Eight Months of Telehealth for a State-Funded Project in Foster Care and Related Services: Progress Made and Lessons Learned.

In response to the COVID-19 pandemic, many behavior analysts and other health professionals modified their services for delivery via telehealth modalities. The transition to telehealth is especially important for providers working with foster youth who exhibit challenging behavior because these youth often move to another placement due to such behaviors. The primary objective of this article was to evaluate the extent to which service indicators for a state-funded team working with foster youth changed after the service delivery model changed from in-person to telehealth services. In particular, we evaluated changes in monthly count of client contacts, appointments, intakes, closed cases, and medication reviews. The secondary objective was to outline potential benefits and environmental barriers encountered by the team and to integrate our findings with the literature on behavior-analytic services provided via telehealth. Overall, results show that we maintained service quality with a broad range of behavioral interventions and increased overall client appointments. Given these outcomes, our team may continue to provide behavioral services via telehealth after the COVID-19 pandemic.

Behavioral Skills Training to Increase Appropriate Reactions of Adolescent Males in Residential Treatment.

Adolescents in secured residential facilities may engage in excess behavior immediately following verbal directives or corrective statements from staff. Excess behavior may include verbal aggression, indices of disrespect (e.g., eye rolling, grunting, and obscene gestures), or even physical aggression. These excess behaviors may evoke further directives or corrective statements from staff that, in turn, escalate the adolescent's excess behavior and can produce undesirable effects for both the adolescent (e.g., loss of privileges) and staff members (e.g., increased burn out). Teaching detained adolescents to respond appropriately to staff directives and corrective statements may produce large collateral changes in the way staff interact with adolescents in detention facilities. These changes could be conceptualized as a behavioral cusp. We used behavioral skills training to teach 11 adolescent males to respond appropriately to staff directives. All 11 students showed low percentages of trials with appropriate reactions in baseline and high percentages of trials with appropriate reactions during treatment and generalization sessions. Further, two students showed maintenance of the skill 1 month and 5 months following treatment.

Using a Multiple-Schedule Procedure to Signal the Availability of Attention: Three Demonstrations.

Adjudicated adolescents detained in residential facilities for illegal sexual behavior, as well as adolescents living at home, may engage in problem behaviors such as excessive vocalizations. In residential detention facilities, these excessive vocalizations may result in disciplinary action and loss of privileges. Moreover, excessive vocalizations may also reduce the amount of positive social interactions that staff members and caregivers have with the adolescents. The current study evaluated a multiple-schedule procedure for reducing excessive vocalizations displayed by three adolescents. The procedure involved (a) a red card to signal that attention was not available and (b) either a green card or no card to signal that attention was available. Results show that the participants learned to abstain from vocalizing for up to 30 min when a caregiver presented the red card. In addition, the treatment effects persisted during generalization assessment sessions.

Brief Report: Evaluating College Students' Perceptions of a Child Displaying Stereotypic Behaviors: Do Changes in Stereotypy Levels Affect Ratings?

One reason for treating stereotypic behavior is that it may negatively impact how others perceive the individual displaying the behavior, thus impeding social interactions; however, few studies have directly evaluated this possibility. As a first step toward testing this position, participants (college students) in Study 1 watched 5-min video clips of a child engaging in hand/finger motor stereotypy at varying levels (0%, 17%, 37%, and 40% of the time) while sound was muted. Following each video, participants completed a questionnaire to evaluate their perception of the child. In Study 2, additional participants completed the same questionnaire after watching the same videos with the sound unmuted to determine if the addition of vocal stereotypy altered their perceptions of the child. Results indicate that (a) observers negatively rated the child when he displayed motor stereotypy for 17% or more of a video clip and (b) the addition of vocal stereotypy yielded more negative judgements than motor stereotypy alone.

Group Procedures for Decreasing Problem Behavior Displayed by Detained Adolescents.

As one component of providing treatment in a residential facility, Brogan, Falligant, and Rapp decreased problem behavior by two groups of detained adolescents using group contingency procedures. The current series of studies evaluated the extent to which group procedures could be extended to other contexts within a residential facility. In Study 1, fixed-time delivery of attention by dormitory staff decreased problem behavior displayed by a group of five to 11 detained adolescents during free periods. In Study 2, rules from a therapist plus contingencies for following those rules increased appropriate line walking during specific transition periods. Subsequently, rules alone maintained appropriate line walking, however, direct training was required to produce appropriate line walking during other transitions. Measures of social validity indicated the procedures and outcomes in both studies were acceptable to facility personnel.

Increasing Quiet Compliance by Detained Male Adolescents.

Some adjudicated adolescents receive treatment for their offenses in residential facilities. Detained adolescents' engagement in either low levels of compliant behavior or excess behavior (e.g., swearing, gestures) while following commands from residential personnel may result in decreased opportunities for those youth to access preferred activities. The current study employed nonconcurrent multiple baseline across participants designs to evaluate the effects of a procedure to increase seven detained adolescents' quiet compliance with academic and vocational demands. Results show that problem behavior decreased to zero or near-zero levels for each participant during simulated conditions and suggest that self-control, alone or in combination with a differential reinforcement of low rate behavior for omitting problem behavior, may have been responsible for the behavior changes. We discuss some clinical implications of the findings.