|Approaches to Assessment and Treatment of Unique Presenting Concerns in Clinical Settings|
|Saturday, May 23, 2020|
|11:00 AM–12:50 PM |
|Area: AUT; Domain: Translational|
|Chair: Chathuri Illapperuma (University of Nebraska-Medical Center; Munroe Meyer Institute; Center for Autism Spectrum Disorders)|
|Discussant: Tracy L. Kettering (Bancroft)|
|CE Instructor: Tracy L. Kettering, Ph.D.|
In this symposium we provide a discussion of unique presenting concerns and clinical evaluations in clinic settings. The first two papers address schedule thinning considerations functional communication training (FCT). The study by Smith and colleagues evaluates a comparison of a compound schedules of reinforcement involving discriminative stimuli (e.g., multiple or chained schedules, Greer et al., 2016) or within the context of probabilistic, progressive-delay schedules (e.g., contingency-based progressive-delay schedule, Ghaemmaghami et al., 2016) and the relative efficacy of these two methods during schedule thinning for individuals with severe challenging behavior. Similarly, the study by Salvatore and colleagues investigates the efficiency and preference for alternative activities during schedule thinning within FCT. Garcia and Wunderlich extend the work of Edgerton and Wine (2017) by using a function-based treatment to increase appropriate voice volume responses. Last, another unique study by Weber and colleagues implemented an adaptation of the Good Behavior Game with a sibling dyad to decrease destructive behavior. Dr. Tracy Kettering will provide comments on navigating challenges presented by adaptations of assessment and treatment to address unique cases in a clinical setting.
|Target Audience: |
Behavioral specialists Graduate Students Practitioners
|Learning Objectives: 1. Attendees will be able to distinguish between chained, multiple, and probabilistic thinning schedules. 2. Attendees will be able to identify unique presenting functions and function- based treatment for voice-volume behaviors. 3. Attendees will be able to identify adaptations of the Good Behavior Game to decrease destructive behaviors in a sibling dyad.|
|A Comparative Analysis of Procedures to Teach Delay Tolerance|
|Katherine Brown (Utah State University), Reagan Gaynor (University of Nebraska Omaha), Amanda Zangrillo (University of Nebraska Medical Center, Munroe-Meyer Institute), SEAN SMITH (University of Nebraska Medical Center)|
|Abstract: Reinforcement schedule thinning, or delay tolerance training, is necessary to make functional communication training (FCT) an effective treatment in naturalistic contexts (Hagopian, Boelter, & Jarmolowicz, 2011). Delay tolerance training is often implemented within the context of a compound schedule of reinforcement involving discriminative stimuli (e.g., multiple or chained schedules, Greer et al., 2016) or within the context of a probabilistic, progressive-delay schedule (e.g., contingency-based progressive-delay schedule, Ghaemmaghami et al., 2016). The purpose of this experiment was to evaluate the relative efficacy of these two methods of delay tolerance training procedures for three individuals referred to a clinic for the assessment and treatment of destructive behavior. First, we conducted a functional analysis and successfully implemented FCT. Next, we conducted a comparative analysis of compound schedules and probabilistic, progressive-delay schedules for teaching delay tolerance within an alternating treatments design. The results showed that the rates of destructive behavior did not differ significantly across the two delay tolerance strategies, however, maintenance of correct FCRs was better in the compound schedule condition for two participants. Results will be discussed in terms of the duration of exposure to establishing operations maintaining destructive behavior and the potential limiting conditions of each strategy.|
Efficiency and Preference for Alternative Activities During Schedule Thinning With Functional Communication Training
|GIOVANNA SALVATORE (Rowan University), Christina Simmons (Rowan University), Kimberly Ford (Rowan University)|
Functional communication training (FCT) is an effective treatment for decreasing socially-reinforced destructive behavior (Carr & Durand, 1985). Multiple schedules are frequently used to thin the reinforcement schedule during FCT (Hanley et al., 2001). An extinction burst is possible with each schedule thinning step, contributing to slow treatment progress. In clinical practice, individuals are often expected to sit and wait during periods of restricted access to functional reinforcers; however, in the natural environment, they generally do not wait without alternative items/activities available. Ten children referred for treatment of destructive behavior participated in this study. Therapists conducted functional analyses and taught participants a functional communication response to access functional reinforcers. Therapists implemented a multiple schedule during schedule thinning, comparing a control condition (nothing available during S-delta intervals) to separate conditions with embedded items/activities during S-delta intervals (moderately preferred tangible items, attention, demands). After reaching the terminal schedule in at least one condition, therapists assessed participant preference across S-delta conditions. For 80% of participants, the terminal schedule was only reached with alternative items/activities. All participants demonstrated preference for alternative items/activities and therapists indicated preference for conducting these sessions. For 6 participants, we simultaneously targeted an escape function during the S-delta condition including demands.
An Experimental Analysis of Voice Volume for Children With Autism Spectrum Disorder
|ARTURO GARCIA (Rollins College), Kara L. Wunderlich (Rollins College)|
Inappropriate prosodic production is often observed, but rarely treated, communication skill deficit for individuals with autism. Few studies have evaluated the acoustic characteristics of prosody in children with ASD, and obtaining a pragmatic measurement of their conversational skills is typically limited to parent and teacher report measures. In one exception in the research, a previous study by Edgerton and Wine (2017) implemented an intervention for shaping the conversational speech volume of an intellectually disabled participant. Expanding on the previous literature, we conducted a functional analysis of the voice volume responses (VVR) of two children with ASD utilizing similar procedures to those from Edgerton and Wine. Further, we evaluated the efficacy of using a function-based treatment, in conjunction with the visual feedback from the app, to increase appropriate VVR. Results of the evaluation, as well as implications for the treatment of inappropriate voice volume and other prosodic behaviors, will be discussed.
|Effects of the Good Behavior Game with Siblings|
|Katherine Brown (Utah State University), Reagan Gaynor (University of Nebraska Omaha), Amanda Zangrillo (University of Nebraska Medical Center, Munroe-Meyer Institute), JESSIE WEBER (University of Nebraska Medical Center’s Munroe-Meyer Institute)|
|Abstract: With the increased prevalence of developmental disorders, the genetic loading associated with many developmental disorders (e.g., autism spectrum disorder; Bertrand et al., 2001), and the comorbidity between developmental disorders and destructive behavior (Matson & Rivet, 2009), practitioners are likely to encounter families with multiple children who engage in destructive behavior. To date, few studies have examined the use of behavior-analytic treatments to simultaneously treat the destructive behavior of siblings. The present study evaluated the use of the good behavior game, a behavior group contingency intervention, to decrease destructive behavior engaged in by two siblings. Procedural integrity data was also collected in an outpatient and home setting to evaluate the feasibility of the treatment. Results showed a decrease in both participants’ rates of destructive behavior to near-zero levels.|