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.


35th Annual Convention; Phoenix, AZ; 2009

Event Details

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Symposium #259
Using Function-Based CBT to Treat OCD in Children and Youth with High Functioning Autism (HFA)
Sunday, May 24, 2009
3:00 PM–3:50 PM
North 124 B
Area: AUT/CBM; Domain: Applied Behavior Analysis
Chair: Tricia Corinne Vause (Brock University)
Discussant: Keith D. Allen (Munroe-Meyer Institute)
Abstract: Research suggests that children and youth diagnosed with High-Functioning Autism (HFA) have increased risk for Obsessive-Compulsive Disorder (OCD) (APA, 2000) in comparison nonPDD clinic samples and nonclinic samples (e.g., Gadow et al., 2004). Despite these findings, few studies (N=1) have attempted to treat OCD in an exclusive PDD population (e.g., Reaven & Hepburn, 2003; Lehmkuhl et al., 2008; Sze & Wood, 2007). These studies adapted a CBT protocol (used for typical children) to fit the cognitive/developmental profiles of children and youth with HFA. Collectively, informant measures indicated positive preliminary findings. The purpose of this symposium is to review two papers that explore a synthesis of CBT (March & Mulle, 1998) and behavior (function-based) methodology to treat OCD. In both papers, within participant multiple-baseline designs across OC behaviors are used. The first paper focuses on youths (ages 14-16), with the second describing treatment with a younger population (ages 8-10). At post-treatment, visual inspection of the data for two youths indicated that OC behaviors were at clinically acceptable levels, and parents reported an increase in quality of life. Ongoing data is being collected for school-age children. This research represents a further step towards developing empirically validated treatments for OCD in this population.
Using Function-Based CBT to Treat OCD in two Youths with HFA
TRICIA CORINNE VAUSE (Brock University), Sarah E Grubb (Brock University), Shauna McCambridge (Brock University), Elizabeth Rombough (Brock University), Maurice Feldman (Brock University)
Abstract: The present paper will describe the results of two male youths (ages 14-16 years) with HFA who participated in Cognitive-Behavior Therapy (CBT) (March & Mulle) plus function-based behavioral intervention (Feldman et al., 2002) in an attempt to reduce targeted OC behaviors. Treatment sessions took place once or twice per week for approximately 20 weeks. CBT included awareness training, cognitive training, and exposure/response prevention. As well, hypothesized functions of OC behaviors were identified and addressed as needed. Examples of targeted obsessions and compulsions included: handwashing, fears of an unwanted event or need for exactness (with precise positioning of items), and fears of inadequate food digestion (with frequent bouts of touching and talking about the abdomen around mealtime). For both participants, at post-test, visual inspection of objective data indicated that target OC behaviors were at clinically acceptable levels; for one participant, results remained stable at 3-month follow-up (and follow-up data for the other participant will be collected shortly).Treatments were adapted to fit the cognitive/developmental needs of the participants. Identifying and addressing hypothesized functions of behaviors, as well as extensive parent involvement appeared to aid in treatment success.
Using Function-Based CBT to Treat OCD in two School-age Children with HFA
SHAUNA MCCAMBRIDGE (Brock University), Tricia Corinne Vause (Brock University), Maurice Feldman (Brock University), Heather Sheen (Brock University), Elizabeth Rombough (Brock University)
Abstract: The second paper replicates the first study with 2 school-age children (ages 8-10 years) who meet criteria for OCD and HFA. The CBT treatment is currently underway and being offered in weekly 1.5 hour sessions. Examples of targeted obsessions and compulsions include: worries related to death and contamination, active avoidance of objects believed to be dirty or unsafe, reassurance seeking and engaging in daily rituals, such as repeating sentences before bedtime. The objective data collected by parents will be visually inspected and will be used to supplement the information collected from standardized OCD assessments and quality of life and consumer satisfaction questionnaires. The treatment has been modified to fit the cognitive/developmental needs of the younger participants. Identifying and addressing the hypothesized functions of behaviors, as well as the inclusion of extensive parent involvement, reinforcement and adaptations to cognitive phase of the CBT are expected to aid in treatment success.



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