Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.

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50th Annual Convention; Philadelphia, PA; 2024

Event Details


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Symposium #396
CE Offered: BACB
Novel Applications of Applied Behavior Analysis (ABA) in Medical Settings or With Unique Patient Presentations
Monday, May 27, 2024
8:00 AM–9:50 AM
Marriott Downtown, Level 4, Franklin Hall 12-13
Area: CBM/AUT; Domain: Applied Research
Chair: Colin S. Muething (Marcus Autism Center)
Discussant: Patrick Romani (University of Colorado, Anschutz Medical Campus)
CE Instructor: Patrick Romani, Ph.D.
Abstract:

The use of behavior analytics strategies has been increasingly shown in the literature in novel settings and with novel patients. This symposium will present four novel applications of Applied Behavior Analysis (ABA) in medical settings or with unique patient presentations. Data will be presented on use of behavior analytic strategies in medical settings related to reducing the use of physical restraint in medical settings by hospital personnel and the acceptability of a crisis management program for use in medical settings. Large sample outcomes incorporating more than ten years of data from over 400 patients of an outpatient clinic targeting reduction of challenging behaviors will be discussed. Finally, strategies related to the treatment of complex motor stereotypy that incorporates times when access to stereotypy is available and the treatment of the understudied and controversial diagnosis of Pediatric Autoimmune Neuropsychiatric Disorders associated with Streptococcus (PANDAS) will be reviewed. Each author will discuss implications for research and practice.

Instruction Level: Intermediate
Target Audience:

BCBAs. Especially those practicing in medical areas.

Learning Objectives: 1. Learners will be able to identify ways that applied behavior analysis can be extended to medical settings. 2. Learners will be able to define and identify ways to treat complex motor stereotypy. 3. Learners will be able to describe PANDAS and how ABA strategies can be used with this population.
 

Outcomes of an Inclusive Intensive Day Treatment Clinic for Individuals With Challenging Behavior

MATTHEW O'BRIEN (The University of Iowa), Alexander Pauls (The University of Iowa), Elizabeth Freiburger (University of Iowa ), Jenny Feng (The University of Iowa)
Abstract:

Clinics specializing in behavior analytic interventions for challenging behavior commonly restrict their services to children diagnosed with an autism spectrum disorder. However, individuals across all ages, with and without disabilities, display challenging behavior necessitating treatment. The BioBehavioral Day Treatment Clinic at the University of Iowa specializes in behavior analytic intervention for challenging behavior for individuals across the lifespan without exclusion criteria related to diagnosis. Over the past 10 years, this clinic has provided assessment and treatment services to more than 400 individuals exhibiting challenging behavior. This talk will provide an overview of the service model used in this clinic and a detailed description of the patients it serves. Data on assessment and treatment outcomes for patients served over the past 10 years will be presented with additional analyses of outcome data based on various patient characteristics. This talk will also include a discussion on the benefits, limitations, and challenges of a fully inclusive clinic service.

 
Evaluation of Evocative Antecedent Events in the Assessment and Treatment of Primary Complex Motor Stereotypy
MATTHEW L. EDELSTEIN (Kennedy Krieger Institute), Emily Pogue (The Hospital for Sick Children), Sydney Pippin Lenfestey (Kennedy Krieger Institute ), Harvey Singer (Johns Hopkinds School of Medicine)
Abstract: While most often noted in children with autism spectrum disorder (ASD), intellectual disability, or sensory deprivation, stereotypic movements can also present in typically developing children. Primary, complex motor stereotypies (PCMS; hand flapping, body rocking, arm waving in otherwise typically developing children) occur in approximately 3-4% of children and can be socially stigmatizing, leading to bullying and social isolation. Previous research has suggested that behavioral intervention consisting of habit reversal therapy can be effective in reducing these behaviors, though outcomes have been primarily via pre/post ratings and/or caregiver report. In addition, there have been no studies to date to use functional analysis methodology to experimentally identify evocative contexts where PCMS occurs. The current study involves the functional analysis and treatment of three children with PCMS using differential reinforcement of other behavior, signaled availability, and schedule thinning in a nonconcurrent multiple baseline design. Treatment sessions occurred in-person, and ranged from 6-20 hours of assessment and intervention. Results suggest a 99% reduction of motor stereotypy from baseline across all three participants. Clinical implications and future directions will be discussed.
 

Applying Behavior-Analytic Methodology to Patient- and Systems-Level Needs in a Tertiary Medical Hospital: It Works (and Is Needed)

ALEC M BERNSTEIN (Children's Mercy Kansas City; University of Missouri-Kansas City School of Medicine), Rebecca M Ebbers (Children’s Mercy Kansas City Hospital; University of Missouri-Kansas City School of Medicine), Nataleigh Messimore (University of Missouri-Kansas City School of Medicine), Kelsey M. Dachman (Center for Supportive Communities; University of Kansas)
Abstract:

Staff injuries and difficulty managing challenging behavior continue to plague the healthcare setting. As the healthcare setting begins to recognize the need for behavior analysts within the interdisciplinary clinical team, their novice understanding of applied behavior analysis—its conceptualization of behavior, methodology, and generality—persists. Empirically demonstrating the clinical success of behavior-analytic services can increase awareness of the usefulness of applied behavior analysis for patient-level issues. Savvy marketing of these outcomes can facilitate awareness of how the healthcare setting might employ a similar conceptualization and methodology for systems-level issues. In this presentation, we describe several projects related to the application of behavior analysis within a tertiary medical hospital. The first projects demonstrate the usefulness of our science for addressing patient-level issues such as evaluating causal relations between violent media and challenging behavior and reducing the use of physical restraint. The latter project, which came at the request of our hospital leadership following the dissemination of our clinical outcomes, demonstrates the generalization of behavior-analytic methodology for addressing a systems-level issue related to the effectiveness and acceptability of the hospital’s current crisis management program.

 

A Behavioral Approach to the Assessment and Treatment of an Understudied and Controversial Diagnosis: Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS)/Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections (PANDAS)

ANDREW GARDNER (The University of Arizona – Departments of Pediatrics and Psychiatry), Chelsea E. Carr (The University of Arizona )
Abstract:

PANS/PANDAS is an autoimmune disorder marked by an acute onset of obsessive-compulsive disorder or severe restricted food intake, along with at least two of the following symptoms: anxiety, emotional lability, depression, aggression, developmental or behavioral regressions, deterioration in school performance, tics, or somatic symptoms. The simultaneous treatment of biological and behavioral symptoms is recommended for children diagnosed with PANS/PANDAS (Thienemann, et al., 2017). Accurate data are crucial to ensure adherence to medical and behavioral interventions to improve functioning and decrease suffering. However, due to the simultaneous treatment of bio-behavioral symptoms, accurate data are often difficult to progress monitor. In this presentation, we demonstrate methods of assessing and tracking changes in symptomatology in children diagnosed with PANS/PANDAS. ABA-based data collection methods including scatterplot, multi-element designs, and function-based narratives were used to track intervention variables as well as changes in symptoms over time for 3 children diagnosed with PANS/PANDAS within our multidisciplinary team of professionals (including behavior analysis, psychiatry, developmental pediatrics, immunology).

 

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