Association for Behavior Analysis International

Many children with autism spectrum disorder (ASD) do not develop functional vocal speech and may require alternative/augmentative communication (AAC) systems, such as speech generating devices (SGD). iPad® and the Proloquo2Go™ application is one example of a SGD that may be implemented by clinicians, along with intervention methods aimed at teaching the child to use the device to communicate. This study compared two AAC intervention methods for children who have a diagnosis of ASD and who use iPad® and Proloquo2Go™: aided language modeling (ALM; Binger & Light, 2007) and incidental teaching (IT; Hart & Risley, 1975). A parallel treatments design (Gast & Wolery, 1988) was employed to compare the effectiveness of the two interventions in increasing the use of novel symbol use on an iPad® with the Proloquo2Go™ application. Initial results suggest that IT results in a higher frequency of independent, contextually relevant, single-symbol utterances during a play activity than does ALM.

Parents of children with autism who live in low-resource settings have reported exacerbated hardships of raising their children with autism due to limited infrastructure for their children’s treatment and education, social and financial support for parents, and stigmatization of disabilities. Parents in Mongolia, an example of low-resource setting, also reported the needs for more training opportunities to build and increase their capacity to deliver interventions themselves in response to inaccessible treatment options in their country. To address the low level of resources, we are conducting a single case research using a multiple probe design across parents who participate as parent-coaches to coach other Mongolian parents with the purpose of increasing capacity of parents who live in LRS. We developed a training and coaching program based on components that were examined previously in the literature. The coaches are trained on principles of behavior management, social-communication teaching strategies, and coaching practices. We will analyze the functional relations between the intervention and the coaching fidelity using visual analysis. Social validity data will also be collected using individual interviews with the participants in order to determine the acceptability and feasibility such intervention and capacity building practices in a low-resource setting.

The maladaptive behaviors accompanying those with Autism Spectrum Disorder (ASD) often cause issues of depression and family cohesion for the child’s primary caregiver. Unfortunately, few programs exist addressing the need for therapeutic interventions for parents of children with ASD. Social support and cognitive-behavioral therapy (CBT) techniques have been shown to have the greatest impact on parental well-being. The current program, Parenting Children with Autism Together (PCAT), will focus on providing social support and therapeutic services to parents of children with ASD. The program will consist of 12 parent pairs meeting biweekly for 12, 2 hour sessions. Therapeutic services will incorporate aspects of CBT, including acceptance commitment therapy and optimism training, while social support will be facilitated through small-group therapy sessions. Program success will be measured using participant pre- and post-scores on the Beck Depression Inventory and Family Adaptability and Cohesion Evaluations Scales IV. At the conclusion of the program, parents should demonstrate reduced depression and increased family cohesion. This program is imperative to ensure parents of children with ASD are receiving the support necessary to overcome parental exhaustion and tension. Providing parents with proper support will increase their quality of life and ability to efficiently raise their child with ASD.

Adults diagnosed with Autism Spectrum Disorder (ASD) are underrepresented in the workforce (Grob et al., 2019). One strategy that has been used to teach job-related skills is Behavioral Skills Training (BST; (Anderson et al., 2017). This project evaluated the effects of BST with embedded video models on the acquisition of customer service signs for one 23-year-old man diagnosed with ASD. Sessions were conducted through video conferencing. Initially, BST was used to teach five dyads of signs as listener responding targets. Generalization to tacts and intraverbals was simultaneously assessed. A multiple probe design across dyads of signs was used to examine the percentage of steps completed with the correct location, handshape, hand movement, and orientation for listener responding and intraverbal targets. Tact performance was analyzed as the number of correct sign segments signed. Preliminary results suggest that BST led to the acquisition of listener responding targets and some tacts and intraverbals emerged without direction training. However, additional training may be necessary to promote maintenance and generalization to other verbal operants. Future directions will include assessing generalization of intraverbal targets to the workplace during contrived customer interactions.

In this study, we tested the effects of gradual exposure to the blood testing lab, to the nurse and to different needles for a 13-year-old male Participant diagnosed with Autism. The subject was selected because of his history of failed attempts to be tested, that resulted in the emission of highly disruptive avoidance behaviour in the presence of doctors, needles, labs and even nurse’s coats. The dependent variable for this study was the duration of appropriate and problem behaviour in pre and post probes. The independent variables for this study were forward chaining and response shaping tactics, with a changing criterion design. The training lasted four days and the total task was achieved after 10 implementation sessions in the clinical setting. A post probe was also conducted at home, where a certified nurse could completed the blood draw and recorded no problem behaviour. This positive result was achieved in a short time and the blood sampling took place successfully at the boy’s home, therefore future studies are in place, with a larger sample of participants and the generalization of performance within healthcare settings.

Children with Autism Spectrum Disorder (ASD) often exhibit deficits in daily living skills, including toileting skills. Previous studies have evaluated components of common toilet training practices, including differential reinforcement, sit schedules, fluid loading, underwear, and wet alarms. Many children with ASD participate in clinic- or school-based toilet training programs; however, due to the COVID-19 pandemic, these services were no longer available to many individuals. The purpose of this study was to coach caregivers of children with ASD via telehealth to implement the toilet training treatment package as described by Perez et al. (2020), utilizing a dense sit schedule, differential reinforcement, and underwear. The participant dyad in this study is a 4-year old boy diagnosed with ASD and his biological mother, who implemented the procedures and collected data under the guidance of the researcher. The caregiver was trained to implement procedures using behavior skills training and demonstrated high treatment integrity throughout the study. The child reached the mastery criteria of 100% successful eliminations and zero accidents, while the sit schedule was faded to 90 min. Performance was maintained at the follow-up session, suggesting the procedures utilized in this study may be an effective practice for toilet training children in this population.

Social dysfunction is a hallmark feature of autism spectrum disorder (ASD) that significantly affects individuals with ASD regardless of cognitive or language functioning (Carter, Davis, Klin, & Volkmar, 2005). Social skills training for children with ASD that incorporate parent training has been found to produce improvements in greeting and play behaviors, as well as conversational skills (Radley, Jenson,Clark, & O'Neil, 2014). Perhaps the most critical element of any parent training program is generalization of skills from the clinic or school to the home setting (Matson, Mahan, & LoVullo, 2009). The purpose of this study was to compare the effects and consistency of the instructional methods self-guided manuals and in-vivo (live class) during parent trainings. The experimental design used was the alternating treatment design with four phases: Phase 1 baseline with parent and instructor, Phase 2 baseline with parent and child, Phase 3 in-vivo training with parent and instructor, and Phase 4 with self-guided manual parent and child. Three parent-child dyads meeting inclusion criteria were selected for the study. Adult participants will participate in two instructional methods, self-instructed manuals and in-vivo trainings, on teaching social skills to their child with ASD. The self-guided manuals and in-vivo training was compared to determine which is more effective for adult participants to utilize and complete. Results indicated the ease of implementation of procedures must be considered if parents are likely to use them. Involving parents in the implementation of this study shown effectiveness is understanding their child with ASD's potential for social independent living and to continue to provide opportunities for child with ASD to use the learned skills even after the completion of the study.

We replicated the toilet training program for children with autism described by Cocchiola, Martino, Dwyer, & Demezzo (2012) and tested its effects with two 5 year old boys with Autism and multiple disability. The study was conducted in a private learning center, where the Participants were brought to the experimenters’ attention due to the failure to reach bathroom independence both in their kindergartens and at their homes. The dependent variable for this study was the number of correct urinations in the toilet and accidents for session. The independent variable was a replicated toilet training procedure, with the removal of diapers during education sessions at the center, a gradually increased scheduled intervals for bathroom visits and the delivery of social reinforcers immediately after a correct independent response. This study used a changing criterion design and showed that the procedure was effective for both Participants in the center’s setting. Parents and regular kindergarten’s teachers also reported that the results were generalized and maintained at home and in school for both children. Future studies should focus on training efficiency, teachers and parents’ training and should investigate more on behaviors pivotal to successful toileting training, such as communication.

As the prevalence of Autism Spectrum Disorder continues to increase, so does the demand for qualified educators that are trained in developing functional behavior assessments and implementing behavior intervention plans. The purpose of this project was to develop a statewide model for training teachers in functional behavior assessment and behavior intervention plans. Through a series of workshop trainings with local educators and state regional education professionals, teachers from across the state of Texas were taught foundational skills for assessing behavioral function and identifying function-based interventions for the behavior intervention plan. Transition implications were also incorporated to emphasize the need for long-term outcomes. Following the trainings, teachers demonstrated increases in competency test scores as well as positive social validity scores. Strategies to improve the dissemination of evidence-based procedures will be discussed and include formal Coaching Models and increased access to online materials. Implementation challenges associated with the COVID-19 pandemic will also be discussed.

Intensive behavior analytic intervention can reduce destructive behavior; however, relapse may occur once treatment is discontinued. Relatively little information is available on the likelihood of readmission to intensive services for the treatment of severe behavior. We reviewed 271 intensive admissions to a university-based severe behavior program over a 10 year period. Over those 10 years, 8.1% (n = 22) of cases represented readmissions. For some cases, the reason for treatment breakdown was relatively clear (i.e., change in topography, change in function, or previously prescribed treatment was no longer feasible), however, in most cases, it was unclear the exact reason treatment had broken down. We discuss several variables which may contribute to treatment readmission and implications for the clinical assessment and treatment of severe destructive behavior.

Clinicians are often faced with challenges regarding the development of interventions for behavior maintained by automatic reinforcement. One common method for treating automatically reinforced behavior involves the noncontingent presentation of competing stimuli. Groskreutz, Groskreutz, and Higbee (2011) compared the use of a paired-choice preference assessment and a competing stimulus assessment as means of identifying stimuli that may effectively compete with automatically reinforced behavior. They found that items identified using a competing stimulus assessment were more effective than those identified by using a paired-choice preference assessment when presented non-contingently on a fixed time schedule to treat vocal stereotypy in a young child with Autism Spectrum Disorder. The present study replicated and extended Groskreutz et al. (2011). Two adult learners with ASD who lived in a residential campus-based program participated. We used a competing stimulus assessment and a paired choice preference assessment to identify stimuli to compete with ritualistic behavior. Results indicated that the highly competing items from the competing stimulus assessment helped to decrease ritualistic behavior more than highly preferred items when presented non-contingently using a fixed time schedule.

Perspective taking skills were found lacking in children diagnosed with autism spectrum disorder (ASD). We evaluated procedures for teaching one student with ASD to describe if a specific stimulus he was or wasn’t able to tact has been tacted or not by a different person. We evaluated the clinical efficacy of a teaching procedure composed by priming, prompting, fading and reinforcement using a multiple baseline across test conditions design (see, hear, touch). During the intervention, after presenting a verbal statement with or without salient stimuli to the student (e.g. “my car is red. Do you know the color of my car?”), (1) we evoked a previously taught set of responses consisting in a qualifying autoclitic (e.g. “yes” or “no”) followed by the tact of sources of control of the previous response, formulated with an autoclitic frame (e.g. “because I see/hear/touch” or “because I don’t see/hear/touch” in response to the question “why do/don’t you know?”); (2) we presented the same questions relating to the condition in which a different person may or may not contact the same stimuli (e.g. “your mother in the other room knows the color of my car? Why does/doesn’t she know?), prompting the correct response using the same kind of autoclitic frames. After no response in baseline for the second set of questions (2) in the three test conditions, we used a different set of stimuli during the teaching phase. After reaching mastery criteria we presented again, as post training, the same set of stimuli used in baseline. The student reached mastery criteria for the untaught sets in each test condition. We discuss how this skill may be related to more advanced perspective taking skills, based on Skinner’s analysis of verbal behavior.

Raising a child with an autism spectrum disorder (ASD) implies that family members are under great pressure. Exploring the needs of caregivers could help them reduce stress and better integrate them into their children's rehabilitation. Most children with autism are difficult to express their needs, the expression of needs based on parents' perspective is more comprehensive and deeper. A total of 162 caregivers of children with ASD completed a family information form and a questionnaire about different needs areas. A descriptive analysis was performed from the responses. The caregivers in the study refer to people who mainly take care of children with autism in the daily life, not limited to parents. Six dimensions of need emerged: professional knowledge, mental health, material, information, emotional support and action support. Needs priorities were different for caregivers with a child with ASD. The main purpose of the study is to explore the needs of caregivers and identify priority needs areas. The results could help researchers support families of children with autism in a practical way.

Youth with autism spectrum disorder (ASD) frequently play video games. Social deficits underlying the disorder make this population more vulnerable to safety threats online than neurotypical children. Behavioral skills training (BST) has proven to be an effective methodology to teach safety skills to children with ASD to use in response to abduction lures. The purpose of this study was to evaluate the effectiveness of using BST to teach youth with ASD safety skills to use in response to lures (e.g., “What’s your real name?”) presented by confederates to participants playing online video games. The safety skills taught to each participant were to not give the personal information, say “No”, leave the video game, and tell an adult. Results indicate that BST successfully resulted in the acquisition of the gaming safety skills. The results are consistent with the findings of previous studies using BST to teach safety skills effectively and efficiently.

Competing stimulus assessments have been shown to identify stimuli that can compete with automatically maintained self-injurious behavior (ASIB; LeBlanc, Patel, & Carr, 2000). There is some evidence emerging that indicates engagement with tasks may also be effective at reducing rates of ASIB (Rooker, et al., in press); however, tasks have rarely been evaluated for this purpose. In the current study, four participants in a clinical trial investigating treatment-resistant ASIB completed a competing task assessment (CTA) to systematically identify tasks that potentially competed with SIB. In doing so, we evaluated the impact of having tasks freely available, and when necessary, systematically included response promotion (e.g., response prompting for task engagement), reductive components (e.g., response blocking SIB), and combinations of these procedures, on the rate of SIB. Using this approach, multiple competing tasks were identified to reduce ASIB for all four participants, but only after the inclusion of response promotion and reductive components were added.

Treatment integrity is the degree to which prescribed interventions are implemented as intended (Gresham et al., 2000). Behavior analysts can use treatment integrity data to assess the quality of intervention, guide programming decisions, and train behavior-change agents. These data may be collected in many ways including rating scales, all-or-none implementation scores, or event recording for each component of the intervention. Each data collection method may differ in utility due to differences in level of detail, ease of use, time to completion, analysis, and reliability. Our lab developed a study to compare these systems. To accomplish this, we created a self-paced training using modified behavioral skills training. Graduate research assistants scored baseline videos following minimal instruction, received individualized training to address deficits, and continued scoring videos with feedback until their responding met the mastery criterion. The purpose of this poster is to describe the training process and types of treatment integrity data collection methods used to evaluate therapists’ treatment integrity when implementing discrete-trial instruction with a three-year-old child diagnosed with autism spectrum disorder. The structure and data produced by each method will be described.

A lack of prevocational skills training, including social skill training, results in barriers to meaningful community involvement and quality of life for individuals with disabilities. The purpose of this study was to determine the extent to which video modeling of others and behavior specific praise affected the acquisition and maintenance of social skills in a functional vocational training context for high school students with autism spectrum disorder and intellectual disability. A multiple baseline design across subjects was used to examine the effects of video modeling and behavior specific praise on the acquisition and maintenance of social skills needed for vocational training, as evidenced by independently demonstrated communication of greetings and closings, positive affect, and eye contact. After the intervention, the majority of study participants exhibited an increase of demonstrated target behaviors (eye contact, positive affect, verbal communication of greetings and closings) during vocational skills training and at two-week maintenance. The study results indicated the use of peer video modeling and behavior specific praise as an efficacious and cost-effective intervention for teaching social skills in a prevocational context to adolescents with severe autism spectrum disorder and intellectual disability.

Equivalence class formation is reflected in the electrophysiological (EEG) component N400, research has demonstrated. Stimuli pair related through symmetry and transitivity/equivalence do not produce a N400 ms after stimuli presentation while unrelated do. In the current experiment, 24 adults with high function autism and 28 normally developed adults participated. 6 conditional discriminations with C-stimuli as meaningful where trained before a priming test, conducted with EEG-measures. Related and unrelated stimuli pairs were presented and the participant was instructed to response to the pairs, related or unrelated. The results show that the unrelated pairs produced N400 and related pair did not. This was the matter in both groups, but the N400 peak was slightly smaller in the group with Autism spectrum disorder. The conclusion is that unrelated stimuli pair produced a change in the N400 component compared with stimuli pair related through symmetry and transitivity/equivalence in both groups.

Joint control procedure has been used to teach complex verbal behaviors such as matching to sample, sequencing, and listener response. Therefore, the purpose of this study is to investigate the effect of using joint control as a teaching procedure on listener response to children with autism. Specifically, the researcher wanted to evaluate the effectiveness of joint control procedure on teaching listener response using language matrix (e.g., having a red train, blue train, red car, blue car) in front of the child and asking the child to find one colored item with other stimuli as distractions. Three school-aged children participate in the study. A multiple probe design was used and there were three phases: pre-test, joint control training, and post-test. The finding reported that joint control is an effective teaching to children with autism. Implications and future studies are discussed in the paper as well.

Functional communication training (FCT) is a highly effective intervention to reduce challenging behavior among individuals with intellectual and developmental disabilities. Even though there is a wide array of literature supporting functional communication training's effectiveness, there are still difficulties that come with implementing the intervention outside of a clinical setting. One difficulty is the continuous schedule of reinforcement for the functional communicative response that is utilized during initial phases of intervention cannot be maintained in natural settings. Reinforcement schedule thinning addresses this drawback with various approaches to systematically thin the schedule of reinforcement to a schedule that is more appropriate for natural change agents in natural settings. Despite the fact that schedule thinning is more appropriate for natural change agents, natural settings, and natural stimuli, there is a gap in the literature on how to successfully implement schedule thinning outside of clinical settings. The aim of the current study is to implement multiple schedules in a home setting via telehealth with caregivers as the implementer while using natural stimuli.

Because of the intimate nature of inappropriate sexual behavior (ISB), there is limited literature on this behavior and its treatments. Additionally, most of the research on ISB has been done with university students or individuals with dementia. The current poster will describe functional behavior assessments (FBAs) conducted for two twin 8-year-old boys with Autism Spectrum Disorder (ASD; pseudo names: Zach & Cody). It was predicted that various functions and frequencies for behaviors might be found in different settings and with different therapists. Both students' FBAs included a therapist-completed Functional Assessment Screening Tool (FAST) and open-ended functional assessment interview (Hanley, 2012) with a therapist, an unstructured parent interview, and direct observations conducted by the researchers. It was found that ISB was more likely to happen during periods of low attention (i.e., transitions, lunch, and recess) and less likely to occur during high attention periods (i.e., one-on-one-therapy). Before developing individualized behavior support plans, the researchers provided the classroom staff and parents with recommendations to decrease both boys' ISB. The Tier 1 training included providing behavior-specific praise when students kept hands to themselves, reminding them of expectations before transitions, during lunch, during recess, and removing attention when students engaged in ISB.

Multiple schedules prevail in the natural environment such as differing rates of reinforcement within and outside of therapy sessions, inconsistent consequences by different caregivers and varying contingencies in the school and home environments. Basic research on multiple schedules have revealed contrast effects in the animal laboratory, yet the extension of these phenomena to human participants warrants further research. This study represents an initial investigation into how multiple schedules may be arranged in the context of intervention sessions to program for the emergence of negative behavioral contrast. During the baseline phase, all occurrences of visual stereotypy and vocal stereotypy were interrupted and redirected. Data were collected on rates of stereotypy occurring during reinforcement intervals and stereotypy occurring during work periods. During the intervention phase, response interruption and redirection continued to be implemented during work periods. However, no programmed consequences for stereotypy occurring during reinforcement intervals. Results suggest negative behavioral contrast, evidenced by reduced rates of stereotypy during the unchanged component of the multiple schedule. This case study suggests that explicitly programming for negative behavioral contrast might benefit the learner by reducing rates of aberrant behavior during teaching. Implications of these initial findings and areas for future investigation will be provided.

Empirical studies had demonstrated the efficacy of group contingency on managing behaviors in multiple contexts. Due to the current COVID 19 pandemic, face-to-face early intervention service at the clinic have been suspended and, for many families, has transitioned to primarily or partially telehealth-based services. Authors extended the literature by directly comparing two variations of group contingency, the independent group contingency (“Fantastakid” condition) and the randomized dependent group contingency (“Team hero” condition), to evaluate the relative effectiveness of each as a tool to promote on-task behavior through a telehealth-based social skills program on children with autism. Two young children with autism (age range from 4-7) participated in the current study. Both of them were able to communicate through clear speech and have a fair repertoire of both receptive and expressive skills. An alternating treatment design was utilized to evaluate intervention effects. Results suggested a lack of clear differentiation between the two conditions. In addition, social validity measures suggested that both procedures were feasible for staff to implement, acceptable to both participants, and produced minimal adverse effects.

Behavior analysts frequently use physical guidance to facilitate skill acquisition. However, in some situations, physical guidance may be contraindicated (e.g., large stature, touch aversion, trauma history). We conducted a systematic literature review of alternatives to physical guidance in articles from 2009-2020 that included school-aged children (3-18 years) with autism spectrum disorder. Preliminary results of 242 articles with 1,247 participants indicate that video modeling was the primary alternative intervention, followed by the use of model (e.g., physical or pictorial), vocal, and gestural prompts within intervention packages. Interestingly, of the interventions using video modeling, 38.04% included another intervention component that did use physical guidance (e.g., least-to-most prompting). Few published studies compared the efficacy of physical guidance and alternative interventions (5.79%). We present data systematically quantifying the efficacy and efficiency of skill acquisition with and without physical guidance. Many intervention packages include environmental manipulations (e.g., activity schedules) and other intervention components (e.g., differential reinforcement) to enhance the efficacy of skill acquisition interventions. We further report on the lack of generalization (51.24%), maintenance (47.11%), and social validity (38.84%) measures in the studies included in this review. Further, we discuss the implications of selecting alternatives when physical guidance is contraindicated and explore best practices.

Finding creative ways to effectively supervise and mentor staff serving children and adults with autism takes a commitment to consistently reflect upon an organization’s practices and evidence-based strategies to provide efficient high quality training. The foundation of our model is assessing and efficiently training new staff within our organization, in many cases new to the field, utilizing a behavior skills training (BST) approach, combined with competencies derived from the Registered Behavior Technician (RBT) task list. The pillars of our model are ongoing monitoring and feedback via data-based decision making. This includes observing registered behavior technicians and completing a customized pre-made treatment integrity checklist to ensure they are following all aspects of an individual’s plan. Once this is completed, staff are further supported by ongoing monitoring and feedback. This includes include frequent supervision and mentorship, individual-specific treatment integrity checklists, ongoing trainings and job supports. These components are necessary to ensure the development and support of qualified staff working to provide effective, evidence-based interventions to enhance the quality of life of children and adults with autism receiving services.

This pilot study investigated the effectiveness of training parents of children diagnosed with autism, on speech therapy home goals, using Behavioral Skills Training and video modelling. Five parents enrolled in the study. All the children were receiving individual speech therapy at an ABA based school . Child specific goals were identified, and parents were trained to implement the goal specific intervention on their own child using BST. A video model of the therapists was shared with parents to practice the same procedure with their child for 20 days. The parents were trained by the speech therapist, in consultation with a doctorate level behavior analyst, until they completed the procedure with 80% accurate. They were asked to use the procedure for 20 days at home. The average independence with which the child was demonstrating the skill before parent training was 18% (Range 10-30) percent. After parent training, this increased to 84% (Range 70-100), which is 4.66 times increase. This pilot study highlighted the effectiveness of training parents and including them in their child's therapy. We used evidence-based method of training the parents on their child's home goals. A significance improvement in their child's skills was noted. This is a one-of-a-kind interdisciplinary study which uses the behavioral technique of teaching skills to individuals. Future investigation should look to see the number of times the parents use the technique at home. Also, we should take data on how accurate they used the treatment at home.

Individuals with autism spectrum disorder (ASD) have been reported, through observations and self-evaluation, to have difficulties engaging in social interactions, including understanding another’s nonverbal social cues and mental states, referred to a theory of mind or perspective taking. Research has shown that adolescents with ASD are more likely to require support with establishing relationships into adulthood if perspective taking needs not addressed and can result in feelings of isolation, peer-rejection, and depression symptoms. Which is why, addressing the foundational social skills at the age in which it typically develops is of critical importance. Several previously published articles have demonstrated the efficiency of using video modeling to teach first-order perspective taking skills, to both children and young adolescents with autism, but have primarily occurred within in-person teaching. Due to COVID-19, in-person applied behavior analysis (ABA) services, had to rapidly adjust to find meaningful ways to provide medically necessary services through telehealth. To further extend the current literature, this research sought to evaluate if first-order perspective taking could be taught through telehealth services using video models and what supports would need to be in place for the program to be successful. A multiple baseline design across participants and within participate across tasks was used with three children with autism. Results revealed that although first-order perspective taking skills could be taught through telehealth using video models, progress occurred at various rates based on prerequisite skills. Recommendations for future research are described as well since generalization in the natural environment was unable to occur.

Aravamudhan & Awasthi (2019) trained a 19-year-old girl with ASD and profound speech sound disorders to echo syllables accurately and at high rates using Precision Teaching (Maloney, 1998) and lip-tongue-teeth prompts. One of the study’s limitations was that it did not demonstrate if the participant could achieve fluent word articulation. In the current study, the participant was substituting the ‘th’ sound for the ‘t’ sound while echoing words such as ‘tomato,’ ‘water,’ and ‘pasta.’ She received training with lip-tongue-teeth prompts to say ‘tu’ correctly at a frequency aim of 60-80 echoic responses per minute. Concurrently she was trained on the target words ‘tomato’ and ‘cootu’ (a dish with vegetables and lentils), which required the ‘t’ sound, using prompts, shaping, chaining, frequency building (Fabrizio & Moors, 2003), within-session feedback, priming (Cihon et al., 2017), and celeration charting. The study is underway with fluency aim achieved with two targets and the third near fluency levels. The preliminary results suggest that the intervention was effective. Other fluency outcomes such as retention, endurance, and agility (Binder, 1996) will be discussed.