Exploring the Clinical Utility of a Stimulus Avoidance Assessment to Enhance a Relaxation Training Model.

The current case study explored the clinical utility of a stimulus avoidance assessment during relaxation training with an adult with an autism spectrum disorder. A multiple stimulus without replacement procedure was implemented with aversive events to identify an aversive situation hierarchy. Aversive events were then systematically presented during the analogue phase of relaxation training across low, medium, and highly aversive events. Results support a clinical utility of using stimulus assessments to inform relaxation training, while suggesting further modifications to relaxation training protocols for generalization of skills.

Applied Behavior Analysis and the Autism Diagnostic Observation Schedule (ADOS): a Symbiotic Relationship for Advancements in Services for Individuals with Autism Spectrum Disorders (ASDs).

The Autism Diagnostic Observation Schedule (ADOS) is a widely used diagnostic tool for the assessment of autism spectrum disorders. We compared interobserver reliability scores for observers using the existing guidelines for administration of the ADOS with those of the same observers using modified guidelines that included operational definitions for each area of observation. The results indicated increased mean interobserver reliability scores from 55.83 % using the existing guidelines to 84 % when using the modified guidelines and enhanced reliability scores for 3 of 3 clients with whom the ADOS was used. The guidelines are the following: integration of a highly effective diagnostic tool with ABA, the inclusion of a diagnostic tool may promote more comprehensive ABA services, more clearly define and identify areas of concern in autism, and impact implementation efficacy and reliability of assessments for individuals with autism.

Blending Stimulus Fading Procedures with Forward Chaining to Address Treatment Resistance in an Adult with an Autism Spectrum Disorder.

The following paper details the implementation of a program to address the high-risk physical aggression and property destruction behavior of an adult male with an autism spectrum disorder (ASD) and severe aggressive behavior. A task analysis (TA) and forward chaining were combined with a stimulus fading procedure to allow the subject to be able to participate in van rides when prompted with no displays of aggressive or self-injurious behavior. A follow-up probe completed at 1-year post intervention demonstrated the maintenance of the gains that were made during treatment.

Behavioral treatment for pathological gambling in persons with acquired brain injury.

The present investigation examined a behavior-analytic clinical treatment package designed to reduce the pathological gambling of 3 individuals with acquired brain injury. A prior history of pathological gambling of each patient was assessed via caregiver report, psychological testing, and direct observation of gambling behavior. Using an 8-week one-on-one client-patient format, a treatment program was developed in which the patient learned about the antecedents, consequences, and motivating operations that controlled the emission of gambling behavior. Data were collected on both self-report of gambling urges and behavior following therapy and during in situ gambling opportunities. The therapy program reduced urges to gamble and actual gambling for all patients. The potential of behavior-analytic therapy for reducing the pathological gambling of patients with and without brain injury is discussed.

A personal intervention substance abuse treatment approach: Substance abuse treatment in a least restrictive residential model.

The following paper will detail demographic information about alcohol and substance abuse issues in the acquired brain injury (ABI) population. Included in such a review will be a systematic presentation of the current data on the incidence of such issues as well as a comprehensive treatment model with outcome data provided. Pre- and post-test measures of separate functional outcome areas were employed to assess the effects of the treatment package. The paper will document the core elements of a substance abuse treatment programme that is based upon community inclusion and positive, proactive treatment methods in facilitating decreases in substance abuse behaviour. The programme employed a host of individual and group session protocols specifically targeted at education and self-monitoring of behaviour in order to facilitate more effective self-control of addictive behaviours. The positive outcomes achieved by the participants involved in the study provide clinical justification for a proactive behavioural approach to substance abuse in the ABI population.

Using stimulus equivalence technology to teach emotion recognition to adults with acquired brain injury.

The purpose of this study was to use stimulus equivalence technology to teach emotion recognition skills to three adults with acquired brain injuries. A pre-test, post-test design was employed to test for acquisition of the facial recognition skills after training. Computer presentation of the stimuli was used. A pre-test was conducted, in which participants' abilities to expressively label facial representations of emotions and match distinct representations of emotions to other representations depicting the same emotion were examined. Next, participants received matching-to-sample training, in which they were first taught to receptively identify the facial representations of the basic emotions happiness, sadness and anger. They were then taught to receptively identify facial representations of those same emotions that were different from the first representations. When mastery criterion was attained, a post-test identical to the pre-test was presented. Results showed that the participants were able to demonstrate increased facial-emotional recognition skills after training.

Self-control and the preference for delayed reinforcement an example in brain injury.

We investigated the effects of a concurrent physical therapy activity (keeping the hand open) during delays to reinforcement in an adult man with acquired brain injuries. Once a relatively stable level of hand-open behavior was obtained, the participant was asked to choose between a small immediate reinforcer and a larger delayed reinforcer contingent on keeping the hand open at greater-than-baseline duration. Afterwards, the participant was asked to select between a larger delayed reinforcer with no hand-open requirement and the identical larger delayed reinforcer with a progressively increasing hand-open requirement. Results suggest a shift in preference to larger delayed reinforcers and an eventual preference for the hand-open requirement option.

Increasing functional rehabilitation in acquired brain injury treatment: effective applications of behavioural principles.

This paper investigated ways to increase the participation of direct care staff in the functional rehabilitation activities (FRAs) of adults with acquired brain injuries (ABIs). FRAs were rehabilitation agendas written by clinical staff for delivery by paraprofessionals. Increases in FRA completion were believed to be directly related to clinical success. These FRAs had been identified as key components in the rehabilitation programmes of the adults living within the residential facilities. Increases in FRAs were crucial in improving the quality of the rehabilitation programmes of the participants involved. The study observed four residential settings serving adults with ABIs using a multiple baseline design. The treatment approach consisted of public posting of weekly FRA documentation, incorporation of staff input, and reinforcement for documentation of FRAs. The results indicated a positive impact on the participation of staff in all of the residences in the study, consistent with implementation of the treatment package.