Teaching an Infant to Request Help.

Teaching an infant manual signs is beneficial as it promotes early communication, improves socialization, and can functionally replace behaviors such as crying and whining. Improving early communication also may reduce the probability of an infant engaging in dangerous behavior, like unsafe climbing. The purpose of this study was to extend Thompson et al. (Journal of Applied Behavior Analysis 40:15-23, 2007) by teaching an 8-month-old infant, who was noted to display developmental delays, to sign for "help" when preferred items were inaccessible. Similar to Thompson et al., delayed prompting and differential reinforcement was efficacious in teaching the infant to sign for "help," and the skill generalized to situations that were previously associated with unsafe climbing. However, undesirable generalization of signs for "help" when the infant could independently access the items was observed. Additional teaching was necessary to ensure signing for "help" occurred under appropriate antecedent control. Supplementary Information: The online version contains supplementary material available at 10.1007/s40616-023-00198-9.

Evaluation of schedule thinning following treatment for aggression maintained by access to higher level restrictive and repetitive behavior.

One of the diagnostic characteristics of individuals with autism spectrum disorders includes engaging in restricted and repetitive behavior. Research has shown that individuals will often display problem behavior when access to restricted and repetitive behavior is blocked. The purpose of the current study was to evaluate the use of functional communication training and schedule thinning to treat aggression displayed by three children diagnosed with autism spectrum disorders when higher level restrictive and repetitive behavior was blocked. Further, we assessed whether all steps in a schedule-thinning sequence were necessary as well as extended the practicality of these procedures by removing the continuous signal during the delay to reinforcement. The results indicated that functional communication with schedule thinning reduced aggression related to blocking access to engaging in higher level restrictive and repetitive behavior for all participants.

A Comparison of Baseline Procedures in Task Analyses.

Several methods for assessing baseline performance in chained tasks have been outlined in the literature, including the fixed-opportunity probe (FOP) and the multiple-opportunity probe (MOP). Concerns have been raised regarding how each of these methods might change the baseline performance of a task, affecting the interpretation of experimental control. The purpose of the current study was to conduct a within-subject comparison of both the FOP and MOP procedures for children with autism performing daily living and self-care skills. Results indicated that, for most participants, the MOP resulted in elevated performance during baseline compared to the FOP, and that for some participants the MOP resulted in acquisition prior to direct training. Because of the possibility that the FOP might result in suppressed baseline performance, it is recommended that in most cases clinicians and researchers use the MOP when assessing baseline performance in chained tasks in order to obtain the most accurate data.

Parents Are People Too: Implementing Empirically Based Strategies During Daily Interactions.

The outcomes of the COVID-19 pandemic have resulted in decision-making related to in-person versus remote behavior-analytic service delivery. For those service providers who shifted from delivering in-person therapy to remote consultation, parents have presumably, at least at times, assumed a role similar to a registered behavior technician (RBT). We suggest that behavior analysts recommend two empirically based strategies to parents that they could incorporate into their daily lives during service disruptions: environmental enrichment and differential reinforcement of alternative behavior. We provide examples of naturally occurring contexts during which parents could integrate these procedures: (1) self-care or daily living activities, (2) physical activity, and (3) preferred learning activities. We support selecting these strategies and their application during exemplar contexts under the premise that they do not result in additional time expenditure, afford parents opportunities to complete essential (household, work-related, or personal) tasks, and still result in therapeutic gains.

Training behavior analysts to conduct functional analyses using a remote group behavioral skills training package.

Behavioral skills training (BST) is a well-established procedure used to train individuals how to perform a variety of complex skills. Previous research has used BST to train parents, teachers, and clinicians how to conduct a variety of clinical procedures, including functional analysis of problem behavior. Although this procedure has been demonstrated to be very effective, it can be time consuming and resource intensive. In the present study, 13 behavior analysts were trained to conduct functional analyses of problem behavior. All participants were employees of a multistate early intervention clinic. This staff training was conducted fully remotely, and trainers acted as child role-play partners. Participants experienced baseline, an instruction/discussion component, a post-instruction probe, group BST, and a post-BST probe. For 5 participants, in-situ probes were also conducted. All participants achieved mastery and in-situ errors were low.

A comparison of re-presentation and modified chin prompt to treat different topographies of liquid expulsion.

Treatment of one behavior in the chain of consumption might be associated with the emergence of other problematic behaviors. For example, some children with feeding disorders expel liquid. Moreover, the form in which children expel liquid might vary and influence whether a treatment to reduce liquid expulsion will result in clinically meaningful outcomes. In the current investigation, we first identified topographies of liquid expulsion (e.g., forceful, run out) for each child. We then compared and evaluated the effects of 2 procedures, a modified chin prompt and re-presentation, on the liquid expulsion of 3 children with feeding disorders. For 2 participants, expulsion decreased to clinically meaningful levels with a modified chin prompt or re-presentation. However, for 1 participant, expulsion decreased to clinically meaningful levels only when we combined the modified chin prompt and re-presentation as part of a treatment package. We discuss possible mechanisms underlying the effects of a modified chin prompt and re-presentation, in addition to areas for future research.

Further evaluation of modified-bolus-placement methods during initial treatment of pediatric feeding disorders.

Children with feeding disorders might pack or expel food when they lack the oral-motor skills, the motivation, or both, to swallow. Bolus placement directly on the tongue with a Nuk (e.g., Milnes et al., 2019) or flipped spoon (e.g., Sharp et al., 2010) is a treatment that researchers generally implement after such behavior emerges (e.g., Girolami et al., 2007). However, Wilkins et al. (2014) tested the relative efficacy of Nuk presentation and upright-spoon presentation during initial treatment of pediatric feeding disorders. In the current study, we compared the effects of (a) upright-spoon presentation; (b) Nuk presentation; and (c) flipped-spoon presentation on two product measures of swallowing: 15- and 30-s mouth clean, and expulsion during the initial treatment of feeding disorders with 5 children. We also monitored lip closure during bite presentation and following bolus placement. Nuk presentation produced the highest levels of mouth clean and the lowest rates of expels relative to upright-spoon presentation and flipped-spoon presentation. We discuss potential reasons why modified-bolus-placement methods improved feeding behavior and how measures of oral-motor skills might predict its necessity during initial treatment.

An extension of commonly used toilet-training procedures to children with autism spectrum disorder.

The current study evaluated a toilet-training treatment package described by Greer et al. (2016) with children diagnosed with autism spectrum disorder (ASD). Most of the current research on toilet-training interventions for children with ASD are replications and modifications of Azrin and Foxx (1971) or (more recently) LeBlanc et al. (2005). However, these procedures are composed of components that are not included in studies with typically developing (TD) children. For example, Greer et al. evaluated the effectiveness of three typical components within a toilet-training package, mostly with TD participants: a 30-min sit schedule, placing participants in underwear, and differential reinforcement. The primary purpose of the current study was to replicate and extend the treatment package described by Greer et al. to children with ASD. A secondary purpose was to evaluate modifications necessary for individualized toilet training when the commonly used components were ineffective. The results of Greer et al. were replicated for 11 participants with ASD in the current study, suggesting that intensive toileting interventions (e.g., interventions requiring overcorrection, reprimands, and dense sit schedules) may only be necessary for a subset of individuals with ASD.

On the definition of differential reinforcement of alternative behavior.

Differential reinforcement of alternative behavior (DRA) has a long history as a behavioral treatment. The term has usually been defined in a manner that suggests one form of behavior (usually some appropriate alternative) is reinforced, while another form of behavior (usually problem behavior) is placed on extinction. In this paper, we will suggest that DRA should not require extinction, either procedurally or by definition. Ideally, problem behavior would be placed on extinction when possible; however, when problem behavior is not or cannot be placed on extinction, the procedure used is still DRA. Thus, we propose the following definition: Providing greater reinforcement, along at least one dimension, contingent on the occurrence of one form or type of behavior, while minimizing reinforcement for another form or type of behavior.

A multicomponent approach to thinning reinforcer delivery during noncontingent reinforcement schedules.

We evaluated a noncontingent reinforcement procedure that involved initially providing three subjects with signaled, continuous access to the functional reinforcer for aggression and slowly increasing the amount of time subjects were exposed to the signaled unavailability of the reinforcer. Additionally, alternative potential reinforcers were available throughout the sessions. Results showed immediate and substantial reductions in aggression for all three subjects. The clinical utility of this intervention is discussed, and future research directions are recommended.