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| DDA Sunday Noon |
| Sunday, May 24, 2015 |
| 12:00 PM–2:00 PM |
| Exhibit Hall C (CC) |
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| 91. The Assessment of Challenging Behavior Across Psychotropic Medication Changes in Adults with Bipolar Disorder and Intellectual Disabilities |
| Area: DDA; Domain: Applied Research |
| MARIA G. VALDOVINOS (Drake University), Meara Henninger-McMahon (Drake University), Danielle Mroz (Drake University), Annika Basham (Drake University), Elizabeth Schieber (Drake University), Margaret Olson (Drake University), Jacob Hunstiger (Drake University), Ashley Fee (Drake University) |
| Abstract: Although long-term use of psychotropics has been used to treat individuals with bipolar disorder and intellectual disabilities (ID), little research has been conducted to assess the interaction of psychotropics and environmental variables on challenging behavior in those with bipolar disorder and ID. In the present study, three participants: Ralph (SIB), 28 year old male, diagnosed with bipolar I disorder, severe ID, and autism spectrum disorder; Ben (SIB), 49 year old male, diagnosed with bipolar not otherwise specified (NOS), profound ID, and dysphasia; Kate (Refusal), 53 year old female, diagnosed with bipolar II disorder and moderate ID participated in experimental functional analysis (FA) to determine the function of each participant's challenging behavior. The Questions About Behavior form was administered at the time of each FA and one-hour direct observations were videotaped weekly. Two weeks after each medication change, another FA was conducted. All data were coded and analyzed using The Observer XT. Changes were observed for all participants although the changes observed were not uniform across participants (e.g., differences in either conditions in which behavior occurred versus frequency of behavior), which suggests function-based data collection would be helpful in the prescribing practices of psychotropics in individuals with bipolar and ID. |
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| 92. Using Differential Reinforcement and Token Economies to Increase Self-Feeding in Children with Pediatric Feeding Disorders |
| Area: DDA; Domain: Applied Research |
| LORI BETH VINCENT (Kennedy Krieger Institute), Melissa Luke Gonzalez (Kennedy Krieger Institute) |
| Abstract: Self-feeding is an important clinical goal for children with pediatric feeding disorders, as it allows for increased independence and social participation with feeding which is often age-appropriate and decreases demands on caregivers. Nonetheless, despite substantial research on increasing food and drink acceptance in children with pediatric feeding disorders, there is limited research on increasing self-feeding. The current study evaluates the use of differential reinforcement and token economies to increase and maintain self-feeding of food and drinks in two five-year-old children with pediatric feeding disorders. Both participants were enrolled in an intensive feeding disorders program and demonstrated low levels of self-feeding of both food and drinks prior to intervention. To increase self-feeding, differential reinforcement was provided for each instance of self-feeding food or drinks. Token economies for each participant were introduced in order to thin the schedule of reinforcement over time. Both participants demonstrated an increase in self-feeding following the introduction of differential reinforcement. High levels of self-feeding were maintained using a token economy. |
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| 93. Improving Physical Therapeutic Outcomes for a Child with Cerebral Palsy Utilizing Precise Measurement and Reinforcement |
| Area: DDA; Domain: Applied Research |
| KRISTINA SAMOUR (Nova Southeastern University ), Sydney Webster (Nova Southeastern University ), Dahlia Magdy (Nova Southeastern University ), Juliana Dadalto (Nova Southeastern University ), Barry Alouidor (Nova Southeastern University ), Joelle Krantz (Nova Southeastern University), Leonette Lee (Nova Southeastern University ), Eric Levin (Nova Southeastern University ) |
| Abstract: Cerebral Palsy (CP), a neurological disorder present in infancy, results in problems with body movement and muscle coordination. Physical therapy treatments for children with CP often incorporate praise and various motivators to promote coordinated body movements. In the current study, we implemented a treatment protocol for a five-year-old male diagnosed with CP to improve his physical abilities. The treatment protocol included the use of praise, in addition to, contingent reinforcement using items identified through preference assessments. Throughout treatment implementation, external validity was promoted through the continuous involvement of the parent, collaboration with physical therapists, and application in various settings. We demonstrated that the use of contingent praise with access to preferred items was more effective in increasing his duration of standing and walking compared to access to either praise or preferred items alone. Additionally, our findings suggest the importance of collaboration between behavior analysts, physical therapists, and parents to achieve improvements in the physical abilities of children with CP. |
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| 94. The Relationship Between the Function of Self-Injurious Behaviors and Resulting Injuries |
| Area: DDA; Domain: Applied Research |
| ALYSSA FISHER (Kennedy Krieger Institute), Louis P. Hagopian (Kennedy Krieger Institute), Griffin Rooker (Kennedy Krieger Institute), Jennifer R. Zarcone (Kennedy Krieger Institute) |
| Abstract: Self-Injurious Behavior (SIB) is a common problem among individuals with intellectual and developmental disabilities. Fundamentally, SIB is a problem because it is injurious, thus measuring the severity of SIB and resultant injuries of SIB may provide a more complete outcome metric for clinical care than reducing the frequency of SIB. This research assessed differences in typography of SIB and the injuries produced by that SIB. We assessed differences in the topographies of SIB across 15 individuals with SIB maintained by automatic reinforcement and 17 individuals with SIB maintained by social reinforcement. Additionally, we examined intake physicals using the Self-Injury Trauma Scale (SITS) to determine differences in the severity of SIB, as measured by wound production for a subset in each group. Results suggest that individuals with SIB maintained by automatic reinforcement engaged in more topographies of SIB, and these topographies were more varied. In addition, individuals with SIB maintained by automatic reinforcement were more likely to produce lacerations from their SIB than individuals with SIB maintained by social reinforcement. These results suggest that individuals with SIB maintained by social and nonsocial reinforcers sometimes engage in SIB in typographically different ways, which may make certain types of injuries more probable. |
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| 95. Assessment and Treatment of Problem Behavior Associated with Caregiver Separation |
| Area: DDA; Domain: Applied Research |
| JILLIAN BENSON (Kennedy Krieger Institute), John M. Huete (Kennedy Krieger Institute), Matthew L. Edelstein (Kennedy Krieger Institute), Patricia Driscoll (Kennedy Krieger Institute) |
| Abstract: Young children often have difficulty separating from caregivers. For children with developmental disabilities, separation may pose a particular challenge, frequently resulting in problem behavior to re-gain access to their caregiver. The present study used a novel method to assess and treat the problem behavior exhibited by a 4-year old male diagnosed with Attention-Deficit Hyperactivity Disorder and Autism Spectrum Disorder presenting with tantrums. Functional analysis (Iwata et al., 1982/1994) results indicated that the subject’s tantrums were associated with separation from his caregiver. Following functional analysis, a formal assessment was completed to measure the baseline latency to tantrums once the caregiver left the room, which averaged 20s. After baseline data were collected, a timer training procedure was used to orient the subject to a visual timer and teach him that attention would be delivered when the timer expired. During this phase, the caregiver did not leave the room. In the treatment phase, the subject was taught to tolerate increasingly longer separations from his caregiver by using the visual timer to signal her return. Results indicate that the subject was able to increase wait time to five minutes for his mother’s return, and engaged in zero rates of tantrums while waiting. |
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| 96. Object Manipulation Preference and Increased Response Effort to Reduce Self-Injurious Behavior |
| Area: DDA; Domain: Applied Research |
| DIANE BERTH (University of North Carolina Wilmington), Cindy Berry (J. Iverson Riddle Developmental Center, Morganton, NC), Martin Thomas Ivancic (J. Iverson Riddle Developmental Center, Morganton, NC) |
| Abstract: Self-injurious behavior maintained by automatic sensory reinforcement can be difficult to treat, particularly for people with profound multiple handicaps. A multi-element design was used to identify preferred items with one individual to assess the substitutability of self-injurious behavior with appropriate object manipulation. The percentage of intervals with self-injurious behavior and object manipulation were compared across 5 conditions using wearable and chewable stimuli that could provide sensory stimulation substitution for self-injurious behaviors. Results demonstrated that when chewable items were available via stiffened padded clothing protectors in 4 conditions, rates of self-injurious behavior were lower than baseline, however, rates of appropriate object manipulation increased only slightly. A marked increase of appropriate object manipulation and decrease of self-injurious behavior occurred only during the condition with the soft clothing protector plus tubing. Increased response effort needed to self-injure or manipulate objects while wearing the stiffened protectors offers one explanation for these results (Shore et al, 1997). This study provided a method of determining individual preference for certain materials. The soft, wearable, chewable stimulus served as a substitute for self-injurious behavior and the stiffened protector and wearable and chewable stimuli offer a means of reducing self-injurious behavior without being overly restrictive. |
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| 97. Consultation in treatment of self-injury in a school for children with visual and auditory disabilities |
| Area: DDA; Domain: Service Delivery |
| NICOLE SCHROEER (Virginia Institute of Autism), Yaniz C. Padilla Dalmau (Virginia Institute of Autism), Anna M. Hoover (Virgina School for the Deaf and Blind), Julie Connor (Virginia School for the Deaf and the Blind) |
| Abstract: Residential schools for the deaf and the blind are being challenged to serve an increasing number of students with multiple disabilities. These students bring with them learning and behavioral challenges that can stress traditional residential support systems. Recently, journals focused on issues specific to deafness and visual impairment, published articles outlining application of behavior analytic principles in order to serve this population (O'Mea, M.,L. (2013), Zane, T., Carlson, M., Estep, D., & Quinn, M. (2014).).
This poster summarizes the collaboration between a behavioral analytic clinic and a residential school to decrease self-injurious behavior of a 13-year-old-male with multiple disabilities. Preference assessments, functional analysis, and treatment probes were conducted to develop a treatment plan. Staff trainings were conducted and data were collected on long-term treatment effectiveness.
The functional analysis suggested an automatic function of SIB, and treatment probes indicated that matched stimuli decreased rate of SIB. A treatment package consisting of response interruption and competing stimuli was implemented. Initial treatment resulted in a reduction of SIB from an average of 150 per hour to 45. After three months of treatment, SIB decreased by an average of 71%. |
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| 98. Transfer of Stimulus Control of Toileting Behavior with Somali Male |
| Area: DDA; Domain: Applied Research |
| ALEXIS WALDIN (St. Cloud State University), Marietta Nel Janecky (Holland Center), Benjamin N. Witts (St. Cloud State University) |
| Abstract: Azrin and Foxx developed an intensive toilet training protocol for individuals with disabilities in 1971. Since the development of the Rapid Toilet Training (RTT) protocol, its efficacy has been replicated with various populations and in various settings. This study replicated the procedures used in RTT with a 6-year-old Somali male diagnosed with autism. The participant demonstrated continence in his educational environment yet demonstrated incontinence in his home environment. The treatment package was used to transfer stimulus control of his toileting behavior in his home environment to increase in-toilet eliminations and decrease accidents. Within ten days of training, accidents decreased to less than two times a day. On the 49th day of training zero accidents were observed for at least 20 consecutive eliminations. However, two-month follow-up data indicated a transfer of stimulus control of the toileting behavior was not maintained in the home environment. These results indicate the RTT procedure is an effective and rapid solution for incontinence; however, fading procedures need to be embedded for maintenance of the behavior. |
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| 99. Using Picture Exchange Communication System in an Adult with Developmental Disabilites |
| Area: DDA; Domain: Applied Research |
| ICHA K. ARIEF (St. Cloud State University), Kim Frost (TSE, Inc.), Eric Rudrud (St. Cloud State University) |
| Abstract: This intervention used picture exchange communication system (PECS) to teach manding in an adult with severe mental disabilities. The individual had no prior communication training prior to this intervention. Before using PECS, the individual would grab and steal items or edibles that he wants. Three phases were conducted: physical exchange, discrimination, and natural setting. A preference assessment was conducted before conducting the intervention. The materials included pictures of highly preferred items, a picture of non-preferred items, a clip board, a binder, and an edible box. Two target pictures were chosen based on the preference assessment, and trained using PECS simultaneously (pretzel and gummy bear). The results showed that the individual independently exchanged pictures at session 25 for both targets. He was also successful in discriminating between highly preferred and non-preferred pictures at session 57, and across staff at session 67. The individual is currently still in training to independently mand for highly preferred items using PECS in a natural setting. |
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| 100. A Function-Based Approach to the Treatment of Audible Diurnal Bruxism |
| Area: DDA; Domain: Applied Research |
| ALEXIS WALDIN (St. Cloud State University), Benjamin N. Witts (St. Cloud State University), Kimberly A. Schulze (St. Cloud State University), Julie A. Ackerlund Brandt (St Cloud State University), Marietta Nel Janecky (Holland Center) |
| Abstract: Bruxism is defined as the grinding of one’s upper and lower teeth such that physical damage is caused. To date, behavioral interventions that examine environmental relations with respect to diurnal bruxism has outperformed medical and psychological treatments. However, the behavioral interventions have relied upon punitive measures to eliminate the behavior. The purpose of this study is to evaluate an antecedent intervention selected based on the function of the bruxism. The function will be determined following a four condition (i.e., attention, escape, play, ignore) functional analysis. If the results of the FA conclude the function is automatic reinforcement, a second functional analysis will analyze the hypothesized sensory stimulations (i.e., external pressure on the jaw, internal pressure on the teeth, and auditory stimulation). Upon conclusion of the function that maintains the participant’s bruxism, treatments will be selected. The treatments selected are matched stimulation (i.e., treatment that matches the function of the participant’s bruxism) and unmatched stimulation (i.e., treatment that does not match the function of the participant’s bruxism). In all treatment conditions, stimulation (matched or unmatched) will be delivered non-contingently. This study aims to evaluate if the function is a necessary consideration regarding the treatment of bruxism. |
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| 101. Development of Family Behavior Observation Assessment Tool for Children With Developmental Disabilities |
| Area: DDA; Domain: Applied Research |
| Minjoo Lee (Yonsei University), Kyong-Mee Chung (Yonsei University), DAYON HEO (Yonsei University) |
| Abstract: Problem behaviors of children with DD are often measured and assessed by direct observation of interaction between children and their parents. One of the most widely used direct observation coding systems is the Revised Family Observation Schedule (FOS-R III) (Sanders et al., 1996) using the 10 second interval coding. It is a very comprehensive measure, yet not cost-efficient because it is time-consuming to record behaviors and difficult to train observers. Therefore, cost-efficient direct observation system for children with DD is needed. The purpose of this study was to develop a direct observation checklist using the Likert scale that measures problem behaviors that are typically shown in DD population. Steps to develop the checklist were followed. First, a focus group interview was conducted with experts in assessing and treating severe problem behaviors and possible items were generated upon discussion based on FOS-R III. Second, reliability and validity of the checklist were examined using the data set of 52 pairs of children with DD (M=36, F=16) and their parents; child-parent interactions were videotaped for 20 minutes in 2 conditions: play (10 minutes) and instruction (10 minutes). Results showed acceptable level of internal consistency and high inter-rater reliability of the checklist. Concurrent validity of the checklist was observed via high correlations with the FOS-R III and the BPI-01. Few items that showed low inter-rater reliability or concurrent validity with FOS-R III were removed from the checklist. Discriminant validity was examined for 16 pairs of typically developing children (M=7, F=9) and their parents and their age matched children with DD (M=12, F=4) and their parents. Significant differences were found in most of childrens behaviors, especially in positive behaviors. However, parents showed differences only in affection, mood and tone of voice. Results showed good psychometrics properties of direct observation checklist. Since the checklist is developed in consideration of typically shown problem behaviors in DD population and cost-efficient, it may be useful in clinical settings that assess and treat problem behaviors in children with DD. |
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| 102. Trial-Based Functional Analysis of Aggression in a Home Setting for a Child with a Rare Genetic Syndrome and Chronic Health Problems |
| Area: DDA; Domain: Applied Research |
| EMILY WEAVER (Vanderbilt University), Blair Lloyd (Vanderbilt University), Johanna Staubitz (Vanderbilt University) |
| Abstract: In this poster presentation, we will present results of a trial-based functional analysis (FA) of aggression conducted in a home setting for a 4-year-old girl with a Cri-du-chat syndrome and chronic health issues. Parents and a 7-year-old sibling with autism spectrum disorder were trained and coached to implement all experimental trials. We recorded both presence and absence of problem behavior across trial segments and latencies to problem behavior within trial segments to analyze response differentiation among conditions. In addition, we collected information on the presence of health-related symptoms via parent report to evaluate potential differences in response differentiation depending on the presence or absence of these symptoms. Both parents and sibling were able to implement FA trials with relatively high fidelity (though fidelity varied by condition). Results indicated aggression was maintained by multiple sources of social, and potentially non-social, reinforcement. The presence or absence of health-related symptoms did not correspond to differences in response differentiation during any FA conditions. The current study provides an extension of trial-based FAs to home settings with family members as implementers. The study also highlights challenges specific to assessing problem behavior that may be influenced by a combination of social and non-social variables, including illness. |
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| 103. Teaching Two Students with Severe Developmental Disabilities to Use AAC Devices in Taiwan |
| Area: DDA; Domain: Applied Research |
| PEI-FANG WU (National Kaohsiung Normal University) |
| Abstract: Two studies were conducted to investigate the effects of using least-to-most prompting to teach two students with severe developmental disabilities to use AAC devices. In Study 1, an A-B design was used to teach 10 sets of vocabularies. The study was conducted in a different classroom other than the participants school during weekends. Least-to-most prompting was used during the intervention, including the use of verbal and gestural prompts. Results showed the student was able to master each set within 7 sessions. However, in Study 1, no generalization and maintenance data were collected. Study 2 is still in progress. In Study 2, a multiple probe design across 5 sets of vocabularies was used. The study was conducted in the participants home, which was a natural intervention setting for the participant. Generalization data will be collected, which investigated whether the participant will use an AAC device to communicate in community settings. The two studies will provide preliminary evidence showing effective use of least-to-most prompting to teach students with severe disabilities to communicate using AAC devices in Taiwan. |
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| 104. Teaching Problem-Solving Skills to Individuals with Intellectual Disabilities Using Matrix Training |
| Area: DDA; Domain: Applied Research |
| Kellie McKee (Stephen F. Austin State University), GLEN L. MCCULLER (Stephen F. Austin State University), Ginger Kelso (Stephen F. Austin State University) |
| Abstract: The present study examined the efficiency of matrix training as a format to teach problem solving skills to two children with intellectual disabilities. Matrix training provides a way to organize and train problem-solving in an efficient way. A 4X4 matrix of problems and materials related to cooking was designed. Then, participants were trained on a subset of material and problem combinations. Training was implemented using least to most prompting and errorless learning. A multiple probe across participants design was used to assess the effects of training on generalized material and problem combinations. Results yielded that both participants achieved generalization to untrained problems thus supporting previous literature of the efficiency of matrix training as a method of achieving skill acquisition. |
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| 105. The Effect of Teacher Greetings on On-Task Behavior |
| Area: DDA; Domain: Applied Research |
| Callie Berry (Stephen F. Austin State University), GLEN L. MCCULLER (Stephen F. Austin State University), Ginger Kelso (Stephen F. Austin State University) |
| Abstract: This study compared two alternating interventions on the on-task behavior of three middle school students receiving special education services. The study took place in a general education classroom. The two treatments were “neutral” and “task-specific” greetings administered at the beginning of class. The on-task behavior of the three students was measured during baseline with the teacher’s “neutral” greeting. After baseline, on-task behavior was measured in class following the randomly alternated neutral vs. task specific intervention treatments of greetings before class. Results showed that two out of three students demonstrated a higher percentage of on-task behavior with the “task-specific” greeting administered at the beginning of class. |
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| Keyword(s): Poster |