|Stepping Outside of Our Comfort Zone: Behavior Analysts Addressing Anxiety and Other Mental Health Challenges in School and Community Settings|
|Monday, May 27, 2019|
|11:00 AM–11:50 AM |
|Swissôtel, Event Center Second Floor, Vevey 1/2|
|Area: CBM/AUT; Domain: Translational|
|Chair: Jesse (Woody) W. Johnson (Northern Illinois University)|
|CE Instructor: Jesse (Woody) W. Johnson, Ed.D.|
Historically, applied behavior analysts have focused on the development of interventions to address problematic behaviors that are easily defined and measured. As a result, many behavior analyst have avoided working with individuals with more complex mental health concerns such as anxiety. Mental health diagnoses involve private events and are therefore difficult to operationally define, observe, and measure. Unfortunately, non-behavioral practitioners often view aberrant behaviors in individuals with mental health diagnoses as symptoms of underlying constructs and use the diagnosis as the reason for these behaviors. As a result, these practitioners often propose more global treatments such as therapies or medications. On the other hand, behavior analysts view those behaviors as serving an environmental function that can be replaced with a more acceptable behavior serving the same function. The behavioral perspective also includes an analysis of motivating operations in the form of private events, physiological sensations, bio-behavioral states, psychological feelings, and covert tacts/mands and learning history with particular discriminative stimuli for reinforcement and punishment. The presenters in this symposium will describe tools and strategies for addressing mental health issues from a behavioral perspective.
|Instruction Level: Intermediate|
|Keyword(s): anxiety, biomarkers, mental health, wearable devices|
|Target Audience: |
BCBAs working in school and community settings
Overview of Wearable Biomarker Devices in Applied Behavior Analysis: Implications for Individuals Who Experience Significant Anxiety
|JESSE (WOODY) W. JOHNSON (Northern Illinois University), Toni R. Van Laarhoven (Northern Illinois University), Michael Ackerman (Indian Prairie School District ), Natalie Andzik (Northern Illinois University ), Maria Wheeler (Indian Prairie School District), Gretta Ward (Northern Illinois University), Heather Kerfoot (Northern Illinois University), Ann Robinson (Northern Illinois University)|
Up to 80% of children and youth with ASDs experience clinically significant anxiety (Leyfer, Folstein, Bacalmen, et al., 2006). Individuals with ASDs and comorbid anxiety are at increased risk for displaying externalizing behavior problems, social avoidance, and difficulties establishing/maintaining peer relationships across environments (Davis, Hess, Moree et al., 2011). A number of physiological markers associated with stress have been identified and often involve measurement of electrodermal activity (EDA)/skin conductance level or response (SCL and SCR), heart rate (HR), heart rate variability (HRV), blood pressure (BP), muscle tension, respiration/breathing patterns (Choi & Gutierrez-Osuna, 2009), and other measures such as Error-Related Brain Activity (ERN) (Rosen & Lerner, 2017), and cortisol (Moskowitz, Rosen, et al, 2017). Much of the research involving biomarkers conducted to date has been done by researchers in the medical field in lab settings with participants having various electrodes and wires attached to their bodies; however, many researchers are investigating the effectiveness of using wearable sensors that are unobtrusive and allow for measurement of physiological markers associated with stress over longer periods of time in naturalistic settings (Lakudzode & Rajbhoj, 2016; Moskowitz, Walsh, et al, 2017). New research is beginning to investigate the effectiveness or wearable biosensor devices to measure physiological indicators of stress and anxiety in naturalistic settings (Lakudzode & Rajbhoj, 2016). The purpose of this presentation is to describe a number of commercially available wearable technologies that have the capacity to measure physiological markers (biomarkers) associated with stress and anxiety. The presenters will provide an overview of current research on the use of wearable biomarker devices and discuss the implications for using these devices in applied settings.
Integrating Wearable Biomarker Devices Into Behavioral Assessment and Intervention
|TONI R. VAN LAARHOVEN (Northern Illinois University), Jesse (Woody) W. Johnson (Northern Illinois University), Lisa Liberty (Northern Illinois University ), Beth Collins (Northern Illinois University), Veronica Cornell (Northern Illinois University), Angie Lobdell (Northern Illinois University), NATASHA A RADNOVICH (Core Therapy, Inc), Jennifer Johnson (Northern Illinois University)|
Researchers suggest that anxiety-related concerns are among the most common presenting problems for children and adolescents with ASD (White, Oswald, Ollendick, & Scahill, 2009). Up to 80% of children with ASDs experience clinically significant anxiety (Leyfer, Folstein, Bacalmen, et al., 2006). Anxiety is a multi-component construct involving affective states (e.g., subjective fear), cognitions (e.g., thoughts, beliefs) behavioral patterns (avoidance), and associated physiological arousal (e.g., increased heart rate, changes in respiration patterns) (Moskowitz et. al 2017). Assessing anxiety in individuals with ASD and IDD is difficult due to communication deficits, difficulty distinguishing symptoms of anxiety from symptoms of ASD/IDD, and the idiosyncratic behavioral expression of anxiety in individuals with ASD/IDD (Hagopian & Jennett, 2008; While et al., 2009). Behavior analysts frequently rely on direct observation measures to quantify observable behaviors associated with anxiety, agitation, and/or stress for individuals with limited verbal skills (e.g., increased rocking, change in tone of vocalizations) while also attending to environmental variables associated with anxiety or stress. Although direct observation is effective for identifying behavioral manifestations of anxiety, this type of measurement may result in incomplete information as anxiety and stress are internal states that may not be accessible through direct observation. As a result, research on behavioral assessment and interventions for individuals with ASD/IDD has not adequately addressed the role of anxiety as a contributing factor in challenging behavior with these individuals. The purpose of this presentation is to describe how physiological information obtained from wearable devices can be used for behavioral assessment and the development of function-based interventions for anxiety-related challenging behavior. We will also provide case study examples to illustrate how these devices can be used to teach the individuals to self- regulate or use coping and/or relaxation strategies.
Treating Children With Complex Behavioral and Mental Health Concerns Across Settings
|KATHERINE SAGE (University of Wisconsin- Milwaukee)|
Complex cases of behavioral, medical, and social difficulties in adolescents can cause emotional distress for children, adolescents, and their families. Helping individuals to build an understanding of their internal emotional states as well as the motivating operations of their behaviors and emotions can decrease problem behaviors due to emotional distress. The presenter works with adolescents in both medical and school settings in a rural, impoverished area. Many of the individuals in this area lack the resources to seek mental health or behavioral services that are needed to address emotional and behavioral concerns. The presenter will describe how she bridged medical, school, and home settings using behavioral principles to address social skill deficits and anxiety in an adolescent presenting with school refusal and Autism-Spectrum Disorder related deficits.