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| Incorporating Preference and Promoting Autonomy in Behavioral Interventions for Individuals With Intellectual and Developmental Disabilities |
| Saturday, May 27, 2023 |
| 11:00 AM–12:50 PM |
| Convention Center Mile High Ballroom 4E/F |
| Area: AUT; Domain: Applied Research |
| Chair: Mindy Christine Scheithauer (Marcus Autism Center) |
| Discussant: Justin B. Leaf (Autism Partnership Foundation) |
| CE Instructor: Justin B. Leaf, Ph.D. |
| Abstract: Treatment strategies based in applied behavior analysis have evolved greatly over the last few decades, allowing for multiple tools that clinicians can pull from to meet treatment goals. For example, several different prompting methods, mand modalities, and reinforcer arrangements are empirically supported for use with individuals with intellectual and developmental disabilities. When multiple treatment may be effective, it is crucial for therapists to incorporate client choice to guide treatment development. In doing so, we can both promote the autonomy of the client and select the strategy that is most likely to be preferred and effective. The aim of this symposium is to present four empirical demonstrations of methods to incorporate choice into treatment planning. Two studies present replications and extensions of assessments for preferred mand modalities. The third study discusses preference for reinforcement arrangements, extending past work to younger individuals who are often excluded from choice-based research. Last, we present a novel assessment to evaluate the efficacy, and subsequent preference, for various prompt methods used to treat escape-maintained challenging behavior. |
| Instruction Level: Intermediate |
| Keyword(s): choice, intervention, preference, treatment |
| Target Audience: Attendees should understand the basics of the interventions discussed (escape extinction, prompting procedures, functional communication training, and differential reinforcement). |
| Learning Objectives: At the conclusion of the presentation, participants will be able to: (1) Describe procedures for identifying client preference regarding mand modality (2)Identify how to arrange different schedules of reinforcement in a manner that allows for choice of procedures. (3) Describe different prompting procedures that can be used for escape-maintained challenging behavior |
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| Demonstrations of Communication Modality Preference During Functional Communication Training |
| ROSE MORLINO (University of Georgia), Joel Eric Ringdahl (University of Georgia), Karla Zabala-Snow (Emory University/Marcus Autism Center), Courtney Mauzy (University of Georgia), Kelly M. Schieltz (University of Iowa), Matthew O'Brien (The University of Iowa) |
| Abstract: Clients’ opinions and acceptance of intervention procedures is a necessary component of applied behavior analysis (Wolf, 1978). One strategy to incorporate clients’ opinions is to offer choices within the context of intervention (Bannerman, 1990). During functional communication training, practitioners can incorporate choice by assessing preference for communication strategies. Winborn-Kemmerer et al. (2009) and Ringdahl et al. (2016) evaluated individual preference for various communication modalities and found that all participants demonstrated preference for one modality when multiple modalities were available and produced reinforcement on identical schedules. Incorporating preference into the communication strategy selection process has been shown to increase treatment maintenance (Ringdahl et al., 2016) and allows for individual choice in intervention procedures. The purpose of the current study was to replicate the procedures implemented by Winborn-Kemmerer et al. (2009) and Ringdahl et al. (2016) to identify communication modality preference and use this information to integrate individual choice into behavioral interventions. Using a concurrent schedule arrangement, we assessed individual preference for various communication modalities with 10 children and adults with intellectual and developmental disabilities. Results indicate that nine participants demonstrated a preference for one communication modality. |
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Incorporating Child and Caregiver Preference Within a Mand Modality Assessment: A Consecutive Controlled-Case Series Design |
| LESLEY A. SHAWLER (Southern Illinois University), Yeni Ramos (Southern Illinois University), Anna Cole (Southern Illinois University) |
| Abstract: Fifty percent of children with Autism Spectrum Disorder (ASD) never develop functional speech (Kasari et al., 2014; Lord et al., 1999) and often engage in challenging behaviors such as harm to self, others, and property. As such, identifying a functional method of communication for these individuals is paramount. The selection of the most appropriate communication modality should be individualized and empirically evaluated. Research has compared various AAC modalities and determined the most appropriate method based on various factors such as proficiency, effort, and preference (e.g., Ringdahl et al., 2016). The current presentation will report on a consecutive controlled-case series design from 2022-2023 in which a mand topography assessment was conducted using a multi-element design for children with complex communication needs. Additionally, collateral interfering behaviors were also observed and reviewed for the selection of the final augmentative and alternative (AAC) communication modality. Child and caregiver preferences were also assessed and considered within the final AAC selection, and demonstrations of the successful modality were programmed for generalization across relevant variables. |
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| An Evaluation of Distributed and Accumulated Reinforcer Arrangements on Skill Acquisition, Preference, and Interfering Behaviors |
| NATALIE MANDEL (Bancroft), Catia Cividini-Motta Cividini (University of South Florida), Jeff Schram (Bancroft) |
| Abstract: Manipulations to the reinforcement component of discrete trial training (DTT) can increase its instructional efficiency (e.g., Cividini-Motta & Ahearn, 2013). Results of previous studies indicate that some individuals prefer (e.g., DeLeon et al., 2014) and it is more efficient (i.e., Robinson & St. Peter, 2019) to complete larger work requirements that result in a larger amount of a reinforcer (i.e., accumulated arrangement), rather than receiving access to small amounts of a reinforcer dispersed throughout the work requirement (i.e., distributed arrangement). However, few studies have evaluated the impact of these arrangements on acquisition and the literature comparing these reinforcer arrangements on efficiency and/or participant preference primarily included adolescent participants and activity-based reinforcers. Therefore, the purpose of this study was to compare the efficacy and efficiency of DTT programs across accumulated and distributed reinforcer arrangements and multiple types of reinforcers (i.e., edibles and activity-based). Participants were young children diagnosed with autism. Overall, the distributed arrangements required fewer sessions and the distributed with edibles arrangement was associated with the shortest duration to mastery and least amount of interfering behavior. Participants preferred the distributed with edible or activity arrangement. Finally, caregivers and clinical team members agreed both types of arrangements and reinforcers are acceptable. |
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| Evaluating Client Preference for Prompting Procedures to Address Escape-Maintained Challenging Behavior |
| COURTNEY HANNULA (Marcus Autism Center), Mindy Christine Scheithauer (Marcus Autism Center), Summer Bottini (Marcus Autism Center), Meara X. H. McMahon (Marcus Autism Center and Emory School of Medicine) |
| Abstract: Differential reinforcement of task completion, is a common treatment for escape-maintained challenging behavior. In this treatment, therapists can implement different methods of prompting to ensure the demand remains in place until task completion occurs. However, there is little research on client’s preference for these different prompting strategies. The current study enrolled five participants referred to an intensive unit for challenging behavior. A functional analysis identified challenging behavior was maintained by escape for all participants. A subsequent multielement prompt assessment was conducted to determine which prompting strategy (3-step least-to-most, repeated vocal prompt, or a single initial prompt followed by representation of material) was effective at reducing challenging behavior and improving task completion. If limited prompting strategies were effective with negative reinforcement alone, positive reinforcement was added. More than one prompting strategy was effective for all clients. Thus, we implemented a concurrent operant chain assessment to determine client preference. A clear preference was identified for 3 of participants, with two selecting the initial prompt and one the repeated verbal. Results are discussed in the context of client autonomy and incorporating choices in treatment planning. |
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