Association for Behavior Analysis International

Many listener training programs target the development of appropriate nonverbal responses to the verbal behavior emitted by the speaker. This type of training is commonly used in the early intensive behavior intervention programs (EIBIs) provided for individuals with developmental disabilities, including autism spectrum disorder (ASD). Instructional procedures play a critical role in the acquisition of listener responses. Practitioners frequently face difficulties in teaching arbitrary auditory-visual conditional discriminations with individuals with limited experience with such tasks. Therefore, this study was to investigate the effects of the stimulus pairing observation (SPOP) procedure in conjunction with match-to-sample (MTS) training to establish untrained listener responses in three children with ASD and limited vocal repertoire. The participants were 4 and 5 years old, and the study used a multiple probe across participants design. Each participant was received MTS and SPOP training until the acquisition criterion was reached. Then, post-test probes were conducted across five stimuli set for each participant after exposure to MTS and SPOP. The results indicate that the intervention is effective in the emergence of untrained listener responses. Also, the participants were able to maintain their untrained listener responses.

Parents influence all aspects of their children’s development. Parent training may help in mental health service provision and increase the chances of treatment generalization to new people and settings. Parent training usually teaches positive parent practices, such as attending, describing, and praising behaviors considered adequate. Behavior skills training (BST) is one format that can be effective for parent training. This study aimed at analyzing which procedures have been used to train parents and their effectiveness. Additionally, it looked at the frequency with which BST and its components have been used in parent training. A systematic review was conducted in 3 phases. At the end of these phases, 28 articles remained. Regarding procedure effects, in 24 out of the selected 28 articles we found an effect of the independent variable on parent behavior. On procedures used for parent training: only 4 studies used the term “behavior skills training” to describe procedures. Instructions, modeling, role play, and feedback were the main procedures implemented in the 28 selected studies. Frequent systematic and narrative reviews are recommended to systematize the literature to those professionals and researchers that might need synthetic, updated, and organized information to make decisions.

When problem behavior is maintained by multiple reinforcers or a combination of reinforcers, functional communication training (FCT; Carr & Durrand, 1991) may begin with an omnibus mand (Hanley et al., 2014; Ghaemmaghami et al., 2018). However, specific and complex communicative responses may a desirable outcome of treatment (Tiger et al., 2008). The present study replicated the methods described by Ward et al. (2020) to differentiate an omnibus mand (“my way please”) into specific mands (“Break, please”, “I want iPad”). First, an interview informed synthesized contingency analysis (IISCA; Hanley et al., 2014) was conducted and suggested that the problem behavior of a young child to be sensitive to escape from demands to access tangibles, edibles, and attention. An omnibus mand was taught to replace problem behavior and then the omnibus mand was differentiated into specific mands using the systematic shaping process described by Ghaemmaghami et al., (2018) to increase the complexity of functional communication. Problem behavior remained low while specific FCRs were acquired. Terminal probes suggested that the systematic shaping process was necessary to teach complex communicative responses while maintaining low rates of problem behavior. A social validity questionnaire indicated that classroom teachers were satisfied with the outcomes.

Reviews of the literature indicate that interventions based in applied behavior analysis (ABA) are highly effective approaches to treat the symptoms of autism spectrum disorder (ASD), although under-utilization of services remains a significant problem. Potential barriers to utilizing services for families include an insufficient number of trained providers, distance to access services, and the time commitment required for comprehensive services. There is thus a need to provide evidence-based services without these barriers. Parent training, such as the Research Unit on Behavioral Interventions (RUBI) Autism Network’s parent training program, has proven efficacious in empowering caregivers and improving the behavior of children with ASD (Scahill et al., 2016), but is typically provided in clinical settings. A telehealth version of RUBI could potentially eliminate impediments to utilization of ABA services. Therefore, the purpose of the current study is to evaluate the feasibility of adapting RUBI parent training to be delivered to caregivers via telehealth, directly in their homes. We will report the current results of this intervention using the RE-AIM framework (i.e., reach, efficacy, adoption, implementation, and maintenance) and discuss implications for both future research and clinical practice.

Tokens are among the most common consequences delivered by behavior analysts who work with individuals with developmental disabilities (Graff & Karsten, 2012). However, recommendations for establishing tokens as conditioned reinforcers vary and many questions remain about best practices. In this study, children with intellectual and developmental disabilities completed preference and reinforcer assessments, from which we identified two to three backup reinforcers. We then evaluated four procedures for establishing tokens as conditioned reinforcers, usually followed by extinction tests to determine if the token had assumed any independent value. We began with stimulus-stimulus (SS) pairing of tokens with the backup reinforcers. If SS pairing did not establish tokens as conditioned reinforcers, we evaluated response-stimulus (RS) pairing and/or noncontingent token-exchange training, in which participants exchanged noncontingently delivered tokens for backup reinforcers. If neither of these procedures established tokens as conditioned reinforcers, we assessed response-contingent token-exchange training. Results suggest that (1) exchange plays a critical role in supporting reinforcer effectiveness, and (2) the conditions under which we evaluate the effects of token training might influence our results and conclusions.

Within recent years, advances in screening and diagnosis allows children with autism and developmental disabilities to receive intervention earlier. Earlier diagnoses of autism and developmental disabilities highlights the need for strong, evidence-based early interventions. Additionally, research demonstrates that earlier intervention is associated with better social skills, language acquisition, communication, and reductions in challenging behavior. Earlier intervention can potentially circumvent some of the risk factors associated with autism and potentially increase the amount of time spent with typical peers in general education. One important preventative life skill derived from the research and school readiness literature was related to following directions. The three-step prompting procedure appears necessary for participants who initially do not respond to other intervention techniques aimed at demonstrating increased levels of compliance. The three-step prompting procedure provided teachers and parents with a tool to promote compliance with children and for increasing overall independence in following directions. The relative ease in training and implementation with a three-step prompting procedure makes it ideal for use in a wide variety of settings as a tool for teaching instruction following; unfortunately, to date, most of the literature available on the uses of this procedure to address noncompliance in highly structured settings. The current study aims to expand the literature base on the use of the three-step prompting procedure as a teaching tool in a group setting. This study provides an extension of the previous research into the three-step prompting procedure as it relates to young children with autism and developmental disabilities in a group setting. The purpose of this study is to compare the effects of teaching instruction following using a three-step prompting procedure versus no explicit instruction and the concurrent effects on on-task and problem behavior of young children with autism and/or developmental disabilities in a group setting.

After acquiring basic verbal behavior, the children extend its functional use of verbal behavior to more naturalistic, contextual situations. The purpose of this study was to investigate the effects of online teaching method on establishing functional verbal behavior in school lives. An elementary school student with autism spectrum disorder participated in the study. The target verbal behaviors were consisted of four sets(20 stimuli): talking naturally (5 stimuli), reacting on unexpected situations(5 stimuli), talking in the contexts(5 stimuli), teaching to peers(5 stimuli). We implemented the multiple baseline design across tasks. The experimenter conducted the probe trials once a week. An experimental stimulus consisted of sentences expressing context and peer’s talk in computer display. The student was required to made four different verbal behaviors fitting in the school situations. The parent was required to teach verbal behavior by iPad including stimuli of teaching program. At baseline, the appropriate verbal responses were low place. After home-based teaching, the appropriate verbal responses drastically increased. The result suggested that telehealth program was effective for increasing functional verbal behavior.

Eye contact is an important ability observed early in human development. We investigated eye-face gaze to gain greater understanding regarding the specific variables controlling the natural acquisition of this behavioral class. We used extinction of high probability responses, keeping motivating operations in place to evoke mands with eye-face gaze as a function of differential reinforcement. We wanted to answer the question: Can children with autism spectrum disorder (ASD) learn social pragmatic skills (e.g., eye-face gaze) while manding? We use a non-concurrent multiple probe baseline design across participants, and we analyzed the data visually. We demonstrated that these procedures increased eye-face gaze while manding for three children with ASD. The procedures controlled the behavioral class of two and had some control over the behavioral class of the other. It is an important finding because these participants had manding in their repertoire and through extinction and differential reinforcement of a more complex behavior, an improvement in their performance was possible. It could pave the way for more efficient tactics to assist this population access social interactions.

Individuals diagnosed with autism spectrum disorder (ASD) may fail to acquire interactive play and leisure skills due to deficits associated with the diagnosis. Through interactive play, individuals gain more opportunities to develop proficiency in areas such as problem solving, communication, and emotional development. In an effort to inform practice and research, this systematic literature review analyzes behavioral interventions used to teach interactive play and social leisure skills to individuals diagnosed with ASD. The predetermined inclusion criteria resulted in 23 studies to be analyzed. The findings of this review indicate that there are interventions that successfully increased interactive play and leisure skills with children, but there is a gap in the research regarding teaching these skills to adolescents and adults. Additional needs for future research are discussed.

Studies in literature (Evans et al., 2005; MacNeil et al., 2009) shows that patients diagnosed with neurodiversity disease rich higher levels of anxiety and phobias. These awkwardness come true even in medical visits, with direct consequences on the patient's health, on family members and on the costs of the National Health Service (Cisini et al., 2019; Raffin, 2018) The purpouse is to create and evaluate a training procedure available for the operators in Modena Health Services. The aim is to ensure an easier execution of instrumental clinical examinations, for users with Autism Spectrum Disorder in developmental age. The start point was create raw materials: task analysis and support in Augmentantive and Alternative Communication (photos, videos and PCS). Secondly, we gather from the literature techniques with proven efficacy for the reduction of phobias during clinical exams. Gradual exposure and differential reinforcement, from the Applied Behavior Analysis, were detect as the most efficient (McMurtry et al., 2016; Shabani and Fisher, 2006). Thanks to studies researchers can create procedures for anxiety and fear reduction relating to the execution of clinical examinations. The procedures involved were: Electrocardiogram, Echocardiogram and blood pressure measurement. The goal is to create a model of “good practice”, ethical sustainable and plain, that can be share with service operators. Furthermore, the project providing for the use of effective techniques to users with no link to a diagnosis with neurodiversity.

The health emergency caused by Covid-19, with the consequent measures of social distancing, produced operational problems with the implementation of services to people with disabilities and their families. In the present study, we conducted a parent training program almost completely via telehealth to teach a parent some strategies to increase the compliance of their son. The boy was a 5-year-old with Autism Spectrum Disorder (ASD) who engaged in challenging behavior when asked to comply with academic tasks, and which was maintained by negative reinforcement. The intervention consisted of a package which included behavioral skills training (BST) with written instructions, video modeling, rehearsal and feedback, to implement demand fading procedures and concurrent schedules arrangements. The intervention reduced challenging behavior to zero, allowing the parents to increase the number of academic tasks presented to the child.

Achieving independence in functional living skills is an important aspect for people safety and dignity. The purpose of this study has been teaching to independently initiate and complete nighttime routines to an adolescent with Autism Spectrum Disorder. A chain composed of brushing his teeth, using the bidet, wearing the pajamas, managing independently his clothes, checking them and putting the dirty ones in the laundry basket was taught using task analysis, most to least prompt fading and positive conditioned reinforcer. The chain was initially evoked with a Whatsapp video message asking to “get ready for the night”, in combination with gestural and verbal prompt and its completion was reinforced with a previously chosen conditioned reinforcer. An intervention has been implemented to transfer the control of the chain to a telephone reminder, set one hour before the bedtime. Data showed rapid acquisition of the nighttime routines, generalization when the participant was alone with his parents and maintenance after 2-months follow up.

Restricted and repetitive behaviors in Autism Spectrum Disorder (ASD) are associated with neurocognitive deficits in flexible choice behavior. Probabilistic reversal learning tasks can be used to evaluate behavioral flexibility by examining individual differences in anticipatory, perseverative, and regressive errors. The present series of experiments conducted via crowdsourcing examined performance in a midsession reversal-learning task to assess error patterns. In two experiments with typically developing participants, we found that responding on the first ‘correct’ pattern rapidly approached the arranged probability of reinforcement. In a separate experiment with individuals with and without ASD, we found that the number of regressive errors was positively correlated with scores on The Autism-Spectrum Quotient (AQ), which measures the degree of traits associated with ASD. We also found that individuals with ASD made more perseverative errors initially, but there was little difference between groups in the total number of perseverative errors. The current set of procedures could be used to assess behavioral (in)flexibility and adaptability in learning in individuals with ASD.

The present study used a multiple probe across behaviors design, with an embedded alternating treatments design to compare the acquisition rates and efficacy of two modified communication programs, the Picture Exchange Communication System (PECS) and a speech generating device (SGD), to teach requesting to a child with multiple disabilities, including autism and visual impairments (VI). Instruction in each intervention phase were adapted from the first three phases in the PECS Manual (Frost & Bondy, 2002) and modified to accommodate the participant’s VI by adding textures and providing a verbal prompt in all three phases. During baseline conditions, the participant demonstrated little to no communicative responding. With intervention, the participant’s communicative responding increased in all three phases (simple request, distance and persistence, and discrimination) to proficient levels for both communication options, however, the PECS program yielded noticeably faster results in the distance and persistence phase. Participant preference and treatment acceptability for each option were also assessed. The participant showed preference for the PECS option. Parents found both procedures to be acceptable, however, the PECS option was also the parents’ preference. The importance of participant and parent preference for using one communication option over another is discussed.

Activity schedules have been used to teach individuals with ASD a variety of skills. Video activity schedules are an evolution of traditional activity schedules in that video models replace the static pictures within the schedule and is delivered on a device rather than a binder. While research has demonstrated that traditional activity schedules are effective at teaching new skills to individuals with ASD, less is known about video activity schedules. The systematic search and predetermined inclusion criteria identified 72 articles, which was a total of 306 unique applications of video activity schedules, for this review. Most of the participants were adolescent and adult aged males. Nearly 50% of the participants had daily living or adaptive skills targeted. Nearly all of the individual cases completed a single task rather than multiple tasks using the video activity schedule. Seventy-one percent of studies were conducted in the school with most of those studies being conducted in special education classrooms. The identified gaps in the literature included a lack of studies conducted in general education classrooms, use with younger participants, and use to teach academic or play skills. Assessment of the quality and outcomes of the included studies will also be discussed.

Learners with autism may experience more challenges tolerating certain tactile sensations than learners who do not have autism. Per CDC, NJDOE, and NJDOH guidelines, it was necessary to ensure students with autism could tolerate wearing cloth face coverings for as long as possible in anticipation of returning to in-person instruction (i.e., a 6-hour school day). This was especially critical for students whose instruction necessitated that instructors spent extended periods of time less than six feet away from them. We found that two such students with autism initially tolerated wearing cloth face coverings for very limited durations (i.e., less than 60 seconds), and another did so inconsistently during 5-minute observations. This was complicated by a state-mandated school closures, meaning that needed teaching could not be delivered in person. Instruction was initially delivered via live videoconferencing with instructors providing coaching to parents regarding reinforcement and error-correction procedures. Mask-wearing durations were shaped using a changing-criterion design in which durations changed both within sessions (for one learner) and target durations (or ranges changed across conditions (for all three leaners). Ultimately, all three learners were able to wear cloth face masks for the entire school day upon return to in-person instruction.

Research has indicated that RIRD often results in the reduction in level of vocal stereotypy in children and adolescents with Autism Spectrum Disorder. However, only one previous study has evaluated the efficacy of RIRD on vocal stereotypy for participants older than 18 years old. Furthermore, though some studies point to punishment as the mechanism by which RIRD produces its effects (Ahearn et al., 2007; Aherns et al., 2011), it is still described as a redirection procedure with unclear contingencies (Cassella et al., 2011). This study used the uninterrupted data collection procedures described by Carroll and Kodak (2014) and Wunderlich and Vollmer (2015) which have been shown to provide a more accurate analysis compared to the interrupted technique. Additionally, this study replicated and expanded upon Wunderlich and Vollmer (2015) by introducing a component analysis of the effects of RIRD on an adult participant. The results showed that motor RIRD was effective in reducing the vocal stereotypy, that random talking may be an establishing operation for vocal stereotypy, and that levels of appropriate vocalizations, while initially suppressed for 12 sessions, did not change meaningfully throughout the study.

Prior to intervention, neither Audrey nor Paulina, both 14-year-old girls with autism, consumed medications in pill form. Though many medications available in tablet/capsule form are also available in liquid, chewable, dissolvable, or sprinkle- capsule forms, one learner only accepted one of these, some medications are available in none of these forms, and in some emergency settings a non-pill form may not be available. Along with parents’ wishes, this prompted us to implement an intervention package to teach both learners to swallow pills. This consisted of individualized positive reinforcement systems and stimulus shaping sequences. For Audrey, initial efforts to shape swallowing edible placebo items identical in size to desired medications or vitamins using a pill-swallowing cup were unsuccessful. Success was ultimately achieved using a 12-step size-fading procedure incorporating a variety of dried pulses (e.g., split peas, lentils) and several sizes of sugar-filled gelatin capsules, delivered in a spoonful of yogurt. For Paulina, similar gains were accomplished in 5 size-fading steps; reinforcement thinning is ongoing, and an additional size-fading step may be implemented. Audrey now consumes placebo items of the desired size in the absence of tangible reinforcement. Additional generalization data will be added for Paulina at the time of presentation.

Previous research has shown that behavioral parent training (BPT) is one of the most effective methods to improve parenting skills and promote meaningful parent-child interactions. A few attempts of preliminary research demonstrate the enhancement effect of Acceptance and Commitment Training (ACT). However, most of the BPT studies and one previous preliminary study of BPT with a subsequent ACT intervention occur through face to face instruction. The purpose of the present research is to a) extend BPT training through telehealth, b) use ACT to enhance the effectiveness of BPT for parents of children with Autism Spectrum Disorder (ASD), and 3) extend research on BPT and ACT for parents in China. The effects of the training are being evaluated by direct observation of parent-child interaction via telehealth. The study is still underway but preliminary results have shown that all of the participants show improvements in implementing behavioral procedures in their parent-child interactions.

Noncompliance with medical procedures may represent a serious issue for people with intellectual and developmental disabilities (IDD). In this study we applied graduated exposure, shaping and stimulus distraction to teach two adolescents with autism spectrum disorder (ASD) to tolerate a blood draw. Both participants showed low level of compliance and high level of signs of anxiety and distress during baseline, consisting in a simulated blood draw. During the intervention phase participants were gradually exposed to a blood draw procedure while approximations to the target behavior were reinforced. Results, shown in a non concurrent multiple baseline design, demonstrated that the treatment was effective in obtaining blood samples during an actual blood draw, with significantly lower levels for both participants of signs of anxiety and distress respect to baseline.

Auditory-visual discrimination can be difficult to establish in children with autism spectrum disorder (ASD) and minimal verbal and pre-academic repertoire. It is common for children who have not mastered tasks involving conditional discrimination, to demonstrate restricted stimulus control during these types of tasks. One strategy to overcome errors related to restricted stimulus control is by using a differential observing response (DOR). DORs are responses that when presented before or with the antecedent stimulus, facilitate the child’s sensory contact with the relevant aspect of the stimulus. The purpose of the current study was to replicated Fisher et al. (2019)’s by incorporating a DOR during an auditory-visual conditional discrimination task with children with ASD. A multiple-baseline design across target sets was used to evaluate the effects of the intervention on the levels of correct selection responses. We also conducted probe of tact responses before the implementation of the intervention and after mastery of target sets. Results were similar of Fisher et al. study in that participants demonstrated the acquisition of target sets and emergence of novel, untrained tacts.

Individuals diagnosed with autism are at a higher risk for COVID due to developmental delays and deficits in health-related life skills. However, the extent to which these deficits exist is unclear, as existed assessments for life skills are not specific enough to capture various skills needed during the COVID-19 pandemic, such as keeping the mask on for extended periods of time, following social distancing rules, maintaining social interaction with peers remotely, etc. The current study examines the COVID-related health skills among children diagnosed with ASD. A caregiver assessment was developed, and a total of 36 skills were identified following recommendations from the CDC to promote children’s physical and mental health. Six skills were identified in each category: Personal Protection Equipment, Symptom Identification, Social Distancing, Hygiene, Daily Routine, and Health and Well-being. Forty caregivers completed the indirect assessment, and results show that children diagnosed with autism often demonstrate deficits in COVID-related health skills. The distribution of skills did not show a clear pattern across different age-groups, suggesting that the developmental approach failed to account for these life skills. Preliminary psychometric properties of the assessment were reported, and implications and recommendations for practitioners were discussed.

The purpose of this study was to investigate the effect of a visual cue (arrow) for specifying a “speaker” in conversation for students with autism spectrum disorder using online telehealth situation. Two elementary school students with autism spectrum disorder participated in the present study. They could talk about their favorite things such as trains, however had weakness in conversation with other people. At first, the therapist set the topic of conversation and evaluated the spontaneous talking and numbers of turn-taking. Telehealth method was used with Zoom. In Student-Student Condition, two students sat facing each other in computer display and made online conversation. In Student-Therapist Condition, each student sat facing with adult therapist and was provided with “arrow” on computer display to specify the speaker implying “your turn for talking”. For both students, numbers of turn-taking were very few in Student-Student Condition. In Student-Therapist condition, Student A showed drastic increase in numbers of turn-taking. The result suggests that the “arrow” functioned as visual indicator for specifying “speaker” in naturalistic conversation.

Challenging behavior maintained by multiple sources of environmental control presents unique challenges during treatment. Often, reduction of these behaviors involves interventions that target each source of reinforcement individually. Following acquisition of multiple functional communicative responses (FCR’s) and reduction of the target challenging behavior, the dense schedule of reinforcement used during functional communication training (FCT) still needs to be thinned for the FCR to generalize successfully across settings and time. Multiple schedules have been used successfully following FCT teaching FCR’s for single functions. The current study, involving two residents of a residential treatment facility, investigates the thinning of a “More Time” request utilizing a multiple schedule. Following successful acquisition of the FCR, schedule thinning consisted of signaling availability of reinforcement of the response with a visual stimulus. Throughout schedule thinning, the work requirement was systematically increased following emission of the FCR until the terminal schedule was reached. Both individuals demonstrated high levels of independence with the FCR and low rates of challenging behavior throughout schedule thinning.