ballroom 4C/D
|Area: AUT; Domain: Applied Research
|Chair: Amber R. Paden (Munroe-Meyer Institute, University of Nebraska Medical Center)
|Discussant: Timothy R. Vollmer (University of Florida)
|CE Instructor: Amber R. Paden, M.S.
Almost all children with autism spectrum disorder (ASD) exhibit restricted or repetitive behaviors or resistance to change. These restricted or repetitive behaviors can range from stereotyped vocalizations to repetitive motor movements. Resistance to change can present as rigidity with routines, resistance to new or novel items or activities, or food selectivity. Repetitive and restricted response can lead to corollary problems such as behavior problems, learning difficulties, inadequate dietary intake, or health issues. As such, the development of effective procedures for assessing and treating restricted and repetitive behaviors represents a critical need. The research presented in this symposium will explore (a) the temporal nature of repetitive behavior in individuals with ASD, (b) decreasing resistance to change using free and forced-choice conditions, (c) the relative effectiveness of behavioral versus sensory-based interventions for food selectivity, and (d) the treatment of repetitive behavior using response interruption and redirection.
|Instruction Level: Intermediate
|Keyword(s): food selectivity, repetitive behavior, RIRD, ritualistic behavior
|Combining Free- and Forced-Choice Procedures to Decrease Resistance to Change
|JESSICA NIEMEIER (UNMC Munroe- Meyer Institute), Wayne W. Fisher (Munroe-Meyer Institute, University of Nebraska Medical Center), Jennifer Felber (Summit Educational Resources), Amber R. Paden (Munroe-Meyer Institute, University of Nebraska Medical Center)
|Abstract: A core symptom of autism is called “resistance to change” (Kanner, 1943; e.g., insisting on wearing the same shirt every day, refusing all non-white foods). In this study we used differential reinforcement and a forced-choice procedure to shift responding towards “acceptance of change” with three boys with various forms of resistance to change. During a free-choice baseline, we allowed each participant to choose between an established pattern of behavior (i.e., resistant behavior) and a new pattern of behavior (i.e., change behavior), and we delivered reinforcement for making a clear choice independent of which response pattern the participant selected. During differential reinforcement, we delivered a highly preferred item only if the participant chose the new response pattern. During forced-choice choice procedure, we prompted the participant to choose the new response pattern (i.e., escape extinction) and provided reinforcement following the forced choice. Results showed that all participants learned to independently select the new response pattern when the force-choice procedure remained in effect. In addition, after exposure to the force-choice procedure, two participants showed strong maintenance effects when we reintroduced differential reinforcement (without the forced-choice procedure). We discuss these finding relative to effects of differential reinforcement and escape extinction on resistance to change.
Decreasing Resistance to Change During Feeding for Children with an Autism Spectrum Disorder
|VIVIAN F IBANEZ (Munroe-Meyer Institute, University of Nebraska Medical Center), Kate M. Peterson (University of Nebraska Medical Center), Cathleen C. Piazza (Munroe-Meyer Institute, University of Nebraska Medical Center), Caitlin A. Kirkwood (University of Nebraska Medical Center/ MMI), Jaime Crowley (Munroe-Meyer Institute, University of Nebraska Medical Center), holly ney (University of Nebraska Medical Center; University of Nebraska Omaha), Trisha Franklin (Munroe-Meyer Institute, University of Nebraska Medical Center), Christopher W Engler (University of Nebraska Medical Center's Munroe-Meyer Institute)
Many children with autism spectrum disorder (ASD) have feeding difficulties, namely food selectivity (i.e., consumption of a limited variety of foods by type or texture). Food selectivity in children with ASD could be conceptualized as one form of higher level, restrictive behavior (Boyd et al., 2012; Turner, 1999) in that these children exhibit rigid mealtime routines, resist novel foods, and only consume foods according to specific types, textures, or under specific mealtime conditions (Schreck, Williams, & Smith, 2004). Food selectivity inevitably leads to inadequate dietary intake, which is associated with learning and behavior problems. If left untreated, children with food selectivity also may suffer from health problems, such as constipation or Type II diabetes. Currently, treatments for pediatric feeding disorders based on ABA research have the most empirical support (Volkert & Piazza, 2012). However, there are not as many studies demonstrating the effectiveness of ABA in the treatment of food selectivity in children with ASD. In the current study, we implemented stimulus fading with differential reinforcement, in the absence of escape extinction, to increase acceptance of novel foods for one participant with ASD thus far.
The Role of Response Requirement and Toy Removal on the Effectiveness of RIRD for the Treatment of Vocal Stereotypy in Children With Autism
|OZLEM TOPER KORKMAZ (UludaÄŸ Üniversitesi), Dorothea C. Lerman (University of Houston-Clear Lake), Loukia Tsami (University of Houston, Clear Lake)
Numerous studies have demonstrated the efficacy of response interruption and redirection (RIRD) for reducing vocal stereotypy and increasing appropriate speech in children with autism. However, the procedure is relatively time-consuming to implement. Results of one prior study (Saini, Gregory, Uran & Fantetti, 2015) suggested that an abbreviated variation of RIRD (requiring one response) was just as effective as a commonly used variation of RIRD (requiring three responses), but further research is needed. In addition, no studies have evaluated the role of toy removal on the efficacy of RIRD even though this procedural component is frequently included in treatment with RIRD. In this study, we examined the separate and combined effects of RIRD and brief contingent toy removal when the child was required to respond to one vocal instruction versus three vocal instructions. Three children, aged 4 to 6 years and diagnosed with autism, participated. Results indicated that one-demand RIRD was as effective as three-demand RIRD for all participants. Furthermore, removing toys during RIRD implementation increased the effectiveness of treatment for two of the three participants.
Distribution of Repetitive Behavior Across Time in Individuals With Autism Spectrum Disorder
|KARLA ZABALA (University of Georgia), Kara L. Wunderlich (University of Georgia), Jorge A. Ruiz (Universidad Nacional Autonoma de Mexico)
Recent research has focused on ways to better classify automatically reinforced behavior; however, no research to date has evaluated the temporal nature of repetitive behavior in individuals with autism spectrum disorder (ASD). Repetitive behavior varies in its topography and instances of when it occurs. Some repetitive behavior might occur in time periods categorized by frequent responding with little time between each response (defined here as a bout of responding), followed by a pause or break in responding, after which a new bout begins. Determining whether or not repetitive behavior occurs in bouts prior to intervention may impact the type of intervention utilized during treatment of these behaviors, specifically by modifying interventions to have an effect on the overall occurrence of these repetitive behaviors. The purpose of this study was to identify whether repetitive behavior of children diagnosed with ASD occurred in bouts or was randomly distributed across time. Models of behavior used in EAB research (e.g., log survivorship curves) were applied for observations of repetitive behavior for several individuals, and results indicate that whether behavior occurs in bouts is idiosyncratic. Implications for future research and intervention efficacy will be discussed.