Association for Behavior Analysis International

Many procedures based on applied behavior analysis (ABA) increase skills for individuals with autism spectrum disorder (ASD). Despite empirical support, issues can arise during ABA intervention, which can be difficult to resolve. Decisions about modifications to intervention may be based on the individual learner’s history or repertoire, the behavior analyst’s repertoire, and resources in the literature. In the current project, a problem solving approach was used to identify potential modifications after constant-prompt delay with represent-until-independent error correction and non-differential reinforcement did not increase correct responses for a six-year-old boy with ASD. We conducted a detailed error analysis, a brief literature review, and multiple brief assessments using strategies identified in the literature. The error analysis suggested prompt dependence and potential sources of faulty stimulus control. Based on the extant literature, we evaluated differential observing responses, prompt fading, blocked trials, and differential reinforcement. Several procedures required multiple teaching steps that were inefficacious or slow to produce change. Ultimately, differential reinforcement with enthusiastic praise increased independent responding. A description of our problem solving approach coupled with supporting data will be presented. Recommendations for the adoption of a similar approach to identify individualized interventions for persistent errors and prompt dependence will be discussed.

Diurnal bruxism is the grinding of upper and lower teeth indicated by an audible sound. The diurnal distinction is due to the individual engaging in bruxism while awake. Previous literature evaluated the use of a prompting procedure that consists of a vocal and physical prompt called a combined cue (Barnoy et al., 2009 & Armstrong et al., 2014). Armstrong and colleagues (2014) also conducted a functional analysis to identify the function of bruxism in one participant. In the current study, we extended the literature in two ways. First, we conducted an extended ignore condition (Querim et al., 2013) to ensure the behavior was not socially mediated. Next, we evaluated the use of a bite band with the combined cue prompting procedure using an ABAB reversal design. We measured the frequency of bruxism and independent mouthing and converted the measures to response per minute. We also measured the duration of independent mouthing following the first iteration of baseline and treatment. Results for a five-year old child with autism indicate that the combined cue and presentation of the bite band decreased rates of bruxism while increasing rates of independent mouthing. However, more participants are needed to determine the effectiveness of this treatment.

Robust research links positive educational and well-being outcomes with students’ participation in SEL programs. Outcomes for students with Autism Spectrum Disorder (ASD), however are not as favourable. The purpose of this study was to identify the outcomes of students with ASD and their NT peers following their participation in a SEL program that was modified to meet the needs of students with ASD. Ninety-seven students participated in this mixed method action research design study. Quantitative data were gained from the pre-post administration of the Social Emotional Intelligence–Youth Version (SEI-YV). Qualitative data were obtained through teacher and student questionnaires. NT students significantly increased their scores of the Apply Consequential Thinking competency. The effect size for three other competencies exceeded Cohen’s (1988) convention for a small effect. The students with ASD achieved a medium effect size for two competencies, and a small effect size for one competency. Qualitative data corroborated the results, showing a reduction in challenging behaviours, generalization of learned targets, and an increase in empathy. When an SEL program is taught in a manner that meets the learning needs of students with ASD, students with ASD and their NT peers can obtain improved outcomes.

Empathy is the ability to identify verbal and non-verbal stimuli associated with different affective states and to respond to them appropriately. The deficit in showing empathy, commonly found in people with autism, can significantly compromise the ability to establish, maintain and develop social relationships. The purpose of this study is to increase the ability of people with autism to identify nonverbal affective stimuli and respond to them with empathic responses. The present research included two participants, aged 7 to 9 years, with autism spectrum disorder. Across multiple exemplars training, nonverbal affective stimuli were presented, commonly associated with various private events, such as physical pain, sadness and fatigue. The therapist (a) provided a rule, (b) presented the non-verbal stimulus, (c) suggested leading questions in order to lead participants to identify non-verbal stimuli associated with other people's private events and to respond with empathic statements. The results indicated that both participants acquired the ability to respond with empathic statements and generalized the ability to novel situations, on which training had never been conducted before. These data show that children with autism can learn to detect non-verbal affective stimuli and provide empathic responses as a result of behavioral interventions.

Conventional training procedures often involve verbal instructions and verbal feedback. However, a parent whose first language is not English might not necessarily speak or understand the language used by the trainer. The primary aim of the present study was to address the question of how to provide effective parent training in the presence of a language barrier between the trainer and the parent. A multiple baseline design across three mother-child dyads was used to evaluate the efficacy of a video prompting intervention on mothers’ fidelity of implementation. A replication was conducted with a fourth mother using an alternating treatments design. All mothers' primary languages were Spanish and had limited English proficiency. English-speaking therapists who did not speak Spanish conducted all training sessions. Parents were trained to teach their children with autism independent dressing skills. All parents reached mastery criterion during sessions with their trainer. Three mothers generalized these skills to sessions with their children. Follow-up data indicates maintenance of skills. Independent dressing skills increased for four children. This pilot study suggests that video prompting could potentially mitigate language barriers and successfully teach immigrant mothers with limited English proficiency to use behavioral strategies to facilitate child independence in dressing.

This study seeks to investigate the effects of staff preference (highly preferred staff versus less preferred staff) on the affect, compliance, and on-task behavior of adolescents and adults with autism spectrum disorder (ASD) during demand activities that require prompting for on task engagement and task completion. Individual participants who indicate (through a preference assessment) a clear preference for certain staff members when compared to others, will be included in the study. Each participant will engage in the same demand activity conditions while direct-care staff members will be randomly alternated (highly preferred and less-preferred). Data will be evaluated through an alternating treatments design. Post hoc analysis will be conducted in order to identify the specific characteristics of the highly preferred staff (e.g., physical contact, facial expression, praise). Implications for the study include the value of providing choice and assessing preference of staff members and the potential impact for changing traditional staff training models to emphasize training for staff to position themselves as conditioned reinforcers to the individuals they serve.

The Interview-Informed Synthesized Contingency Analysis (IISCA) has been safely and successfully implemented in a variety of clinic, school, and home settings (Jessel, Hanley, & Ghaemmaghami, 2016; Hanley, Jin, Vanselow, & Hanratty, 2014; Santiago, Hanley, Moore, & Jin, 2016), however, there are no studies showing the IISCA being used with individuals who engage in severe self-injurious behavior (SIB) necessitating all-day use of multiple types of protective equipment. The aim of the present study was to safely functionally analyze two participants SIB who wore helmets and arm limiters. A multifactorial analysis was first conducted in which the presence of preferred items and availability of protective equipment was manipulated. Both participants engaged in less dangerous SIB when preferred items were available and when protective equipment was applied. More dangerous SIB and self-restraint occurred when protective equipment was not applied. Next, an IISCA was conducted which showed that both participants’ SIB was also sensitive to a synthesis of social consequences involving escape from demands to access preferred items, protective equipment, and presumably automatic reinforcement. These analysis results allowed for the development of a function-based treatment to decrease rates of SIB.

The purpose of this study was to examine the effects of the individualized positive behavior support on classroom disruptive behaviors for a student with autism spectrum disorder in Korean inclusive regular elementary school . The study utilized multiple baseline design across settings (math subject class, language art subject class, & activity based subject class). Through the functional behavior assessment, it was found that the challenging behaviors functioned as a means for obtaining objects and activity the student want to get in the classroom. The finding from the study indicated that the individualized positive behavior supports(i.e., setting event strategies, antecedent strategies, alternative behavioral strategies, and consequent strategies) were effective reducing those challenging behaviors (lying down on a desk, screaming, hitting on the desk with palm) and increasing use of functional communication of a student with ASD during the intervention and maintenance periods. In other words, teaching AAC use in student as an alternative behavior (a mand) of those challenging behaviors reduced the rate of challenging behaviors and increased AAC use for requesting the prefered objects and choice making in activity. The limitation of the study and future direction in research will be suggested.

Generalized Motor Imitation is a fundamental evolutionary cusp, we could say that autistic children often have difficulties acquiring it. We collected the results of the "Mirror Protocol" (Greer & Ross, 2008) on 5 teenagers aged 11 to 18 without the verbal repertoire of generalized imitation, all with autism and multiple disabilities. The dependent variables were the number of imitative responses issued and the duration of their observational responses to the instructor's poses during a Yoga class before and after the intervention. The independent variables were implemented using the Learn Units with an individual intensive gross-motor imitation training at the mirror. The experimental design for this study is Multiple Probe Across Subiect. Post-survey data showed a significant increase in attention skills in all participants, while generalized imitation improved for a single subject. The probes were conducted during yoga classes due to the social meaning of inclusion. Furthermore, we should continue to use the imitation skills protocol implementation and improve the efficiency of the intervention. The limitations of this study are due to the short duration of the protocol implementation. The study shows positive results in inducing basic verbal skills and improving participation in group activities in this age group.

We replicated and extended research on teaching children with autism to mand for information (e.g., Ingvarsson and Hollobaugh, 2019) by evaluating transfer of the “I don’t know please tell me” (IDKPTM) response across operants. We used a progressive prompt delay to an echoic prompt to teach three school-aged boys diagnosed with autism to mand for information when presented with unknown questions (intraverbals) and unknown pictures (tacts). Sessions consisted of three known targets intermixed with six unknown targets, only three of which were exposed to the teaching procedures. Thus far, all participants acquired the IDKPTM response for at least one operant. Ivan’s IDKPTM response generalized within, but not across operants. After directly prompting and reinforcing the answer while differentially reinforcing answering correctly versus manding for information, Ivan acquired previously unknown intraverbals; this additional procedure was not required to acquire previously unknown tacts. Generalization to novel targets in naturalistic settings did not occur until multiple exemplar training was implemented in those settings; however, generalization was subsequently observed when his mother presented unknown intraverbals and tacts. Data collection is ongoing.

An omnibus mand is sometimes taught when a functional analysis suggests that problem behavior is maintained by a synthesized contingency. However, specifying mands may be a desired outcome. Ward, Hanley, Warner, and Gage (under review) recently differentiated an omnibus mand into specific mands for three learners, but treatment stopped after functional communication training. The present study replicated the methods described by Ward et al. and extended the study to include a skill-based treatment that taught a tolerance response, compliance with academic work, and extension to a second caregiver (e.g., Hanley, Jin, Vanselow, & Hanratty, 2014). First, a functional analysis was conducted and suggested the client’s problem behavior was sensitive to escape from demands to tangibles and attention. An omnibus mand was initially taught and then differentiated into specific FCRs (“I want a break”). Next, the learner was taught a tolerance response (“okay”) when reinforcers were denied. Academic tasks were then progressively introduced until the client completed a maximum of 18 demands. Last, treatment was extended to a second caregiver; problem behavior remained low, and communication and completion of academic tasks remained at optimal and desirable levels. A social validity questionnaire indicated that classroom teachers were satisfied with the outcomes of treatment.

Social skills, such as the ability to initiate conversations or engage in play, is a commonly identified deficit among individuals with autism spectrum disorder (ASD). Despite the increase in classroom integration, social skills deficits among children with ASD remain evident. Researchers have identified several strategies (e.g., peer modeling) that have been demonstrated to be beneficial in alleviating some social skills deficits. However, previous meta-analyses have found mixed results regarding the efficacy interventions to address social skills deficits in ASD. The current meta-analysis sought to examine and extend the current literature on social skills interventions in inclusive school-based settings for preschool-aged children with ASD. Twenty-five single-case (SCD) and group design studies were evaluated to determine the overall efficacy and fidelity of each intervention; maintenance and generalization of target skills were also assessed. Results from the current study suggest that the reviewed social skill interventions were moderately effective overall with higher treatment fidelity observed in SCD studies. The results of this synthesis could be beneficial to applied behavior analysts in terms of the identification of strategies to modify interventions to improve their use and accessibility in inclusive school settings. Keywords: autism spectrum disorder, inclusive settings, meta-analysis, social skills

One of the main deficits among individuals with ASD is the presence of stereotypic behaviors, which are described as “repetitive and apparently purposeless body movement, body parts movement, or use of the body to generate object movement (Lewis & Bodfish, 1998).” Although previous applied behavior analysis research has indicated consequence- and punishment-based interventions can be effective in decreasing stereotypic behaviors, recent research has focused on antecedent-based interventions. For example, recent research suggested antecedent physical exercise interventions can be effective on reducing stereotypic behaviors. The purpose of the current meta-analysis was to examine the literature pertaining to the effects of physical exercise interventions on stereotypic behaviors among individuals with ASD. The current meta-analysis included 10 intervention studies (i.e., four group design studies and six single-subject design studies) to examine the effectiveness of exercise interventions on stereotypic behaviors. To quantify and compare results, we calculated effect sizes for the group design studies and percentage of nonoverlapping data points for all participants included in the single-subject studies. Results indicated that exercise interventions can be effective in reducing stereotypic behaviors in individuals with ASD. No significant differences were found in the moderator analyses related to participant’s sex, age, and total number of treatment sessions.

Discriminating when to raise your hand is a necessary skill for children to acquire in order to actively participate within group instruction and to minimize distracting behaviors such as shouting over teacher instruction and interrupting peers (Charania, LeBlanc, Sabanathan, Ktaech, Carr & Gunby, 2010; Vargo, Heal, Epperley, & Kooistra, 2014). The skills involved with hand raising help prepare children for the general education setting as well as group activities that comprise most of the instruction in preschool settings. Previous researchers have taught learners to raise their hands using discrimination training and rules (e.g., Charania et al., 2010) as well as implementing a multiple schedule with rules (e.g., Vargo, et al., 2014). In the current study we extended previous research by teaching a child with Autism Spectrum Disorder (ASD), to raise his hand using behavior skills training (BST) prior to group instruction sessions that contained intraverbal and motor response opportunities that simulated circle time activities in a classroom. Ongoing results suggested that BST was an efficacious procedure to teach a child to raise their hand during group instruction following instruction to do so. Potential future directions and clinical implications will be discussed.

One in 59 children in the general US population has a diagnosis of autism spectrum disorder (ASD), and approximately 30% of those children are unable to function in everyday activities due to lack of appropriate verbal communication (CDC, 2019). Augmentative and alternative communication (AAC; picture exchange, manual sign, or a dynamic speech-generating device) are alternatives to verbal speech, which enables children with ASD to successfully participate in their homes and community. However, no known research-based communication-screening tool is currently available to providers when selecting an AAC. In Study 1, an online communication screener for families of non-verbal children with ASD was developed to identify an effective alternative modality of communication along with a direct observation tool to verify caregivers’ report of child skills. Study 2 determined the potential efficacy and efficiency of four different augmentative communication modalities for teaching requests to four children with ASD within an adapted alternating treatments design. The results of Study 1 and 2 were compared to determine if the screener recommendations resulted in the selection of the most efficient and appropriate modality of communication for each child. Implications of these findings will be discussed.

Motor and vocal stereotypy are topographies of behavior common among individuals with Autism Spectrum Disorder (ASD). Such maladaptive behavior may impede and interfere in learning new skills and decrease work performance in a vocational setting. Previous research has evaluated different intervention strategies to decrease these topographies of behavior. Most commonly, there is a focus on interventions, which have been conducted with children, and less common, with adults, in controlled settings. We evaluated the practicality of implementing a simple differential reinforcement procedure with an adult with ASD in multiple, dynamic environments. A differential reinforcement of other behavior (DRO) was used to reduce vocal and motor stereotypy in which positive reinforcement was delivered in the absence of the target behavior for a systematic period of time. Results indicate rapid decreases in motor and vocal stereotypy upon implementation of the intervention and maintenance of low levels of behavior.

Many researchers have replicated Practical Functional Assessment and Skill-based Treatment procedures with individuals with Autism Spectrum Disorder; however, this has typically involved younger children, often who are language able (e.g., Hanley, et al., (2014); Strand et al., (2016); Herman et al. (2018)). Currently, there is a gap in the literature involving adolescents with severe disabilities attending a residential school. This study aimed to conduct a Practical Functional Assessment and implement Skill-based Treatment with two non-verbal adolescents with severe problem behavior and no functional communication. In addition to conducting this treatment with this profile of student, unique synthesized reinforcers were identified and treatment design deviated from what is outlined in the existing literature. The results showed that a novel, omnibus mand and waiting (toleration) response were acquired without evoking problem behavior. In addition, several chains of contextually appropriate behavior were successfully developed for each adolescent.

Approximately 30% of persons diagnosed with autism under the age of 18 have a co-morbid diagnosis of a specific phobia (van Steensel et al., 2011). Responses to these phobic stimuli can vary and often interfere with adaptive functioning. The current study evaluated effects of graduated exposure plus differential reinforcement to decrease phobic avoidance responses (i.e., vocal protests, covering ears, flopping on the floor, and elopement) to a pressure cooker by a seven-year old male diagnosed with autism. The treatment package reduced phobic avoidance responses related to the presence of a pressure cooker across analog and naturalistic settings. In addition, parents reported high satisfaction of the procedures and results

Matrix training consists of arranging components of target responses across two axes (e.g., nouns, verbs) and strategically selecting combinations for intervention (e.g., diagonal noun-verb tacts). Frampton, Wymer, Hansen, and Shillingsburg (2016) found that tact noun-verb training with diagonal targets in Matrix 1 produced correct responding with non-diagonal targets in Matrix 1 and all targets in a Generalization Matrix. We replicated these procedures and extended them using instructive feedback (IF). The baseline and post-treatment probes consisted of the instructor demonstrating an action with a figure and asking “What’s happening?” During treatment sessions for Matrix 1 diagonal targets, the instructor demonstrated the action with the figure then asked the 5-year-old with autism to imitate it. As the child imitated the action, the instructor provided IF action what the figure was doing (e.g., “The bird is flying”). Results indicated that some targets were acquired after only exposure to IF; however, not all tacts were demonstrated consistently. Differential reinforcement and tact probes were added to treatment sessions and responding stabilized for the majority of targets. The findings indicate recombinative generalization may be established after exposure to IF, more closely mirroring procedures used with typically developing children.

Echolalia is a stereotypical behavior usually maintained by its sensory consequences. Previous research has shown how difficult it is to reduce problem behavior maintained by automatic reinforcement. For this reason, it is necessary to identify the specific treatment options for each student. The present study investigates the application of 3 different treatment packages to reduce echolalia in a boy with autism, using a multi-element design: (a) response interruption and redirection (RIRD), (b) listening to music, (c) DRO and contingency contract. The participant showed a reduction in echolalia when a DRO and contingency contract were used. After the identification of the most effective treatment, the duration of the treatment sessions was gradually increased and the reinforcement schedule was thinned. In fact, in the initial assessment in the contingency contract and DRO condition, reinforcement was provided each 30 seconds, for the absence of problem behavior. During treatment, the duration of the treatment sessions was systematically increased, amounting at 5, 7 and 10 minutes and reinforcement was provided every 60 seconds. Echolalia continued to decrease in these conditions as well. The present research contributes to identify effective and individualized treatment packages for behavior maintained by automatic reinforcement.

The purpose of this study was to teach an adult male with Autism to tolerate occasional denied access to purchasing a preferred item at a retail location. Shaping was utilized to increase (a) the length of time in a retail location, (b) the length of time the client waited to receive his preferred item, and (c) the number of peers accompanying the client in the retail location. In addition, the client was provided with noncontingent access to an alternate preferred item. Through this intervention, the client's rates of problem behavior and repeated mands decreased to levels manageable enough to transition him from being a 1:1 client to joining a 3:1 group.

Food selectivity is a common feeding problem that refers to food refusal behaviors and consumption of a limited variety of foods which may lead to negative health effects (Bandini et al., 2011). Escape extinction has found to be effective for treating food selectivity; However, it may lead to unwanted behavioral side effects and be inappropriate for certain environments (Sharp et al., 2017). Differential reinforcement has been used as an alternative to escape extinction, however, its efficacy in isolation is mixed (Najdowski et al., 2010). Penrod and colleagues (2010) examined the effect of a treatment package consisting of differential reinforcement, demand fading, manipulation of the reinforcer magnitude, and escape extinction on consumption of non-preferred foods for three individuals with autism spectrum disorder (ASD). Only one participant demonstrated increased food consumption without escape extinction. Therefore, the purpose of the present study was to examine the effects of differential reinforcement with demand fading and manipulation of the schedule of reinforcement on the food selectivity of a young boy with ASD within a school setting. The results of the multiple baseline across food groups with an embedded changing criterion design indicated an increase in the food consumption of non-preferred foods from baseline levels.

One of the earliest and most noticeable characteristics of children with Autism Spectrum Disorder (ASD) is impaired eye contact. Currently published research on increasing responding to name with eye contact has primarily involved separate and combined procedures such as physical prompting, visual prompting, differential reinforcement, and overcorrection. The current study evaluated the effects of an auditory orienting response using a variety of short, non-social sounds to elicit eye contact. When eye contact occurred following presentation of the non-social auditory stimulus, the experimenter used conditioning procedures to pair the presentation of the participant’s name with a highly preferred stimulus. This procedure was used as a supplement to differential reinforcement to increase eye contact in four young children with ASD. Results suggest the current procedure may be an effective way to teach young children with ASD to make eye contact in response to a name call.

Individuals with autism and other developmental disorders frequently display behaviors that interfere with daily function, including potentially dangerous behaviors such as aggression, self-injury, and tantrums (Murphy, Beadle-Brown, Wing, Gould, Shah, & Holmes, 2005). Delay-Denial Tolerance (DDT) training is shown to be an effective intervention in decreasing problem behavior and increasing acceptable alternative behaviors (Hanley, Jin, Vanselow, & Hanratty, 2014). This intervention incorporates eliciting attention, manding, a tolerance response, and contextually-appropriate behavior (CAB) during the delay period. The traditional DDT approach involves the use of an omnibus mand (i.e., “My way”). However, this may not be suitable with all students with already varied manding repertoires. In this study, we examined DDT training with the use of specific mands in the school setting across three individuals with different communication modalities using a multiple-baseline across behaviors design. All participants demonstrated reduced problem behavior and increased alternative behaviors. One participant demonstrated generalization of all responses to the natural environment without specific training. The incorporation of specific mands and the limitations of implementation in a school setting are discussed.

According to recent surveys, clinicians rarely conduct a functional analysis (FA) prior to intervention due to time constraints. A solution that has been evaluated and found to be promising is to conduct a 5-min session FA. However, the relative utility of independent 5-min and 10-min session FAs has not yet been evaluated. The purpose of the current study was to compare two independently conducted FAs of 5- and 10-min sessions, for the problem behavior of six individuals with autism spectrum disorder. For each participant, the same function of problem behavior (escape) was identified across 5- and 10-min session FA. In addition, the 5-min session FA averaged 67 min (range, 45-100 min), whereas the 10-min session FA averaged 125 min (90-150 min), showing that the 5-min session FA resulted in an average time savings of 45%. A subsequent treatment analysis that included differential reinforcement of alternative behavior (DRA) was conducted to assess FA outcome validity. DRA was effective in decreasing problem behavior and increasing appropriate communication for all participants. The 5-min session FA and DRA treatment analysis combined averaged 122 min (range, 100-155 min), suggesting that an effective function-based treatment could be identified in under 3 hours, without compromising validity.

Handwriting is an important fine motor skill and it may act as a prerequisite for other academic and communication skills. The skills involved in handwriting are especially important in school-age children due to their prominence and inclusion in activities during a large portion of the school day (Marr et al., 2003). Previous researchers have used the Handwriting Without Tears ® workbook to teach handwriting to typically developing children. However, due to the relative novelty of the iPad application, there is limited research on the efficacy of the program with children who have fine motor deficits through a behavior analytic lens. The present study evaluated the efficacy of a modified Handwriting Without Tears (HWT) ® application for two children with autism spectrum disorder. Prompts, reinforcement, and modified trial arrangements were included as part of the treatment package. In addition to efficacy, we assessed generalization to handwriting with a stylus and a natural writing instrument. Preliminary results suggest the program was efficacious in teaching letter tracing. Implications will be discussed, and future research ideas will be provided.

The picture exchange communication system (PECS) is a commonly used form of augmentative communication for individuals with autism spectrum disorder (ASD) given its relative ease of teaching, inexpensiveness, and limited complex motor movements required (Bondy & Frost, 1994; Charlop-Christy, Carpetner, Le, LeBlanc, & Kellet, 2002). However, limited research exists on using PECS to teach autoclitics. Autoclitics are verbal behavior that alter the function of other verbal behavior and can increase the precision of verbal statements, which can promote more reinforcing consequences for the speaker (Howard & Rice, 1988; Skinner, 1957). The present study evaluated this gap in the research by teaching autoclitics to a child with ASD who used PECS for 1-2-word phrases. The tact frames “I see” and “I hear” were trained using sound recordings and stimulus cards. To teach these frames, a progressive prompt delay was initially used, but due to over-selection of one stimulus, a within stimulus-fading procedure was implemented. The ongoing results suggest that the stimulus-fading procedure lead to higher levels of correct responses. Future research should extend these procedures with different autoclitics to facilitate learners’ ability to communicate with their community by using longer phrases (e.g., talking about the environment, asking for quantities of items).

Individuals diagnosed with Autism Spectrum Disorder (ASD) may also be diagnosed with other disorders which may impact effective treatment. Current research finds between 30%-50% of individuals diagnosed with ASD also present with characteristics of Attention Deficit Hyperactivity Disorder (ADHD), yet prior to the DSM-V, this dual diagnosis was not possible, as an ASD diagnosis was an exclusionary criterion for ADHD (Leitner, 2014). With the change in the DSM-V criteria for diagnoses, a dual diagnosis of ASD and ADHD became possible, and research regarding comorbidity of ASD and ADHD became more prevalent. Leitner (2014) suggests that when comparing individuals with both diagnoses versus individuals with a single diagnosis, individuals with co-occurring symptoms experience greater symptomology, are more difficult to treat, and may be less responsive to standard treatments for either disorder. A collaborative interdisciplinary team may be one solution in effectively treating individuals dually diagnosed with ASD and ADHD. The present data are the result of collaboration between a Board Certified Behavior Analyst (BCBA) and a Mental Health Nurse Practitioner (MHNP) to reduce aggression and darting, and increase on task behavior for a 14-year old female diagnosed with ASD and ADHD. Here, the behavior Analyst was able to provide frequency data and temporal relations for multiple behaviors, which were analyzed by the BCBA and MHNP together. From there, medication changes in the form of introducing a stimulant were prescribed, and data were collected pre and post treatment change for analysis by the BCBA and MHNP. The addition of the medication resulted in a significant decrease in aggression and darting, and an increase in on task behavior.

Failure to adhere to medical regimens is associated with negative health outcomes and increased mortality rate (CDC, 2017). However, individuals may struggle with swallowing pills, resulting in noncompliance and disruption during medication administration. As a result, medication administration techniques such as crushing medication or allowing pills to be chewed may be used. However, crushing or chewing some medications can cause patients to overdose or can render the drug ineffective. Past research has investigated the use of behavioral interventions such as differential reinforcement of alternative behavior (DRA) and stimulus fading as well as other interventions including modeling and visual aids to increase compliance with pill swallowing. The purpose of this literature review is to outline the efficacy and behavioral basis of interventions used to increase compliance with pill swallowing and discuss directions for future research. The keywords pill swallowing and compliance were used to identify relevant research.

Previous research has demonstrated that the method of presenting a variety of tasks(varied task condition) is more efficient than the method of presenting a single task(constant task condition) to children with autism spectrum disorders (Dunlap & Koegel, 1980). The current study systematically replicated the earlier study by comparing the two approach with 2 boys with ASD. Specifically, we used mastered tasks and an adapted alternating treatments design was implemented to compare the correct responses, response latencies, and affects. The results showed that varied task condition was similar to constant task condition for correct responses and response latencies. Observers judged the Child 1 to be more enthusiastic, interested, happier, and better behaved during the varied task condition. The results suggest that the method of variety of tasks produced superior to the method of presenting a single task for the affect of Child1, the relative effectiveness of the varied task versus constant task conditions during correct responses and response latencies is less clear. The results were discussed for the differences between mastered tasks and target tasks.

Many children with autism spectrum disorder (ASD) do not develop functional vocal speech and may require alternative/augmentative communication (AAC) systems, such as speech generating devices (SGD). iPad® and the Proloquo2Go™ application is one example of a SGD that may be implemented by clinicians, along with intervention methods aimed at teaching the child to use the device to communicate. This study compared two AAC intervention methods for children who have a diagnosis of ASD and who use iPad® and Proloquo2Go™: aided language modeling (ALM; Binger & Light, 2007) and incidental teaching (IT; Hart & Risley, 1975). A parallel treatments design (Gast & Wolery, 1988) was employed to compare the effectiveness of the two interventions in increasing the use of novel symbol use on an iPad® with the Proloquo2Go™ application. Initial results suggest that IT results in a higher frequency of independent, contextually relevant, single-symbol utterances during a play activity than does ALM.

As the number of individuals diagnosed with Autism Spectrum Disorder (ASD) increases, the need to provide an appropriate, school based education grounded in evidence based practice is critical. Recent developments in the functional analysis of problem behaviour have yielded a new tool: the Interview-Informed Synthesized Contingency Analysis (IISCA). Hanley and colleagues (2014) were able to successfully assess and decrease the challenging behaviour of 3 individuals with ASD in a clinic setting through the use of the IISCA and its corresponding skills-based treatment plan. While additional studies have attempted to replicate the IISCA (Santiago et al 2016), additional research is warranted on its utility across various settings, such as schools. This poster reviews differences in the use of the IISCA and extensions of the IISCA to assess the challenging behaviour of 6 pupils that attend a special school for individuals with Autism Spectrum Disorder. Results show varied success across pupils. This indicates that the IISCA may be useful for some, however, without modifications it may not consistently yield data that demonstrate a functional relationship.

Automatically maintained self-injurious behavior is estimated to occur in approximately 25% of individuals with autism. Several studies noted some of these individuals will also engage in self-restraint; which is described as a form of restricting one’s own responding (Oliver, Murphy, Hall, Arron, & Leggett, 2003) to avoid SIB. One form of self-restraint may be described as recruited restraint, such as manding for handholding or hugs. In contrast, research by Kodak, Northup, and Kelley (2013) demonstrated that physical attention may differentially reinforce problem behavior. The current study was conducted with a 10-year-old boy who engaged in SIB maintained by automatic reinforcement and often held onto caregiver’s hands and arms. In order to determine whether holding hands with others was reinforced by positive reinforcement (access to physical attention) or negative reinforcement (avoiding injury from SIB) a recruited restraint assessment was conducted. During the control condition, Darrin wore arm restraints that limited his ability to engage SIB. During the test condition, Darrin did not wear any protective equipment. During both conditions, access to hand holding with the therapist was freely available. Results from this assessment suggested Darrin recruited staff to hold his hands as a form of self-restraint.

This study purports to provide procedural extension to Naturalistic Developmental Behavioral Interventions (NDBI: Schreibman, et al. 2015) by addressing over-selectivity of certain stimulus modality often documented (e.g., Liss, Saulnier, Fein, & Kinsbourne, 2006) in children on autism spectrum disorders (ASD). The goals of the intervention were to establish practical procedures for a child who functions on his/her interests to become more receptive to other people’s interests, and to demonstrate how ensuring core skills such as toy play, engagement, or joint attention would lead to instruction of more advanced skills. Based on a hypothesis that unique pattern of stimulus processing over-selectivity is preventing a child from registering common social cues, we assessed the pattern of stimulus over-selectivity during a naturally occurring play on 3 preschool children with ASD and implemented a three-tier intervention on a condensed schedule (1.5 to 6 hours/week), examining the effects of increased and natural exposure to selected interactions that utilized the specific modality identified as less proficient. Results indicated an increase in the frequency per minute use of all modalities along with generalized quantitative and qualitative improvements in the functional use of untaught skills across setting and people, providing another set of data supporting generative learning (Johnson & Layng, 1994) in preschool children with ASD.

One of the most important and influential activities of daily living for assimilating into the community is the ability to safely navigate unfamiliar settings. Individuals with autism spectrum disorders (ASD) typically have difficulty with this (Goldsmith, 2009), and in particular street safety is a major concern and may have severe consequences such as injury and possible death. Pedestrian street crossing training is recognized as an integral life skill and is a fundamental step in the development of independence, increasing safety awareness, mobility, and safely integrating into society. The current evaluation utilizes a virtual reality (VR) procedure to facilitate training in a safe, controlled environment to acquire the necessary skills to independently cross the street. Along with VR, behavior skills training was used to examine whether skills would generalize in a natural setting. Results showed four of five participants mastered VR conditions and generalized skills in a natural setting. This study provides a model for efficiently and safely teaching pedestrian street crossing to adults with ASD.

Many children with autism spectrum disorder (ASD) demonstrate significant social skills deficits. The use of technology, including robots, is becoming increasingly popular as an intervention to teach social skills to children with ASD, however the research supporting these interventions is limited (Sartorato, Przybylowski & Sarko, 2017). Milo the Robot (Robokind, 2019) is one example of a technology- based intervention to teach social skills. The current study compared social skills training delivered by Milo the robot to training delivered by a human facilitator. The participants included three children with ASD, ages 4, 6, and 8. An ABCB design was used to compare the effectiveness of the two intervention conditions across participants and social skills lessons. During the course of implementation, limitations of the robot condition included slow, repetitive, and lengthy verbal instructions, with unclear expectations as to the expected target responses, which resulted in lack of attending and engagement of the participants during this condition. While data collection is ongoing at this time, the initial findings for two of three participants suggest there is no significant difference in the percentage of correct responding when comparing training delivered by a robot and training delivered by a human.