Association for Behavior Analysis International

People with disabilities often engage in problem behavior which can produce numerous problematic side effects (e.g., prevention of access to inclusive environments; competition with skill acquisition programming; tissue damage). The function-based approach to the assessment and treatment of problem behavior is the most effective approach to addressing problem behavior. Many research functional analyses identify single functions of behavior; however, multiple functions of behavior are prevalent and can be accompanied with an array of challenges in terms of the provision of effective treatment. This synthesis examined intervention strategies focusing on the treatment of problem behavior with multiple functions including primary components and effectiveness. Studies were identified using a systematic electronic search which included broad inclusion criteria to produce full scope of the knowledge and effectiveness of treatments concerning multiply controlled behavior. Thirty-seven studies qualified for the synthesis and were coded and analyzed. General results indicated that treatments for multiply controlled behavior were effective at decreasing problem behavior. Interventions were most effective when addressing all maintaining functions of the behavior. Most treatments had several components, but no specific treatment proved to be more effective than others. More research is needed to better understand multiply controlled behavior across different disabilities, ages, and behaviors.

Telehealth delivery is becoming increasingly essential for children with Attention Deficit Hyperactivity Disorder (ADHD). Previous research has evaluated the effect of Multiple Exemplar Training (MET) in the generalization of self-control choice, but only exemplar training across settings has been studied. The aim of the current study was to evaluate the effect of MET both across and between settings in the generalization of self-control choice via telehealth in seven children with ADHD (M = 7.14 years; SD = 1.07). A multiple-baseline-across-settings design was used. Three of four exemplars across-settings and two of three exemplars between-settings were trained during synchronous videoconferences. Self-control choice was trained using delay fading with differential reinforcement of alternative behavior, self-instructions, or presentation of a signal during the delay to the reinforcer. Probes with exemplars between and across settings showed that self-control choice increased from <60% in pre-training to >80% at both post-training and 1-month follow-up. Non-overlap of All Pairs Index was >0.90 comparing training and follow-up to baseline (i.e., a large effect size). Transition to telehealth services for children with ADHD was socially accepted by the children’s caregivers. Generalization of self-control choice, therefore, was observed with remote training using systematic variation of exemplars.

Individuals diagnosed with developmental or intellectual disabilities often face challenges when attempting to enter the workforce in adulthood. While supported employment models provide various avenues of modifications for individuals seeking services to acquire and retain vocational placement positions, there exists a lack of structured procedures for assessing the pre-requisite skills necessary for workplace readiness. The current study describes the procedures used to develop a vocational skills pre-requisite assessment tool for individuals with disabilities. Clinicians and employers working with individuals with disabilities were interviewed and recruited to participate in a Q-sort ranking procedure to select items for inclusion on this tool. The Q-sort procedure involved ranking commonly researched and taught behaviours against a definition of vocational readiness, from least to most relevant. Subsequent acceptability questionnaires were distributed to collect preliminary social validity data for the developed tool. The results of this study tentatively showed that employers and clinicians consider behaviours that represent a generalizable repertoire of skills required across various workplaces most relevant to workplace readiness. Initial social validity data indicates that this tool may provide useful information to clinicians and employers to streamline pre-vocational training in this population.

In behavior analysis reinforcement is considered a key tool for implementing effective behavior change. However, a point of contention for reinforcement-based programs is the use of edible reinforcers, especially “unhealthy” edible reinforcers. Some feel that it is akin to bribery, others have gone so far as to say that the science is “M&M therapy.” To date, there is no research to justify this claim. The purpose of this study is to determine the extent to which “unhealthy” food reinforcers are used within published clinical research, discuss the implications and impact of their use, and determine the need for future research on the use of healthy edible reinforcers in clinical practice and research contexts. Using all articles published in five major behavior analytic journals in the past three years (2017-2019), the authors sorted each article based on four criteria. Those criteria were experimental or non-experimental, use of reinforcement procedures, use of edible reinforcers and use of “unhealthy” edible reinforcers. The evaluation is currently ongoing, however the results of this study could determine whether there is a need for reform in the use of edible reinforcers in behavior analytic research and practice.

A telehealth model has been shown to be efficacious for the assessment and treatment of problem behavior (Machalicek, et al., 2016; Wacker et al., 2013). With recent events involving the COVID-19 pandemic, telehealth has become a more widely utilized service delivery model for behavioral health services. However, when utilizing this service delivery model, behavior analysts have an obligation to consider the acceptability and preference of their clients and the caregivers they are working with (PECC, 2014). The purpose of this project was to analyze the acceptability of consultative behavior analytic services delivered using a telehealth model over time in order to assess and treat challenging behavior. A survey was disseminated to clients and caregivers receiving behavior analytic consultative services following three months and six months of telehealth services. The survey assessed the utility of a telehealth treatment model to maintain rapport with the clinician, the feasibility of implementation of services using telehealth, client progress, and overall acceptability. Results indicate that consultative telehealth services are generally accepted upon initial implementation.

Pediatric feeding disorders are prevalent in typically developing children, and even higher rates are found in children with developmental disabilities. Feeding treatments rooted in applied behavior analysis (ABA) to increase food consumption have the highest rates of empirical evidence. When using prompting to increase food consumption, using the least restrictive prompt necessary is important in order to decrease prompt dependency. The current study examines the use of a rapid assessment of physical prompts (RAPP; Shrewsbury, Hardesty, & Smith, 2019) to determine the least restrictive prompt sequence necessary out of a jaw prompt, finger prompt, and finger prompt with side deposit. The participant was a 4-year-old male with a history of significant food refusal and liquid dependence. The participant’s significant food refusal and the treatment duration of eight weeks indicated the use of RAPP would be beneficial in order to quickly develop the least intrusive treatment. The results indicate that each level of prompting was effective in maintaining acceptance within 10 seconds. However, a finger prompt with side deposit was necessary for the introduction of new foods. Additionally, the finger prompt with side deposit was found to be the most acceptable by caregivers. Limitations and future directions will be further discussed.

Qualitative research differs from quantitative research in its methods, analytic strategies, and purpose. Whereas quantitative research seeks to identify orderly patterns and trends in data across independent dimensions, qualitative research seeks to identify patterns and themes in specific cases within a broad context. Behavior analytic methods such as interview informed functional assessments (Jessel, Hanley, et al., 2016) utilize both quantitative and qualitative methods that have been adapted for clinical use. We conducted a scoping review of qualitative research within behavior analytic research and found that, relative to quantitative analytic strategies, systematic quantitative analyses were nascent within major behavior analytic journals. To demonstrate the potential utility of qualitative strategies, we developed two case-specific questionnaires that we will share with attendees. The first is an open-ended interview to capture the experience of adolescents with disabilities, their parents, and school staff during COVID-19 transitions to online learning. We will also discuss thematic trends in participant responses. The second is a semi-structured functional interview tool called the Barrier to Valued Living Interview (BVLI) that we developed to isolate functional barriers to independence and empowerment in adults with disabilities. We will discuss initial correlations between this measure and valued living.

Establishing conditioned reinforcers is often a critical step in service delivery for children with Autism Spectrum Disorder (ASD) and/or intellectual and developmental disabilities (IDDs). Therefore, identifying effective procedures for establishing conditioned reinforcers is also critical. In this review, we systematically searched the literature for published and unpublished single-case design studies that evaluated stimulus-stimulus (S-S) pairing, response-stimulus (R-S) pairing, and/or operant discrimination training (ODT) for establishing conditioned reinforcers for children with ASD and/or IDDs. We searched two electronic databases for studies that included pre- and post-pairing measurements of responding that resulted in access to the stimulus targeted for conditioning. Fourteen studies, including three dissertations, met inclusion criteria. Across studies, there were a total of 44 participants, 61% of which were diagnosed with autism. None of the studies evaluated S-S pairing alone, five evaluated ODT, and 11 evaluated R-S pairing. Combined, R-S pairing and ODT were inconsistently effective at establishing conditioned reinforcers. However, our results indicate that R-S pairing is more effective than ODT.

Severe and profound intellectual disabilities are characterized by significant limitations in both intellectual functioning and in adaptive behavior, including social and daily living skills. Assistive technology can be utilized by individuals with intellectual disabilities to facilitate communication, request choices, more effectively engage in daily living and community activities with increased independence. Eye gaze technology has been utilized as an instrumental and communication tool with various populations (American Psychiatric Association, 2013; Luckasson & Schalock, 2012; Mechling, 2006). This study aims to evaluate the effectiveness of eyegaze technology on identifying reinforcers. The effectiveness of eye gaze technologies varies with students. An individual’s attention span, sitting position, tasks, and the screen size of the device may all need to be taken into consideration when using this technology. Further research is needed with larger scale studies and statistical analyses to determine overall effectiveness. More studies also need to be conducted to address one-side preference. In this study, the correct choices were presented equally on both sides.