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

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Poster Session #96M
AUT Saturday Poster Session
Saturday, May 25, 2024
1:00 PM–3:00 PM
Convention Center, 200 Level, Exhibit Hall A
Chair: Kozue Matsuda (Children Center Inc)
Diversity submission 129. The Effect of Brief Acceptance and Commitment Training on Values-Based Behaviors of Japanese Parents
Area: AUT; Domain: Service Delivery
MARI URAMOTO (The Chicago School of Professional Psychology; Children Center, Inc), Yors A. Garcia (Pontificia Universidad Javeriana), Colleen Moore (The Chicago School of Professional Psychology), Yukie Kurumiya (The Chicago School)
Discussant: Kozue Matsuda (Children Center Inc)
Abstract: There is a rapidly growing awareness of parent-focused treatment strategies to help parents of children with autism who are experiencing an enormous amount of stress (Andrews et al., 2022; Garcia et al., 2022). The purpose of this study was to examine the effects of brief acceptance and commitment training (ACT) on overt values-based behaviors, psychological flexibility, psychological well-being, and parental adherence of four Japanese mothers of children with autism. A non-concurrent multiple baseline design across participants with pre- and post-measures was used in this study. All four participants received five 45-60 minutes of online ACT sessions. The level of psychological flexibility and psychological well-being were assessed using a 6-PAQ and PWBS-42, respectively. In addition, a social validity questionnaire assessed the feasibility and acceptability of the ACT. To establish clinically significant change, between-case standardized mean differences and non-overlap of all pairs (NAP) were calculated for overt values-based behaviors. The NAP analysis demonstrated that three out of four participants showed moderate to strong improvement in overt values-based behaviors. The results suggest that ACT was effective and acceptable for the Japanese population. The importance of cultural variables in designing, implementing, and analyzing data and providing direction for future studies are discussed.
 
130. Offsetting the Demand for School-District Board Certied Behavior Analysts by Supporting Teachers Interested in Registered Behavior Technician Certification
Area: AUT; Domain: Service Delivery
KRISTINE TURKO (University of Mount Union)
Discussant: Lindsey Sneed (Catalight Research Institute)
Abstract: There is a growing need for Board Certified Behavior Analysts (BCBAs) in school districts nationwide. Many districts do not hire full-time BCBAs, but rather contract with service providers who plan, develop, and monitor behavior support service delivery options to meet the needs of students diagnosed with Autism Spectrum Disorder (ASD) and/or students with other behavioral and social/communication challenges. While contracted support is helpful, it tends to be utilized in a reactive manner and the need for support often exceeds the contracted BCBAs availability. In an effort to become more proactive, school districts can support teachers who are interested in learning to use ABA to improve student behavior. RBT certified teachers can implement behavior plans with the goal of achieving outcomes that direct future intervention and improve students’ quality of life. In addition, certified teachers can work under the direction of a BCBA to prioritize goals, conduct preference assessments, and implement behavior plans that involve modeling, schedules, and self-management. Teachers have the advantage of being aware of individual student’s strengths and weaknesses. Certified teachers can support colleagues and offset the administrative burden of recruiting contractors.
 
Diversity submission 131. Parent-Implemented Functional Communication Training (FCT) to Reduce Challenging Behavior in Nonvocal Culturally and Linguistically Diverse (CLD) Children With Autism Spectrum Disorder (ASD)
Area: AUT; Domain: Theory
MONERAH N. AL-DUBAYAN (University of Maryland), Gulnoza Yakubova (University of Maryland, College Park)
Discussant: Kozue Matsuda (Children Center Inc)
Abstract: Parent-implemented interventions have become more common in the last few decades and many studies looked at their effectiveness with children with autism spectrum disorder (ASD) and intellectual and developmental disabilities (IDD). However, there is still a need to evaluate the literature on parent-implemented interventions with children who display challenging behavior, are nonvocal or minimally vocal, and come from culturally and linguistically diverse (CLD) backgrounds. In this review, we identified eight peer-reviewed studies and dissertations focusing on parent-implemented functional communication training (FCT) with nonvocal and minimally vocal children with ASD and IDD who display challenging behavior and come from CLD backgrounds. Across all studies, child participants’ challenging behavior decreased as a result of the parent-implemented FCT and some studies also reported an increase in appropriate replacement behavior (i.e., independent communication). Both procedural fidelity and social validity were reported in all studies, indicating parents implemented the intervention with high fidelity and had mostly high acceptability of the coaching and intervention outcomes. The findings from this review suggest future research should continue focusing on sustainable and effective parent coaching, while taking into account culturally responsive practices and extending coaching procedures to other non-researchers, such as teachers, paraprofessionals, and other caregivers.
 
132. Establishing Concurrent Mand From Peers in Japanese Children With Autism Spectrum Disorder
Area: AUT; Domain: Service Delivery
SATOKO NITADORI (Children Center Inc.), Ren Murata (Children・Center), Kozue Matsuda (Children Center Inc)
Discussant: Lindsey Sneed (Catalight Research Institute)
Abstract: Typically, developing children learn mand at an early stage of their development. However, children with Autism Spectrum Disorder (ASD) may require structured instruction to acquire a diverse range of mand words. Although mand training has been studied for decades, there is a need for specific interventions to establish peer-manding in children with ASD due to the absence of generalization of mand from adult to peer listeners. The purpose of the current study was to combine these lines of research to teach Japanese children with ASD to use mands "I want (item)(XX ????)" toward their peers instead of adults. The participants were two elementary school-aged children with ASD who used a tablet-based speech-generating device or vocalizations to communicate with their caretakers. Using a multiple baselines across-subjects design, the participants were instructed to spend leisure time with a peer listener with an item required to complete the activity. Both participants acquired the skills to mand to their peers, which were maintained over time. According to the social validity evaluation findings, caretakers reported the procedures as highly acceptable.
 
133. Enhancing Functional Communication Skills in Chinese-Speaking Children Through a Speech Generating Device (SGD)
Area: AUT; Domain: Service Delivery
XIAOFAN ZHANG (University of Pittsburgh; Wuhan Linjie Rehabilitation Medical Center ), Rachel E. Robertson (University of Pittsburgh), DAN LI (Wuhan Linjie Rehabilitation Medical Center), Wei Shen (Wuhan Linjie Rehabilitation Medical Center), Qing Li (Wuhan Linjie Rehabilitation Medical Center)
Discussant: Kozue Matsuda (Children Center Inc)
Abstract: This study tested the effect of a speech generating device application on Chinese-speaking children with autism spectrum disorder to enhance their functional communication skills. Given that a significant percentage of individuals with autism struggle to communicate effectively using verbal language, alternative methods for expressing their needs are necessary. The speech generating device employed speech synthesis technology to provide visual cues and vocal sounds for selected items. A multiple baseline design was implemented across participants, consisting of four phases. The speech generating device was introduced across all phases to enable participants to mand items of interest. A most-to-least prompting procedure was used during the intervention phase. Following the intervention, all participants demonstrated a significant increase in both the frequency and variety of items they manded using the speech generating device. Although each participant demonstrated unique characteristics during the experiment, they all successfully generalized and maintained their skills in using the speech generating device for manding items.
 
134. Teaching a Caregiver to Implement a Feeding Protocol via a Telehealth Training Program
Area: AUT; Domain: Applied Research
Jason Travers (Temple University), RACHEL ELIZABETH BECK (Elevated Kids )
Discussant: Lindsey Sneed (Catalight Research Institute)
Abstract: Behavior analytic interventions can effectively broaden food consumption and reduce inappropriate mealtime behaviors in children with autism spectrum disorder and Avoidant Restrictive Food Intake disorder (ARFID) (Piazza et al., 2003; Volkert & Piazza, 2012), some of which focus on training caregivers (Anderson & McMillan, 2001; Galensky et al., 2001; Gentry & Luiselli, 2007; Mueller et al., 2003; Najdowski et al., 2010; Peterson et al., 202; Penrod et al., 2010). The purpose of this study was to train caregivers of a child with ARFID via a telehealth training program to follow a mealtime protocol to increase the child’s food acceptance and decrease inappropriate mealtime behaviors. A caregiver attended telehealth trainings where the investigators implemented didactic lessons (verbal and written descriptions treatment procedures), video models, real-time performance feedback, and written performance feedback. Caregiver adherence three treatment procedures was measured during mealtime with the child. Visual analysis supports the conclusion that the telehealth training program had a positive effect on the caregiver’s adherence to the three treatment procedures. The findings from this study are consistent with the limited albeit positive prior research, and further demonstrate the beneficial effects of telehealth training to improve parent-implemented feeding intervention protocols.
 
135. The Evidence-Base of Antecedent Exercise for Autistic Individuals: A Multilevel Meta-Analysis
Area: AUT; Domain: Service Delivery
Saehee An (Temple University), Fernando Roldan (Temple University), ART DOWDY (Temple University)
Discussant: Kozue Matsuda (Children Center Inc)
Abstract: Antecedent exercise (AE) is a behavior intervention that leverages the benefits of exercise or physical activity to reduce problem behavior of an individual in a non-exercise environment (e.g., classroom; Allison et al., 1995). AE has been shown to increase adaptive behavior (Fox et al., 2010) and reduce problem behavior (Chazin et al., 2018). Exercises commonly included in AE are jogging (Allison et al., 1991), walking (Levinson, 1993), roller skating (Powers et al., 1992), team sports (Riker, 2019; Richards, 2019), and aerobic exercise (Bachman & Sluyter, 1998). Copious empirical research on AE has been conducted over the past 35 years with Autistic individuals. Given the breadth of research, we aimed to meta-analyze the empirical base of AE to understand the research quality, perceived acceptability, and effectiveness. We also evaluated the extent to which moderating variables impacted AE outcomes (e.g., age, sex, interventionist, context, exercise type). Findings related to quality, acceptability, and effectiveness will be shared along with suggested best practices for clinicians and educators.
 
136. Connecting the Dots Program
Area: AUT; Domain: Service Delivery
RACHEL HOFFMAN-SENSAT (University of Houston-Clear Lake), Jennifer Carrera (University of Houston-Clear Lake), Jennifer N. Fritz (University of Houston-Clear Lake), Sarah A. Lechago (University of Houston-Clear Lake), Amber Groat (University of Houston-Clear Lake), Megan E Vosters (University of Houston-Clear Lake), Allison N. Radomski (University of Houston-Clear Lake)
Discussant: Lindsey Sneed (Catalight Research Institute)
Abstract: The University of Houston-Clear Lake (UHCL) Center for Autism and Developmental Disabilities (CADD) established the Connecting the Dots (CTD) program to provide free caregiver training to families of children with an autism spectrum disorder. The CTD was managed by Board Certified Behavior Analysts® and overseen by UHCL professors Dr. Jennifer Fritz and Dr. Sarah Lechago. From 2016-2022 this program served a total of 473 families and their children, and of these families, 69% completed the program for a total of 326 families served. The program included 12-weeks of 2-hour on site or virtual services in which a target behavior to decrease and/or a target behavior to increase was identified, as well as a lecture series geared towards increasing the caregiver’s general knowledge of both verbal behavior and target behaviors for reduction. Caregiver participation was evaluated through procedural integrity checks. Procedural integrity across 326 families was 96%, with 98% of their child’s responding meeting the targeted goals of either increase or reduction. A significant barrier of note occurred between the years 2020-2021 when the country was affected by the COVID-19 pandemic. All services were no longer given face-to-face and instead transitioned to telehealth. From the years 2016-2020 the clinic met 100% of the projected goal to serve 348 families. During the pandemic, the clinic met 43% of the projected goal serving 125 of the desired 368 families. The families that completed the program during 2020-2021 met their goals for procedural integrity and client responding; therefore, telehealth is a viable method of providing services when technological or other barriers do not preclude service provision. However, with the additional barriers presented, such as presence of other family members (e.g., siblings), caregivers working from home, and potential lack of resources, it was difficult for families to commit to the services and complete the program. Based on this information, in-person services seem to be a more efficient method of service provision.
 
137. Participant Preference of Challenging Behavior Interventions: A Systematic Review
Area: AUT; Domain: Applied Research
EMILY PAIGE EXLINE (Baylor University), Tonya Nichole Davis (Baylor University), Monserrat Austin (Baylor University)
Discussant: Kozue Matsuda (Children Center Inc)
Abstract: When selecting a treatment for a client, practitioners often consider a variety of factors including treatment efficacy, contextual fit, and stakeholder preferences. In the past two decades, there has been an increased emphasis on considering the client’s preference for treatment, particularly treatment aimed to reduce challenging behavior. The purpose of the purpose of this review was to synthesize the studies that evaluated the participant’s relative preference for challenging behavior reduction intervention. To be included in the review, the study must have included a participant with a developmental disability and evaluated participant’s relative preference for two or more challenging behavior interventions or one or more challenging behavior intervention and a no-intervention condition. We identified 25 studies including 69 participants who participated in 99 preference assessments. The most common mode of assessing preference was using a concurrent-chain arrangement, followed by a free-operant arrangement. Only 13 preference assessments evaluated participant preference between intervention and a no intervention condition. All 13 participants preferred the intervention over the no intervention condition.
 
138. Stimulus Pairing to Condition Novel Reinforcers for Bermudian Participants With Autism
Area: AUT; Domain: Applied Research
JAHNAE HARVEY (Tomorrow's Voices Bermuda Autism Early Intervention Centre; Walden University; Bermuda Association of Behavior Analysis (BABA) ), Steven G. Little (Walden University)
Discussant: Lindsey Sneed (Catalight Research Institute)
Abstract: Reinforcement is crucial to an individual’s quality of life and acquisition/maintenance of skills, but a limited bank of reinforcers could lead to a reduction in engagement with pre-established reinforcers, reducing motivational strength to contrive teaching opportunities, and increase maladaptive behaviors, self-stimulatory behaviors, or idle time. Though the stimulus-stimulus paring (SSP) method has been effective in establishing novel reinforcers for individuals diagnosed with autism, there is a gap in the literature on cross-cultural variations seen among responses when using SSP. This study was conducted to determine the generalizability of the effect when using the method of SSP with Bermudian participants, as Bermuda’s culture is influenced by several cultures. This study used secondary data collected at a local intervention center that utilizes applied behavior analysis. The results for all three participants demonstrated (a) an increase in engagement with the targeted stimuli, (b) ascending data trends within their overall SSP intervention, and (c) a percentage of nonoverlapping data points between the pre-intervention baseline and post-intervention baseline were 80% or greater. These findings can assist therapists by equipping them with culture-specific evidence-based strategies, which can be socially significant for their clients, their client’s families, and the community as a whole.
 
139. Functional Communication Training for Toddlers At-Risk for Autism With Tangibly Maintained Early Problem Behavior
Area: AUT; Domain: Applied Research
CHA YONG PATTERSON (UTSA), Leslie Neely (The University of Texas at San Antonio), Amarie Carnett (Victoria University of Wellington), Katherine Cantrell Holloway (University of Texas at San Antonio )
Discussant: Kozue Matsuda (Children Center Inc)
Abstract: Problem behavior tends to manifest in early childhood as a natural part of human development. In the case of children who are at risk for autism, there may be a necessity to intervene during this early phase to prevent the exacerbation of problematic behavior and encourage effective communication. Functional Communication Training (FCT) is a well-supported intervention strategy that involves identifying the function of problem behavior and then teaching the child a functional communication response (FCR) that serves the same purpose as the problematic behavior. This study aimed to assess the effectiveness of FCT in teaching toddlers at risk of autism to appropriately request for access to tangibles instead of resorting to early problem behavior (EPB) when access is restricted or removed. Methods Six children participated in this study. Researchers used a non-concurrent multiple baseline design to evaluate the effects of FCT on participants. Results EPB decreased for all participants from baseline to intervention. Functional communication increased in all participants from baseline to intervention. EBP was observed to increase in the reversal phases. Conclusion This study builds upon prior FCT research to include younger children who exhibit characteristics that classify them as being at risk for autism.
 
140. Evaluation of Language Preference Within Functional Communication Training
Area: AUT; Domain: Applied Research
LAURA MAGALY PENA (University of Texas at San Antonio), Leslie Neely (The University of Texas at San Antonio), Thu Le (The University of Texas at San Antonio)
Discussant: Lindsey Sneed (Catalight Research Institute)
Abstract: Prior studies have demonstrated the efficacy of Functional Communication Training (FCT) in reducing challenging behaviors while fostering communication. However, there has been a shortage of research investigating whether FCT can influence the language preference of bilingual individuals with autism. This study aims to assess whether language preference undergoes changes as a consequence of FCT, specifically focusing on a single case involving a 6-year-old boy with autism from a bilingual Vietnamese-English family. To investigate this, the researcher administered language preference assessments before, during, and after the implementation of FCT. During the FCT sessions, the participant was instructed in both languages to acquire functional communication responses (FCRs) that would replace challenging behaviors. The findings indicate a shift in the participant's language preference, with a quicker acquisition of English FCRs compared to Vietnamese. Additionally, the frequency of challenging behaviors decreased significantly to zero rates in both Vietnamese and English settings. The study concludes by acknowledging its limitations and offering suggestions for future research endeavors.
 
141. Finding the Right Job Using a Multi-Dimensional Preference Assessment
Area: AUT; Domain: Applied Research
KYLE VISITACION (Western Michigan University), Paige Lee Sherlund-Pelfrey (Western Michigan University ), Jessica E. Van Stratton (Western Michigan University)
Discussant: Kozue Matsuda (Children Center Inc)
Abstract: Individuals with developmental disabilities are known to have lower employment rates than those without (Bureau of Labor Statistics, 2023). Increasing job satisfaction by aligning employment opportunities with individual preferences can enhance performance in general (Morgan & Horrocks, 2011). It may also make it more likely employees will be motivated to improve their performance, thereby possibly enhancing the social validity and effectiveness of interventions designed to promote desired work outcomes. The current poster displays information about a paired-stimulus preference assessment used to evaluate preferences across multiple job dimensions for a young adult with autism seeking employment. Evaluated job dimensions included prospective job tasks, compensation statuses (i.e., paid v. volunteer), and scheduling types (i.e., part- v. full-time). Job tasks were selected based on previously expressed preferences and potential job opportunities feasible at the time of the assessment. Prior to the assessment, the person was exposed to stock videos of someone else completing job tasks as well as contingencies related to compensation status and scheduling type. Results of the preference assessment across each job dimension will be shared, implications, and future directions will be discussed.
 
142. Social Communication Interventions for Students With Autism Spectrum Disorder in School Settings: A Systematic Review of the Literature
Area: AUT; Domain: Applied Research
FAHAD ALRESHEED (Easterseals Southern California), Faisal Alnemary (Autism Center of Excellence, Riyadh, Saudi Arabia), Wendy A. Machalicek (University of Oregon), Shaji Haq (Easterseals Southern California)
Discussant: Lindsey Sneed (Catalight Research Institute)
Abstract: Poor social communication skills are one of the many barriers that hinder the ability of students with ASD to learn and interact with peers in school settings. Therefore, this systematic literature review evaluates peer-reviewed single-subject research targeting social communication skills for students with ASD in school settings. 105 studies located in ERIC, PschINFO, and MEDLINE were published from 1995 to 2022 and met the inclusion criteria. The following variables were examined in each study: the number and the characteristics of participants, diagnosis, settings, dependent variables, independent variables, type of single-subject design, documentation of generalization and maintenance, the person delivering the intervention, rigor of the study, and non-overlap indice (Tau-U score). Findings from this review suggest the availability of a wide range of specific interventions (and intervention packages) to improve different social communication skills for students with ASD in school settings. Suggestions for practical implications will be provided and directions for future research are proposed.
 
143. Evaluating the Effects of Therapist Behavior on Paired Stimulus Preference Assessment Outcomes
Area: AUT; Domain: Basic Research
NICOLE SCHWARTZ (Bancroft), Tracy L. Kettering (Bancroft), Kelly Owen (Bancroft), Deanna Gross (Bancroft), Anna Sulpizio (Bancroft)
Discussant: Kozue Matsuda (Children Center Inc)
Abstract: Studies have demonstrated preference assessment outcomes can be influenced by several different variables. Kanaman and colleagues (2022) found that preference for toys in a paired stimulus preference assessment (PSPA) was influenced by social interaction provided during the engagement period. It is also possible that unplanned or inadvertent attention delivery may influence preference assessment outcomes. In the current study, we examined the impact of treatment integrity failures, in the form of differential attention toward specific items, on the preference assessment outcomes. Participants were 3 children in a residential treatment facility receiving treatment for challenging behavior. Following a baseline PSPA, the therapist delivered high quality attention during pre-session access and contingent upon item selection for one predetermined target stimulus in each of three subsequent PSPAs. The impact of the altered attention on stimulus selection was evaluated in a variation of a parallel treatment design. Specifically, one stimulus was pre-selected to receive altered attention during each session, while attention delivery toward the other stimuli remained unchanged. Across all participants, results showed that stimulus selection never shifted significantly following altered attention delivery. Selection of stimuli was variable in the 4 assessments completed for each participant, consistent with previous studies on preference stability.
 
Diversity submission 144. Implementation of a Compassionate Care Based Framework in Nigerian Counties: Barriers and Potential Supports
Area: AUT; Domain: Theory
REVA MATHIEU-SHER (Duquesne Univeristy), Olajumoke Oshokoya (Duquesne University )
Discussant: Lindsey Sneed (Catalight Research Institute)
Abstract: Autism is a widely studied neurodevelopmental disability across the globe. However, there is a dearth of information about autism in Nigeria, yet the disorder is prevalent (Bakare et al., 2019; Ojo, 2015). Although there is a growing recognition of the importance of autism awareness and inclusion, autistic individuals in Nigeria have continued to experience mistreatment and at times elements of mistreatment from the community and even family members in some cases (Ajanwachukwu, 2017). This poster explores the application of a systematic framework of compassionate care as it related to utilization of Applied Behavior Analysis (ABA) to support autistic clients and their caregivers. Various definitions of compassionate care are explored, along with cultural implications and barriers in an effort to consider how implementation of a compassionate care approach could reduce barriers and increase supports for autistic children and caregiver in Nigerian countries. Discussion provides a cultural overview, possible barriers, and targeted supports of ABA implementation using a compassionate care ABA approach.
 
145. Using a Concurrent Feeding Mat to Increase Acceptance of Low-Probability Foods in a Child With Autism and Food Selectivity
Area: AUT; Domain: Applied Research
HAYLEY JOHNSON (Tennessee Tech University), Krystal Kennedy (Tennessee Technological University)
Discussant: Kozue Matsuda (Children Center Inc)
Abstract: This single case study employed a multiple baseline design with an embedded changing criterion design to determine the effectiveness of using a concurrent schedule of reinforcement to decrease latency in responding following the presentation of low-probability foods and increase acceptance of novel or previously rejected foods and in a child with autism and identified food selectivity. This study applied the concurrent schedule to increase acceptance of low-probability foods by presenting two or more foods with differing bite requirements on a concurrent feeding mat (CFM). Access to a preferred reinforcer was delivered following one of the schedules being met. A functional relation between the concurrent schedule of reinforcement and acceptance of low-probability foods was demonstrated through the replication of increased bite acceptance and decreased latency over five criterion changes and across five low-probability foods, with maintenance and generalization probes. The findings from this study support the consideration of using a concurrent feeding mat (CFM) approach to increase food acceptance.
 
Diversity submission 146. Bridging Communications Gaps: Co-Development of a Mobile Application and Web-Based Platform for Care Coordination and Communication Between Professional Caregivers and Families of Adults on the Autism Spectrum in Residential Care
Area: AUT; Domain: Service Delivery
CAMELLIA BÙI (Penn Medicine, Center for Mental Health), Heather Joy Nuske (University of Pennsylvania), Marius Mathisen (Pletly), Frode Werner Kjersem (Pletly), Garrett Ellwood (Bancroft), Dominique Fioravanti (Bancroft)
Discussant: Lindsey Sneed (Catalight Research Institute)
Abstract: Effective and consistent collaboration between professional caregivers and families are fundamental to treatment gains for individuals on the autism spectrum. However, in residential care programs where families are removed from the care setting, maintaining communication and care coordination is a frequent challenge and often creates additional burden on professional caregivers. Our Pletly web-based platform and phone application is designed to streamline communication and care coordination between professional caregiving teams and families of individuals with autism receiving care. Through three key features, 1) social feed, 2) care recipient’s information library, and 3) direct messaging feature, Pletly Care (interface for professional caregivers) and Pletly Pal (interface for families) will support the transfer of soft information, e.g. information about daily routines and social activities of individuals in care programs, and centralizes all communications between families and care teams. Secondary outcomes include increased family’s engagement and collaboration with care team, increased family’s awareness of their family member’s experience in the program, higher family satisfaction with services, less family dependence on care team, and others.
 
147. Honoring Individual Strengths: Customizing Augmentative and Alternative Communication (AAC) Interventions Using a Functional [Dynamic] Assessment
Area: AUT; Domain: Applied Research
LILITH REUTER YUILL YUILL (Comprehensive Speech and Therapy Center), Tamara S. Kasper (Kasper Enterprises/Caravel Autism Health)
Discussant: Cameron Montgomery Scallan (University of North Texas)
Abstract: Emergent communicators and their families present with a unique constellation of strengths and communication priorities. Clinicians that embrace evidence-based practice are tasked with big decisions to individualize augmentative and alternative interventions to meet the unique of each learner. Research-informed guidance is lacking, leading to an increase in adoption of one-size-fits-all approaches with low quality evidence. There is an unfortunate trend in practice that has kept the conversation in augmentative and alternative communication on finding “the right” high-tech device, application, vocabulary, symbols, and display with less emphasis and “HOW” we teach. Results demonstrate how results from a functional [dynamic assessment] assessment can be used to guide the data-based selection of teaching strategies in augmentative and alternative communication. The work represents an extension of mand topography assessment which emphasize the modality or topography of the response. These data also serve to remind BCBAs that functional behavior assessment is not just for problem behavior.
 
148. Adults With Autism Using Self-Management to Decrease Problem Behavior: A Review of the Literature
Area: AUT; Domain: Applied Research
ASHLEY MCHUGH (Eden Autism services), Thomas L. Zane (University of Kansas)
Discussant: Alec M Bernstein (Children's Mercy Kansas City; University of Missouri-Kansas City School of Medicine)
Abstract: In the field of autism treatment, the gold standard is ‘evidenced-based treatments.” This means that the treatment being considered has quality evidence that supports its positive impact of the target behaviors for which the treatment is designed to change. The purpose of this literature review was to examine the state of research on the use of self-management procedures in reducing problem behaviors in adults diagnosed with an intellectual disability. Studies were located by conducting a systematic search of literature across various journals. Seven- teen studies were included in the review and were evaluated along the dimensions of adherence to quality research design and outcomes. Results showed that self-management techniques were associated with decreased levels of challenging behaviors across adults with intellectual disability and autism spectrum disorder. However, the quality of research design was inconsistent, decreasing confidence in a causal relationship between self-management and reduction in challenging behaviors. This review should encourage more research in using self-management procedures with individuals having intellectual disability, especially with adults.
 
149. Evaluation of Children's Intensive Behavioral Health Services and Applied Behavior Analysis Program in Pennsylvania
Area: AUT; Domain: Service Delivery
JOSEPH D. CAUTILLI (Behavior Analysis and Therapy Partners), Lynn Santilli Connor (Behavior Analysis & Therapy Partners)
Discussant: Cameron Montgomery Scallan (University of North Texas)
Abstract: In PA, agencies are now required to gather outcome data on treatment outcomes for children with emotional and behavioral disorders in its IBHS and ABA programs. Behavior Analysis and Therapy Partners has always taken this responsibility seriously. As an eighteen-year-old agency, Behavior Analysis and Therapy Partners currently services over two hundred children and adolescents. Since our founding, in addition to behavioral data on progress toward goals, we have collected effectiveness data on various elements of psychopathology and adaptive behavior. Using the reliable change index calculation (RCI), we will conduct our annual chart review in early May. We will analyze data on the Vineland scale of behavior for children with developmental disabilities and the Behavioral Assessment Scales for Children Third Edition to determine what percentage of children who receive treatment in our program make a clinically significant change and what percentage of children show partial or full-scale recovery. As these measures represent parent's and teacher's perceptions of the child's behavior, they can be seen as an independent evaluation of the program. The most common interventions for children will be recorded if they are on any specific behavioral health curriculum (PEAK, AIM, Essentials for Living, ABBLS, etc.). In addition, to establish the social validity of the change, customer satisfaction data using the Therapy Attitude Inventory will be collected and reported.
 
150. I Choose When I Script: A Multiple Treatment Phase Program for an Autistic Teen’s Stereotypy
Area: AUT; Domain: Service Delivery
SAMANTHA HEINRICHS (Kerry's Place Autism Services), Melanie Willis (Kerry's Place Autism Services), Colleen Moore (The Chicago School)
Discussant: Alec M Bernstein (Children's Mercy Kansas City; University of Missouri-Kansas City School of Medicine)
Abstract: The intervention examined the effectiveness of a combination of treatment phases for the management of an autistic teen’s vocal stereotypy. During the context-appropriate scripting phase, the participant was taught how to identify expected and unexpected stereotypy and appropriate and inappropriate times for engaging in stereotypy behaviours. During the self-recording phase, the participant was taught how to self-record occurrences and non-occurrences of both a model response and his own stereotypy behaviour. During the discrimination training phase, stimulus control (i.e., a sports wristband) and a differential reinforcement of other behaviour (DRO) procedures were introduced. The participant’s ability to identify context-appropriate scripting and self-record occurrences and non-occurrences of stereotypy increased from baseline conditions. Stimulus control was established during discrimination training, with the participant refraining from vocal stereotypy for 30 minutes in the presence of the sports wristband. This intervention extends the current knowledge of interventions available for vocal stereotypy by demonstrating the efficacy of a combination of treatment phases.
 
151. Interventions of Facial Emotion Expression and Facial Emotion Recognition in Autism Spectrum Disorder: A Systematic Review
Area: AUT; Domain: Theory
TINGTING ZHOU (Duquesne University ), Ann Huang (Duquesne University)
Discussant: Cameron Montgomery Scallan (University of North Texas)
Abstract: Facial Emotion Expression (FEE) and Facial Emotion Recognition (FER) are pivotal components of social interaction as they underpin nonverbal communication. Individuals with Autism Spectrum Disorder (ASD) often exhibit deficits in FEE and FER, which can negatively impact their social interactions with others. In recent years, numerous studies have explored various facial emotional interventions, including behavior-based, picture-based, and computer-based approaches, aiming at enhancing facial emotion recognition and expression in individuals with ASD. However, more research needs to be done to validate the effectiveness of these interventions. This current study systematically reviews 20 articles published in the past decade to analyze the effects of these FEE and FER training. The results reveal significant improvements were noted in FEE and FER in individuals who received such training. However, some limitations noted from this review of existing literature included small sample sizes and lack of a comprehensive documentation of the generalization and long-term effects of these interventions. In conclusion, this systematic review suggests that facial and emotional training can improve FEE and FER in most participating individuals with autism spectrum disorders, but more research is needed to determine the best approach in this area.
 
152. Stimulus Fading and Transfer in the Treatment of Self-Injurious Behavior
Area: AUT; Domain: Applied Research
ALEXANDRA M DEMEO (May Institute), Jacob Andrew Richardson (May Institute)
Discussant: Alec M Bernstein (Children's Mercy Kansas City; University of Missouri-Kansas City School of Medicine)
Abstract: Protective equipment, while generally effective at mitigating the risk of severe self-injury, pose well-documented adverse effects. These effects range from social stigmatization to loss of time on learning, restricted use of limbs, and muscular atrophy, if breaks from equipment are not adequately provided (Powers et al, 2007). In some individuals, access to such equipment may also function as a variable maintaining self-injury (Favell et al, 1978). We implemented a treatment package of stimulus fading, stimulus transfer, and skill acquisition to maintain low rates of dangerous behavior while fading the use of protective equipment, in a manner similar to Pace et al. (1986) and Lerman et al. (1994). Fading and transfer of protective equipment occurred based on an assessment of matched stimulation (Rapp, 2013) in collaboration with an occupational therapist. The matched stimulation was the provision of equipment that was less restrictive while still providing sensory input to areas receiving similar input from the previous equipment. For example, we were able to fade leather arm limiters with metal stays to a combination of fabric elbow splints and wrist bands. Preliminary results suggest a possible framework for protective equipment fading with a focus on matched stimulation.
 
Diversity submission 153. The Effects of the Video Modeling Product GemIIni© On Verbal Response Production of Individuals With Autism Spectrum Disorder Who Are Nonverbal or Minimally Verbal
Area: AUT; Domain: Applied Research
WILLIAM J. SWEENEY (The University of South Dakota), Miranda Galvin (Sioux City Community Schools & University of South Dakota)
Discussant: Cameron Montgomery Scallan (University of North Texas)
Abstract: The current study evaluates the effectiveness of the commercial video modeling program GemIIni© (GemIIni© Educational Systems, 2012) for increasing expressive spoken language production in individuals who exhibit characteristics of Autism Spectrum Disorders (i.e., ASD) with concurrent severe intellectual disabilities and are considered nonspeaking or minimally speaking. Based upon the principles of Applied Behavioral Analysis, video modeling has been identified as an evidence-based practice in teaching skills to students with disabilities. In this study, the criteria for using a single-case alternating treatment design embedded within an AB experimental design was implemented to evaluate the effect of the video modeling system on the number of responses produced. No appreciable differences were found related to the effectiveness of the GemIIni© self-management system when comparing baseline performance to the intervention performance. Discussion of potential limitations and the difficulty of conducting consistent, ongoing, behavioral research during the Covid-19 pandemic appeared as important considerations related to the implementation of this research. Additonal implications for practice and future research related to the implementation of self-management interventions for students with severe intellectual disabilities, other health impairments, and autism were discussed.
 
154. Adventures in Assessing Restricted and Repetitive Behavior
Area: AUT; Domain: Applied Research
RILEY FERGUS (New England Center for Children )
Discussant: Alec M Bernstein (Children's Mercy Kansas City; University of Missouri-Kansas City School of Medicine)
Abstract: Engagement in restricted and repetitive behavior (RRB) is part of the diagnostic criteria for an autism spectrum disorder (DSM-5-TR). Topographies of RRBs include stereotypy, repetitive language, perseveration, object attachment, specific interests, repetitive manipulation of objects and automatically maintained self-injurious behavior. To date, only one study has used functional analysis methodology to examine arranging and ordering, which is a “higher-level” RRB (Rodriguez et al., 2012). Hagopian and colleagues (2015; 2017; 2023) evaluated a model for subtyping and predicting effective treatment methods for automatically reinforced self-injurious behavior (SIB) based on level of differentiation between conditions of a functional analysis. It is possible that this subtyping model could be extended to treatment of other topographies of automatically maintained challenging behavior, including RRB. The current study applied the foundational functional analysis methodology (Iwata et al. 1982/1994) to several different topographies of RRBs across multiple participants. Modifications to functional analysis procedures were necessary to consistently evoke the target response. These procedures produced idiosyncratic response patterns across participants that indicated both automatically maintained and socially maintained RRB, as well as some inconclusive results. This poster will concentrate on the FA outcomes for 3 participants that did not suggest automatic reinforcement as the maintaining variable.
 
155. Differences in Medication and Behavioral Treatment Among Male and Female Children With Autism Spectrum Disorder: 2022 National Survey of Children's Health (NSCH)
Area: AUT; Domain: Basic Research
WILLIE LEUNG (The University of Tampa), Gracie Bent (The University of Tampa), Rachel Frias (The University of Tampa), Kim Vo (The University of Tampa)
Discussant: Cameron Montgomery Scallan (University of North Texas)
Abstract: Autism Spectrum Disorder (ASD) is a disorder characterized by difficulty with social and communication skills. However, ASD presents differently among males and females, which could lead to different treatments. Currently, there is limited research examining the associations between treatment types prescribed and sex among children with ASD. Therefore, the purpose of this secondary data analysis is to determine the associations between sex and treatment types among children with ASD. This secondary data analysis used data from the 2022 National Survey of Children’s Health with a total sample size of 1719 children with ASD (23.7% female). Multiple and separate unadjusted and adjusted logistic regression was performed to examine the association between sex and treatment types (medication, behavioral treatment, and both medication and behavioral treatment). The results found males were more likely to receive behavioral treatment than females (OR=1.37, p=.006). The adjusted logistic regression found males were more likely to receive medication than females (aOR= 1.34, p=.048). Acknowledging differences between treatment types for children with ASD of different sexes can help healthcare professionals be more cognizant of the treatments prescribed. Healthcare professionals should be educated on the differences between male and female children with ASD so that they can provide appropriate treatment.
 
156. Comparison of Caregivers' and Children's Preference for Mand Preference Hierarchy Topography During Functional Communication Training
Area: AUT; Domain: Applied Research
GRACE LAFO (University of Nebraska Medical Center), Cynthia P. Livingston (University of Nebraska Medical Center), Brinea Charles (University of Nebraska Medical Center)
Discussant: Alec M Bernstein (Children's Mercy Kansas City; University of Missouri-Kansas City School of Medicine)
Abstract: Functional communication training (FCT) is an effective approach to treat and reduce problem behavior (Tiger et al., 2008). When conducting FCT, a functional communication response modality must first be selected and there are a number of variables that may influence selection. These variables include reinforcement history (Ringdahl et al., 2023), response effort (Bailey et al., 2002), proficiency (Ringdhal et al., 2009), and preference for the FCR topography (Kunnavatana et al., 2018; Winborn-Kemmerer et al., 2009; Ringdahl et al., 2018). All of which have been shown to influence the FCT treatment outcomes. Given this, clinicians should be intentional and consider these variables when selecting an FCR topography to optimize the generality of effects and resistance to treatment challenges (Ringdahl et al., 2018). Moreover, the incorporation of preference into functional communication training can lead to more efficacious treatment outcomes. Mand Preference Assessments (MPA) can be used to determine client FCR preferences during FCT (Ringdhal et al., 2009), however, few research has explored a procedure to identify both client and caregiver FCR preferences. The purpose of this study was to Comparison of caregiver preference hierarchy to child preference hierarchy for FCR topographies. Additionally, we sought to establish an FCR hierarchy for both participants and caregivers. Although the results found that no participant-caregiver dyad preferences matched, this information may be useful for clinical decision making and treatment considerations.
 
157. Analysis of Demand Difficulty and Error Correction on Aggression Emitted by a Child With Autism
Area: AUT; Domain: Service Delivery
MIA MCGOWAN (REED Intensive Behavior Services), Nicole Marks (REED Autism Services), Keyshla Melendez (REED Autism Services), Caroline O'Boyle (REED Autism Services), Alissa Velarde (REED Autism Services), David M. Wilson (REED Autism Services)
Discussant: Cameron Montgomery Scallan (University of North Texas)
Abstract: Response latency has been shown to be a useful measure during functional analyses (e.g., Thomason-Sassi et al., 2011). In an earlier study, Call, Pabico, and Lomas (2009) used latency to the first occurrence of challenging behavior to determine the aversiveness of demands. Demands ranked as highly aversive were associated with higher response rates during subsequent functional analyses for two participants. The current case study describes the assessment process for an 11-year-old girl with autism who engaged in high-intensity aggression. The initial functional analysis was inconclusive and the aggression that did occur resulted in therapist injury. A second analysis was designed to assess demand difficulty and the presence or absence of error correction as influential variables related to the occurrence of aggression. A latency measure was used to minimize the risk of injury. The results of the modified analysis, using latency as a measure, showed that difficult demands and the presence of error correction reliably evoked aggressive behavior. These results are limited in that errors vs non-errors were not recorded and treatment data are not reported.
 
158. Choose the Best and Mute the Rest for Autism Treatments: The Sequel
Area: AUT; Domain: Basic Research
JONATHAN LYON (Penn State University), Kimberly A. Schreck (Penn State Harrisburg), Samara Wilson (Penn State Harrisburg), Julia Leslie (Penn State University)
Discussant: Alec M Bernstein (Children's Mercy Kansas City; University of Missouri-Kansas City School of Medicine)
Abstract: This project replicated and extend Schreck & Ramirez (2016). In the 2016 study, we evaluated news transcripts providing information and sometimes recommendations about treatments for behaviors associated with autism. The results indicated that news networks (i.e., CBS, ABC, NBC) often reported and sometimes implicitly recommended pseudoscientific and sometimes harmful treatments for autistic individuals. The current project replicated and extended this study by evaluating treatment recommendations across additional news networks (e.g., CNN, FOX) and to explicitly record the words used to describe and recommend the treatments (optimistic/contrast rhetoric words-see below). Transcripts for more than the last decade (i.e., 2010-2022) were evaluated for treatment mentions across news networks and analyzed across treatments’ levels of scientific support. The results indicated that keyword mentions of evidence-based treatments have decreased with reporting concentrating on more non-science-based treatments. Trends for positive journalistic comments about non-science significantly trended upwards while negative based comments had more variability until the last 6 years, where non-evidence-based treatments received 100% of the negative comments. Support for non-science used a variety of words meant to persuade. Due to these results, consumers of television must investigate treatments thoroughly and carefully to evaluate source trustworthiness to avoid harm to autistic individuals.
 
159. Joke is Not a Joke! Helping Children With Autism About Losing in a Game
Area: AUT; Domain: Applied Research
ELISA NICCOLAI (Strabiliaba ), Chantal Hening (Strabiliaba-Clinics for developmental disability)
Discussant: Cameron Montgomery Scallan (University of North Texas)
Abstract: Some children with autism may find it very difficult to control their emotions when they don’t win in a game or a quiz or when they don’t get the highest score in their class. This can lead to emotional outbursts, much to the dismay of those in charge and their fellow students. This is connected with tthe difficulties with Theory of Mind, rigid thinking as inflexibility of thinking and focusing on the single aspect of the activity, in our case winning in the game. or lack of Experience. Some children may not have experienced losing at games, because parents or caregivers may have protected them from getting upset by allowing them to win during competitive activities. They simply didn’t have any practice in developing the skill of graciously coping when losing. Lorenzo is a 9 year old boy that exhibits important problem behavior such as crying, screaming, swearing every time he lose at a game. This study assess the efficacy of a procedure of DRO, teaching skills with a DRA ("what I can do if I lose at a game?" I lost, that was fun, let’s play again"), reinforce for staying calm and accepting not being a winner in a child with autism.
 
160. An Extention of a Break-to-Choice Intervention With Tests of Generalization in Isolated Conditions for Children With Multiply Maintained Problem Behavior
Area: AUT; Domain: Applied Research
MCKENNA REILLY (University of Nebraska Medical Center's Munroe Meyer Institute), Cynthia P. Livingston (University of Nebraska Medical Center's Munroe Meyer Institute), Colleen McGrory (University of Nebraska Medical Center's Munroe Meyer Institute), Amanda Mae Morris (University of Nebraska Medical Center Munroe-Meyer Institute )
Discussant: Alec M Bernstein (Children's Mercy Kansas City; University of Missouri-Kansas City School of Medicine)
Abstract: Functional communication training has been shown to be a highly effective treatment for socially maintained problem behavior (Tiger et al., 2008). For problem behavior maintained by multiple social variables, a package of isolated treatments is often utilized to address each variable which is effective but time-consuming (Tasami & Lerman, 2020). A more efficient option of a synthesized treatment utilizing FCT with chained schedules of reinforcement, break-to-choice, has been shown to be effective in decreasing multiply maintained problem behavior (Livingston et al., 2023). However, it is unclear whether effects of the synthesized treatment will transfer to isolated contingencies of each functional reinforcer. In this study, a break-to-choice treatment was implemented with children determined to have multiply maintained problem behavior and the schedule of reinforcement was thinned to caregiver-informed terminal schedules. Additionally, this study extended previous research by implementing isolated contingency tests following schedule thinning criteria being met in the break-to-choice condition. The results of the study showed that the break-to-choice intervention was effective in decreasing multiply-maintained problem behavior and increasing functional communication responses and compliance. Additionally, these effects generalized to the isolated contingencies for each functional reinforcer.
 
161. Validation of an Attention Preference Assessment for a Child Diagnosed With Autism Who Exhibits Problem Behavior
Area: AUT; Domain: Applied Research
MELODY LYNN CULBERTSON (UNMC), Cynthia P. Livingston (University of Nebraska Medical Center), Daniel Olson (University of Nebraska Medical Center's Munroe-Meyer Institute )
Discussant: Cameron Montgomery Scallan (University of North Texas)
Abstract: Attention preference assessments are often utilized to identify a preferred attention type to deliver contingent on appropriate alternative responses during functional communication training for attention-maintained problem behavior (Piazza et al., 1999). One relatively new attention preference assessment format is the rapid assessment of attention types (RAAT; Strohmeier et al., 2018). In this study we implemented a modified version of the RAAT to identify preferred attention types to include in functional communication training for a child with a synthesized escape to attention maintained problem behavior. Four attention types were included in the RAAT (praise only, reprimands only, physical only, and praise and physical combined) and were included based on the results from the indirect and direct assessments. Next, the results of the RAAT were compared with a reinforcer assessment that was embedded within functional communication training. The results indicated a partial correspondence between the preference and reinforcer assessment. Clinical implications and future research directions are depicted.
 
162. Evaluating the Social Validity of Treatment Components Post-Discharge
Area: AUT; Domain: Applied Research
VALERIA BEATRIZ MACUARE (Kennedy Krieger Institute; University of Maryland Baltimore County), Michelle A. Frank-Crawford (Kennedy Krieger Institute; Johns Hopkins University; University of Maryland Baltimore County), Samantha Hardesty (Kennedy Krieger Institute)
Discussant: Alec M Bernstein (Children's Mercy Kansas City; University of Missouri-Kansas City School of Medicine)
Abstract: Wolf (1978) outlined the importance of social validity in the field of applied behavior analysis. Although many researchers highlight the importance of this paper to the field, adoption of assessments of social validity in our research and clinical practices has been slow. Further, the degree of acceptability of behavioral programs with a single client over time, particularly as behavioral services are tapered, is unknown. Therefore, the purpose of this pilot study was to assess caregiver’s social validity of a treatment plan developed for their child who was a patient at an inpatient hospital for individuals with severe challenging behavior. A social validity survey was completed by the caregivers at three different points post-discharge. Overall, the results suggested that the majority of caregivers agreed that their child’s treatment was acceptable at discharge. For three of four caregivers, opinions on treatment acceptability decreased slightly 2 weeks post-discharge. Finally, for two their opinions on treatment acceptability increased to levels comparable to those at time of discharge. This represents one of the first studies to examine trends in social validity with the same caregivers to date; implications of these findings and areas for future research will be discussed.
 
163. Alterations to the Assessment and Treatment of Social Avoidance
Area: AUT; Domain: Applied Research
CARLEY SMITH (Kennedy Krieger Institute; University of Maryland, Baltimore County), Ellye Gersh (Kennedy Krieger Institute), Megan Ryan (Kennedy Krieger Institute), N'dia McCloud (Kennedy Krieger Institute), Amanda Goetzel (Kennedy Krieger Institute), Jonathan Dean Schmidt (Kennedy Krieger Institute)
Discussant: Cameron Montgomery Scallan (University of North Texas)
Abstract: Previous research has demonstrated some individuals may engage in problem behavior to escape social attention from caregivers (Harper et al., 2013). In the current study, we assessed and treated aggression exhibited by a 13-year-old female diagnosed with IDD and autism. Observations indicated she was likely to engage in problem behavior when caregivers were close in proximity, regardless of whether they were interacting with her. A functional analysis was conducted where, in the control condition, the therapist remained 6-8 feet away. In the test condition the therapist sat in close proximity and only moved 6-8 feet away contingent upon aggression. After confirming the function, treatment was implemented to reduce aggression and increase tolerance for caregivers being in close proximity. Treatment consisted of a functional communication response (FCR) for “space,” which resulted in the caregiver moving away, and extinction for aggression. Results showed a significant reduction in aggression, even as the duration with which she had to tolerate a caregiver being in close proximity increased, before her FCR would be reinforced. Clinical recommendations for practitioners and implications for future research will be discussed.
 
164. Collaborating With Interdisciplinary Team Members to Decrease Inappropriate Oral Behavior Across Instructional Contexts
Area: AUT; Domain: Applied Research
ELLYE GERSH (Kennedy Krieger Institute), Carley Smith (Kennedy Krieger Institute), N'dia McCloud (Kennedy Krieger Institute), Megan Ryan (Kennedy Krieger Institute), Kate Smidl (Kennedy Krieger Institute), Amanda Goetzel (Kennedy Krieger Institute), Jonathan Dean Schmidt (Kennedy Krieger Institute; The Johns Hopkins University School of Medicine)
Discussant: Alec M Bernstein (Children's Mercy Kansas City; University of Missouri-Kansas City School of Medicine)
Abstract: Previous research on functional analyses of inappropriate oral behavior (IOB), such as spitting and saliva play, in individuals with intellectual and developmental disabilities (IDD), has indicated it is likely maintained by automatic reinforcement (Hartz et al., 2020). In this study, Remy, a 13-year-old female engaged in severe problem behavior to escape demands. She also engaged in IOB, specifically spitting, across most contexts. Results of consecutive ignore sessions (Querim et al., 2013) indicated Remy’s IOB was automatically maintained. Treatment for IOB consisted of response disruption via the presentation of a visual stimulus card paired with a vocal statement contingent upon IOB. Following a sustained reduction in IOB within a leisure context, treatment components were combined with a demand treatment, which included differential reinforcement via functional communication for a break; IOB frequently occurred in the demand context prior to combining the treatments. Next, we collaborated with Remy’s speech and language pathologist (SLP) to generalize the comprehensive treatment to the speech therapy context where IOB was occurring at elevated rates, thus impacting participation. As a measure of social acceptability, the SLP indicated that she would be willing to implement this intervention again in the future.
 
165. Increasing Spontaneous Mands With Speech-Generating Devices Through a Modified Picture Exchange Communication System (PECS) Procedure for Individuals With Autism Spectrum Disorder (ASD)
Area: AUT; Domain: Applied Research
KAYLA CURRAN (Evergreen Center), Rebecca Hotchkiss (Evergreen Center)
Discussant: Sakurako Sherry Tanaka (Asia-Pacific ABA Network)
Abstract: There are different tools and effective teaching methods to establish communication repertoires for non-vocal individuals (Bondy & Frost, 2001; Shillingsburg et al., 2019), including Picture Exchange Communication Systems (PECS), speech-generating devices (SGD), and augmentative and alternative communication (AAC) devices. This study aims to pilot an adaptation of the initial phases of the PECS protocol (Bondy & Frost, 2001) with an SGD to evaluate spontaneous mands. Multiple stimulus without replacement (MSWO) preference assessments (DeLeon & Iwata, 1996) were conducted to determine preferred items. During baseline, the SGD was open to the home screen. Ten preferred items were within the participant’s eyeline by the communication partner and participant responses to reach for the item or the device were recorded. Teaching procedures were then introduced to prompt selecting the SGD icon to access the preferred item. Following the first intervention phase, participants were taught discrimination between icons on the SGD. Preliminary results demonstrate success with the first steps of the PECS protocol - reaching towards the SGD device and discriminating between two icons. The study will continue to evaluate the effect of the protocol on remaining steps of the PECS protocol. Results will be discussed in relation to the expanded training for additional navigation through the SGD.
 
166. Self Management Combined With Colorful Fading Strategies to Create Conversation Skills
Area: AUT; Domain: Applied Research
ZOË MAE AKIN-AMLAND (Florida Institute of Technology School of Behavior Analysis), Valeria Sonderegger (Florida Institute of Technology School of Behavior Analysis), Elizabeth Reagan Wortham (Florida Institute of Technology School of Behavior Analysis ), Andrew John Houvouras (Florida Institute of Technology School of Behavior Analysis )
Discussant: Mashiath Binti Mahabub
Abstract: Conversation skills continue to be a significant area of investigation in applied behavior analysis since social independence is often a desired goal expressed by clients. Improvement in conversation skills has meaningful quality of life impacts in notable areas such as interpersonal relationships, employment, and mental health - all major indices of health. A 27-year-old male with Autism Spectrum Disorder (ASD) participated in this study with similar age conversation partners. To evaluate the effectiveness of self management and script fading, the study utilized a concurrent multiple baseline design across behaviors. Researchers recorded all 5-minute sessions with a camera and analyzed data post-session. Results showed significant improvements with contextually relevant replies, reciprocal responding, and follow-up statements and question asking. Generalization and maintenance were assessed with novel conversation partners that accounted for various demographics. Social validity was examined using a Likert-type scale feedback form by the participant along with his immediate family. Key words: autistic adult, conversational skills, adult intervention, self-management, script fading, social skills
 
167. Evaluation of Topography of Self-Injurious Behavior as a Predictor of Injury Type, Severity, and Location
Area: AUT; Domain: Applied Research
DREW E. PIERSMA (Kennedy Krieger Institute), Michelle A. Frank-Crawford (Kennedy Krieger Institute), Louis P. Hagopian (Kennedy Krieger Institute), Jonathan Dean Schmidt (Kennedy Krieger Institute)
Discussant: Sakurako Sherry Tanaka (Asia-Pacific ABA Network)
Abstract: Many individuals with intellectual and developmental disabilities engage in self-injurious behavior (SIB), such as head-hitting or self-pinching. SIB may place individuals at elevated risk of injury, ranging in severity from transient (e.g., bruising) to permanent (e.g., blindness). Rooker et al. (2018, 2020) found that function and subtype of SIB may influence injuries. Specifically, individuals with an automatic function had more injuries to the head than those with a social function; additionally, individuals who engaged in Subtype 2 SIB had more frequent and severe injuries than the other functions or subtypes. It is plausible that other variables, such as the mechanics of SIB (the action and target site, which define the response topography), may also influence presentation of injury. Therefore, the purpose of this study was to evaluate whether topography of SIB could predict type, location, and severity of injury by retrospectively evaluating injuries documented in Self-Injury Trauma Scales upon intake to an inpatient unit. We hypothesized that head- and skin-directed SIB would produce higher severity injuries and more frequent abrasions/lacerations, whereas body-directed SIB would produce lower severity injuries and more frequent contusions. Results of this study confirmed this hypothesis, but additional prospective research is necessary in this area.
 
Diversity submission 168. Cultural Humility and Awareness Training in Applied Behavior Analysis: An Exploratory Study
Area: AUT; Domain: Service Delivery
MOHAMMED ALASMARI (University of Jeddah )
Discussant: Zhihui Yi (Univeristy of Illinois at Chicago)
Abstract: The study highlighted the importance of cultural diversity practices in applied behavior analysis (ABA) using recommended individual questions to assess and improve professionals' cultural humility (Wright, 2019). As family therapy expands globally, the majority of interventions, training programs, and supervision protocols are established based on Western values and ethics (Ennis-Cole et al., 2013; Seponski & Jordan, 2018; Sumari & Jalal, 2008), and ABA practices are similarly based on Western values and ethics within its interventions and training programs (Fong et al., 2017). Because culture matters, it is ethically necessary to have professionals competent in delivering ABA services to diverse families and their children. Thus, 30 participants were recruited and exposed to case scenarios representing cultural and practice-influenced dilemmas. Participants were board-certified behavior analysts (BCBA). Pre-service behavior analysts were also eligible. A pretest-posttest design was used. Results from the paired t-test indicated that there was a significant difference in the scores for the pre-test (M = 26.37, SD = 3.52) and post-test (M = 29.27, SD = 2.79), t(29) = 3.73, P < .001. That is, BCBAs who received training in cultural humility and awareness practices (i.e., case scenarios, course materials, individual cultural humility questions) reported improved culturally humble, self-reflective, and personal accountability skills toward individuals and families from diverse backgrounds.
 
169. Addressing the Handwriting Needs of Students With Autism Spectrum Disorders Through Technology-Mediated Interventions: A Pilot Study for ABC Stories
Area: AUT; Domain: Applied Research
PATRICIA K. HAMPSHIRE (Mississippi State University)
Discussant: Sakurako Sherry Tanaka (Asia-Pacific ABA Network)
Abstract: For many individuals with autism spectrum disorders (ASD), tasks that require handwriting or other fine motor activities can be challenging (Kushki, Chau, & Anagnostou, 2011). Specifically, legibility and letter formation have been found to be characteristically impaired in these individuals. Finnegan & Accardo (2018) note further characteristic challenges among this population in the areas of length, legibility, size, speed, spelling, and structure when compared to their same-age peers. If not addressed, evidence suggests the potential for higher levels of difficulty in grasp posture and motor execution as children age (i.e., initiating a task, planning complex sequences) (Sacrey, Germani, Bryson, & Zwaigenbaum, 2014). This presentation will summarize the findings of a mixed-methods study (i.e., single case design and qualitative) aimed at testing the effectiveness of a handwriting app, ABC Stories, on handwriting accuracy in three first grade students with autism. Results of this study suggest the effectiveness of this application in increasing handwriting accuracy and engagement time. In addition, results also suggest positive changes in parent perception regarding their child’s ability to improve in the area of handwriting over time. Extensions of this line of research will also be described in this presentation.
 
170. Augmented Reality to Train First Responders to De-Escalate Autistic Individuals
Area: AUT; Domain: Applied Research
KIMBERLY CANTU-DAVIS (University of Texas at San Antonio ), Leslie Neely (The University of Texas at San Antonio)
Discussant: Zhihui Yi (Univeristy of Illinois at Chicago)
Abstract: This is a replication and extension of Hinkle, et al. (2021). During situations when a first responder needs to engage an individual with autism spectrum disorder (ASD), first responders oftentimes lack the necessary training on how to assess and de-escalate situations properly. Research shows training for first responders is limited to role-play and modeling. While these methods have been shown to be effective, they reduce scalability since there is a lack of qualified personnel available to conduct specialized training involving behavioral scenarios of individuals with ASD. This reveals the need for an alternative training solution. Augmented Reality (AR) simulations allow first responders to practice real-life procedures before encountering those situations in the line of duty while also developing their skills in a controlled environment. The study conducted used AR to evaluate 3 participants' ability to assess and de-escalate crisis scenarios. In baseline, the participants wore AR equipment which simulated different behavioral situations for them to de-escalate without assistance. After baseline Behavioral Skills Training (BST) was employed to teach de-escalation procedures while providing immediate feedback during the training scenarios. Results suggested that AR technology is a useful tool accompanied by BST that can be used for de-escalation training purposes.
 
171. Behavioral Skills Training on Child-Directed Interactions and Effective Instructions for Parents of Children With Autism Spectrum Disorder (ASD)
Area: AUT; Domain: Applied Research
MARISOL LOZA HERNANDEZ (University of Nebraska Medical Center: Munroe-Meyer Institute ), Heather Anderson (University Nebraska Medical Center), Sara S. Kupzyk (University of Nebraska Omaha), Mary Halbur (University of Nebraska Medical Center, Munroe-Meyer Institute)
Discussant: Sakurako Sherry Tanaka (Asia-Pacific ABA Network)
Abstract: Child-directed interactions (CDI) and effective instruction delivery (EID) are evidence-based interventions associated with improved child outcomes, parent-child relationships, and decreased stress. Behavioral skills training (BST) has been successfully used to teach various skills to parents. The present investigation evaluated the efficacy of BST on parents' use of CDI and EID. In addition, we examined the effect of these interventions on children's engagement in play with the parent and compliance with parent directions. A multiple probe across participants and skills (i.e., CDI and EID) was used to evaluate the effectiveness of BST on parent and child behaviors. Generalization and maintenance of the skills were also assessed across locations (i.e., clinic, home). Ongoing results have suggested efficient parent acquisition of child-directed interactions (e.g., description, reflection, imitation, and praise). The present poster will discuss training data for both CDI and EID, suggestions for future research, and practical considerations for modified Parent-Child Interaction Therapy.
 
172. Effectiveness of a Token Economy System and a Rule in Maintaining Target Behaviors With a 12-Hour Delay in Reinforcement
Area: AUT; Domain: Applied Research
NICOLA CEFALO (Data Driven ABA), Francesca Siciliano (Data Driven ABA), Michael Nicolosi (Data Driven ABA), Satia Riva (Data Driven ABA), Gaia Pilotto (Data Driven ABA)
Discussant: Zhihui Yi (Univeristy of Illinois at Chicago)
Abstract: Delayed reinforcement can be challenging for individuals with ASD. This study investigated the effectiveness of a treatment package that included a rule and a token economy system with a 12-hour delay between reinforcement schedules. A 10-year-old boy with ASD participated in a multiple baseline design across behaviors embedded with a reversal design. Baseline data revealed low levels of two target behaviors: reading books and pouring water into glasses. The intervention introduced a rule and a token economy system with FR1 token production. Ten tokens were needed to earn the backup reinforcer, a walk to the grocery store to purchase candy. The delay between token exchange and reinforcement was variable, ranging from 12 hours to 24 hours. Results demonstrated a significant increase in both target behaviors during the intervention phase compared to baseline. The rule likely contributed to behavior maintenance by bridging the temporal gap between the behavior and reinforcement. The token economy system provided immediate positive reinforcement and feedback, further promoting the target behaviors. The findings suggest that rules can enhance the efficacy of delayed reinforcement, particularly for individuals with ASD.
 
Sustainability submission 173. Interventions by Rule or by Contingency? They Both Work! Improve Responses to Nonvocal Social Cues in a Girl With Autism Spectrum Disorder (ASD)
Area: AUT; Domain: Applied Research
GIULIA FERRAZZI (ABA ITALIA)
Discussant: Sakurako Sherry Tanaka (Asia-Pacific ABA Network)
Abstract: Many individuals with autism spectrum disorder experience challenges with social communication, including recognizing and responding to non-verbal cues. There are not many studies in literature regarding how to help a neurodivergent student monitor signs of boredom during conversation. The girl in this study began an intervention based on rule and contingency. The intervention initially involves the explanation of the social rule, priming activities with photos of people emitting signs of boredom and finally an activity based on contingency. During the conversation the child puts the skill into practice and tact boredom sign. She immediately improves her ability to recognize (tact) signs of boredom of her conversation partner. We will generalize this intervention also in other natural contexts like school and home. We will use a multiple baseline across setting to describe the intervention. The findings add to the literature support the use of rule and contingency intervention strategies for improving conversational skill for child with autism spectrum disorder.
 
174. On the Use of a Functional Analysis Screener for Assessment and Treatment Planning With Individuals With Autism
Area: AUT; Domain: Applied Research
RIMA HAMAWE (Easterseals Southern California), Justin Chan (Easterseals Southern California), Mark Lewis (Easterseals Southern California), Anna Isabel Saucedo Chavez (Easterseals Southern California), Michael Chao (Easterseals Southern California), Shaji Haq (Easterseals Southern California)
Discussant: Zhihui Yi (Univeristy of Illinois at Chicago)
Abstract: Querim et al. (2013) showed convergent results on the function of problem behavior when an automatic reinforcement screener (“screener”) was followed by functional analyses (FA). That is, when an automatic function was indicated on the screener, the FA also yielded the same results. Thus, there may be benefits to initially completing an automatic screener for problem behavior that is hypothesized to be automatically maintained, as it could reduce the need for a standard functional analysis if the targeted behavior is (a) found to be automatically maintained, and (b) unlikely to be socially mediated. The current study used the screener with four individuals with Autism and severe problem behavior, and the results showed an automatic function for only one participant, thereby precluding the need for additional assessment. Subsequent FAs for the remaining three participants showed socially mediated functions. These results confirmed the utility of the screener. Implications for research and clinical practice will be discussed within the paper.
 
175. Response-Restriction Free Operant Compared to Paired-Stimulus Preference Assessment With Individuals Who Engage in Severe Problem Behavior
Area: AUT; Domain: Applied Research
AMAYA ROCHELEAU (University of Nebraska Medical Center's Munroe-Meyer Institute), Cynthia P. Livingston (University of Nebraska Medical Center), McKenna Reilly (University of Nebraska Medical Center's Munroe-Meyer Institute), Jordan DeBrine (Kennedy Krieger Institute), Becky Barall (Munroe-Meyer Institute, University of Nebraska Medical Center), Colleen McGrory (University of Nebraska Medical Center )
Discussant: Sakurako Sherry Tanaka (Asia-Pacific ABA Network)
Abstract: Preference assessments are typically employed to identify potential reinforcers. Unfortunately, there may be challenges to implementing preference assessment with individuals who engage in severe problem behavior if the removal of preferred items evokes problem behavior. Nevertheless, previous research has demonstrated different preference assessment formats produce varying levels of problem behavior (e.g., Kang et al., 2010). However, to date, no study has assessed problem behavior during a response-restriction free operant (RRFO) preference assessment. In this study, we compared problem behavior and preference hierarchies across the RRFO and paired-stimulus preference assessment (PSPA) for 5 participants referred to an outpatient severe behavior clinic. Secondary comparisons included indices of happiness, assent, item engagement, and duration of each preference assessment format. Results indicated that in most cases both preference assessment formats resulted in similar levels of problem behavior or the RRFO resulted in less problem behavior than the PSPA. Additionally, preference hierarchies were relatively similar across both formats. Clinical implications and future research are depicted.
 
176. The Play Unit? Response Variability and Verbal Operants in Play Following Learn Unit Instruction
Area: AUT; Domain: Applied Research
HAYLEY LOUISE LOCKE (Jigsaw CABAS School), Kate Hewett (Jigsaw School), Veronica Baroni (Jigsaw School), Mariann Szabo (Jigsaw CABAS School)
Discussant: Zhihui Yi (Univeristy of Illinois at Chicago)
Abstract: It is common for autistic children to exhibit limited pretend play skills due to delays in their social repertoire combined with the tendency to emit stereotypical and repetitive sequences. Neurotypical children learn to play and develop related verbal operants by watching and engaging with others. Autistic children may have limited observational learning skills and if attending specialist settings may not access appropriate peer models. The current study took place in a Comprehensive Application of Behavior Analysis to Schooling (CABAS®) setting with teaching primarily based on the learn unit; a three-term contingency used to teach skills across repertoires with generalisation and novel responding demonstrated as a result. A multiple probe design was used. Baseline observations suggested that although participants demonstrated some pretend play responses and related verbal operants, these were limited for all three participants. Play related verbal operants and actions were taught using learn unit instruction. Following the intervention, all participants demonstrated increases to the variability and rate of play responses and verbal operants during free play sessions as well as increased interactions with peers.
 
Diversity submission 177. Increasing Access to Behavioral Services for Spanish-Speaking Families Through a Collaborative Interdisciplinary Team Approach
Area: AUT; Domain: Service Delivery
VALENCIA PANKEY (James Madison University), Trevor F. Stokes (James Madison University), Maria leventhal (James Madison University), Hannah Lockwood (James Madison University)
Discussant: Sakurako Sherry Tanaka (Asia-Pacific ABA Network)
Abstract: When seeking behavioral support for their child with Autism Spectrum Disorder, families are often faced with long waitlists that delay access to support. The barrier to accessing services is even greater when there is a language barrier. In an attempt to increase access to culturally responsive behavioral interventions, our clinic has piloted the use of an interprofessional treatment team to increase access to culturally responsive Applied Behavior Analytic services for families where the primary language spoken within the home is Spanish. The treatment team included student clinicians from the Applied Behavior Analysis and Clinical Psychology programs, licensed professionals in these areas, and a student translator. The student translator serves as an active and essential addition to the interdisciplinary team. Interventions included parent training and one-to-one instruction. Programming adaptations focused on incorporating family voices (e.g. providing instruction in both Spanish and English). The pilot version of this interprofessional treatment team has produced promising results. The model has successfully increased access to behavior-analytic services in an underserved community. Additionally, this pilot clinic represents an important area of interprofessional education and training that is focused on interprofessional practice in the presence of language barriers.
 
178. Evaluating Possible Interactions Between Challenging Behavior and Pain and Discomfort States
Area: AUT; Domain: Applied Research
JANAE' A. PENDERGRASS (University of Florida), Timothy R. Vollmer (University of Florida), Lindsay Lloveras (University of Florida ), Kerri P. Peters (University of Florida), Kacie McGarry (University of Florida), Justin Boyan Han (University of Florida)
Discussant: Zhihui Yi (Univeristy of Illinois at Chicago)
Abstract: Children with autism spectrum disorder are more susceptible to comorbidities than their neurotypical peers (Al-Beltagi, 2021). Previous research has provided evidence for a potential relation between pain or discomfort and challenging behavior, suggesting that challenging behavior increases in the presence of pain and discomfort states including GI distress, allergies, menstruation, sleep deprivation, etc (Carr & Owen-DeSchryver, 2007, Christensen et al., 2009, Kennedy & Meyer, 1996). Most studies, however, rely on indirect measures of either challenging behavior or pain or discomfort. The current study will use direct measures of both pain and discomfort states and challenging behavior. Stool typing, stomach distension, and cold symptoms as operationally defined by trained medical personnel will be used to identify pain/discomfort states. A modified trial-based functional analysis method will be used to assess the occurrence of challenging behavior and evaluate behavioral sensitivity to different social contingencies. Preliminary data reveals no relation between challenging behavior and pain and discomfort states for 2 participants. For both participants, there is an overall bias toward appropriate responding across each condition. The current data suggests that pain/discomfort states may not have a functional relation to challenging behavior.
 
179. Leveling Up Social Skills: A Game-Based Intervention Enhancing Responses in Adolescents With Autism Spectrum Disorder
Area: AUT; Domain: Applied Research
CECELIA ALISE POWELL (Mississippi State University), Jamie Moss (Mississippi State University), Hailey Ripple (Mississippi State University), Kayla BATES-BRANTLEY (Mississippi State University)
Discussant: Sakurako Sherry Tanaka (Asia-Pacific ABA Network)
Abstract: Ample literature demonstrates the effectiveness of social skills groups in increasing individuals' ability to interact in social settings. Game-based interventions are commonly used as an alternative to lesson-based methods. The current study expands the literature pertaining to social skills interventions for adolescents through a game-based method – specifically, aiming to decrease inappropriate game responses and increase appropriate game responses.? Participants included three adolescent boys with ASD and an ABAB design was used. During baseline participants could respond freely when engaging in a game of their choice. During intervention, a structured game in which clients were redirected to posted rules when inappropriate responses were given was implemented. Preliminary results indicate appropriate responses for participants one and two increased suddenly with implementation of the structured game phase with a decreasing trend. Inappropriate responses for participant three showed a sudden decrease with a decreasing trend upon implementation of the structured game phase. These findings have potential implications for the effectiveness of structured play in decreasing inappropriate social responses and support the need for future research in game-based play in social skills groups across populations.
 
180. A Comparison of Observed Functional Relations Across Measurement Methods Used to Assess Vocal Stereotypy in Two Adolescents With Autism
Area: AUT; Domain: Applied Research
THEONI MANTZOROS (Felician University), David L. Lee (Penn State)
Discussant: Zhihui Yi (Univeristy of Illinois at Chicago)
Abstract: Implementing the most effective and efficient type of measurement is important to both clinician and researcher. Although it is ideal to implement continuous methods to record the phenomenon of interest, it is often impractical due to resources or the nature of the behavior. The extant literature on measurement has most often assessed the validity of discontinuous measures (e.g., momentary time sampling [MTS], partial interval recording [PIR]) as compared to continuous measures (e.g., duration) using accuracy between measurement types. Ultimately, however, the measurement method must be assessed by its capacity to observe effects of the intervention, also referred to as functional relations. This study assessed both accuracy and the degree to which functional relations were identified across MTS, PIR at the intervals of 10s, 20s, 30s, and 60s as compared to duration measures to assess the effects of an intervention for the vocal stereotypy of two adolescents. Results indicate that the PIR errors consistently increased as the intervals increased, while MTS errors remained constant across intervals, although with increased variability at the largest interval. In terms of identifying functional relations, all MTS intervals resulted in similar outcomes as duration, however, percentage of agreement dropped for the larger PIR intervals.
 
Diversity submission 181. Decrease of Harmful Behavior in a Child With Cochlear Implant and Autism Spectrum Disorder (ASD): Effects of Sign Language
Area: AUT; Domain: Service Delivery
Lucas Aguiar de Moura (University of São Paulo (USP)), Renata Caroza (University of Sao Paulo), ARILZA LANDEIRO GUIMARAES DALONSO (University of Sao Paulo), Mariana Baptista Morales (University of Sao Paulo), Ana Carolina Schroeder (University of Sao Paulo), Martha Costa Hübner (University of São Paulo), Valeria Mendes (University of São Paulo)
Discussant: Sakurako Sherry Tanaka (Asia-Pacific ABA Network)
Abstract: Applied Behavior Analysis (ABA) is the gold standard intervention for Autism Spectrum Disorder (ASD). Nevertheless, the work can be challenging when there is a deafness condition associated. The study is based on direct observations and data collected by four simultaneous therapists (undergraduate students), with real time in person behavior therapy supervision with a seven years old child with ASD and a cochlear implant (CI), placed at age of five. The therapy was part of the CAIS Project (Center for Autism and Social Inclusion), an undergraduate discipline within the Institute of Psychology of USP, a public university in Brazil. The goal of the study is to analyse the effects of sign language over harmful behavior.From the third weekly session on, sign language was applied. After that (comparing first and sixth sessions), harmful behavior decreased from 65 to 23 and the child’s abilities increased (mand, listener behavior, motor imitation, among others). Those changes are seen as related with sign language application, as well as with the teaching programs in course. But because the largest positive changes occurred after the introduction of signs, they are considered the major controlling variable upon the progress of the child’s response.
 
182. Interprofessional Collaborative Practice Among Occupational Therapists, Speech Therapists and Behavior Analysts for Children With Autism: A Systematic Review
Area: AUT; Domain: Service Delivery
LUIZA ASFORA (Guia para Análise do Comportamento (Guia.AC)), Anne Costa Carneiro (Guia AC; UFSCar), Natany Ferreira Silva (Universidade Federal de São Carlos - UFSCar)
Discussant: Zhihui Yi (Univeristy of Illinois at Chicago)
Abstract: A multidisciplinary team plays a crucial role in the treatment and support of individuals with autism spectrum disorder (ASD) due to the complex and diverse nature of the condition. Despite multiple professionals working with the same child simultaneously, there are numerous barriers preventing effective collaboration that benefits the client. This literature review aims to (1) outline the challenges inherent in the multifaceted nature of ASD, (2) synthesize the barriers to multidisciplinary collaboration, (3) explore the strategies presented in the literature and their outcomes, and (4) develop guidelines for effective and ethical Interprofessional collaboration. Initially, a systematic literature review was conducted on Interprofessional collaboration in the treatment of autism (n=441). Further analysis narrowed the study focus to empirical studies published between 2013-2023 in English (n=14). This present study marks the first instance where research findings on collaboration are jointly analyzed and presented for professionals from three distinct fields (OT, behavior analysts, and SLP) who also work together to develop guidelines for collaborative practices.
 
183. Behavioral Assessment and Treatment of Pica Maintained by Automatic Reinforcement
Area: AUT; Domain: Basic Research
SEAN CONOR MADDEN (Kennedy Krieger Institute), John Falligant (Kennedy Krieger Institute/Johns Hopkins University School of Medicine), Emily Ann Chesbrough (Kennedy Krieger Institute)
Discussant: Tracy L. Kettering (Bancroft)
Abstract: Pica is a life-threatening form of severe problem behavior in which an individual persistently consumes inedible substances (e.g., glass, feces). Pica is often maintained by automatic reinforcement and is typically treated using a combination of response blocking and noncontingent reinforcement (NCR; Hagopian et al., 2011). In addition to response blocking and NCR, reinforcing alternative behaviors that are incompatible with pica (e.g., discarding inedible objects in lieu of consuming them) may also decrease pica and enhance the social acceptability and long-term maintenance of behavioral treatment (Schmidt et al. 2017). The current study used similar procedures described by Schmidt et al. by using differential reinforcement of alternative behavior (DRA) with response blocking to decrease pica and increase an appropriate, alternative response with a young boy diagnosed with an intellectual disability. The DRA procedure successfully decreased rates of pica and increased appropriate behavior across a number of treatment contexts. Recommendations for practitioners will be discussed.
 
184. Stimulus Control Refinements of Functional Communication Training
Area: AUT; Domain: Applied Research
TIMOTHY MORRIS (CSH-RUCARES Severe Behavior Program), Wayne W. Fisher (Rutgers Robert Wood Johnson Medical School), Casey Irwin Helvey (Rutgers University (RUCARES)), Brian D. Greer (Children’s Specialized Hospital¬–Rutgers University Center for Autism Research, Education, and Services (CSH–RUCARES); Rutgers Brain Health Institute; Department of Pediatrics, Rutgers Robert Wood Johnson Medical School,), Daniel R. Mitteer (Children’s Specialized Hospital¬–Rutgers University Center for Autism Research, Education, and Services (CSH–RUCARES); Department of Pediatrics, Rutgers Robert Wood Johnson Medical School), Ashley Marie Fuhrman (Trumpet Behavioral Health)
Discussant: Lauren K. Schnell-Peskin (Hunter College)
Abstract: Despite the effectiveness of function-based treatments like functional communication training (FCT), research has shown that relapse of destructive behavior is highly prevalent when treatment conditions are challenged. Common challenges to treatment include a change in treatment context (i.e., renewal), worsening of reinforcement conditions (i.e., resurgence) that may be combined with a change in context (i.e., super-resurgence), or delivery of reinforcement at times other than following the functional communication response ([FCR]; i.e., reinstatement). Although research suggests that signaling when the FCR will and will not produce reinforcement using a multiple schedule during FCT (Mult FCT) can mitigate resurgence (e.g., Fisher et al., 2018) and renewal (e.g., Fisher et al., 2015), research on this stimulus-control refinement for other forms of relapse is limited. Gradually changing the context using stimulus fading is another potential stimulus-control refinement for mitigating relapse that has been infrequently evaluated. In this project we evaluated the effects of Mult FCT with and without stimulus fading for mitigating renewal, super-resurgence, and reinstatement. We also evaluated the effects of Mult FCT with and without stimulus fading during a relapse test that combined relapse variables. Implications of these findings will be discussed.
 
185. Using a Video Activity Schedule to Teach Cooperative Games to Autistic Children
Area: AUT; Domain: Applied Research
ROBERTA CARRILLO VEGA (University of Texas at San Antonio), Marie Kirkpatrick (University of Texas at San Antonio)
Discussant: Tracy L. Kettering (Bancroft)
Abstract: Video activity schedules are a combination of the interventions video modeling and activity schedules that teach a singular task or a series of tasks to be completed. Instead of a sequence of pictures, videos demonstrate to the learner what is expected to be done. Research has focused heavily on using video activity schedules to teach daily living skills or vocational skills; however, there is a lack of research on using video activity schedules to teach play skills. In this study, a non-concurrent multiple baseline design across participants was used to evaluate the effect of a video activity schedule to teach three dyads of autistic children between six to nine years old how to play cooperative games during a summer day camp. Results indicate that all participants learned how to play the cooperative game, including maintenance probes for the first two dyads. Social communication data on the participants will be discussed.
 
186. Project Social Code: Building Social and Coding Repertoires in Students With Autism
Area: AUT; Domain: Applied Research
ROBERT C. PENNINGTON (OCALI), Sarah Grace Hansen (30306)
Discussant: Lauren K. Schnell-Peskin (Hunter College)
Abstract: Computer engineering is one of the fastest growing areas of employment in the U.S.. Despite its potential as a meaningful vocation, many students with autism spectrum disorder and other development disabilities are not provided instruction in the area of computer engineering. In this poster session, researchers will describe Year 3 results of a project funded by the U.S. Department of Education’s Office of Special Education Programs to develop and implement a curriculum designed to teach computer coding and social skills to students with autism The curriculum embeds behavioral teaching technologies (e.g., response prompting, establishing motivating opoerations, contingencies of reinforcement) into lessons focused on teaching social skills essential to employment in the field of computer engineering and coding skills related to operating a small robot. The authors will present their results regarding teacher implementation fidelity and student performance. They also will propose implications for practice and areas in need of future research.
 
187. Creating Conversationalists: A Three-Component Teaching Procedure for Learners With Autism Spectrum Disorder (ASD)
Area: AUT; Domain: Service Delivery
Priya P Patil (Somerset Hills Learning Institute; Caldwell University), Julia Jacobs (Somerset Hills Learning Institute), EMILY E. GALLANT (Somerset Hills Learning Institute), Kevin J. Brothers (Somerset Hills Learning Institute)
Discussant: Tracy L. Kettering (Bancroft)
Abstract: Sophisticated, effective conversational repertoires include component skills like contextual responses, interaction focused on mutually-engaging topics, and increased duration that produce reinforcers for both speaker and listener behaviors. Jenna and Sophie, two adolescent girls with ASD, had previously learned to use and respond to statements and questions during conversations in a variety of everyday activities (e.g., lunch, interactive games) at approximately normative levels. Despite this, clinical observations indicated that the proportion of these interactions that were contextually-relevant utterances were below normative levels. A skill acquisition program was therefore implemented to increase interactions related to the ongoing activity across frequency of learners’ (a) statements and (b) questions and (c) percentage of others’ utterances with learner responses. Measures were analyzed separately, but new activity contexts were introduced only once individual criteria was met all three of the target responses. Rule-based instruction and naturalistic conversational consequences have been effective thus far to teach both Jenna and Sophie to display all three conversational components across the contexts of five different activities; learners have also generalized these skills to novel settings and activities. Goals for continued programming include increased comparisons to normative data and ongoing incorporation of additional activities.
 
188. Variable-Time Schedules Protect Against Effects of Integrity Errors During Noncontingent Reinforcement
Area: AUT; Domain: Basic Research
EVAN JAMES SWITZER (Salve Regina University ), Sofia E. Abuin (Salve Regina University ), Michael Catalano Jr. (Salve Regina University), Stephanie Hope Jones (Salve Regina University)
Discussant: Lauren K. Schnell-Peskin (Hunter College)
Abstract: Noncontingent reinforcement (NCR) is an effective intervention that typically consists of response-independent reinforcer delivery according to a time-based schedule and withholding reinforcers following problem behavior. Inconsistent implementation (i.e., implementation with integrity errors) of NCR results in degraded therapeutic outcomes. Previous research that shows degraded therapeutic outcomes when NCR is implemented with integrity errors has focused on NCR implemented with fixed-time schedules. It is unclear if scheduling response-independent reinforcer delivery according to fixed-time or variable-time schedules would impact the effects of integrity errors. To evaluate this question, we randomly assigned participants to experience NCR with fixed- or variable-time schedules. In each group, participants experienced baseline, full-integrity NCR, and 80% integrity NCR conditions in an ABAC design. Full-integrity NCR was similarly effective at suppressing problem behavior across the fixed and variable-time groups, but variable-time schedules suppressed problem behavior significantly better (p?= .005) relative to fixed-time schedules. Implications for researchers and practitioners are discussed.
 
189. Comparison of Multiple Error Correction Procedure on Consonant-Vowel-Consonant Word Identification With a Participant With Autism Spectrum Disorder
Area: AUT; Domain: Applied Research
REBECCA WARD (Salve Regina University), Kimberly N Vieira (Salve Regina University), Jesse Perrin (Pathways), Cody Morris (Salve Regina University )
Discussant: Tracy L. Kettering (Bancroft)
Abstract: Error correction procedures may help individuals increase independent responding in various academic skills. Several studies have evaluated error correction procedures, and shown that many forms of error correction can be beneficial. However, research indicates that the efficacy of error correction procedures are idiosyncratic, depending on individual needs. The purpose of this project is to identify an effective error correction procedure for the participant by comparing the effectiveness of three different error correction strategies for consonant-vowel-consonant (CVC) word identification. The three different error correction strategies consist of: (a) an error statement, (b) an error correction with a descriptive statement and (c) an error correction with a single response repetition requirement. The participant was an 8-year-old hispanic/latino male diagnosed with autism spectrum disorder (ASD) who attended a special education and treatment school with ABA. Results showed that of the three error correction procedures, error correction with single response repetition was best at increasing CVC word identification for this participant. Interobserver agreement was measured at 95.45% for 78% of sessions.
 
190. The Effect of Stimulus-Stimulus Pairing Procedure on Establishing Adult and Peer Observing Responses
Area: AUT; Domain: Applied Research
GIMO LEE (Teachers College, Columbia University ), Jennifer Longano (Fred S. Keller School), Sanam Rahimi (Teachers College, Columbia University)
Discussant: Lauren K. Schnell-Peskin (Hunter College)
Abstract: One of the primary social deficits in autism is the lack of attending to human faces and making eye contact. In social development, eye contact is the earliest form of communicative behavior that often develops into more complex social interactions. In educational settings, increased attention to adult faces leads to enhanced learning of children with autism. The current study utilized a conjugate stimulus-stimulus pairing procedure to condition the observing behaviors of three preschoolers with disabilities towards adult faces using naturally reinforcing stimuli. We used concurrent multiple probe design across participants with pre- and post-intervention measures. Post-procedure, all three participants showed improved attention to adult faces and more frequent eye contact. Additionally, this conditioning led to improved learning outcomes for the participants. A notable observation was the increased attention to peers following the conditioning of attention to adult faces, a phenomenon not previously studied. The study elaborates on the implications of these results.
 
191. Evaluation of a Skills-Based Treatment, With Supported Application, to Reduce Problem Behavior
Area: AUT; Domain: Applied Research
BELEN INARAJA LOPEZ (Mohammed Bin Rashid Center for Special Education operated by the New England Center for Children), Shannon Ward (Mohammed bin Rashid Center for Special Education operated by The New England Center for Children)
Discussant: Tracy L. Kettering (Bancroft)
Abstract: Functional assessments followed by function-based treatments are widely considered best practice when addressing challenging behavior. In recent years, evidence towards the efficacy and efficiency of a practical functional analysis and skill-based treatment (e.g., functional communication, toleration to denials, and cooperation with contextually appropriate behavior related to problem behavior) has been published in the literature (e.g., Jessel et al., 2018; Fiani & Jessel, 2022). Although some efforts have been made to study treatment effects in less controlled settings (e.g., Taylor et al., 2017), and under different clinical supervision conditions (e.g., Metras et al., 2023), replications are scarce. This study seeks to replicate a comprehensive treatment (i.e., practical functional analysis and skill-based treatment), in a specialized school setting, for two students diagnosed with autism spectrum disorder who engage in challenging behavior. The comprehensive treatment was conducted by Board Certified Behavior Analysts, who were also classroom supervisors, with periodic support (consultation, data review, in-vivo training) from clinicians with expertise in assessment and treatment of problem behavior. Results showed reductions in challenging behavior and an increase in communication, toleration to denials, and cooperation with adult-led demands for both participants. Interobserver agreement averaged 97.8%, across both participants, ranging 92.1-100%.
 
192. A Learning Management System Designed to Facilitate Applied Behavior Analysis (ABA) Technology Based Interventions, Both In-Person and Remotely: RoboMate for ABA
Area: AUT; Domain: Service Delivery
GIOVAMBATTISTA PRESTI (Kore University), CHIARA VONA ( Kore University), Silvia Cau (Kore University), CLAUDIA MINUTOLA (Kore University), MARCO LOMBARDO (Behavior Labs CT (Italy)), DANIELE LOMBARDO (Behavior Labs CT (Italy))
Discussant: Lauren K. Schnell-Peskin (Hunter College)
Abstract: Our research project focuses on technology-assisted therapy for individuals with neurodevelopmental disorders. Specifically, we've developed a Learning Management System (LMS) platform capable of various functions to facilitate in-person or remote Applied Behavior Analysis (ABA) interventions. These functions include verbal behavioral trainings (listener, speaker, reader, etc.), mediated by tablets and/or robots, as well as digital forms for data collection and analysis. We have two primary objectives: first, to implement technology-assisted and evidence-based interventions; second, to streamline data collection and analysis, reducing therapist workload and enabling faster decision-making by supervisors on a case-by-case basis. Remote ABA interventions through our platform offer notable advantages, facilitating and increasing the frequency of effective supervisions (or therapies) while ensuring accessibility in underserved/rural areas. To achieve these goals, we tested our software during numerous in-person and remote ABA interventions and investigated the platform's usability and technology acceptance among therapists and supervisors. This poster presents our preliminary results.
 
Diversity submission 193. The Effectiveness of Social Stories Intervention Compared to Social Stories Combined With Videos on the Social Skills in Children With Autism Spectrum Disorder and Other Developmental Disorders
Area: AUT; Domain: Applied Research
CHONGYING WANG (Nankai University ), Naiqian Mao (Nankai University)
Discussant: Tracy L. Kettering (Bancroft)
Abstract: Background Social stories have been widely used in special schools and rehabilitation service centers to improve the social skills in children with autism spectrum disorders and other developmental disorders. Objectives In this study, we aim to investigate the effectiveness of social stories intervention compared to social stories combined with videos on social skills of children with autism spectrum disorder and other developmental disorders. Methods In this study, three children with autism spectrum disorder and other development disorders were selected to participate, and the selection criteria were: (1) children aged 3-6 years were diagnosed with autism spectrum disorder or developmental disorders; (2) they had intermediate cognitive comprehension ability and were able to follow the teacher's instructions; (4) they were interested in pictures, videos, and would like to watch pictures or videos (5) they had basic language comprehension abilities. This study was a single-case design with multiple baseline cross-behaviors, and three children's social skills, including praising others, inviting play, and comforting others, were intervened by using the social stories and social stories combined with videos. In order to further explore which presentation method has the best effectiveness, this study will teach social stories through social story text and social story video at different intervention stages. Therefore, the experimental process of this study was divided into a baseline period, intervention period 1, intervention period 2 and maintenance period. Each objective skill explains the target skills to participants through the steps of listening/watching social stories-comprehensible question asking-listening/watching again-asking again-feedback; After each intervention session, the teacher in charge leads the children to observe and evaluate the target behavior. In the classroom setting, three children were intervened three times a week, each intervention lasted 15-20 minutes. Results The results showed that all the three participants showed improved correct response percentage in both intervention sessions, however, better response in the session of social stories combined with videos than social stories text. Conclusion This study confirmed our hypothesis that the social stories combined with videos are more effective in improving the social skills of children with autism spectrum disorder and other developmental disorders than social stories text.
 
194. Delays to Behavioral Therapy in Michigan for Children Diagnosed With Autism: A Summary of Needs Assessment Outcomes to Inform Public Policy Advocacy Initiatives
Area: AUT; Domain: Service Delivery
Andrea Stephens (Eastern Michigan University), Adam M. Briggs (Eastern Michigan University), Brittany Hope Loder-Lafferty (University of Nebraska Medical Center- Munro-Meyer Institute ), ALYSSA LEE MILLER (ABA Insight), Jaimie Barr (Eastern Michigan University)
Discussant: Lauren K. Schnell-Peskin (Hunter College)
Abstract: Children diagnosed with autism spectrum disorder (ASD) are eligible to receive behavioral health services in Michigan, including those based on the principles of applied behavior analysis (ABA). Demand for these specific services far outpaces the number of qualified professionals in the state (Yingling et al., 2022), thus resulting in delayed access to a much-needed service. The purpose of our survey was twofold. First, we surveyed families throughout Michigan (N = 78) to identify the types of barriers encountered and the extent to which families of autistic individuals experience them when pursuing ABA services. Second, our survey assessed the needs of these families during service delays in an attempt to understand how to best support them during this time. Results indicated that 73% of children spent time on a waitlist, varying in duration from 1 month to over 1 year. Further, most caregivers indicated they were concerned about their children’s behavior while awaiting services and would have been interested in training to help them manage behavioral concerns and teach new skills to their children. We conclude by reviewing recommendations for addressing child and caregiver needs during this time and discussing implications for public policy advocacy initiatives.
 
195. A Systematic Literature Review of Peer Mediated Interventions for Joint Attention
Area: AUT; Domain: Applied Research
ALYSSA FLITER (Endicott College), Lisa Tereshko (Endicott College)
Discussant: Tracy L. Kettering (Bancroft)
Abstract: Each year, one in six children are diagnosed with a developmental disability and of those children, one in 44 are diagnosed with autism spectrum disorder (ASD; Center for Disease Control and Prevention, 2022). Individuals with ASD often lack skills related to social competence (Tsao & Odom, 2006). Joint attention is pivotal skill that occurs when there is a shared experience between an individual and another object or experience. Children who are diagnosed with autism spectrum disorder (ASD) and other developmental disabilities often have difficulty displaying this skill. Peer experiences are important for children with developmental disabilities and can aid in teaching important skills through play and structured sessions. This literature review includes six articles that implemented peer-mediated interventions that targeted joint attention. Each article was analyzed across specific dimensions (participants, setting, dependent variables, independent variables, outcome and generalization). Information from this review includes the use of these interventions and the efficacy of joint attention skill acquisition in children with ASD.
 
196. Comparing Multiple-Exemplar Sets, Minimal Rational Sets, and Single Stimulus Sets and Their Effects on Generalization
Area: AUT; Domain: Applied Research
ANALIS CAPOBIANCO (Endicott College, Bierman Autism Centers), Lisa Tereshko (Endicott College), Victoria Verdun (Bierman Autism Centers), Jessica Piazza (Endicott College)
Discussant: Lauren K. Schnell-Peskin (Hunter College)
Abstract: There is a lack of research regarding Minimal Rationale Sets (MRS) being compared to other sets of stimuli, such as single exemplar and multiple exemplar, and the effects these sets have on the generalization of skills. MRS are stimuli sets used to teach individuals specified targets which also promote generalization. MRS includes specific examples with criteria for features that will help the individual discriminate between classes. This current study compared these three sets of stimuli across three participants that ranged from 3-7 years of age diagnosed with Autism Spectrum Disorder (ASD.) The study was conducted during ABA therapy sessions using discrete trial teaching. All participants in this study showed an increase in generalization across each condition. This study provided results to help behavior analysts discover which sets of materials would suit their learners and the available resources and showed that regardless of the set of materials used, individuals can learn a concept. With future research, we can further investigate if this is true across different ages, skill levels, and operants.
 
197. Comparing No-No Prompt to Flexible Prompt Fading, in Teaching Expressive Labels to Children With Autism Spectrum Disorder
Area: AUT; Domain: Applied Research
JIYOUNG PARK (Endicott College), Julia Ferguson (Autism Partnership Foundation), Jessica Piazza (Endicott College), Lisa Tereshko (Endicott College)
Discussant: Tracy L. Kettering (Bancroft)
Abstract: Currently, there is only one experimental study that directly compares no-no prompt (NNP) to flexible prompt fading (FPF) for individuals diagnosed with autism spectrum disorder (ASD). Leaf et al. (2019) used an adapted alternating treatments design to evaluate the effectiveness of the two prompting systems in teaching four children diagnosed with ASD to expressively identify pictures of athletes. While the results of the previous study indicated that both NNP and FPF are effective prompting systems, a limitation was the absence of assessing the long-term maintenance and generalization of the targets taught. Furthermore, when compared to other prompting systems that are commonly utilized in the field, there is a lack of empirical evidence for NNP and FPF in the literature. Further research must be conducted to compare different prompting systems to identify the conditions under which each system is more effective and efficient. Therefore, the purpose of the current study is to measure the effectiveness and efficiency of flexible prompt fading compared to no-no prompt when teaching expressive labels to two children diagnosed with ASD. Additionally, this experimental study will measure the long-term maintenance and generalization of targets taught through each prompting system.
 
198. Exploring the Utility of Multidisciplinary Interventions: Combination of Occupational Therapy and Applied Behavior Analysis to Improve Dishwashing Skills in Adolescent With Autism Spectrum Disorder (ASD) and Marfan Syndrome
Area: AUT; Domain: Applied Research
HARRY BOBAK (Mississippi State University), Mattie Williams (Mississippi State University), Mark E. Wildmon (Mississippi State University)
Discussant: Lauren K. Schnell-Peskin (Hunter College)
Abstract: Incorporating person-centered planning into everyday behavioral health care, is driving the the need to incorporate integrated approaches of disciplines to create multidisciplinary interventions. This research assessed the effectiveness of integrating an evidence-based intervention from two related disciplines of Applied Behavior Analysis and Occupational Therapy to teach a participant to hand-wash dishes. The participant was an adolescent male with a diagnosis of Autism Spectrum Disorder with an Intellectual Disability and Marfan Syndrome. Our research used an alternating treatment design between three different interventions of combined intervention, Behavior Skills Training in isolation, and control to asses effectiveness of the interventions. Intervention effectiveness was established based on rate of acquisition and maintenance of the learned skill at 100% of a step-by-step task analysis. The participant demonstrated a quicker rate of skill acquisition with the combined treatment. The skill was later tested at 1 month-intervals to assess maintenance and using different cutlery to assess generalization. Discussion of limitations, direction of future research and ways to improve this format of research will be included.
 
200. The Effects of Behavioral Skills Training on Discrimination of Bodycam Video
Area: AUT; Domain: Applied Research
LYNDSY MACRI (Apollo Behavior; Cambridge College)
Discussant: Lauren K. Schnell-Peskin (Hunter College)
Abstract: There is a lack of research regarding the effectiveness of law enforcement training on autism using a performance-based measurement system. This study compared behavioral skills training with traditional lecture to teach law enforcement officers discrimination between correct and incorrect behavior when presented in a bodycam video. Participants reviewed a video and then evaluated six pre-specified officer responses. These responses included approach, providing enough time to respond to a question, minimizing physical touch, giving clear instructions, seeking information, and maintaining distance. Officers whose score was lower than 73% during baseline were placed into one of two groups. Group A received didactic lecture training and group B received behavioral skills training and didactic lecture. The results revealed that officers who were provided didactic lecture training were as successful at discriminating responses as those who received behavioral skills training. This finding has implications for selecting training format based on the behavioral/cognitive performance specifications.
 
202. An Evaluation of the Use of Role-Play to Effectively Teach Social Skills to an Adolescent With Autism Spectrum Disorder
Area: AUT; Domain: Applied Research
Trevor Stokes (James Madison University), HANNAH LOCKWOOD (James Madison University), Sydney E Setchel (James Madison University), Amanda Heillman (James Madison University)
Discussant: Lauren K. Schnell-Peskin (Hunter College)
Abstract: Modern social skills literature show the use of behavior skills training and role-play in social skills instruction in small-group and school-based settings, although there is limited research showing these methods of teaching in a one-to-one clinic setting where peers are unavailable to rehearse with. The purpose of the present study was to fill the gaps in the research on the use of behavior skills training and role-play as an effective treatment in teaching social skills in a one-to-one setting. A multiple-baseline design across behaviors was used to measure the effectiveness of the intervention across different behavior domains for an adolescent participant with autism spectrum disorder. The participant was given context to a social scenario and was instructed to role-play the interaction with the clinician with no feedback during baseline. The teaching phase utilized behavior skills training (instruction, model, role-play, feedback) to teach appropriate responding. The final phase looked for maintenance of the skill when presented with familiar scenarios in a role-play format in the absence of instruction and modeling. The results of this study will contribute to the literature on social skills instruction in a one-to-one client-therapist setting.
 
 

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