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.


41st Annual Convention; San Antonio, TX; 2015

Event Details

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Symposium #311
CE Offered: BACB
Examinations of outcome data from clinical programs that address behavior disorders
Monday, May 25, 2015
9:00 AM–10:50 AM
214D (CC)
Area: DDA/CBM; Domain: Applied Research
Chair: Henry S. Roane (Upstate Medical University)
Discussant: Joel Eric Ringdahl (Southern Illinois University)
CE Instructor: Henry S. Roane, Ph.D.
Abstract: A core feature of ABA is its focus on data collection and analysis. Typically, these data permit an evaluation of an individual’s responding across an observation period and allow for the examination of functional relations. Organizations that conduct such data on individuals often assess those data on a program level. Information gleaned from such analyses can inform a number of organization parameters such as service delivery, treatment implementation, and research – areas that can, in turn, affect the larger practice of ABA. This symposium will describe outcomes from clinics that specialize in the treatment of behavior disorders. The first presentation describes outcomes from a clinic that conducts brief (30-60 min) appointments, including the prevalence of referral concerns, diagnostic profiles of clients, cancellation rates, and percent reduction in problem behavior. The second talk will discuss the evaluation of noncontingent reinforcement across 28 individuals and will compare differences between socially and non-socially mediated behaviors. The third talk details follow-up data on the use of an outpatient approach to address enuresis and encopresis. The final talk will describe the effects of using brief outpatient visits to treat feeding disorders. Each talk will include case examples, and Dr. Joel Ringdahl will discuss the results.

Outcome data from a pediatric outpatient clinic specializing in the treatment of severe problem behavior

NICOLE DEROSA (Update Medical University), Leah Phaneuf (Upstate Medical University), Henry S. Roane (Upstate Medical University)

A number of clinics exist worldwide that employee functional analysis-based treatments for severe problem behavior. This presentation will describe the organization and outcome data from a pediatric outpatient clinic at Upstate Medical University. Unique to this clinic is the fact that all services are provided within the constraints of psychotherapy current procedural terminology (CPT) codes. One facet of this method of billing is that all psychotherapy CPT codes are time-limited (e.g., 60 min) which could impact a number of client-related factors such as response to treatment and cancellation rates. We will discuss clinical procedures that have been developed to address these issues while maintaining the technical requirements of the functional analysis process. Case examples will be provided to illustrate the utility of the model. We will also provide outcome data on the types of problems addressed, diagnostic profiles of clients, cancellation rates, and percent reduction in problem behavior (presently over 90% reduction relative to baseline levels of problem behavior). These outcomes will be discussed in terms of factors to consider for clinic development, program evaluation, and client retention.


Noncontingent Reinforcement for the Treatment of Severe Problem Behavior: A Consecutive Case Analysis of 28 Applications

Cara Phillips (Kennedy Krieger Institute and the Johns Hopkins Un), JULIA IANNACCONE (Kennedy Krieger Institute), Griffin Rooker (Kennedy Krieger Institute), Louis P. Hagopian (Kennedy Krieger Institute)

Noncontingent reinforcement (NCR) is a commonly used treatment for severe problem behavior displayed by individuals with intellectual and developmental disabilities. The purpose of the current study was to expand on the existing literature on NCR by reporting outcomes achieved with 28 applications of NCR as the primary treatment across consecutive cases with severe problem behavior using a collective case series to minimize selection bias. Participants ranged in age from 5 to 33 years and had intellectual and developmental disabilities. 14 application were for behavior maintained by automatic reinforcement, 13 for behavior maintained by social reinforcement (i.e., attention, escape, tangible), and one for behavior with unknown function (i.e., inconclusive FA). Results suggest that the effectiveness of NCR may in part be determined by behavioral function. NCR resulted in a 90% or better reduction in problem behavior for only 7 of 15 cases in which problem behavior was maintained by automatic reinforcement. In these cases, additional treatment components were added to bolster effects. In contrast, when NCR in isolation was applied to socially maintained behavior, the result was a 90% or better reduction for 12 of 13 cases. Results suggest that NCR is an effective treatment for socially maintained problem behavior.

Refinements and Outcomes from a Toileting Program Targeting the Treatment of Enuresis and Encopresis for Individuals with Developmental Delays
JOANNA LOMAS MEVERS (Marcus Autism Center), Nathan Call (Marcus Autism Center), Mynaria Everett (Marcus Autism Center)
Abstract: Toilet training is a critical self-help skill. Whereas typically developing children generally achieve continence by 2-4 years of age (Blum, Taubman, & Nemeth, 2003) individuals diagnosed with developmental disabilities are often delayed in achieving independent continence or never achieve it at all. Incontinence has many negative side effects, such as an increased burden of care for parents, poor hygiene, physical discomfort, lack of independence, and social stigma (Cicero & Pfadt, 2002). In addition, incontinence can lead to exclusion from many settings, such as regular educations classrooms, camps, or extracurricular activities. Despite the social significance and importance of achieving continence there have been few advances beyond the procedures outlined in the study by Azrin and Fox (1971), which presented an early treatment for enuresis. Furthermore, there are no well-established procedures for the treatment of encopresis. The current study includes datasets from a clinical protocol for the treatment of enuresis that includes several refinements to previous methods. In addition, data from a novel procedure developed for the treatment of encopresis will be presented, as well as long-term outcomes that show sustained continence and emergence of skills that were not specifically targeted for intervention (e.g., self-initiation).

A Presentation of Outcome Data from an Intensive Pediatric Feeding Program

AARON BOYCE (Munroe-Meyer Institute, University of Nebraska Medical Center), Jennifer M. Kozisek (Munroe-Meyer Institute, University of Nebraska), Valerie M. Volkert (Munroe-Meyer Institute, University of Nebraska Medical Center), Suzanne M. Milnes (Munroe-Meyer Institute, University of Nebraska Medical Center), Cathleen C. Piazza (Munroe-Meyer Institute, University of Nebraska Medical Center)

The behavior analytic literature indicates multiple effective interventions to address pediatric feeding disorders (Milnes & Piazza, 2013; Sharp, Jaquess, Morton, & Herzinger, 2010). While the breadth of published interventions affirms that clinicians are developing effective treatments to progress children diagnosed with feeding disorders toward age-typical eating, these published studies provide information on only a small percentage of the children being treated. Furthermore, while there are a few published reviews summarizing which interventions clinicians are using to successfully treat feeding disorders (Volkert & Vaz, 2010), these reviews do not provide information about the totality of successful interventions used in their clinics. Success could be indicated by decreases in enteral feedings and disruptive mealtime behavior or increases in oral intake and integrity when transitioning to caregivers feeding (i.e., rather than a trained therapist). Thus, to contribute to our understanding of successful interventions for pediatric feeding disorders, we preliminarily evaluated outcomes for 46 children from a well-established Midwestern pediatric feeding disorders clinic, which included evaluation of the interventions we used to treat each child. These data may assist in bridging the gap between science and practice in determining which interventions are successful and used most often by clinicians to treat pediatric feeding disorders.




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