Advancing Methods in Animal-Assisted Intervention: Demonstration of Starting Points in Clinical Practice for Children with Autism Spectrum Disorder.

Therapy animals have been frequently included in interventions for children with autism spectrum disorder (ASD); however, direct and systematic procedures such as assessing preference for and reinforcing efficacy of the animals are rarely conducted. Assessing preference for stimuli is valuable when determining how to make interventions for children with ASD most effective. We conducted paired-stimulus preference assessments and follow-up reinforcer assessments to determine if a therapy dog might be an effective reinforcer. We found one third of participants preferred the dog the least, one third of participants moderately preferred the dog, and one third of participants highly preferred the dog relative to other stimuli. Furthermore, we found preference predicted reinforcing efficacy for five of six participants. We suggest clinicians systematically conduct assessments to clearly identify the role of the therapy animal, to improve quality of, and demonstrate efficacy of interventions including animals for clinical populations.

Feasibility of virtual reality behavior skills training for preservice clinicians.

Effective training procedures include behavioral skills training (BST), which involves providing written and verbal instructions, modeling of the skill, rehearsal of the skill, and feedback on the performance. This training typically involves in vivo experience in which trainees and students are exposed to risks such as proximity to infectious disease, behavioral issues such as aggression, and errors in teaching performance. Conducting BST in a virtual reality (VR) context involving virtual individuals with problem behavior may be an effective means of mitigating these risks. The purpose of this study was to examine the feasibility of training students to conduct functional communication training (FCT) in a VR environment using BST. We trained 13 preservice college students to implement FCT for attention and escape functions. We found VR BST was effective at increasing correct steps performed of FCT to mastery criterion levels with all participants. Future researchers should examine generalization and maintenance of VR BST.

Evaluation of Free-operant Preference Assessment: Outcomes of Varying Session Duration and Problem Behavior.

Previous researchers have found brief versions of preference assessments correspond to outcomes of longer preference assessments, and that varying levels of problem behavior occur in different preference assessments. Researchers conducted two studies to examine 1-, 2-, and 5-min duration outcomes of the free-operant preference assessment and evaluated the correspondence between the shorter and longer session durations and to identify frequency of problem behavior at each duration. Researchers also assessed relative reinforcing efficacy of the highest preferred stimulus from the shortest duration sessions. Moderate to high correlations were found between the 1- and 2-min sessions and 1- and 5-min sessions across six of eight participants diagnosed with autism spectrum disorder in Study 1 and two of three participants in Study 2. Furthermore, all highest preference stimuli identified in the shortest duration assessment served as reinforcers. Researchers found problem behavior generally occurred more in longer duration sessions.

Language preference and reinforcing efficacy of praise in bilingual children with disabilities.

We conducted a stimulus preference assessment to identify preference for praise delivered in English versus Spanish for bilingual students. Next, a concurrent-operant reinforcer assessment was used to evaluate the reinforcer efficacy of praise in each language. Participants showed limited to no preference for one language over another. One participant showed a slight preference for Spanish praise and Spanish praise functioned as a slightly more potent reinforcer. If a participant did not prefer a specific language of praise (i.e., undifferentiated preference or equal percentage of approaches), both languages were considered to be similarly reinforcing.

Evaluating preference for and reinforcing efficacy of a therapy dog to increase verbal statements.

The purpose of this study was to evaluate preference for and reinforcing efficacy of a therapy dog to increase verbal statements across different contingencies. Five children with autism spectrum disorder ages 3-8 years participated. Alternating treatments and reversal designs were used to compare conditions in which (a) a therapy dog was not present, (b) access to a therapy dog was noncontingent, (c) access to a therapy dog was contingent on interacting with a therapist, and (d) access to another preferred item was contingent on interacting with a therapist. Results varied across participants. Noncontingent access to the therapy dog slightly increased verbal statements for 1 participant. Contingent access to the therapy dog increased social interactions for 2 participants; however, this was the most effective intervention for only 1 participant. Practitioners should be aware that some clients may be better suited for interventions including therapy dogs than others.

Dog Phobia Intervention: A Case Study in Improvement of Physiological and Behavioral Symptoms in A Child with Intellectual Disability.

Background: Children with intellectual disability are at risk for anxiety disorders involving intense physiological reactions and risky behavioral responses. Interventions have been identified in this field; however, assessment of underlying anxiety is limited and flawed.Method: We implemented a single-subject case study using differential reinforcement to treat dog phobia in a boy with intellectual disability. We recorded elopement and compliance with goals and measured physiological expressions of stress: galvanic skin response, heart rate variability, temperature, and latency to calm down.Results: After fifteen therapy sessions, the boy decreased elopement and noncompliance considerably and showed dramatic improvements in emotional self-regulation.Conclusions: Future research should examine the utility of including biosensing measures in clinical applications and the relationship between physiological measures of anxiety and traditional questionnaires. Children with intellectual disability at risk for anxiety disorders should be tracked longitudinally to examine the effect of interventions on social-emotional well-being and self-regulation.

Evaluation of a Performance Management Intervention to Increase Use of Trial-Based Functional Analyses by Clinicians in a Residential Setting for Adults with Intellectual Disabilities.

We evaluated the effects of a performance management package on the implementation of trial-based functional analyses (TBFAs) by 6 clinical supervisors working in a large agency providing residential and day-program services to approximately 800 adolescents and adults with intellectual disabilities across 2 states using remote methods. Implementation of TBFAs increased for 5 of the 6 participants following introduction of the treatment package.

Behavioral Interventions for Inappropriate Sexual Behavior in Individuals With Developmental Disabilities and Acquired Brain Injury: A Review.

Inappropriate sexual behavior (ISB) is a common, but understudied, issue for individuals diagnosed with developmental disabilities (DD), intellectual disability (ID), and/or acquired brain injuries (ABI). We conducted a systematic review to identify, analyze, and synthesize published behavior-analytic approaches to intervention for ISB in DD, ID, or ABI populations. Twenty-three studies employing single-subject research methodology were identified and evaluated using quality indicators described by Horner et al. (2005) . Results of our analysis suggest insufficient evidence exists to consider any specific response-suppression technique an overarching treatment for decreasing ISB using the Horner et al. criteria. However, broadly speaking, behavior analytic approaches have been highly effective. Practitioners should consider function-based intervention and draw from studies identified as having strong supporting evidence.

Manipulating parameters of reinforcement to reduce problem behavior without extinction.

Differential reinforcement of alternative behavior (DRA) most often includes extinction as a treatment component. However, extinction is not always feasible and it can be counter-therapeutic if implemented without optimal treatment integrity. Researchers have successfully implemented DRA without extinction by manipulating various parameters of reinforcement such that alternative behavior is favored. We extended previous research by assessing three participants' sensitivities to quality, magnitude, and immediacy using arbitrary responses and reinforcers that maintain problem behavior. The results were used to implement an intervention for problem behavior using DRA without extinction. Our findings indicate that arbitrary responses can be used to identify individual and relative sensitivity to parameters of reinforcement for reinforcers that maintain problem behavior. Treatment was effective for all participants when we manipulated parameters of reinforcement to which they were most sensitive, and, for two participants, the treatment was less effective when we manipulated parameters to which they were least sensitive.

Further Evaluation of Presentation Format of Competing Stimuli for Treatment of Automatically Maintained Challenging Behavior.

Behavioral interventions have been effective in reducing automatically maintained skin picking for individuals with disabilities including autism spectrum disorder (ASD). A competing stimulus assessment (CSA) is typically utilized in behavioral intervention and assessment to identify potential stimuli which compete with the reinforcer for various forms of challenging behavior (CB). Treatment evaluations have validated the results of these assessments by demonstrating competing stimuli may reduce levels of CB. In Phase 1 of this study, we conducted a functional analysis (FA) to determine what variables were maintaining skin picking of an 11-year-old girl diagnosed with ASD. In Phase 2, we conducted a CSA to determine which stimulus competed the most with skin picking. In Phase 3, we utilized a multielement with reversal design to compare the effectiveness of three presentation formats: (a) single stimulus (single), (b) multiple stimuli (multiple), and (c) alternating stimuli (alternating) in reducing levels of automatically maintained CB. We found noncontingent access to a single item was the most effective intervention to decrease skin picking. This study adds to the literature on reducing CB in children with ASD by incorporating a CSA before the evaluation of different formats of delivering competing stimuli, across extended duration session times.

Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior.

Applied behavior analysts work with many populations including individuals with developmental and intellectual disabilities. Although behavior analysts have a variety of empirically supported treatments to implement when working with individuals with disabilities, sometimes, other variables may adversely impact treatment effectiveness. The degree to which problematic thoughts and feelings (private events) influence behavior may be a variable that contributes to treatment efficacy. Traditional behavior analytic services are not always equipped to successfully address the private events influencing client behavior. In such cases, it may be beneficial for behavior analysts to consider additional philosophically aligned treatments for private events. One such treatment, acceptance and commitment therapy, may be a useful tool for behavior analysts to incorporate into their toolbox in order to help clients. The purpose of this paper is to introduce behavior analysts to a potential solution to the problem of effectively addressing private events in behavior analytic services. We then propose a model for thinking about private events in relation to clients with disabilities and present a guide for taking steps to address private events in the clinical setting. We conclude this paper with a call for research and present a possible research agenda for behavior analysts.

Training residential staff and supervisors to conduct traditional functional analyses.

In this study we extended a training outlined by Iwata to behavioral technicians working for a residential service provider for adults with developmental disabilities. Specifically, we trained ten supervisors and four assistants to organize, conduct, collect data for, and interpret the results of traditional functional analyses (FA; Iwata et al.,1994). Performance was initially low and improved across all measures following training. Results extend previous FA training research by including a tangible condition and by demonstrating that individuals with little to no prior experience conducting FAs can be taught all of the skills required to autonomously conduct them in a relatively short period of time.

Training residential staff to conduct trial-based functional analyses.

We taught 6 supervisors of a residential service provider for adults with developmental disabilities to train 9 house managers to conduct trial-based functional analyses. Effects of the training were evaluated with a nonconcurrent multiple baseline. Results suggest that house managers can be trained to conduct trial-based functional analyses with a high degree of procedural fidelity.

Treating stereotypy in adolescents diagnosed with autism by refining the tactic of "using stereotypy as reinforcement".

Use of automatically reinforced stereotypy as reinforcement has been shown to be successful for increasing socially desirable behaviors in persons with intellectual disabilities (Charlop, Kurtz, & Casey, 1990; Hanley, Iwata, Thompson, & Lindberg, 2000; Hung, 1978). A component analysis of this treatment was conducted with 3 adolescents who had been diagnosed with autism, and then extended by (a) progressively increasing the quantitative and qualitative aspects of the response requirement to earn access to stereotypy, (b) arranging objective measures of client preference for contingent access to stereotypy compared to other relevant treatments for their automatically reinforced stereotypy, and (c) assessing the social validity of this treatment with other relevant stakeholders. Implications for addressing stereotypy and increasing the leisure skills of adolescents with autism are discussed.

Assessing preference for social interactions.

We examined a procedure to assess preference for social interactions in individuals with intellectual and developmental disabilities. Preferences were identified in five individuals using a paired-choice procedure in which participants approached therapists who provided different forms of social interactions. A subsequent tracking test showed that participants' approaches were under control of the form of social interaction provided as opposed to idiosyncratic features of the therapists. Results of a reinforcer assessment found that the social interaction identified as preferred also functioned as a reinforcer for all five participants.