Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.


49th Annual Convention; Denver, CO; 2023

Event Details

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Symposium #228
CE Offered: BACB
Subtyping, Predictive Validity, and Treatment of Restrictive and Repetitive Behaviors
Sunday, May 28, 2023
4:00 PM–4:50 PM
Convention Center Mile High Ballroom 4A/B
Area: AUT; Domain: Applied Research
Chair: Meka McCammon (University of South Florida)
CE Instructor: Meka McCammon, Ph.D.
Abstract: Researchers have established subtyping procedures for predicting effective interventions designed to treat self-injurious behavior (Hagopian et al., 2015). This symposium extends this methodology by subtyping and treating restricted and repetitive behaviors in children with autism spectrum disorder. The first presenter discusses the application of a hands on shoulder intervention to treat idiopathic toe -walking, its effectiveness and social validity. The second presenter applied subtyping methodology to inform a multicomponent intervention for the treatment of higher level restricted and repetitive behavior; arranging and ordering. Finally, the third presenter will discuss findings from a systematic review of automatically maintained stereotypy during functional analysis conditions. Their findings suggest promising predictive validity of the subtyping methodology when combined with an expanded analysis.
Instruction Level: Intermediate
Keyword(s): functional analysis, RRB, subtyping
Target Audience: Attendees should have a thorough understanding of functional analysis methodology
Learning Objectives: At the conclusion of the presentation, participants will be able to: (1) describe the application and effectiveness of a hands-on shoulder procedure to reduce instances of toe-walking among children with autism; (2) understand the subtyping methodology, its expanded analysis, and be able to identify predictors of treatment efficacy when assessing and treating stereotypy; (3) understand the application of subtyping analysis to higher level repetitive behavior.

Evaluation of a Hands-On Shoulder Procedure to Reduce Toe Walking Among Children With Autism

FRANCHESCA IZQUIERDO (Florida Institute of Technology), Christina Marie Sheppard (Florida Institute of Technology), David A. Wilder (Florida Institute of Technology)

Idiopathic toe-walking (ITW), also known as toe-walking, is commonly exhibited among children with intellectual and developmental disabilities. There have been many medical and behavioral treatments that have been evaluated as interventions for toe-walking. The behavioral interventions include differential reinforcement procedures, feedback paired with reinforcement, stimulus control procedures, and punishment based procedures. In a recent study, Wilder et al. (2020) used a feedback procedure with paired reinforcement and a hands-on shoulder procedure to decrease toe-walking to low levels. The hands-on shoulder procedure includes both positive and negative punishment-based components. Although the hands-on shoulder procedure has been used as an intervention component within other studies to treat toe-walking, but has not been evaluated as the main intervention. The purpose of the current study was to further evaluate the effectiveness of hands-on shoulder procedure to reduce instances of toe-walking among children with autism. The procedure was largely effective; we discuss the results and social validity of the procedure in this presentation.


Functional Analysis and Delineating Subtypes of Restricted and Repetitive Behavior in Individuals With Autism Spectrum Disorder

ASHLEY MATTHEWS (New England Center for Children), RILEY FERGUS (New England Center for Children ), William H. Ahearn (New England Center for Children)

Hagopian, Rooker, and Zarcone (2015) evaluated a model for subtyping and predicting effective treatment methods for automatically reinforced self-injurious behavior (SIB). It is possible that this subtyping model could be extended to treatment of other topographies of automatically maintained challenging behavior, including stereotypy. To date, only one study has examined automatically maintained arranging and ordering, which is a form of higher level repetitive behavior (Rodriguez et al., 2012). The current study applied Hagopian’s subtyping analysis to higher level repetitive behavior (Hagopian et al. 2015, 2017). Treatment applied information from the subtyping literature in that Subtype-1 higher level repetitive behavior was exposed to reinforcement alone while Subtype-2 higher level repetitive behavior involved reinforcement with added components (e.g., redirection, response-blocking). A variety of assessments, including preference assessments and augmented-competing stimulus assessments (A-CSA) were conducted to inform treatment methods. Following treatment, generalization probes were conducted. Treatment effects were reviewed to determine if the subtyping model was effective in predicting effective intervention. Reliability data were collected across at least 30% of all sessions, conditions, measures, and participants. Mean interobserver agreement (IOA) data ranged from 80%-100%.

Subtyping Stereotypy: Do Subtypes Predict Treatment Outcomes?
ALYSSA ROJAS (University of South Florida), Catia Cividini-Motta Cividini (University of South Florida), Tiago Sales Larroudé de Man (Universidade Estadual de Feira de Santana/Western New England), William H. Ahearn (New England Center for Children)
Abstract: The identification of predictors of treatment efficacy has extensive value for clinical programming. In this review, we re-analyzed data from functional analysis (FA) and treatment evaluations from the studies on automatically reinforced stereotypy included in the reviews published by Virués-Ortega et al. (2022) and Wunderlich et al. (2022). Using subtyping methodology similar to those described by Hagopian et al. (2015) which entail analyzing data from the FA, each data set was categorized into two subtypes. To further extend this methodology and validate its applicability to stereotypy, we completed an expanded analysis which entailed comparing levels of stereotypy during the alone to the play condition and the levels of stereotypy during the alone condition to the other test conditions (i.e., demand, attention). To evaluate correspondence between subtypes and treatment efficacy, we evaluated which types of treatments were associated with reductions in stereotypy classified as Type 1 and Type 2. Preliminary results indicate the presence of different subtypes across analyses, predictive validity is partially obtained when using the Hagopian et al. (2015) subtyping methodology, with a minor increase in predictive validity when using the expanded analysis.



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