|The Azrin-Foxx Self-Initiation Legacy: Toileting Practices and Social Validity|
|Saturday, May 24, 2014|
|1:00 PM–2:50 PM |
|W192a (McCormick Place Convention Center)|
|Area: CSE/DDA; Domain: Service Delivery|
|Chair: Amanda W. Doll (Hawthorne Foundation, Inc.)|
|Discussant: Peter J. Blechman (Hawthorne Foundation, Inc.)|
|CE Instructor: Frank R. Cicero, Ph.D.|
The initial Azrin-Foxx self-initiation training protocol was both a gift and a challenge to the field of behavior analysis. It provided a robust, highly-effective, and easily replicated treatment package with broad applicability to other populations, as evidenced by results obtained in institutional, school, and community settings across the United States and in other countries. However, it also raised expectations about the range of learners who could learn to self-initiate and challenged us to create environments that accommodated these newly acquired skills. Our symposium will consider the evolution of self-initiation training protocols since their initial applications in terms of developments in the field which have required overcorrection procedures to be dropped and request procedures to be added. Data from the original Willowbrook Cohort will be contrasted against those from two present community agencies; and a data collection tool for coding these data will be presented, together with reliability and validity data. We will discuss implications for practice.
|Instruction Level: Basic|
|Keyword(s): outcomes assessment, overcorrection, self-initiation, toileting|
|Target Audience: |
Psychologists, behavior analysts, graduate students and anyone interested in self-initiation.
|Learning Objectives: At the conclusion of the presentation, participants should be able to (1) Identify data-collection systems to track toileting progress across programs serving large numbers of participants; (2) Describe intensive, behaviorally based toilet training procedures that have shown empirical support in the literature; and (3) Describe the current state of toilet-training outcomes for people with autism being served in several ABA programs within New York State.|
Willowbrook Cohort Data as an Historical Frame of Reference for Toileting Self-Initiation Training
|ALBERT PFADT (Quality Improvement Consultant)|
The Willowbrook Sate School was an institution for individuals with developmental disabilities located on Staten Island and run by New York State. Willowbrook was made infamous as a snake pit and an incompetent environment through the reporting efforts of Geraldo Rivera and litigation and legislation by Senator Robert Kennedy and others. One of the many stipulations of the Willowbrook Consent Decree was that individuals residing at Willowbrook were to receive comprehensive toilet training. This talk will describe what conditions were like at the time of the Willowbrook Consent Decree and immediately thereafter; the presenter's experience as a team member administering and training others to administer the original Azrin-Foxx toileting protocol as part of the original intervention team; and outcome data from these efforts.
Forget "Readiness." Start Teaching Toileting by Assessing Toileting Skills with a Toileting Skill Survey.
|AMANDA W. DOLL (Hawthorne Foundation, Inc.)|
Reasonable people, even or perhaps especially professionals, can and do disagree (often vigorously, and usually beyond the available data) about the number, order, and necessity of various prerequisite skills for teaching toileting. This presentation will provide participants with a simple 16-item toileting survey that may be used to obtain a cross-section of toileting-related skills for groups of learners of any age (e.g., classes of students in schools; groups of individuals in residences or habilitation programs). Each learner is assessed for Self-Initiation, Requesting, Scheduled Elimination, and Accident Rate using a 4-point scale which is descriptive in nature and written in plain language in order to be equally accessible to paraprofessionals, direct-care workers, or professionals. Administration instructions, anecdotes about administration, inter-observer agreement data, and construct validity data will be presented, along with implications for practice.
|Self-Initiation Status of Students at the Eden School|
|FRANK R. CICERO (Eden II Programs)|
|Abstract: The self-initiation toilet training protocols as originally applied at Willowbrook included overcorrection and did not include request training. The punitive nature of overcorrection has made this component of the original treatment package increasingly unacceptable over time; meanwhile, the reality of most school environments is that requesting is preferred over self-initiation for reasons of school safety and classroom management. In this presentation, program-wide cross-sectional data on the present self-initiation status of the students at the Eden School will be discussed. The Eden School is a community agency location that presently utilizes a mostly uniform set of protocols with respect to teaching toileting within its programs. Data from the present-day Eden School will be compared to the original Willowbrook Cohort data set, and also to the data from the present-day Hawthorne Foundation data set. Implications for practice will be discussed.|
|Self-Initiation Status of Students at Hawthorne Country Day School|
|DAREN CERRONE (Hawthorne Country Day School), Kim Arruda (Hawthorne Country Day School)|
|Abstract: Both the Willowbrook Cohort data set and the Eden II data set are cross-sectional outcome data reflective of populations exposed to uniform or relatively uniform treatment packages. The Hawthorne Country Day School is a community agency; while the agency provides a behavior analytic approach to lifelong care and uses entirely data-based practices, in the area of teaching toileting, present practice at the school allows for selection of teaching protocols for toileting based on each individual student's assessed skills and needs. In this presentation, program-wide cross-sectional data on the present self-initiation status of the students at the Hawthorne Country Day School will be discussed. The Hawthorne Country Day School is a community agency location that presently utilizes many different data-based protocols with respect to teaching toileting within its programs. Data from the present-day Hawthorne Country Day School will be compared to the original Willowbrook Cohort data set, and also to the data from the present-day Eden II School data set. Implications for practice will be discussed.|