Association for Behavior Analysis International

We will present a systematic review of individual participant data from the published articles on the outcomes of early intensive behavioral intervention (EIBI) for children with autism. The findings will expand on and be compared with other recent reviews of EIBI. Implications of the findings for general implementation practices will be discussed. The preliminary outcome from an EIBI center in London, UK will be presented and we will describe how a standardised framework for measuring a wide range of effects is implemented in this setting. We will consider the resources and training needed to employ these measures and the possible benefits of it. We will present data on how the quality of EIBI can be affected by measuring and improving the general learning environment in local mainstream pre-schools, where EIBI usually is implemented in Norway. Lastly, a case study demonstrates how behavioral analytic procedures such as functional analysis can be used to assess and reduce seizure-like behavior in a girl with Rett syndrome.

Internediate

We gathered individual participant data on 784 children from 17 clinically controlled studies on behavioral intervention for children with autism. The participants were between 2 and 7 years of age at intake and had received behavioral intervention for a minimum of 1 year. The participants were placed either in a behavioral intervention group or in a comparison group. We analyzed outcome in terms of clinical significance. First, we computed the Reliable Change Index for IQ, adaptive behavior, and autism severity. Significantly more children receiving behavioral intervention achieved reliable change in IQ, adaptive behavior, and autism severity. Second, we computed the proportion. of children scoring within the normal/non-clinical range at intake and after the intervention. A significantly larger proportion of the children receiving behavioral intervention scored within the normal range on IQ, adaptive behavior and within the non-clinical range on autism severity following intervention. The most consistent predictor of outcome was intensity in terms of the weekly intervention hours provided. These findings are compared to the findings of other recent reviews and we make some recommendations for intervention implementation and measurements of outcome.

The centre-based model of service delivery developed over the last 3 years at the First Bridge Centre in London will be presented. Possible pros and cons of a centre-based provision compared to other models of service delivery will be discussed. Also, we will present data on the time and resources needed to implement a broad range of outcome measures and the possible benefits of it. Recently published frameworks recommended standardized measures of autism severity, adaptive behavior, challenging behavior, quality of life and social validity, along with criterion referenced measures. Outcome after 6 months on skill acquisition, autism severity and preferences for social stimuli will the presented for 16 children. Outcome after 12 and 24 months on adaptive behaviors, autism severity and problems behaviors will be presented for 12 children and compared to the published outcome of other EIBI provision models and suggested benchmarks. Lastly, we will present the results on social validity.

In recent years, there have been reports of inconsistent quality in general education and challenges in implementing special education support and Early Intensive Behavioral Intervention (EIBI). These results indicate that staff training is needed to improve the quality of services for children with special needs attending preschool. This study employs a delayed multiple baseline design to evaluate a staff training program's influence on the quality of general education, EIBI, and learning opportunities (learn units) in three inclusive preschool units. The intervention period was 17 weeks, consisting of a 4-hour post-baseline workshop followed by bi-weekly coaching with the entire staff group in the unit. The results showed an increase in the number of learn units with an effect size ranging from medium to large and improved EIBI quality. The quality of general education, measured by the Autism Program Environment Rating Scale (APERS-P-SE), improved in each preschool from baseline to posttest and on to follow-up. Promising results and assessment of staff social validity indicate that staff training with the entire staff group, using APERS-P-SE, and focusing on learn units may be one way to improve the implementation of EIBI and the general quality in preschools.

Contextual events are recognized to affect seizure-like behaviors, yet there is limited research on procedures assessing contextual control of seizure-like behaviors. This study aimed to examine the utilization of a brief precursor functional analysis (FA) within a clinical team assessment. Also, this study investigated if telehealth supervision could guide a parent administered replication of the FA. The participants were a young female with Rett syndrome and a history of epilepsy as well as non-epileptic seizures and her mother. The main outcome measure was precursor behavior occurrence and condition interval duration. In addition, data on procedure fidelity, inter-rater agreement (IRR), and social validity were obtained. Tau-U statistics were used for statistical analysis. The clinical FA revealed that the seizure-like behaviors served functions of access to attention and preferred activities. The parent-administered FA showed a procedure fidelity of 92 percent and resembled clinical FA findings and statistical analysis showed a large effect size (Tau = 1, p .014. Cl 90% .328 < > 1). Overall IRR was substantial with a mean of 93.3 percent and social validity ratings were high. This study suggests that adapted FA procedures could provide important information in the assessment of non-epileptic seizures.