Association for Behavior Analysis International

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The training of human services staff in behavior change methods is often a labor-intensive function of the supervising behavior analyst. The pyramidal application of behavioral skills training (BST) has been demonstrated an effective means for promoting the acquisition of skills related to behavior analytic treatment, while increasing the efficiency of the individual behavior analyst’s training efforts. As BST has potential for broad application, we extended a pyramidal BST approach toward job skills training for service recipients enrolled in a program providing support for adults with autism in the community setting. During pre-training assessments, 10 staff members were instructed to role-play BST using given task analyses. Following BST-based instruction in the application of BST (a pyramidal paradigm), participants demonstrated improved performance of BST component skills in the role-play setting, with regard to baseline levels. High performance levels were also observed during subsequent on-the-job assessments of staff conducting BST with service recipients in the generalization setting.

Few studies have examined evaluation and treatment of social avoidance as a function of behavior in children with autism despite this characteristic being commonly associated with the disorder. A standard functional analysis of aggressive, self-injurious, and disruptive behavior was completed with a boy diagnosed with autism. A potential social avoidance function was indicated by elevated behavior in the toy play condition and low rates of behavior in the ignore condition. It was suspected that avoidance may be specifically sensitive to verbal attention. A modified functional analysis was conducted comparing responses during sessions with no verbal attention, continuous verbal attention, and a control of no interaction. Rates of behavior were elevated in both test conditions. After functional analysis, a modified 3-step prompting procedure consisting of a textual, gestural, and physical prompt hierarchy was utilized to teach the functional communication response (FCR) of asking for “time by myself” using an iPad application. Treatment was implemented in which only the FCR produced reinforcement and all problem behavior was placed on extinction. Signaled availability was also introduced to indicate when the FCR would result in reinforcement. This case demonstrates a method for successfully identifying a social avoidance function, leading to a successful function-based treatment.

Children should engage in at least 60 min of moderate-to-vigorous physical activity (MVPA) daily, per the recommendation by the Centers for Disease Control and Prevention (CDC). However, many children do not meet this requirement, and children with intellectual disabilities are less likely to do so. Therefore, it is important to evaluate strategies for increasing physical activity in this population. The purpose of this study was to conduct a treatment analysis in the context of a single activity duration-based preference assessment. Physical activities were identified via an indirect assessment and included treadmill, elliptical, stepping on a bosu ball, and a stationary bike. Intervention components included prompting alone, prompting plus noncontingent reinforcement (NCR), and prompting plus differential reinforcement of alternative behavior (DRA). Dependent variables were appropriate activity engagement and heart rate. The two activities associated with the highest levels of physical activity were the treadmill (with prompting and NCR intervention components) and elliptical (with prompting and DRA intervention components). Once an effective treatment was identified for each form of physical activity, a modified paired-stimulus preference assessment was conducted both with and without intervention components to assess the effects of intervention on response allocation to each physical activity over a sedentary activity.

This poster shows how practioners can plan and effectively train for generalized behavior change in the applied setting utilizing The R.E.AL. Model (Recreating Environments to Accelerate Learning). It teaches for generalization using a unique five step process, which systematically changes environmental antecedents and consequences in order to effectively increase skill acquisition within any existing ABA program. The structure of each level allows for observable, measurable accountability as to how a concept, verbal operant, skill, or repertoire was acquired based on the environmental conditions present. Each level provides the practitioner with a behavior analytic structure by which treatment plans are evaluated and targets to teach for generalization are identified. The R.E.AL. Model begins the behavioral process to teach for generalization during stimulus discrimination training of concepts and the teaching of skill acquisition taught in a highly structured environment. The process continues when systematically introducing stimuli and contingencies within the natural environment. Special emphasis in bridging concepts and skills in order to teach complex repertoires follows, establishing multiple-control, and generalized social behavior to the verbal community. Data indicate skill acquisition across all ABA program areas. The R.E.AL. Model systematically trains for generalization so practitioners can increase skill acquisition across all applied settings.

Up to 89% of individuals with autism spectrum disorder (ASD) have some type of feeding difficulties (Ledford & Gast, 2006). Food selectivity, while common in young children typically resolves in the neurotypical population. However, it may persist into adulthood in individuals with ASD if left untreated (Birch, 1999). Kuschner et. al. (2015) found, using self-report, that young adults with ASD were more likely to report food selectivity than in the neurotypical comparison group. While effective treatments for food selectivity have been identified for young children and the school-aged population, little research has been conducted on treatments with the adult population. This is important because adults have a longer history of food selectivity, which may make it more resistant to treatment. In this study, we used a combined changing criterion and alternating treatment design to compare positive and negative reinforcement contingencies to increase consumption of a variety of novel foods by an 26-year-old adult with ASD. We found that both contingencies increased consumption of novel foods. Additionally, he preferred the positive reinforcement contingency. Finally, treatment effects generalized to non-treated foods. The current protocol represents a novel strategy for addressing food selectivity in adults with ASD.

Early intensive behavioral intervention (EIBI) has been shown to have positive effects on the language outcomes of children with autism spectrum disorder (ASD). Child language outcomes are often measured using standardized assessments. Some biases that are can be associated with standardized assessments that threaten their internal validity can be associated with the assessor’s presence, the assessor’s ability to implement the assessment, the and the contrived nature of many assessments. Many of these biases can be addressed when automated data collection procedures are implemented to capture and asses a child’s language ability. The purpose of the present investigation was to capture the language outcomes of children with ASD one year after beginning EIBI. A pre-test post-test design will be used to analyze the changes observed in the child’s language. The children’s language was measured using Language ENvironmental Analysis (LENA) software and affiliated devices to collect and analyze data on the child’s language throughout one full treatment day. The primary language measure of interest is the child’s vocalization count per hour. Clinical results and implications will be discussed.

A core deficit in Autism Spectrum Disorder (ASD) is restricted interests, which for children with ASD often manifests as few items with which they engage with in a leisure context. When children have few leisure items that function as reinforcers during intervention, progress can be limited. This study used a discrimination training procedure to condition non-preferred leisure items as reinforcers for two children with ASD. Neutral tangible items were established as discriminative stimuli by reinforcing a specific engagement response in the presence of the item. Free-operant preference assessment probes of item engagement were conducted prior to conditioning, during conditioning, and post-conditioning. Following an observed treatment effect during free-operant probes, the conditioned item was then tested for reinforcing efficacy while teaching a new skill. Results indicated the discrimination training procedure led to greater levels of engagement during free-operant probes with each item that was conditioned for both participants. During the test for reinforcing efficacy, the conditioned item demonstrated some reinforcing properties, though not as strong as the participants’ primary reinforcers.

Within this poster, we behavior-analytically defined the functions of sarcasm and provided practical implications for individuals with autism. By understanding the contextual cues contributing to a sarcastic statement individuals with developmental disabilities can contact more reinforcement by interacting with another person or group of people. Additionally, a study was conducted in which individuals with autism were taught to detect the literal meaning of sarcastic comments and their contextual cues. The results of this study supported the assertion of Persicke, Tarbox, Ranick, and St. Clair (2013) that non-literal language deficits can be reconciled using teaching procedures such as the delivery of rules, clear immediate feedback, and multiple exemplar training.

This research has been carried out for several years to identify ASD risk in siblings of children diagnosed with ASD and its design is a longitudinal prospective one. We pretend to identify early risk signs in siblings aged 7 to 36 months old. Thirteen tasks were developed to evaluate siblings target behaviors by therapists or parent: turning the body to sounds, following instructions, pointing, making eye contacting, babbling, social smiling, imitating, understanding signs looking to an object pointed by others, pretend play. Evaluations of every infant are taken monthly and each new year new infants are included. This study was developed in 2019 and its aim was to verify if new results obtained by application of the protocol on five infants aged 8 to 36 months old would increase the generality of previous results. Four infants had speech language impairment and referral for speech therapist assessment. Only one of the siblings showed severe impairment in different areas of development and referral to ASD specialists indicated agreement with our evaluation. External specialist evaluations agreed with our assessment showing with new participants protocol´s generality. Additional results were related to protocol improvement.