Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.

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45th Annual Convention; Chicago, IL; 2019

Event Details

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Poster Session #285
Sunday, May 26, 2019
1:00 PM–3:00 PM
Hyatt Regency East, Exhibit Level, Riverside Exhibit Hall
Chair: Amy Murrell (University of North Texas)
97.

Staff Training to Reduce Over-Prompting for Activity Engagement in Adult Clients

Area: CBM; Domain: Service Delivery
SHAI MAOR (Pyles and Associates), Adrienne Mubarek (Pyles and Associates)
Discussant: Amy Murrell (University of North Texas)
Abstract:

This treatment evaluation was conducted to assess implementation of a prompting procedure which would be effective in decreasing the rate of prompts per minute with regards to activity engagement for an adult client. Assessments and direct observation were conducted to assess the most preferred reinforcer or reinforcing activity to increase independence in activity completion. Data were collected on staff’s total prompts per minute per session. During baseline, staff attempted to verbally prompt activity engagement (e.g., “it’s time to clean your room”) at a rate of about one prompt per minute. Direct support staff were then trained on specific prompting strategies that consisted of if/then statements as an antecedent and implementation of variable ratio (2 min) schedules of reinforcement. These were then implemented during sessions as a replacement for previous verbal prompting of task reminders only. Data during intervention shows a slight decrease in the rate of prompts per minute, showing an average of ½ a prompt per min (or 1 prompt every two minutes). The results of this treatment evaluation suggest that providing staff training on prompting strategies plus reinforcer delivery is effective at reducing rates of prompting per minute, while still maintaining client activity engagement.

 
98. A Look at Parental Stressors and Behavior Skills Training on Parents as an Indication of Adherence to Behavioral Health Therapies
Area: CBM; Domain: Applied Research
STEPHANIE BAKAZAN (Arizona State University), Donald M. Stenhoff (Arizona State University)
Discussant: Amy Murrell (University of North Texas)
Abstract: Researchers have reported that training parents to teach their children leads to increased communicative behavior, correct gross motor and vocal imitation, as well as increased maternal knowledge of autism, parent-child interactions and reduced maternal depression (Lafaskis & Sturmey, 2007; McConachie & Diggle, 2005). The current study had two goals. First, we wanted to identify parents’ competing contingencies and their application of behavior interventions in the home environment within a behavior health organization. The second goal was to increase parent adherence to the individualized therapy plan through implementing a parental behavior skills training (BST) package with a textual prompt. The BST package included the following four components: instruction, modeling, role-play and feedback. Two families with children receiving services from a behavior health organization participated in the study. Upon completion of baseline, each family underwent a BST session that included instruction, modeling, role-play and feedback. Following BST, an individualized, textual prompt was provided to each family to help adhere to the treatment plan when therapists were not in the home. Results of the study suggest that a BST package plus a textual prompt was effective in increasing parent adherence to a treatment plan. Future research should address the progress of the child following a parental BST package and how parent involvement can effect adherence to treatment plans.
 
99. Decreasing Caregiver Stress Through Concurrent Social Skills Curriculum
Area: CBM; Domain: Applied Research
JENNA MARIE RABE (Child Communication and Behavior Specialists), Courtney Chase (Child Communication and Behavior Specialists), Paige Marie Ritari (Child Communication and Behavior Specialists)
Discussant: Amy Murrell (University of North Texas)
Abstract: Studies have found caregiver stress levels for families with children diagnosed with Autism are consistently higher than that of caregivers of typically developing children. Research has shown reduction in caregiver stress through child participation in behavior analytic services. The current study looks to determine if child and caregiver participation in behavior analytic social skill group curriculum has a positive impact on self-reported caregiver stress levels. Participants were assigned to each condition based off age, adaptive level, and geographic location. Participants received either the Social Thinkers curriculum, The Accept Identify Move (AIM) curriculum, or the Acceptance and Commitment Theory (ACT) curriculum. Participants completed the curriculum within a group format with peers. Caregiver trainings occurred within a group format as well and provided caregivers with access to similar peers. Caregiver and child application of the curriculum outside of session was measured through caregiver data collection. The current study will compare self-reported caregiver stress levels using the Children’s Psychological Flexibility Questionnaire (CPFQ) and Parental Stress Scale. Baseline levels will be compared to scores at the end of the 4 month curriculum. The current study hopes to identify potential resources for caregiver stress reduction. Keywords: Social Skills, Parental Stress Levels, ACT, AIM
 
100.

Fear Hierarchies and Demand Fading: A Case Study of Feeding Therapy With an Adolescent

Area: CBM; Domain: Service Delivery
DANIELLE TARVER ALEXANDER ( Kennedy Krieger Institute)
Discussant: Amy Murrell (University of North Texas)
Abstract:

Behavioral treatment of children with feeding disorders has been widely documented; however the research of the treatment of adolescents with feeding difficulties is limited. This study focuses on Brandon, a 13-year-old boy with a history of anxiety symptoms and limited food variety, during his daily outpatient admission in a behavioral psychology feeding program to increase his food variety and decrease gagging in the presence of novel/non-preferred foods. Therapists worked with caregivers and Brandon to develop a list of target foods that Brandon would eat at age-appropriate portions, organized by least-to-most anxiety producing per Brandon’s report, while utilizing coping skills (e.g., deep breathing and muscle relaxation) and food strategies (e.g., alternating bites of non-preferred and preferred foods, taking small bites, and taking sips of water between bites). Brandon’s treatment package included demand fading procedures to decrease anxiety symptoms and gagging behaviors during meals. With exposure to the target foods, Brandon’s gagging decreased across sessions, and on average, resulted in lower levels of gagging during portion challenges. In addition to the five target foods that Brandon wanted to incorporate into his diet, he increased his food variety by 21 novel foods within his six week admission. The methods utilized in this study may be useful to practitioners to extend the behavioral treatment components to older children and adolescents with feeding disorders, and warrants further evaluation in future research.

 
101. Implications for the Use of Reversal Designs to Evaluate Treatments for Pediatric Feeding Disorders
Area: CBM; Domain: Applied Research
ASHLEY ANDERSEN (University of Nebraska Medical Center, Munroe-Meyer Institute), Kathryn M. Peterson (University of Nebraska Medical Center's Munroe-Meyer Institute), Bethany Hansen (Munroe Meyer Institute ), Jaime Crowley (University of Nebraska Medical Center), Cathleen C. Piazza (Munroe-Meyer Institute, University of Nebraska Medical Center)
Discussant: Amy Murrell (University of North Texas)
Abstract: Pediatric feeding disorders affect between 6 and 45% of typically developing children and 72% of children with Autism Spectrum Disorder, and may lead to learning, behavior, and health problems (Schreck, Williams, Smith, 2004; Volkert & Piazza, 2012). Fortunately, treatments involving escape extinction (EE) are highly effective and often necessary to treat feeding disorders (Volkert & Piazza, 2012). Escape extinction treatments are frequently evaluated using single-subject reversal designs in which a baseline phase (A1) is conducted first, followed by treatment with EE (B1), then the removal of EE (A2), and finally, reimplementing EE (B2) to demonstrate experimental control. In clinical practice, we often encounter problems with demonstrating functional control of the treatment when a child’s improved feeding behavior maintains after being exposed to the treatment in the absence of EE (A2). There are multiple explanations for this outcome including the robust treatment effects of EE, lack of discrimination across phases, and skill acquisition. In the current investigation, we will display our findings that illustrate this phenomenon and discuss explanations. We will also discuss directions for future research in demonstrating functional control during treatment and implications for generalization.
 
102.

Comparison of Therapist-Fed Versus Caregiver-Fed Functional Analysis Outcomes in Children With a Pediatric Feeding Disorder

Area: CBM; Domain: Applied Research
LAURA E PHIPPS (Munroe-Myer Institute, University of Nebraska Medical Center), Jaime Crowley (University of Nebraska Medical Center), Vivian F Ibanez (University of Florida), Caitlin A. Kirkwood (Center for Pediatric Behavioral Health, University of North Carolina Wilmington), Jason R. Zeleny (Munroe-Meyer Institute, University of Nebraska Medical Center), Kathryn M. Peterson (University of Nebraska Medical Center's Munroe-Meyer Institute), Cathleen C. Piazza (Munroe-Meyer Institute, University of Nebraska Medical Center)
Discussant: Amy Murrell (University of North Texas)
Abstract:

Previous research has demonstrated that therapist-fed functional analyses can be used to identify the environmental events that maintain inappropriate mealtime behavior of children with feeding disorders (Bachmeyer et al., 2009; Girolami & Scotti, 2001; Piazza et al., 2003) and has indicated the necessity of a matched, function-based treatment to achieve clinically acceptable levels of inappropriate mealtime behavior (Bachmeyer et al., 2009; Iwata et al., 1994; Smith et al. (1993). However, Ringdahl and Sellers (2000) demonstrated that results of functional analyses of problem behavior can vary across caregivers and therapists. If problem behavior is more prevalent during caregiver-conducted sessions, an evaluation of caregiver-fed versus therapist-fed functional analyses of inappropriate mealtime behavior is warranted. Our team previously analyzed functional analysis data for 5 participantsfrom an intensive feeding programand determined that in 78% of cases the function matched across caregiver and therapist. The current investigationextended thesefindings by evaluatingand comparingthe outcomes of a caregiver-versustherapist-fed functional analysisfor 5 additionalparticipants.Overall, we found that the functionsmatchedfor 88% of cases.Implications for function-based treatments and considerations for future research in the assessment and treatment of pediatric feeding disorders are discussed.

 
103. Using Structured Criteria for Visual Interpretation of the Functional Analysis of Inappropriate Mealtime Behaviors
Area: CBM; Domain: Applied Research
LISA GUERRERO (University of Nebraska Medical Center), Christopher W Engler (University of Nebraska Medical Center's Munroe-Meyer Institute), Alison Ruckstuhl (University of Nebraska Medical Center's Munroe-Meyer Institute), Bethany Hansen (Munroe Meyer Institute )
Discussant: Amy Murrell (University of North Texas)
Abstract: During the treatment of pediatric feeding disorders, one of the first steps is conducting a functional analysis (FA) to identify the environmental events maintaining inappropriate mealtime behaviors (IMB; Piazza et al., 2003). To analyze a FA, visual interpretation is traditionally used by board certified behavior analysts (BCBAs) despite criticism for its lack of standardized rules and subjectivity (Fisch, 1998). However, previous research in visual interpretation of FAs found using structured criteria provides a method to increase agreement between reviewers (Hagopian, Fisher, Thompson, Owen-DeSchryver, 1997; Roane, Fisher, Kelley, Mevers, & Bouxsein, 2013). This study applied the modified visual-inspection criteria developed by Roane and colleagues (2013) to interpret FAs of IMB. FA graphs for 154 children were collected and given to a panel of at least three BCBAs for traditional visual inspection. Once the panel identified the function, the modified visual-inspection criteria were applied to cross-check the function of IMB. The functions identified by both methods were compared for agreement. Results of this study indicate a high level of agreement between methods; however, future research is needed to further assess the utility, benefits, and drawbacks of each method of analysis.
 
104. Examining Establishing Operations and Meal Volume in an Intensive Treatment to Increase Self-Feeding
Area: CBM; Domain: Applied Research
HEATHER WHIPPLE (Kennedy Krieger Institute), Hailey Ormand (Johns Hopkins University)
Discussant: Amy Murrell (University of North Texas)
Abstract: Research is limited on treatment for typically-developing children with feeding difficulties. Additionally, most studies of self-feeding have focused on improving feeding skills rather than increasing compliance with mastered feeding tasks. Luiselli (2000) described a treatment comprised of cueing, demand fading, and differential reinforcement of alternative behavior (DRA) that increased self-feeding for a typically-developing young child with history of gastrostomy tube dependence. The current case study aimed to replicate and extend this literature within an intensive treatment model for a typically-developing 4-year-old male with a history of failure to thrive, gastroesophageal reflux, and severe food refusal. A changing criterion design with an embedded level system for access to preferred items was used to systematically increase self-feeding. Self-feeding responses increased but volume varied and administrative constraints began functioning as an abolishing operation. The child’s meal schedule was adjusted and success criteria were changed from number of bites to a volume-based goal in consideration of establishing operations and feasibility within the home setting. Follow-up data indicate the mastery criterion (i.e., ≥80% of meals in “green level”) was achiever over a 30-day period following discharge.
 
105.

A Comparison of Therapist-Fed and Caregiver-Fed Functional Analyses of Inappropriate Mealtime Behavior

Area: CBM; Domain: Applied Research
CONNOR SHEEHAN (University of North Carolina Wilmington; Center for Pediatric Behavioral Health), Melanie H. Bachmeyer (University of North Carolina Wilmington; Center of Pediatric Behavioral Health), Caitlin A. Kirkwood (Center for Pediatric Behavioral Health, University of North Carolina Wilmington), Jessica Keane (University of North Carolina Wilmington), Taylor Kristina Moseley (UNCW)
Discussant: Amy Murrell (University of North Texas)
Abstract:

Functional analyses are used to better understand the effects of environmental variables on inappropriate mealtime behavior when developing effective interventions for children with feeding disorders (Bachmeyer et al., 2009; Bachmeyer, et al., in press; Piazza et al., 2003). Trained therapists typically serve as feeders during functional analyses and provide previously observed caregiver-delivered consequences following inappropriate mealtime behavior. It is unclear if the same environmental variables would be identified as functions if a caregiver served as the feeder. Previous literature suggests that caregivers can be trained to implement pediatric feeding protocols, including a functional analysis of inappropriate mealtime behavior (Anderson & McMillian, 2001; Najdowski et al., 2008; Mueller et al., 2003). Caregiver-conducted functional analyses could be beneficial, as caregiver-delivered prompts and consequences better mimic the natural mealtime and potentially serve as discriminative stimuli within the mealtime context. We observed correspondence between identified functions for 7 of 8 therapist-fed versus caregiver-fed functional analyses. We discuss implications for creating and implementing function-based treatments.

 
106.

The Use of Variety Fading to Treat Food Selectivity

Area: CBM; Domain: Applied Research
ADDAM J WAWRZONEK (The Marcus Autism Center and Emory School of Medicine; Michigan State University ), Valerie M. Volkert (Marcus Autism Center and Emory School of Medicine), William G. Sharp (The Marcus Autism Center)
Discussant: Amy Murrell (University of North Texas)
Abstract:

Variety fading is an antecedent-intervention strategy based on the high-p instructional sequence which is used to increase bite acceptance in the treatment of pediatric feeding disorders. While initial studies have demonstrated its efficacy, only six studies have been published evaluating the components of the high-p instructional sequence in feeding. Additionally, previous studies have focused on bite acceptance, with limited data examining inappropriate mealtime behavior (IMB), such as pushing the spoon away or head turning. The present study is an evaluation of a clinical application of variety fading for children admitted to a day-treatment feeding program for food selectivity. The protocol implemented included the presentation of non-preferred food interspersed with empty spoon (or preferred food) presentations within five-bite sessions. As bite acceptance increased and IMBs decreased, we systematically interspersed additional non-preferred foods, with novel food probes between each phase change. Data indicated that acceptance increased and IMB decreased to low levels once all non-preferred foods were introduced, and remained at low levels during probes of novel foods. Results suggest variety fading may be useful to increase acceptance of nonpreferred food while minimizing bursts in IMB, but more research is needed for replication and to identify specific protocol elements related to efficacy.

 
 

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