The effects of work-reinforcer schedules on skill acquisition for children with autism.

This study evaluated the effects of continuous and discontinuous work-reinforcer schedule arrangements on skill acquisition for three students with autism. Participants were initially exposed to both schedules in an alternating schedules condition where they were taught different but equivalent skills for each schedule. In the discontinuous schedule condition, participants completed work in small increments to gain access to a reinforcer for short periods of time. In the continuous schedule condition, participants completed larger increments of work to gain longer access to a reinforcer. Results showed that two participants mastered the target responses with both schedules and the third participant only met mastery criterion with the continuous schedule. Preference for schedules varied across participants. Session duration was consistently shorter during the continuous work-reinforcer schedule, suggesting that continuous work-reinforcer schedules are more efficient. Participants engaged with the reinforcer less when provided longer access, suggesting that reinforcer access might be reduced with continuous schedules for further efficiency gains.

An evaluation of the observer effect on treatment integrity in a day treatment center for children.

Treatment integrity is an important concern in treatment centers but is often overlooked. Performance feedback is a well-established approach to improving treatment integrity, but is underused and undervalued. One way to increase its value to treatment centers may be to expose unrealized benefits on the observer who collects the performance feedback data. This "observer effect" could increase the value of performance feedback and promote more consistent evaluation of treatment integrity. The purpose of this investigation was to evaluate the observer effect on treatment integrity. Five supervisors who worked in a day treatment center were asked to collect performance feedback data on staff members' integrity in following a standard treatment protocol that supervisors were also expected to follow. Results showed an immediate and marked improvement in treatment integrity in three supervisors who collected but never received performance feedback. For two supervisors, this effect was reversed and replicated. Implications are discussed.

Use of video eyewear to manage distress in children during restorative dental treatment.

PURPOSE: The purpose of this study was to evaluate the effectiveness of video eyewear in reducing disruptive behavior in a typical pediatric dental population during restorative treatment appointments. METHODS: One hundred twenty-eight 4- to 16-year-olds were recruited from a continuous sample of patients seen in an urban dental clinic. Direct observations of distress, self-reported measures of pain, and patient satisfaction were obtained in a randomized clinical trial comparing 2 different types of glasses: (1) wraparound video eyewear; and (2) sunglasses (typical treatment in this dental clinic). RESULTS: Analyses of covariance, using treatment condition (control vs experimental) as the primary independent variable and controlling for the effects of age, found that children wearing video eyewear glasses demonstrated significantly less disruptive behavior than those in the control group and that they liked their eyewear significantly better than those wearing the regular sunglasses. CONCLUSIONS: Wraparound video eyewear can be an effective approach to managing distress in children undergoing restorative dental treatment.

Visual performance feedback: effects on targeted and nontargeted staff.

This study used a multiple baseline with reversal design to assess whether visual performance feedback (VPF) influenced targeted and nontargeted staffs' use of behavior-specific praise (BSP) in a day-treatment program. This study expands on the typical VPF audience and assesses whether VPF can be effective with noncertified staff in a day-treatment program for young children with behavior disorders, an environment in which it is difficult to maintain high rates of BSP. In previous school-based studies, VPF has been collected by researchers and provided to targeted teaching staff. In the current study, rather than relying on researchers, the authors used staff instructors to collect VPF and assessed how that experience influenced the instructors' use of BSP. Results suggest that VPF provided, on average, a doubling in rates of BSP use by directly targeted staff and more than a 50% increase in rates of BSP in nontargeted instructors who collected BSP data. Furthermore, three of the four participants had substantially higher praise-to-correction ratios during the VPF intervention when compared with baseline and reversal conditions. Implications for improving treatment fidelity and reducing supervision time are discussed.

Use of audio cuing to expand employment opportunities for adolescents with autism spectrum disorders and intellectual disabilities.

We evaluated audio cuing to facilitate community employment of individuals with autism and intellectual disability. The job required promoting products in retail stores by wearing an air-inflated WalkAround® costume of a popular commercial character. Three adolescents, ages 16-18, were initially trained with video modeling. Audio cuing was then used by an attendant who delivered prompts regarding when to perform job skills. The two interventions were evaluated in an interrupted time series withdrawal design during training and then again in an actual job setting. Results show video modeling was not effective. However, the audio cuing produced job performances well above the designated criteria during training and when on the job. These changes were replicated with each participant, demonstrating clear experimental control. The changes proved statistically significant as well. Participants and parents reported high job satisfaction. The challenges of competitive employment for individuals with autism and intellectual disabilities are discussed.

Evaluation of two instruction methods to increase employment options for young adults with autism spectrum disorders.

We evaluated the efficacy of a vocational training program including behavioral skills training, and a "performance cue system" (i.e., a proprietary iPhone application adapted for the study) to teach targeted social-vocational skills to six young adults with an Autism Spectrum Disorder. In two separate studies, participants were employed to assist in the delivery of a fire safety education program. Participants were asked to wear an inflatable firefighter WalkAround® mascot costume and to perform 63 scripted behaviors in coordination with a fire prevention specialist who was the lead program presenter. In Study 1, three participants were initially exposed to established company training procedures comprised of behavioral skills training components to determine whether they met mastery of the skills. If necessary to reach criteria, participants were then exposed to a performance cue system. In Study 2, three additional participants were provided with the performance cue system alone, and then behavioral skills training if required. A single case, multiple-baseline design across subjects was used to evaluate efficacy of each intervention. Results indicate that 5 of 6 participants reached criterion only after introduction of the cue system while the sixth reached criterion with behavioral skills training alone. The program received high satisfaction ratings from participants, their parents, and consumers. Implications and potential use of the PCS in other employment settings are discussed.