Association for Behavior Analysis International

One of the primary goals of applied research is to identify efficacious treatments for problem behavior that relevant caregivers can implement in relevant settings. In this symposium, we will review efficacious strategies for treating problem behavior and specific methods that will assist in training caregivers on the implementation of those strategies. First, an assessment and treatment model for treating feeding problems in the home setting will be reviewed in which caregivers were involved from the initial assessment through a 12-month follow-up. Next, we will review a skill-based treatment for food selectivity in an adolescent diagnosed with autism who engages in problem behavior, without evoking problem behavior throughout the teaching process. Then, an efficacious training program will be reviewed in which parents were taught to implement a comprehensive treatment for socially mediated problem behavior with their child. Finally, the utility of a training rubric will be reviewed as a tool for successfully transferring skill-based treatments to parents and caregivers in the treatment of socially mediated problem behavior.

Graduate students, practitioners, researchers

Multiple reviews focusing on the treatment of severe feeding disorders have recommended an increased focus on caregiver implementation, and nutritional and social outcomes. However, research continues to concentrate on the analysis of specific treatment procedures implemented by trained therapists during treatment admission. In this study, a home-based behavioural assessment and treatment model was evaluated for nine children with tube dependency. Caregivers informed assessment conditions, participated during experimenter-led sessions, and then received sequential phases of training to implement treatment protocols. We monitored caregiver implementation until the child's treatment goal was achieved (tube feeding cessation), then during follow-up visits conducted up to 12 months following the study. By the final follow-up, six of nine children had ceased tube feeding. We discuss the impact of caregiver participation on child performance, training requirements, and procedural integrity. In addition, we highlight barriers to longer-term adherence and recommendations for future research.

Between 67 and 89% of individuals with developmental disabilities have feeding problems (Silbaugh et al., 2016). This study describes a skill-based treatment to address food selectivity in children with autism who engage in problem behavior. An assessment was conducted with the participant's caregivers to identify foods to use in a preference analysis and to identify possible reinforcement contingencies influencing food refusal. Results were used to design a functional analysis of refusal. The reinforcement contingency shown to influence refusal in the analysis was then arranged to strengthen more appropriate food refusal behaviors. A contingency-based delay fading procedure was used to thin the schedule of reinforcement for appropriate refusal while suppressing inappropriate refusal and problem behavior and increasing mealtime requirements prior to reinforcement. By the end of this study, the participant consumed small meals consisting of multiple bites of a variety of foods that he did not eat previously, but that caregivers had reported wanting him to eat. Treatment was extended to caregivers in relevant environments. Interobserver agreement averaged 92% (range, 85% to 100%) for all variables measured. The results of this study suggest that these procedures may be useful for treating food selectivity without evoking problem behavior in children with autism.