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| Applications of Exposure-Based Treatment Approaches for Common Problems in Children With Autism Spectrum Disorders |
| Tuesday, June 1, 2010 |
| 12:00 PM–1:20 PM |
| 204AB (CC) |
| Area: AUT/DDA; Domain: Service Delivery |
| Chair: Julia Barnes (Binghamton University) |
| Abstract: Children with autism spectrum disorders frequently avoid particular stimuli and situations (Evans, Canavera, Kleinpeter, Maccubbin & Taga, 2005). Many avoid particular types of food, or refuse to have their hair cut, for example. They may also avoid or resist changes in particular routines or rituals. There is a large base of empirical support for using exposure-based methods to treat maladaptive behavioral avoidance (Gillis, Hammond-Natof, Lockshin & Romanczyk, 2009). The aim of this symposium is to review relevant empirical literature on exposure-based treatment methods and to illustrate how these methods can be applied to a range of problem behaviors. Discussion will focus on the considerations involved in formulating conceptualizations of behavioral avoidance and in implementing treatment of such avoidance.
This symposium is intended to provide instructional guidelines on exposure-based treatment for professionals treating children with ASD within the context of a supervised intervention setting. Cautions against attempts to employ the intervention techniques that will be presented without appropriate training and supervision will be emphasized. |
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| Perspectives on Conceptualization and Treatment of Avoidance Behaviors in Children |
| LAURA B. TURNER (Binghamton University), Raymond G. Romanczyk (Institute for Child Development, Binghamton University) |
| Abstract: Models of maladaptive behavioral avoidance were first developed over 60 years ago (e.g. Mowrer, 1947). Since that time, these well-established models have been used to explain patterns of behavioral avoidance observed in individuals with a variety of disorders. To date, both associative and operant learning are implicated as primary contributors to the development of avoidance behaviors. Exposure techniques that utilize associative and operant procedures have been shown to be effective in treating various forms of maladaptive behavioral avoidance. Habituation to aversive stimuli that typically trigger avoidance behavior is also an important component of successful treatment for maladaptive behavioral avoidance. The aim of this presentation is to discuss both historical and current perspectives on conceptualizations of behavioral avoidance, focusing on theories regarding the development and maintenance of maladaptive avoidance behaviors. An additional aim of this presentation is to discuss current perspectives on treatment of maladaptive avoidance in children with Autism Spectrum Disorders, focusing on exposure-based interventions. |
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| Using Graduated Exposure for Children With Autism Spectrum Disorders Who Avoid and Resist Hygiene Procedures |
| LAUREN BETH FISHBEIN (Binghamton University), Raymond G. Romanczyk (Institute for Child Development, Binghamton University) |
| Abstract: Many children with autism spectrum disorders (ASD) exhibit fears and phobias that result in behavioral avoidance (Luscre & Center, 1996). Among the fears commonly exhibited among children with ASD are fears of undergoing hygiene procedures such as hair cutting or washing, tooth brushing and nail clipping. Due to behavioral avoidance or resistance children may exhibit in the face of stimuli associated with certain hygiene procedures, parents may struggle with performing basic procedures that are necessary to maintain their child’s hygiene. Maintaining appropriate hygiene is important to social integration and acceptance among typically developing peers, especially as children age into adolescence and adulthood. Consequently, targeting fears of hygiene procedures during childhood is often a priority for parents of children with ASD. The aim of this presentation is to review the relevant literature on behavioral avoidance of hygiene procedures in children with ASD. Several case examples will be drawn upon to provide a description of how avoidance of hygiene procedures can be conceptualized and how graduated exposure techniques can be applied to fear of hygiene procedures. Emphasis will be placed on the importance of appropriate training for implementing these techniques in applied settings. |
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| Treatment of Disruptive Rituals and Resistance to Change in Children With Autism Spectrum Disorders Using Exposure-Based Methods |
| JULIA BARNES (Binghamton University), Raymond G. Romanczyk (Institute for Child Development, Binghamton University) |
| Abstract: The apparent inflexible adherence to specific, nonfunctional routines or rituals that are characteristic of some individuals with Autism Spectrum Disorders (ASD) often presents impediments to daily functioning for these individuals and their families. Ritualistic behavior and resistance to changes in routines may limit the range of activities in which individuals with ASD will participate. Often family activities in the community and even within the home are also restricted due to the routines or rituals of a family member with ASD. Exposure with response prevention has been shown to be a highly effective treatment for treating the obsessions and compulsions characteristic of obsessive-compulsive disorder (Foa & Kozak, 1996). As the rituals observed in ASD may be conceptualized in certain cases as being similar to compulsive behavior, utilizing exposure with response prevention techniques can also be effective for treating ritualistic behavior. The aim of this presentation is to illustrate application of exposure-based methods to treat rituals and resistance to change in children with ASD. Case examples will be used to illustrate case conceptualization and exposure-based treatment development. |
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| Utilizing Exposure to Treat Feeding Problems in Children With Autism Spectrum Disorders |
| COURTNEY A. POOLER (Binghamton University), Raymond G. Romanczyk (Institute for Child Development, Binghamton University) |
| Abstract: Children with Autism Spectrum Disorders (ASD) are at an increased risk for feeding problems when compared to typically developing children. Seventy-two percent of parents of children with autistic disorder or PDD-NOS report their child consumes a narrow variety of foods (Shreck, Williams, & Smith, 2004). In addition, they are reported to eat fewer foods in each food category than typically developing children, and are more likely to eat foods of low texture (Shreck, Williams, & Smith, 2004). A fundamental component of treatment of food selectivity is repeated exposure to non-preferred foods. In addition, treatments also often include differential reinforcement for consuming non-preferred foods, and escape extinction (Ledford & Gast, 2006). This presentation will outline exposure-based treatments for food selectivity, from careful individualized assessment to treatment implementation and revision. Case examples will be used to illustrate the principles discussed. Cautions against implementation of feeding treatment without sufficient training or supervision will be discussed. |
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