Association for Behavior Analysis International

Given the substantial conceptual overlap between subfields of applied psychology (e.g., behavior analysis, clinical/school psychology, mental health), treatment outcomes can be strengthened by integrating knowledge and practice from these other areas of practice. In this symposium, we will provide an overview of evidence for integrated treatment packages to support clients and families with problems of social significance. In the first presentation, Dr. Lent will highlight discuss the role caregiver accommodation in the maintenance of compulsive behavior in autistic individuals. In the second, Dr. Picardo will present data on developing a scalable model of universal behavior intervention in an early learning setting. In the third, Dr. Chunta will discuss the identification of caregiver variables that could improve procedural fidelity. In the fourth, Dr. Han will present a set of procedures integrating behavior analytic techniques into an attachment-based caregiver-mediated intervention. Collectively, these studies seek to highlight the benefits of integrating clinical perspectives to increase the generality of behavior analytic procedures.

Audience members should have familiarity with functional assessment procedures, caregiver training, and multidisciplinary collaboration.

Caregiver treatment adherence, also known as procedural fidelity (PF), impacts parent-mediate behavioral treatment outcomes. PF is influenced by caregiver specific variables, including their memory, planning, and organization skills, referred to as executive functioning (EF). Within traditional behavioral treatments (1 hour per week), poor caregiver EF negatively impacts PF and treatment outcomes. Because high dosage behavioral treatments (4-10 hours per week) allow for increased practice opportunities and in-the moment coached, they may ameliorate some of the barriers associated with poor EF. Limited research exists examining how PF and treatment outcomes differ based on caregiver EF across treatment dosages. The current study examines clinical outcomes based on caregiver EF across different treatment dosages. High dosage participants completed 20-hours of intervention over two or five weeks. Traditional treatment participants completed 10 hours over 10 weeks. Intervention procedures included behavioral skills training, differential reinforcement, and contingency management. Caregivers differed in self-reported EF scores. Results suggest that regardless of caregiver EF, parents completed at least 85% of recommended treatment hours and children demonstrated at least 76% behavior reduction in session. Differences in parent reported behavior reduction at home and PF will be explored. Implications for a priori treatment dosage recommendation and related modifications are discussed.

Compulsive and repetitive behaviors are common features of autism spectrum disorder (ASD) and obsessive-compulsive disorder (OCD). When ASD and OCD present comorbidly, the compulsive behaviors may be difficult to treat. Specifically, cognitive behavioral techniques, the most used treatment for compulsive behavior, may be ineffective for socially mediated compulsive behaviors (e.g., reassurance seeking) for individuals with ASD because the functional reinforcer (i.e., attention) is provided to the target behavior as part of the treatment process. This study replicates an alternative behavioral treatment modality, which uses functional assessment, differential reinforcement of other behavior (DRO), and extinction procedures. An ABAB withdrawal design was implemented with individuals with ASD and OCD who engage in socially mediated compulsive behaviors. Caregivers were trained to implement all treatment procedures via behavioral skills training, and results suggest decreased rates of compulsive behaviors measured via direct data collection. Implications for integrating traditional cognitive-behavioral and applied behavior analysis techniques are discussed.

Early intervention for behavior problems and adaptive skill development in preschool-aged children is critical for school readiness. Current approaches require substantial, time-intensive baseline data collection, teacher training, and direct intervention. For example, Hanley et al.’s (2007) seminal Preschool Life Skills program required approximately 2.5 weeks of data collection and 7 weeks of intervention.). Such approaches may not be feasible in time-and-resource constrained early-childhood settings, yet there is a dearth of scalable, sustainable, and efficient programs to assist early childhood educators with the identification and treatment of behavior problems and adaptive skill deficits. The purpose of this study was to provide proof of concept for an efficient adaptive behavioral skills program in an early childhood inclusive school setting using an ABC design. Participants were students (n=14) and teachers (n=4) in two inclusive classrooms. Baseline data collection on four school readiness skills (i.e., functional communication, tolerance of delays, instruction following, and sharing) consisted of three 15-minute naturalistic observations per student participant. The treating provider then implemented a class-wide intervention with one hour of teacher consultation, 20-minutes of class-wide direct intervention, and two days of in vivo teacher coaching. Preliminary results indicate a decrease in total classroom problem behaviors and an increase in functional communication, delay tolerance, sharing, and instruction following in one classroom.

Parent-Child Interaction Therapy (PCIT) is a widely disseminated evidence-based treatment for disruptive behavior in children ages 2-7 years. PCIT aims to reduce problem behavior by teaching caregivers to use differential attention and a manualized time-out procedure for noncompliance. Though rooted in behavioral principles, PCIT differs from an ABA approach to treating problem behavior in several key ways: (1) it fails to evaluate and account for function(s) of problem behavior, (2) it emphasizes caregiver skill acquisition rather than child skill acquisition, and (3) it uses a punishment procedure prior to using a reinforcement procedure to improve compliance. In this presentation, a function-informed adaptation of PCIT is introduced, outlining the changes made to the standard PCIT protocol and detailing the rationale for these changes. Preliminary data demonstrate the use of function-informed PCIT procedures as a promising alternative to the standard protocol. Implications for the use of a function-informed adaptation of PCIT in lieu of the standard approach are discussed.