Association for Behavior Analysis International

Rapid eating (food stuffing) is an undesirable feeding behavior that may lead to adverse social and health consequences. While current research has evaluated other feeding problem behaviors such as food refusal, food selectivity, and ruminative operant vomiting, there is a lack of research involving rapid eating. We used a video-enhanced activity schedule intervention involving an iPad mini and the software application My Pictures Talk to teach appropriate eating and reduce dangerous food stuffing in an 8 year-old boy diagnosed with Pervasive Developmental Disorder—Not Otherwise Specified (PDD-NOS), Bilateral Moderate-Severe Sensorineural hearing loss, and Severe Expressive and Receptive Language Disorder. A concurrent multiple probe design indicated that the intervention was effective in decreasing the frequency of food stuffs across three meals. Generalization probes suggest that the participant's improved eating behavior generalized from meals with the therapist to meals with his mother. The child's mother endorsed high social validity ratings indicating satisfaction with the intervention approach, treatment goals, and outcomes.

There is growing evidence that point of view (POV) video prompting (VP) is an effective method to teach vocational skills to adults with intellectual disabilities. Due to the need for effective and socially valid interventions to teach adults vocational skills in the workplace, studies using portable video instruction were evaluated to determine the effectiveness of self-guided teaching. A multiple baseline design was used evaluate the effectiveness of a POV VP to teach a multi-step scheduling task. All participants performed at 88-100% accuracy when the novel skill was introduced through POV VP. Three of the participants generalized the skill to their personal phones and maintained their performance to criterion levels four weeks later. Social validity results suggest that the use of an iPhone was a socially acceptable mode to deliver a video prompting intervention in a vocational setting.

The current study aims to determine whether video prompting differs when provided on tablet compared with smartphone in terms of effectiveness and efficiency in teaching leisure skills to children with intellectual disabilities, which errors the participants demonstrate in the probe sessions, and the opinions of the mothers on the social validity of the study. Four children with mild to moderate intellectual disabilities, aged between 5 and 6 years old participated in the study. In order to compare the effectiveness of video prompting displayed by means of a tablet and smartphone in the study, an adapted alternating treatments design was used and replicated for all four children. The results indicate that video prompting was effective on both the tablet and smartphone at teaching leisure skills to children with intellectual disabilities, and that the acquired skills were maintained even after the end of the training. There was no significant difference between video prompting on the tablet and smartphone in terms of effectiveness and efficiency. In addition, the most common mistakes in probe sessions were sequence and duration errors, and the social validation findings of the study were positive. Implication for future research are discussed.

This study investigated the effects of an instructional package, mainly using video prompting, to toilet train 3 junior high school students with developmental disabilities in Taiwan. Two students were taught to make bowel movements, and one student was taught to urinate. Toileting was divided into 15, 9 and 20 steps respectively, based on students' needs. Custom-made videos using an adult model were used during training. A multiple probe design across three participants was employed to assess the effects of the intervention. Results showed that the intervention package was effective in teaching toileting skills, and the skills were maintained for 2 months. The current study contributes to the small body of research literature regarding toilet training and video prompting, highlighting the needs of using custom-made videos to toilet train students with developmental disabilities to facilitate skill acquisition.

People diagnosed with developmental disabilities often have limited options for recreation and leisure activities during their free time at school, home, or other locations (Zijlstra & Vlaskamp, 2005). The purpose of this literature review was to analyze peer-reviewed journal articles that reported the outcomes of interventions used to teach video-based recreation and leisure activities to individuals with developmental disabilities. Examples of such recreation and leisure activities include playing video games, watching movies and videos, and participating in other video-related activities. Ten articles met the criteria for inclusion in the review, and the following information was analyzed: participant characteristics, setting, implementer, intervention components, research design, and results. Further, we analyzed reports of generalization, maintenance, treatment fidelity, and social validity data. Results of the synthesis indicate that researchers implemented a variety of common behavioral intervention methods, such as video modeling, activity schedules, manual prompting, visual prompting, and positive reinforcement. Multiple studies employed virtual reality technology as part of the intervention. Researchers conducted studies in varied environments such as day treatment centers, residential facilities, and schools. Participants ranged in age from 9 to 58 years old. Researchers reported positive results across all studies. Implications for practice and future avenues for research will be discussed.

A multiple-baseline design across three individuals diagnosed with a developmental disability and/ or an emotional impairment was used to evaluate handwashing behavior after a video training, and then after providing individualized visual feedback on the outcome of handwashing behavior. The individualized visual feedback was provided by applying a substance that was luminescent under black light to the hands prior to washing and then providing visual feedback on the amount or the luminescent substance after each washing episode. Areas missed during handwashing glowed under a blacklight, providing feedback on the outcome of handwashing and serving as prompt and motivational operation for future handwashing behavior. The handwashing behaviors of three school-aged individuals were analyzed in terms of number of fluorescent spots on the hand, and the total amount of time spent handwashing. Results indicate that the fluorescent visual feedback was acceptable and entertaining for children with developmental and/or emotional disabilities and an effective intervention to improve the quality and motivation for handwashing.

Previous research has indicated that after a functional communicative response (FCR) has been repeatedly strengthened with continuous reinforcement, the interventionist can gradually introduce and increase a delay between the FCR and delivery of reinforcer (Hagopian et al., 1998). Although there have been studies demonstrating the consequential effectiveness implementing functional communication training (FCT), problem behaviors can resume when the FCR is not maintained. The current study evaluated the effects of providing high-probability tasks during delayed reinforcement after FCR with a single participant (14 year old nonverbal male with Autism) who displayed aggression maintained by attention and denied access to tangibles based on observations. A multiple treatment reversal design was conducted using tolerance training and compliance training. Tolerance training was introduced after FCR was established. Once wait time increased to 10-seconds, high probability tasks were presented to the client after each FCR during compliance training. As criteria were met, more tasks were introduced while reinforcement was further delayed. Quantitative analyses found that aggression increased during compliance training while number of independent mands increased across treatments.

Augmentative and alternative communication (AAC) devices have been widely and effectively used throughout classrooms, clinics, communities and homes. Specifically, teaching students to mand for preferred items and express needs. However, there is limited research on how to use AAC devices to assess a student's current level of performance and teach academic content. Furthermore, how can you properly assess a student that is unable to vocalize or physically deliver the target response? If we are unable to assess the student's current level of performance, then how can we effectively plan treatment or curriculum? A single-subject multiple probe design across academics research study was conducted, on the effectiveness of discrete trial training (DTT) procedures through the use of an eye tracking and AAC device to learn colors, shapes, and letters. The participant was a five year old boy with severe disabilities to the extent that he required a wheelchair for mobility and an AAC device for communication. Participants will be provided with procedures, practical strategies, and video demonstrations of implementation.

Functional communication training is a treatment for reducing problem behavior in which individuals are taught an appropriate mand to access the reinforcer previously delivered for problem behavior. Research on risky choice (i.e., choice between fixed and variable alternatives) offers implications for functional communication training treatments that do not include an extinction component for problem behavior. Using a reversal design, the current study examined whether four preschool-age children diagnosed with a developmental disorder were sensitive to variance in delay to reinforcement during functional communication training. Sensitivity to variance in delay was assessed via the children's choices to mand or engage in problem behavior when concurrent mixed or fixed reinforcement delays were programmed for the two responses. Following a preference assessment and functional analysis, each child was taught a mand. Mixed and fixed reinforcement delays were then arranged for the response alternatives across experimental phases. Results indicated that two children were sensitive to variance in delay (i.e., allocated more responding toward the mixed delay across phases). Results are discussed in relation to previous research on functional communication training and risky choice. This study offers implications for future applications of risky choice to the treatment of problem behavior.

The Research Units in Behavioral Intervention (RUBI) Parent Training for Disruptive Behaviors (PT) program is a manualized intervention based on ABA principles including the use of a parent-directed descriptive functional assessment followed by development of a treatment plan including manipulation of antecedents, consequences or both to reduce the child's disruptive and noncompliant behavior and teach functionally equivalent behaviors. The current study aimed to test the efficacy of the manual when translated to a community clinical setting. The study investigated 54 families enrolled in the Marcus Autism Center's RUBI Parent Training program from July 2015 to July 2017. Children's average age was 6.61 (SD=2.21), 90% were males, the majority were Caucasian (57.8%), followed by African American (35.6%). Response to treatment was described using the Aberrant Behavior Checklist (ABC) Home Situations Questionnaire (HSQ) at baseline, mid-point of treatment, end of treatment, and follow-up). There was a significant reduction (p=.001) in noncompliant behavior reported through the HSQ and in disruptive behavior (p=.001) reported through the ABC from baseline to post-treatment assessments. This preliminary data suggests promising replication of the RUBI PT model in diverse clinical settings, yet larger scale trials completed through randomized clinical trials would increase the ability to standardize this program.

Verbal praise is a consequence that caregivers can provide quickly and with relatively minimal effort; it is also often an effective reinforcer for increasing the frequency at which clients with intellectual disabilities engage in appropriate behavior. However, caregivers often do not provide verbal praise when clients engage in appropriate behavior. Direct support caregivers in a residential facility were previously taught to reinforce appropriate behaviors using verbal praise. Written and verbal instructions, modeling, role-plays, and feedback were used across multiple training settings to teach caregivers how to perform the steps required for reinforcement. Prior to the study, compliance and attention-getting behaviors were identified as appropriate (i.e., "reinforceable") behaviors for the majority of clients in the facility. The current project assesses the generalization of caregivers' use of reinforcement for compliance and appropriate attention-getting behaviors with clients in the natural environment. For caregivers performing below criterion, a progressive prompt delay was used to train them to identify opportunities to use reinforcement. When caregivers are able to identify opportunities independently, the fidelity with which reinforcement is delivered is assessed. Feedback will be used to retrain caregivers who do not demonstrate all steps of reinforcement accurately. Baseline results indicate that some caregivers require additional training to identify opportunities to use reinforcement in the natural environment.

Non-dangerous, annoying behavior (sometimes referred to as "junk" behavior) is common among individuals with intellectual disabilities. One approach to addressing these behaviors is to withhold attention contingent on the occurrence of such behaviors and provide it only when the client has begun to engage in better behavior. Caregivers, however, frequently provide attention contingent on these behaviors, which may reinforce them. In the current project, caregivers had been previously taught to ignore junk behavior and differentially reinforce appropriate behavior (pivot) when interacting with clients. In the current project common junk behaviors occurring in a residential facility were identified and graduate research assistants were trained to identify junk behaviors in the natural environment during single-opportunity probes. Interobserver agreement (IOA) was used to refine the definitions of junk behavior when feedback was not sufficient to produce agreement between observers. Graduate assistants were also taught to score opportunities for caregivers to pivot, or attend to better behavior, in the natural environment. Result showed that it is possible to operationally define opportunities to implement the pivot procedure in the natural environment and to train observers to record opportunities and caregiver responses accurately.

Behavior skills training (BST) is a procedure that can be used to teach a variety of skills, including conducting functional analyses (Ward-Horner & Sturmey, 2012), discrete trial instruction (Crockett, Fleming, Doepke, & Stevens, 2007), and natural language paradigm teaching skills (Gianoumis, Seiverling, & Sturmey, 2012). However, there are currently no published studies analyzing the extent to which BST improves training for parents with their own children with developmental disabilities and behavior disorders. To that end, we used BST to train parents to implement multi-component interventions (e.g., functional communication training, extinction) for severe problem behavior. Participants were three mothers whose children were receiving clinic-based outpatient behavioral treatment for aggression or self-injury. A nonconcurrent multiple baseline design was used to evaluate the effects of BST on the parents' skill acquisition of the interventions. Parents' integrity of treatment implementation was initially evaluated after watching a therapist implement the intervention with their child. Then, BST was conducted with mothers using confederate staff. After participants met mastery criterion for implementing the multi-component interventions, their performance generalized when they were asked to implement treatments with their own children. Results are discussed in terms of parent adherence to intensive behavioral interventions.

Complex behavioral interventions involving multiple treatment components (e.g., extinction, differential reinforcement of alternative behavior, response interruption and redirection) are often required to adequately address severe problem behavior in individuals with autism and/or intellectual disability. Previous studies suggest that decreases in the integrity with which these components are implemented may negatively impact their effectiveness at producing desired reductions in problem behavior (St. Peter Pipkin, Vollmer, & Sloman, 2010). The current studies evaluated the effects of an antecedent intervention via materials (Study 1) and procedural (Study 2) checklists on the integrity with which an empirically derived, individualized treatment protocol was implemented by 15 direct care staff in a clinical setting. After an initial baseline where participants received standard training, both checklists were evaluated separately within the context of a modified alternating treatments design. Targeted treatment components consisted of extinction, response interruption and redirection, differential reinforcement of alternative and other behavior, presence of visual rules, signaled availability via a multiple schedule, and competing items. Results showed the intervention increased treatment integrity for over 81% of participants. Interobserver agreement was above 80% for all targeted behaviors. Considerations on utility and generalization of this strategy in school and community settings will be discussed.

Given that children with developmental disabilities often engage in high levels of challenging behavior, we developed a behavior analytic interactive web training (IWT) designed to support parents in addressing this issue. The purpose of our initial study was to conduct a preliminary examination of (a) its effects on function identification and treatment selection by parents, (b) its implementation, and (c) its social validity. To this end, 26 parents of children with developmental disabilities responded to function identification and treatment selection tasks before and after following the 2-hr training. We then conducted a randomized control trial to examine its effects on challenging behavior and parental practices in 40 families. Our results show that parents were more accurate in the identification of behavioral function and selected more adequate treatments following IWT. Furthermore, the training was short, generally easy to follow, and rated highly by parents. Our results suggest that IWT appears to be a viable training tool to support parents in the reduction of challenging behavior.

The direct measure of behavior is the foundation of Applied Behavior Analysis. Valid, accurate, and reliable data is critical in making informed decisions that affect the service delivery for the individuals we work with. This study will evaluate the effectiveness of differential positive reinforcement on the accuracy of data collection with direct service providers of adults with developmental disabilities. Accuracy will be determined by collecting Interobserver Agreement between the Direct Service Provider and a Board Certified Behavior Analyst in a group home setting. Researchers will use paired choice preference assessments to determine a preference hierarchy and deliver potential reinforcers, in least-to most order, for reaching each set criterion throughout the changing criteria design. This paper will discuss the implications for future research related to the effects of positive reinforcement on accuracy of data collection with Direct Service Providers. As well as, how changes in accuracy affect the collection of behavioral data in group home settings with adults with developmental disabilities.

OBJECTIVE. To explore caregiver factors associated with severity ratings of self injurious behavior (SIB) in 196 children with developmental concerns using demographic characteristics and standardized measures of parenting stress and SIB. MEASURES. Caregivers completed the Inventory for Client and Agency Planning (ICAP) to assess the severity of their children's SIB and the Parenting Stress Index - Short Form to measure the magnitude of parent self-reported stress levels. Demographic factors of interest included level of education, race, occupation, and household structure. RESULTS. Caregiver factors statistically associated with higher SIB severity ratings were household structure and parental education. Specifically, two-parent households and parents with a college education reported lower severity of SIB than parents with a high school education or those who provided care as a single parent. There was a trend of Parental Distress associated with greater SIB severity. CONCLUSIONS. Higher ratings of SIB severity were related to parental education and household structure. Although causal direction cannot be inferred, the findings are consistent with existing literature linking caregiver factors and the occurrence of atypical behavior in children with developmental disabilities.