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1.
J Appl Behav Anal ; 57(2): 372-382, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38226687

RESUMO

Procedural extinction is sometimes associated with a temporary increase in responding known as an extinction burst. Extinction bursts present unique challenges in the context of treating behavior targeted for reduction. The present study updates the prevalence of extinction bursts using a clinical sample (N = 108) receiving treatment for targeted behavior. The prevalence of extinction bursts in our sample (24%) was consistent with that in prior literature. The extinction-burst magnitude decreased across sessions after extinction was contacted during treatment, but this sample did not demonstrate decreased persistence or magnitude of extinction bursts across successive transitions from baseline to treatment. We also examined the prevalence and magnitude of extinction bursts based on the function and topography of targeted behavior and treatment components and found no consistent relation among these variables. These findings should lead clinicians to prepare for transient extinction bursts when implementing extinction-based treatment for challenging behavior.

2.
Behav Modif ; 48(2): 111-127, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37864323

RESUMO

Past research suggests behavioral treatments are effective for challenging behavior in children and young adults with neurodevelopmental disorders, such as autism spectrum disorder (ASD). However, access to these services can be limited and require substantial resources. To address this issue, the current study provides a programmatic description of an individualized parent-mediated service model targeting moderate challenging behavior. In the program, therapists coached parents to implement functional analyses and individualized function-based treatment packages. Forty-one families of children and young adults with neurodevelopmental disorders participated. Most clients (75.6%) met all admission treatment goals and parents reported significant decreases in frequency and severity of challenging behaviors at discharge. Parents also reported less stress at discharge. Outcomes of the study suggest this parent-mediated treatment model is a viable option to treating moderate challenging behavior in children and young adults with intellectual and developmental disorders.


Assuntos
Transtorno do Espectro Autista , Criança , Adulto Jovem , Humanos , Transtorno do Espectro Autista/terapia , Desenvolvimento de Programas , Pais
3.
Perspect Behav Sci ; 46(2): 349-354, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37425987

RESUMO

In this article, the authors provide their response to the Association for Behavior Analysis International (2022) position statement on the use of contingent electric skin shock (CESS). In this response, we address concerns raised by the task force regarding limitations of the Zarcone et al. (2020) review article in which both methodological and ethical concerns were raised about the quality of research in the use of CESS with people with disabilities in the treatment of challenging behavior. We note that with the exception of the Judge Rotenberg Center in Massachusetts, no state or country currently supports the use of CESS as it is not recognized as the standard of care in any other program, school, or facility.

4.
J Am Psychiatr Nurses Assoc ; : 10783903231172997, 2023 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-37160762

RESUMO

INTRODUCTION: Autistic individuals often have comorbid medical conditions, which can increase the likelihood of being severely affected by COVID-19. The best prevention for this is vaccination. However, some autistic individuals engage in behaviors that might create a barrier to successful vaccination. AIMS: We describe the development and acceptability of a clinic specializing in the administration of COVID-19 vaccines for individuals diagnosed with autism spectrum disorder (ASD) who exhibit challenging behavior. METHOD: The clinic utilized behavioral antecedent strategies and contingencies to increase compliance with the vaccine and decrease distress associated with the procedure. RESULTS: We achieved a 100% success rate with vaccine administration and caregivers reported high satisfaction with the clinic. CONCLUSIONS: The present vaccine clinic is adaptable to various settings and patients and was well-received overall by caregivers. Replication in different geographic regions may be beneficial when resources allow for this type of clinic.

5.
Behav Anal Pract ; 16(2): 611-616, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36249891

RESUMO

Bainbridge-Ropers syndrome (BRPS) is a rare and understudied developmental disorder associated with medical (e.g., sleep disruption) and behavioral (e.g., self-injury) challenges. There are no published treatments for BRPS. We targeted self-injury in a child with BRPS using a functional analysis and differential reinforcement, with several extensions to common procedures. Results present the first example of behavioral reduction for self-injury in BRPS. • ABA strategies can reduce self-injury in BRPS • Evaluating multiply maintained self-injury following identification of an automatic function is important. • Sleep deficits may complicate assessment. Supplementary Information: The online version contains supplementary material available at 10.1007/s40617-022-00749-x.

6.
J Autism Dev Disord ; 51(8): 2866-2875, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33125623

RESUMO

Elopement is a common and dangerous concern in autism spectrum disorder (ASD). There is evidence that behavior analytic treatments can successfully treat elopement, but the research is limited due to small samples and treatment components varying across studies. The current study evaluated the feasibility of studying a manualized intervention for elopement, based on strategies from single-subject research, in a randomized clinical trial with 24 individuals with ASD. Results demonstrated that recruitment was feasible; the manual was acceptable to parents; and therapists followed the manual with high-integrity. Initial efficacy results measured by the Aberrant Behavior Checklist, Clinical Global Impression Scale, and a Home Elopement Safety Checklist suggested improvement in the treatment group that should be studied in future research.


Assuntos
Transtorno do Espectro Autista/psicologia , Transtorno do Espectro Autista/terapia , Terapia Comportamental/métodos , Pais/psicologia , Recusa do Paciente ao Tratamento/psicologia , Criança , Pré-Escolar , Estudos de Viabilidade , Feminino , Humanos , Masculino
7.
J Appl Behav Anal ; 53(1): 102-120, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-30887502

RESUMO

It is common practice in research on the treatment of problem behavior to compare levels of targeted behaviors during treatment to levels when treatment is not in place. Some researchers use data collected as part of a multielement functional analysis as the initial baseline, whereas others collect new baseline data following completion of the functional analysis. We evaluated whether the source of baseline data influences the reliability and efficiency of decision-making. Results suggest that similar decisions are made in regard to treatment efficacy using the different sources of baseline data, but using data from a multielement functional analysis as baseline may save time. Interrater agreement was adequate, but lower for some graphs than has been observed in past studies. Several potential explanations for this discrepancy are discussed.


Assuntos
Terapia Comportamental , Conjuntos de Dados como Assunto , Comportamento Problema/psicologia , Tomada de Decisão Clínica , Humanos , Reprodutibilidade dos Testes , Resultado do Tratamento
8.
Behav Modif ; 44(5): 727-745, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-30983381

RESUMO

Studies on preference assessments have shown that when both edible and leisure items are compared, edible items tend to displace leisure items in preference hierarchies. However, the mechanisms behind this process are currently unclear. One possibility is that displacement may be a product of the relatively brief periods of access to leisure items typically used in preference assessments. The purpose of the current investigation was to examine whether the duration of access to leisure items affects displacement. In this study, participants chose between preferred leisure items and the edible items that had previously been shown to displace those leisure items in a preference hierarchy. Duration of access to the leisure item was systematically increased across series to identify the magnitude at which leisure items became more preferred than edible items. Results indicate that as the duration of access to leisure items increases, displacement decreases.


Assuntos
Transtorno do Espectro Autista/fisiopatologia , Comportamento de Escolha/fisiologia , Reforço Psicológico , Adulto , Criança , Feminino , Alimentos , Humanos , Atividades de Lazer , Masculino , Fatores de Tempo , Adulto Jovem
9.
J Autism Dev Disord ; 50(3): 757-765, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31768718

RESUMO

Children with autism spectrum disorder (ASD) are often delayed in achieving bowel continence, resulting in negative outcomes. In this pilot trial, 20 children with ASD and encopresis were randomly assigned to multidisciplinary intervention for encopresis (MIE; n = 10) or a waitlist control group (n = 10). The MIE group was treated for constipation and received a 10-day behavioral intervention that utilized suppositories to produce predictable bowel movements that were reinforced. Caregivers were trained to implement the intervention. Results support the feasibility of clinical trials of MIE, with high enrolment, competition, attendance, and caregiver acceptability. Preliminary outcomes were positive, with six of 10 in the MIE group achieving continence by the end of treatment compared to 0 in the control group (p = 0.005).Registered at clinicaltrials.gov (https://clinicaltrials.gov); ID: NCT02383732.


Assuntos
Transtorno do Espectro Autista/complicações , Terapia Comportamental/métodos , Encoprese/terapia , Fármacos Gastrointestinais/uso terapêutico , Adolescente , Criança , Pré-Escolar , Terapia Combinada/métodos , Encoprese/complicações , Encoprese/tratamento farmacológico , Feminino , Fármacos Gastrointestinais/administração & dosagem , Humanos , Masculino , Projetos Piloto , Supositórios/uso terapêutico
10.
J Sch Psychol ; 69: 45-55, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30558753

RESUMO

Prior research on treatment integrity has focused either on the lack of measurement of the independent variable or on methods to increase overall levels of treatment integrity. Little research has focused on the effectiveness of common interventions when implemented with less than perfect integrity. The current investigation evaluated the effectiveness of using differential reinforcement of alternative behavior (DRA) and prompting to increase math completion for 36 early elementary students. Treatment was evaluated when both components were implemented, when only reinforcement was implemented, when only prompting was implemented, and when neither was implemented. In addition, preferences for either attention or escape and order-effects of conditions were evaluated. Results indicated treatment was effective at all levels of implementation compared to baseline. However, when preferences for escape and attention were evaluated, analysis revealed individuals who preferred escape responded best when both treatment components were implemented, whereas for individuals who preferred attention, all treatment conditions were equally effective. In addition, results evaluating order effects indicated that exposure to either prompting or reinforcement prior to baseline significantly increased math completion as well as exposure to reinforcement in the first condition.


Assuntos
Terapia Comportamental/métodos , Transtornos do Comportamento Infantil/terapia , Motivação , Reforço Psicológico , Atenção , Criança , Transtornos do Comportamento Infantil/psicologia , Pré-Escolar , Feminino , Humanos , Masculino , Pesquisa
11.
Am J Intellect Dev Disabil ; 123(6): 558-573, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30421967

RESUMO

Smith-Magenis syndrome (SMS) is a genetic disorder, commonly caused by a 17p11.2 deletion, affecting the Retinoic Acid Induced 1 gene. It affects approximately 1 in 25,000 individuals, with over 90% engaging in challenging behaviors. Function-based treatments, using the principles of applied behavior analysis, have consistently been shown to decrease challenging behaviors exhibited by individuals with developmental delays. However, additional research is needed to determine the effects of these interventions with specific diagnostic subsets, including SMS. The current study identified the function of challenging behavior for 2 children with SMS and found a function-based treatment, consisting of differential reinforcement and extinction, reduced challenging behavior for both.


Assuntos
Terapia Comportamental/métodos , Deficiências do Desenvolvimento , Comportamento Problema , Reforço Psicológico , Síndrome de Smith-Magenis , Adolescente , Pré-Escolar , Deficiências do Desenvolvimento/etiologia , Deficiências do Desenvolvimento/fisiopatologia , Deficiências do Desenvolvimento/reabilitação , Extinção Psicológica/fisiologia , Feminino , Humanos , Masculino , Síndrome de Smith-Magenis/complicações , Síndrome de Smith-Magenis/fisiopatologia , Síndrome de Smith-Magenis/reabilitação , Resultado do Tratamento
12.
Dev Neurorehabil ; 21(5): 336-344, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29652207

RESUMO

Children with developmental disabilities (DD) are more likely than typically developing peers to have issues with enuresis. Past research has shown the success of behavioral treatments consisting of scheduled sits and reinforcement for continent voids. However, this research has included small sample sizes, while studies with larger numbers have lacked key information (i.e., baseline rates and follow-up data to evaluate maintenance and generalization). The current study conducted a consecutive case series analysis of 44 individuals with developmental disabilities who completed a 2-week program for enuresis. Results showed significant improvement in continent voids and follow-up data suggested positive results maintained when treatment was implemented by caregivers in a home environment.


Assuntos
Terapia Comportamental/métodos , Deficiências do Desenvolvimento/reabilitação , Enurese/terapia , Criança , Pré-Escolar , Deficiências do Desenvolvimento/complicações , Enurese/etiologia , Feminino , Humanos , Masculino , Reforço Psicológico
13.
Int J Dev Disabil ; 65(4): 265-276, 2018 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-34141347

RESUMO

Objectives: Evaluations of treatments using applied behavior analysis (ABA) for challenging behavior have relied mostly on direct behavioral observation. While observation is crucial, qualitative information can also be beneficial. In this study, we describe methods for using qualitative information in ABA treatments for challenging behavior. Method: Three participants were undergoing treatment for challenging behavior. Information was collected through caregiver interviews at the start and end of the admission. Directed content analysis identified themes in the interviews and we compared treatment outcomes using qualitative and quantitative measures. Results: Three themes emerged: description, frequency, and impact of the behavior. Quantitative and qualitative measures both suggested successful interventions for two participants. For the third, direct observation suggested treatment was effective while caregiver report did not. Conclusion: Incorporation of qualitative information into outcomes allowed for a more comprehensive view of treatment success and guided assessment and treatment decisions. Treatments based on applied behavior analysis (ABA) are commonly studied for the treatment of challenging behavior, but these studies rely mostly on direct behavioral observation. While observation is crucial, qualitative information is also useful in ensuring meaningful results. In this study, we describe a method of collecting, analyzing, and using qualitative information collected from caregivers and compare qualitative to quantitative outcomes.

14.
J Appl Behav Anal ; 50(2): 278-289, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28332715

RESUMO

We taught three children with visual impairments to make tactile discriminations of the braille alphabet within a matching-to-sample format. That is, we presented participants with a braille character as a sample stimulus, and they selected the matching stimulus from a three-comparison array. In order to minimize participant errors, we initially arranged braille characters into training sets in which there was a maximum difference in the number of dots comprising the target and nontarget comparison stimuli. As participants mastered these discriminations, we increased the similarity between target and nontarget comparisons (i.e., an approximation of stimulus fading). All three participants' accuracy systematically increased following the introduction of this identity-matching procedure.


Assuntos
Discriminação Psicológica/fisiologia , Leitura , Auxiliares Sensoriais , Ensino , Tato/fisiologia , Transtornos da Visão/reabilitação , Pré-Escolar , Desenho Assistido por Computador , Feminino , Humanos , Masculino , Resultado do Tratamento , Transtornos da Visão/psicologia
15.
J Appl Behav Anal ; 50(2): 332-344, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28211576

RESUMO

Achieving continence of one's bowel movements is a key step in development and failure to do so leads to many negative consequences. Treatments for encopresis appearing in the literature have employed behavioral strategies; medications such as suppositories, laxatives, or enemas; and in some studies a combination of these approaches. To date, attempts to extend successful treatments for encopresis in typically developing children to those with developmental disabilities have been limited. The current study included three participants diagnosed with developmental disabilities who had a history of encopresis. None of the participants had a continent bowel movement under baseline conditions. Continent bowel movements increased during treatment that included the addition of suppositories to elicit continent bowel movements. Two participants began having independent continent bowel movements (i.e., without requiring suppositories) and medication was successfully faded out for the remaining participant. Treatment took between 13 and 21 days.


Assuntos
Terapia Comportamental/métodos , Deficiências do Desenvolvimento/complicações , Encoprese/etiologia , Encoprese/terapia , Criança , Deficiências do Desenvolvimento/psicologia , Deficiências do Desenvolvimento/reabilitação , Humanos , Masculino , Avaliação de Resultados em Cuidados de Saúde
16.
J Atten Disord ; 21(12): 1030-1039, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25319163

RESUMO

OBJECTIVE: There is a lack of empirically supported treatments for college students with ADHD and academic deficits. The current study evaluated self-monitoring, an intervention that may improve academics in children with ADHD, with a college sample diagnosed with ADHD. METHOD: Fifty-three participants were recruited, 41 of which completed the study and are included in the analyses. Participants were randomly assigned to a group that received study skills instruction, goal setting, and self-monitoring instruction (SM+ group; n = 22) or a group that received only study skills and goal setting (SM- group; n = 19). RESULTS: Participants in the SM+ group demonstrated significant improvement in their ADHD symptoms, academic behavior, grade point averages (GPAs), and goal attainment. These improvements were not significant for the SM- group. CONCLUSION: These findings suggest that self-monitoring might be used to improve academic performance in college students with ADHD.


Assuntos
Desempenho Acadêmico , Logro , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Estudantes/psicologia , Habilidades para Realização de Testes , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Criança , Feminino , Humanos , Masculino , Universidades
17.
Autism ; 21(3): 375-379, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-27178995

RESUMO

The external validity of behavioral treatments for elopement (i.e. leaving supervision without permission) remains unclear because studies to date include only small samples ( n = 1-3). This study quantified the overall effectiveness of behavioral treatments for elopement by retrospectively examining treatment data from all patients seen for the treatment of elopement at an intensive day treatment clinic ( n = 11), irrespective of treatment success. Reductions in elopement from baseline to the final treatment for each participant demonstrate that behavioral intervention is a highly effective treatment for elopement, as determined by the large effect size (Cohen's d = 1.18).


Assuntos
Absenteísmo , Transtorno do Espectro Autista/terapia , Terapia Comportamental/métodos , Deficiências do Desenvolvimento/terapia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Estudos Retrospectivos , Resultado do Tratamento
18.
J Appl Behav Anal ; 49(4): 900-914, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27469462

RESUMO

Unlike potential tangible positive reinforcers, which are typically identified for inclusion in functional analyses empirically using preference assessments, demands are most often selected arbitrarily or based on caregiver report. The present study evaluated the use of a demand assessment with 12 participants who exhibited escape-maintained problem behavior. Participants were exposed to 10 demands, with aversiveness measured by average latency to the first instance of problem behavior. In subsequent functional analyses, results of a demand condition that included the demand with the shortest latency to problem behavior resulted in identification of an escape function for 11 of the participants. In contrast, a demand condition that included the demand with the longest latency resulted in identification of an escape function for only 5 participants. The implication of these findings is that for the remaining 7 participants, selection of the demand for the functional analysis without using the results of the demand assessment could have produced a false-negative finding.


Assuntos
Terapia Comportamental/métodos , Transtornos Mentais/psicologia , Transtornos Mentais/reabilitação , Comportamento Problema/psicologia , Reforço Psicológico , Adolescente , Atenção , Criança , Feminino , Humanos , Masculino , Transtornos Mentais/diagnóstico , Jogos e Brinquedos , Reprodutibilidade dos Testes , Adulto Jovem
19.
J Appl Behav Anal ; 48(4): 907-11, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26223787

RESUMO

When self-restraint and self-injurious behavior (SIB) co-occur, self-restraint might be maintained by negative reinforcement through the removal of SIB. The current study evaluated this possibility with an individual who exhibited hand-to-head SIB. Three functional analyses of SIB were conducted: (a) no consequences for self-restraint, (b) self-restraint blocked, and (c) hypothesized aversive effects of SIB blocked. The outcomes of the 3 analyses suggested that self-restraint was maintained by negative reinforcement.


Assuntos
Terapia Comportamental/métodos , Síndrome de Down/psicologia , Motivação/fisiologia , Reforço Psicológico , Restrição Física/psicologia , Comportamento Autodestrutivo/etiologia , Criança , Síndrome de Down/complicações , Feminino , Humanos , Deficiência Intelectual/complicações , Deficiência Intelectual/reabilitação , Avaliação de Resultados em Cuidados de Saúde
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