Association for Behavior Analysis International

Dentists report difficulty in completing routine dental examinations for neurodiverse patients due to behavioral differences (Chandrashekhar & Bommangoudar, 2018). Many dental clinics therefore rely on the use of sedation and/or restraint to complete exams, despite the increased risk of adverse health outcomes for neurodiverse patients using sedation (Soldani et al., 2010), and negative associations with medical providers, lack of bodily autonomy, and trauma for neurodiverse individuals with repeated use of restraint. St. Christopher’s Hospital for Children (SCHC) established a collaboration between the behavioral health and dental clinic to create a sensory-friendly dental program (SFDP), aimed to reduce the use of sedation and restraint for neurodiverse patients by integrating behavioral health practitioners (psychologist and Applied Behavior Analysis (ABA) therapist) to teach cognitive behavioral therapy (CBT) and ABA-based techniques in-vivo to dental residents. This study examined the acceptability, feasibility, and appropriateness of the novel SFDP as reported by patients n=7, caregivers n=18, and dental residents n=9. Surveys included Likert scale and open-ended responses. Feedback from respondents was analyzed, then used to inform the development of a formal behavior skills training program that will teach dental residents at SCHC to independently engage in sensory-friendly, CBT, and ABA-based exam practices with fidelity.

Difficulties associated with diagnoses of autism spectrum disorder can have a significant impact on family systems. The relationship between parents and children with autism spectrum disorder is complex and is likely to vary per child. As behavioral therapists have an important role in supporting the learning and well-being of children with autism spectrum disorder, a better understanding of the role parents can play in implementation of services can be helpful in tailoring and implementing individualized treatment and behavior plans. Given these premises, the purpose of this poster was to explore the extant literature on parental stress and parental efficacy in families with children with diagnosed autism spectrum disorder. The thematic literature search identified 30 papers that will be presented in a poster format as a resource that interventionists and psychologists can use to increase their understanding of family system factors involved within parenting an individual with an autism spectrum disorder diagnosis.

Rule-based insensitivity to contingencies has been suggested to form the basis of psychopathologies, although conclusive evidence is lacking in clinical population studies. This study investigated how programmed consequences influence rule-following in 51 university students with different levels of depressive symptomatology. Participants were assigned to one of two conditions (i.e., point gain or point loss) and instructed to perform a matching-to-sample task, comprising four blocks with 20 trials each. In Gain Groups, the objective was to gain points, while in Loss Groups participants should avoid losing points. In Blocks 1 and 3, contingencies were correspondent to the presented rule, in Blocks 2 and 4, contingencies were reversed and became inconsistent with the rule. Median correct responses were measured. Results showed that all participants followed the rule in Blocks 1 and 3. In Blocks 2 and 4, participants in the Loss Groups presented significantly more correct responses than those in the Gain Groups, indicating that rule-following is more likely to be abandoned when it produces loss of reinforcement compared to extinction conditions. Importantly, there were no differences between high and low depressive symptom participants, suggesting that depressive symptomatology did not exacerbate rule-based insensitivity to contingencies in this context.

Although the rate of new HIV infections in the US has declined from its peak in the mid-1980s, HIV still remains a serious public health challenge in the US. A safe and effective HIV vaccine will be particularly vital in reducing the incidence of HIV infections locally in the US and globally. As exemplified with smallpox, polio, and more recently, COVID-19, the development of a preventive HIV vaccine can provide long-lasting protection and community immunity for a wide range of people, while also eliminating many of the problems currently associated with HIV treatment including high costs, delayed onset of treatment, drug resistance, adverse side effects, poor adherence, and stigma. However, as we have learned from the COVID-19 pandemic, vaccine efficacy is not the only constraint on vaccine acceptance behavior. Personal, interpersonal, contextual, and vaccine-dependent factors can also impact people’s valuations of a vaccine, as well as their intentions to accept them. To better understand how these factors can influence and interact with each other to affect vaccine acceptance, my research project aims at using simulated markets to safely model and rapidly evaluate demand for HIV vaccines among at-risk population groups in the US. By exploring the factors facilitating or hindering HIV vaccine acceptance in the US, the proposed research endeavor has the potential to inform public health interventions and public policies on HIV vaccines when they eventually become widely available in the US.

The current study examined the use de-escalation techniques with the availability of physiological data by employees in an analogue work environment on work related task with six employees at a congregate care facility. The participants were taught how to read the physiological data obtained through the EliteHRVTM device and how changes in those data may impact their performance at work. During the training, the participants were taught to perform two different de-escalation strategies (i.e., diaphragmatic breathing and applied muscle relaxation). Following the acquisition of these skills, participants were exposed to an agitating task (i.e., Stroop effect test) and a sequencing task (i.e., SimonTM). The dependent variables were the number of correct responses on the sequencing task, a self-report survey during each condition, and their physiological data (i.e., heart rate and heart rate variability). The participants demonstrated differential performance and differential physiological data on the sequencing task following one or both de-escalation techniques, and provided initial evidence to support that spending time to train staff on personal de-escalation techniques was beneficial in an analogue setting. Limitations, confounding variables, future research, and contributions to the field were discussed.

Vascular Dementia (VaD) is the second most common cause of dementia worldwide. It involves cognitive impairment and it usually causes impossibility to have gainful employment, to drive safely and to live independently. Behavioral gerontology, namely the implementation of behavioral principles and procedures to treat various geriatric problems, has been an emerging field in the last 40 years. The present study proposes the use of forward chaining with errorless learning procedure to teach an 80-year-old man with VaD some independence related numbers. All the sessions were conducted at the participant's home. The percentage of correct responses was measured for each one of the target behaviors. A multiple probe design combined with changing criterion design was implemented to test the effectiveness of the procedure. The intervention was effective in teaching independence related numbers to the participant. The study showed strong internal validity. The results may be important to develop future support services for people with VaD.

Many individuals struggle with feeding difficulties. Most of those families have a difficult time gaining access to appropriate treatment. This case study aims to look at a behavior-based feeding program treatment package that is delivered completely via telemedicine and primarily parent delivered. Preliminary results show an increased consumption of both variety and volume of non-preferred foods and more flexible eating behavior. In this case study exploring the effectiveness of a parent-delivered behavior-based feeding program, significant improvements were observed in the child’s dietary habits and eating behavior. The intervention focused on parents as the primary agents of change and aimed to enhance their child’s consumption of non-preferred foods, as well as promote greater flexibility in eating behavior. The results of the treatment, so far, show a notable increase in the consumption of both a wider variety and greater volume of non-preferred foods. Additionally, the child is exhibiting more flexible eating behavior, indicating a positive shift in her food preferences and attitudes towards food. This study hopes to highlight the potential benefits of both telemedicine and parent-delivered behavior-based feeding programs as an effective tool for improving a child’s eating habits and enabling a more diverse and balanced diet. These findings have practical implications for clinicians, educators, and parents seeking strategies, as well as more flexible treatment options to address selective eating and food-related challenges in children.

Dental disease is more common in people with intellectual disability (ID) than in the general population (Newton, 2009). Receiving a dental examination and engaging in daily oral hygiene are known to improve oral health (Newton, 2009), however, they are often invasive, aversive and may be more challenging for someone with an ID. There is evidence for using behaviour analysis in supporting individuals with intellectual disabilities for dental procedures e.g. dental cleaning (Allen and Stokes, 1987., Altabet, 2002), dental treatment (Neumann et al., 2000) and dental assessment (Cuvo et al., 2010a, Hine et al., 2009). However behaviour analytic interventions are not consistently implemented by healthcare workers in Wales and England. This research aimed to study the barriers and facilitators to accessing medical care for individuals with ID by interviewing parents or carers of individuals with ID and medical professionals on their experiences treating individuals with ID. The results highlighted the specific issues for accessing quality care from both carers and medical professional perspectives and were categorised into 6 themes; 4 barriers and 2 facilitators. We hope to use the results to improve access to medical care for individuals with ID, enabling better diagnoses, and improving quality of life.

Previous research has identified re-presentation an effective treatment for expulsion (i.e., spitting out food/liquid) when used alone or in combination with other treatments (e.g., chin prompt; escape extinction; Coe et al., 1997; Girolami et al., 2007; Ibañez et al., 2021; Sevin et al., 2002). Researchers have described re-presentation as being implemented in two distinct formats: re-presenting the expelled bite/drink or re-presenting a new bite/drink of the same food/liquid that was expelled. However, the re-presentation format may vary across clinicians and contexts. For example, clinicians may present a new bite/drink only under certain conditions such as following expulsion onto the floor or other unsanitary surface; Ibañez et al., 2021; Shalev et al., 2018). There is no existing literature that explores which re-presentation format is more effective at decreasing expulsions. In the current study, we used a multielement and reversal design to compare the efficacy of both re-presentation formats. Caregivers completed a satisfaction questionnaire measuring the acceptability of each re-presentation format. Results revealed that both re-presentation formats were similarly effective at reducing expulsion. Additionally, caregivers preferred the re-presentation format with a new bite of food. We discuss the application of these results to the treatment of expulsion for children with feeding disorders.

Self-monitoring and goal setting procedures have been implemented in various sports and performance levels and have shown promising results. Applications of these procedures in swimming in the last two decades are rare. Using an ABAC design, this study aimed to investigate the effects of a self-management package including self-monitoring, verbal feedback, and goal setting on the swimming performance of four competitive athletes aged 10-13. The dependent variable was a complete freestyle tumble turn consisting of five phases: approach, rotation, push-off, underwater swimming, and stroke resumption, and presented as a percentage of tumble turns completed of the turns assigned. Social validity was also assessed. The first intervention application included immediate self-monitoring of the behavior on dry-erase boards and vocal feedback for performance. The second application (i.e., C condition) was boosted by a daily goal setting procedure. Participants' mean performance data was 38% under baseline, 74% under the B condition, and 81% under the C condition. The self-monitoring intervention successfully increased the number of complete tumble-turns from baseline to intervention, with greater performance when goal setting was added. The swimmers were in favor of the intervention's goals and procedures and particularly of the goal setting procedure.

Clinicians may consider children’s preference while increasing food intake and variety during treatment by conducting repeated edible preference assessments (Kozlowski et al., 2016), offering choices (Crowley et al., 2020; Taylor et al., 2020), and using reinforcement-based procedures (e.g., levels systems; Ripple et al., 2022). Current research is mixed regarding whether food preferences change (e.g., in favor of target foods) following treatment for children with feeding disorders (Penrod & VanDalen, 2010; Zeleny et al., 2020). Another dimension of preference may include evaluating the perceived level of difficulty with trying a food pre- and post-treatment. In the current study, we asked a 13-year-old female with gastrostomy-tube dependence and eosinophilic gastroenteritis to rate the difficulty level of trying various foods using a 10-point Likert scale (i.e., 1=easiest to try, 10=hardest to try). We used a multiple baseline design across food-rank categories (i.e., easy, medium, and hard) to evaluate a treatment package consisting of noncontingent attention, demand fading, and post-meal reinforcement for increasing percentage of bites taken. Overall, percentage of bites taken increased across all food-rank categories and bite-volume increases. Additionally, most food rankings changed across treatment. We discuss the potentially important applications of utilizing food rankings during treatment of feeding disorders.

Functional analyses (FA; Iwata et al., 1982) has been continuously referred to as the “gold standard” of behavior assessment as it is the only assessment methodology that shows a causal relationship between environmental events and an individual’s behaviors. When a functional analysis produces differentiated results, treatments are developed based on those results and the FA is unlikely to be repeated. However, little research has explored the degree to which FA outcomes are stable over. Thus, the purpose of this study was to examine the concordance of FA results for patients in an intensive outpatient clinic who had repeated FAs with at least 12 months in between. In addition to assessing any changes in topographies and frequencies of challenging behaviors, we compared the outcomes of the repeated FAs in terms of function and classified them as full concordance, partial concordance, or zero concordance. In addition to sharing the outcomes of these comparisons, this poster will discuss the implications for both assessment and treatment of challenging behavior over time.

Objective: A new virtual reality system for upper limb rehabilitation (VRactce) has been developed to measure arm movements, immediately reduce prompt stimuli based on movement mastery, and generate spontaneous reaching movements. This study investigated the effects of visual prompt-fading on motor learning and self-efficacy during behavioral practice using VRactice. Methods: Participants, healthy adults, received feedback by varying the transparency of the model avatar image in two dimensions, the distance (strict or latent) from the subject's avatar, and the number of task cycles (two or five cycles) to be judged. As a verbal behavior measure, self-efficacy was assessed five times in the experimental sessions. Results: Under the conditions of strictness and two cycle conditions, the distance between the avatar and the actual movement was smaller, indicating that more accurate reaching movement occur in this condition. Self-efficacy did not necessarily correspond to the degree of motor learning. Conclusion: We suggest that the degree of learning of the reaching movement differs depending on the prompt fading conditions, and that motor learning is performed more smoothly when appropriate information is fed back at an appropriate frequency. The virtual reality system may serve as an effective tool to improve the behavior of patients with movement disorders.