Computer-based interventions to improve social and emotional skills in individuals with autism spectrum disorders: a systematic review.

OBJECTIVE: To review studies involving the use of computer-based interventions (CBI) to improve the social and emotional skills (e.g. emotional recognition) of individuals with autism spectrum disorders (ASD). METHODS: The use of computer-based intervention (CBI) in the treatment of autism spectrum disorders (ASD) may offer some advantages to traditional one-to-one or group instruction including easier differentiation of instruction, decreased distractions and the incorporation of an individual's relative visual learning strengths. However, the results of past research suggest varying outcomes for CBI with individuals with ASD. This review provides a systematic analysis of studies investigating CBI to improve social and emotional skills (e.g. emotion recognition) of individuals with ASD. Electronic database searches and ancestral searches were used to identify studies that met pre-determined inclusion criteria. The included studies were then summarized in terms of: (a) participant characteristics, (b) social and emotional skills targeted, (c) details of the CBI, (d) results, and (e) certainty of evidence. RESULTS: The results of these studies indicated that CBI's effect on social and emotional skills was mixed, with the majority of studies reporting unacceptable outcomes following intervention. CONCLUSIONS: Overall, this review suggests that the use of CBI to improve the social and emotional skills of individuals with ASD is a promising practice. A comparison of CBI plus tutoring and face-to-face social skills training suggests that CBI can be as effective as face-to-face instruction. Practitioners should carefully consider the preferences and existing abilities of individuals with ASD and the customizability of the software when deciding to use CBI and selecting a software program.

Behavioral intervention to treat selective mutism across multiple social situations and community settings.

We evaluated a behavioral intervention for a 9-year-old girl with selective mutism. The intervention consisted of role play and video self-modeling. The frequency of spoken initiations, responses to questions, and communication breakdowns was measured during three social situations (i.e., ordering in a restaurant, meeting new adults, and playing with new children) and in three community settings. Results demonstrated increases in spoken initiations and responses and decreases in communication breakdowns across all situations and settings.

Behavioral interventions for rumination and operant vomiting in individuals with intellectual disabilities: a systematic review.

We conducted a systematic analysis of studies that involved the treatment of rumination and operant vomiting in individuals with developmental disabilities. A total of 21 studies involving a combined 32 participants were identified and analyzed in terms of (a) participant characteristics, (b) dependent variables, (c) intervention procedures, (d) functional assessment procedures and results, (e) intervention outcomes, and (f) certainty of evidence. In comparison to previous reviews on rumination and operant vomiting, this review identified fewer studies involving punishment-based interventions and an increase in function-based reinforcement interventions. Preliminary guidelines for practitioners faced with assessing and treating these behaviors are offered and directions for future research are discussed.

Behavioral treatment of chronic skin-picking in individuals with developmental disabilities: a systematic review.

Skin-picking is a type of self-injurious behavior involving the pulling, scratching, lancing, digging, or gouging of one's own body. It is associated with social impairment, and increased medical and mental health concerns. While there are several reports showing that skin-picking is common in individuals with developmental disabilities, knowledge about effective treatment approaches is sparse. We therefore reviewed studies involving the treatment of chronic skin-picking in individuals with developmental disabilities. Systematic searches of electronic databases, journals, and reference lists identified 16 studies meeting the inclusion criteria. These studies were evaluated in terms of: (a) participants, (b) functional assessment procedures and results, (c) intervention procedures, (d) results of the intervention, and (e) certainty of evidence. Across the 16 studies, intervention was provided to a total of 19 participants aged 6-42 years. Functional assessment procedures included direct observations, analog functional analyses, and functional assessment interviews. The most commonly identified function was automatic reinforcement. Treatment approaches included combinations of differential reinforcement, providing preferred items and activities stimuli (e.g., toys), wearing protective clothing (e.g., helmets or gloves), response interruption and redirection, punishment, and extinction. Improvements in behavior were reported in all of the reviewed studies. Suggestions for future intervention research are offered.

Treatment of elopement in individuals with developmental disabilities: a systematic review.

We reviewed studies involving the treatment of elopement in individuals with developmental disabilities. Systematic searches of three electronic databases, journals, and reference lists identified 10 studies meeting the inclusion criteria. These studies were evaluated in terms of: (a) participants, (b) procedures used to assess elopement, (c) intervention procedures, (d) results of the intervention, and (e) certainty of evidence. Across the 10 studies, intervention was provided to a total of 53 participants aged 3-47 years. Assessment procedures included anecdotal staff reports, participant interviews, direct observation, and modified analog functional analysis. Intervention approaches included differential reinforcement, extinction, functional communication training, response blocking, non-contingent reinforcement, shaping, and scheduled exercise. Positive outcomes were reported in 80% of the reviewed studies. The evidence base suggests that function-based assessment (e.g. functional analysis procedures) and function-based treatments (e.g. functional communication training) may be most effective in the treatment of elopement in this population. Directions for future research are offered.