Association for Behavior Analysis International

Individuals with autism spectrum disorder can have a particularly challenging time completing necessary preventative measures for the health and safety of themselves and those around them. This has become especially evident during the past year as society responds to the COVID-19 pandemic. Limiting the spread of viruses, such a COVID-19, is extremely important. This symposium includes two presentations on increasing compliance with COVID-19-related preventative practices such as mask wearing and nasopharyngeal testing. In the first study, a graduated exposure procedure was used to teach mask wearing for a minimum of one hour in an early intensive behavioral intervention clinic to three children diagnosed with autism. The second study, evaluated the effects of differential reinforcement without extinction and stimulus fading on disruptive behavior during a nasopharyngeal swab procedure for five individuals diagnosed with autism. Together, these papers contribute to the research on methods used to increase compliance with preventative health measures in individuals with autism by providing efficient methods to increase compliance in the absence of more intrusive and restrictive procedures. Implications of the findings of each study will be discussed.

Target audience is graduate students, practitioners - BCaBA, BCBA, and BCBA-D Necessary prerequisite skills and competencies the audience should have include: Functional Analysis, Preference Assessments, Differential Reinforcement, Stimulus Fading, Graduated Exposure, Generalization

During the COVID-19 outbreak, the Center for Disease Control (CDC) recommended that everyone 2 years and older wear a face mask while in a community setting. However, children with autism may be reluctant to wear a mask, particularly for extended durations. In the current study, we implemented a graduated exposure procedure to teach mask wearing for a minimum of one hour in an early intensive behavioral (EIBI) intervention clinic to 3 children diagnosed with autism. We subsequently probed mask wearing, and if necessary implemented the graduated exposure procedure, in each participant’s home and in a mock physician’s office. Finally, we collected probe data on mask wearing in another community setting and one month post-treatment maintenance data in the EIBI clinic. During baseline, participants wore masks for 0 s to 5 min. After treatment, all participants wore the mask for at least one hour in each setting, with maintenance probes indicating 4-5 hour mask tolerance.

Individuals with autism spectrum disorder (ASD) can exhibit low levels of compliance with, and engage in disruptive behavior during medical procedures. Research has shown that differential reinforcement without extinction and stimulus fading have been successful in increasing compliance with these procedures. The purpose of the current study was to evaluate the effects of differential reinforcement without extinction and differential reinforcement without extinction plus stimulus fading on disruptive behavior during a nasopharyngeal swab procedure, often used to test for COVID-19 and the flu, for five participants with autism. A functional analysis showed that disruptive behavior was maintained by escape from the nasal swab procedure. Differential reinforcement without extinction alone was successful for one of the five participants to increase compliance with and decrease disruptive behavior during a nasopharyngeal swab procedure. The addition of stimulus fading was effective in increasing compliance and decreasing disruptive behavior for the remaining four participants. Maintenance of compliance with the nasopharyngeal swab procedure was observed for all five of the participants.