Differential negative reinforcement of other behavior to increase compliance with wearing an anti-strip suit.

Using a changing-criterion design, we replicated and extended a study (Cook, Rapp, & Schulze, 2015) on differential negative reinforcement of other behavior (DNRO). More specifically, educational assistants implemented DNRO to teach a 12-year-old boy with autism spectrum disorder to comply with wearing an anti-strip suit to prevent inappropriate fecal behavior in a school setting. The duration for which the participant wore the suit systematically increased from 2 s at the start of treatment to the entire duration of the school day at the termination of the study. Moreover, these effects were generalized to a new school with novel staff and persisted for more than a year. These findings replicate prior research on DNRO and further support the use of the intervention to increase compliance with wearing protective items, or medical devices, in practical settings.

A Practitioner Model for Increasing Eye Contact in Children With Autism.

Although many teaching techniques for children with autism spectrum disorder (ASD) require the instructor to gain the child's eye contact prior to delivering an instructional demand, the literature contains notably few procedures that reliably produce this outcome. To address this problem, we evaluated the effects of a sequential model for increasing eye contact in children with ASD. The model included the following phases: contingent praise only (for eye contact), contingent edibles plus praise, stimulus prompts plus contingent edibles and praise, contingent video and praise, schedule thinning, and maintenance evaluations for up to 2 years. Results indicated that the procedures increased eye contact for 20 participants (one additional participant did not require consequences). For 16 participants, praise (alone) was not sufficient to support eye contact; however, high levels of eye contact were typically maintained with these participants when therapists used combined schedules of intermittent edibles or video and continuous praise. We discuss some limitations of this model and directions for future research on increasing eye contact for children with ASD.

Decreasing Stereotypy Using NCR and DRO With Functionally Matched Stimulation: Effects on Targeted and Non-Targeted Stereotypy.

We conducted a series of studies on multiple forms of repetitive behavior displayed by four children with autism spectrum disorder. Study 1 showed that each participant's highest probability repetitive behavior persisted in the absence of social consequences, thereby meeting the functional definition of stereotypy. Study 2 showed that preferred, structurally matched stimulation decreased each participant's targeted (highest probability) stereotypy, as well as their non-targeted (lower probability) stereotypy. Study 3 showed that for three participants, non-contingent access to preferred stimulation decreased immediate and, to some extent, subsequent engagement in targeted and non-targeted stereotypy. For the fourth participant, non-contingent access to preferred stimulation decreased immediate engagement in the targeted stereotypy, but increased subsequent engagement in non-targeted stereotypy; this subsequent increase was attenuated by reducing the duration of access to the preferred stimulus. Study 4 showed that a trial-based differential reinforcement of other behavior (DRO) procedure systematically increased the period of time for which the targeted stereotypy was not displayed for three of three participants. In addition, results showed that the participants' non-targeted stereotypy either decreased or was unchanged when DRO was provided for the targeted stereotypy.

Systematic review of the effect of home modification and fall prevention programs on falls and the performance of community-dwelling older adults.

This systematic review explored the impact of fall prevention programs and home modifications on falls and the performance of community-dwelling older adults. It was conducted as part of the American Occupational Therapy Association's Evidence-Based Practice Project. Thirty-three articles were analyzed and synthesized. The strongest results were found for multifactorial programs that included home evaluations and home modifications, physical activity or exercise, education, vision and medication checks, or assistive technology to prevent falls. Positive outcomes included a decreased rate of functional decline, a decrease in fear of falling, and an increase in physical factors such as balance and strength. The strength of the evidence for physical activity and home modification programs provided individually was moderate. Implications for practice, education, and research are also discussed.