Prefrontal Cortex Responses to Social Video Stimuli in Young Children with and without Autism Spectrum Disorder.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder affecting individuals worldwide and characterized by deficits in social interaction along with the presence of restricted interest and repetitive behaviors. Despite decades of behavioral research, little is known about the brain mechanisms that influence social behaviors among children with ASD. This, in part, is due to limitations of traditional imaging techniques specifically targeting pediatric populations. As a portable and scalable optical brain monitoring technology, functional near infrared spectroscopy (fNIRS) provides a measure of cerebral hemodynamics related to sensory, motor, or cognitive function. Here, we utilized fNIRS to investigate the prefrontal cortex (PFC) activity of young children with ASD and with typical development while they watched social and nonsocial video clips. The PFC activity of ASD children was significantly higher for social stimuli at medial PFC, which is implicated in social cognition/processing. Moreover, this activity was also consistently correlated with clinical measures, and higher activation of the same brain area only during social video viewing was associated with more ASD symptoms. This is the first study to implement a neuroergonomics approach to investigate cognitive load in response to realistic, complex, and dynamic audiovisual social stimuli for young children with and without autism. Our results further confirm that new generation of portable fNIRS neuroimaging can be used for ecologically valid measurements of the brain function of toddlers and preschool children with ASD.

"They Have Shown Me It Is Possible to Thrive within STEM": Incorporating Learning Assistants in General Chemistry Enhances Student Belonging and Confidence.

Students often experience social and psychological barriers to success in General Chemistry, which is a key gateway to many students' science pathways. Learning assistants (LAs) have the potential to reduce these barriers and to strengthen students' sense of belonging in General Chemistry and STEM more broadly. Here, we used a 17-item Likert scale to determine whether incorporating LAs into General Chemistry I and II enhances students' sense of belonging in these courses. The incorporation of LAs into General Chemistry I had a significant positive effect and a medium to large effect size for students in all student groups examined: women and men; students in both racially and ethnically underrepresented and well-represented groups; first- and continuing-generation students. In General Chemistry II, similar results were observed for women and men; students in well-represented racial and ethnic groups; continuing-generation students. Further, we asked students to reflect on the impact that working with LAs had on their sense of belonging in STEM and confidence in talking about science. Sixty percent of students indicated that working with LAs had a positive impact on their STEM belonging, with five themes describing LA impacts: reducing isolation, serving as inspirational role models, providing mentoring, increasing opportunities for engagement and confidence building, and serving as accessible and approachable sources of support. Sixty-one percent of students also indicated that working with LAs increased their confidence in talking about science, with three themes emerging: fostering an environment with a lower risk of negative judgment, providing increased opportunities for feedback, and supporting students as they practiced their growing skills. Together, these results indicate that LAs can be an important means to reduce social and psychological barriers for students in gateway science courses, increasing their sense that they belong to the class and STEM more broadly.

Teaching children to identify and avoid food allergens using behavioral skills training.

Allergic reactions to allergenic foods can pose a lethal threat to children with food allergies. Previous research has demonstrated the effectiveness of using behavioral skills training (BST) plus in situ training (IST) to teach safety responses to children. However, there has not been an evaluation of using BST to teach food safety to children with food allergies. Three elementary-school children of neurotypical development with food allergies participated. We evaluated the efficacy of BST with IST in teaching participants to identify and respond to allergenic foods by (a) asking to see the food packaging, (b) scanning the food label for the allergenic food, and (c) reporting the safety threat to an adult while not consuming the food. Trials without allergenic foods were also presented to ensure discriminated responding. All participants demonstrated the three correct safety responses after BST and responded differentially across allergenic and nonallergenic foods, with two participants requiring feedback (IST).

The influence of video-based training on caregiver arrangement of infant sleeping environments.

Recent behavior analytic studies have examined behavioral skills training to teach adults to arrange safe infant sleeping environments. These studies were conducted in an analogue environment and with all training components delivered by an expert staff trainer. The purpose of the current study was to replicate and extend this literature by substituting video-based training for behavioral skills training. We assessed whether expectant caregivers could arrange safe infant sleeping environments following video-based training. The results suggested that video-based training alone resulted in positive outcomes for a portion of participants, whereas a subset of participants required feedback to reach mastery criteria. The social validity data suggest that the participants found the training procedures favorable.

Experiences of Parental Presence in the Induction of Anesthesia in a Canadian Tertiary Pediatric Hospital: A Cross-Sectional Study.

Background Parental presence at induction of anesthesia remains controversial and has been reported to provide mixed results. As such, parental presence at induction of anesthesia is not practiced routinely everywhere. There are currently limited data describing the practice of parental presence at induction of anesthesia or the experiences and perceptions of parents in Canada. Objectives We sought to investigate (1) the frequency of parental presence at induction of anesthesia and (2) the experiences and perceptions of parents accompanying their child into the operating room compared to those who did not at a tertiary Canadian pediatric hospital. Methods Institutional quality improvement approval was obtained. This study was a cross-sectional survey. Parents waiting in the parent surgical waiting room during the procedure were invited to complete a web-based survey. Consent was implied via completing the survey. The cross-sectional survey elicited the prevalence of parental presence during induction of anesthesia as well as their experience and perceptions. We also investigated the parents' preferences for preoperative education. Results Of the 448 parents approached, 403 completed the survey between May and June 2017. Sixty-eight (16.9% [13.4-20.9]) parents accompanied their child into the operating room (parental presence at induction of anesthesia), while 335/403 (83.1% [79.1-86.7]) did not (no-parental presence at induction of anesthesia). Reasons for not accompanying their child into the operating room included "not being aware they could" (158/335, 47.2% [41.9-52.5]), "I didn't think my child needed me" (107/335, 31.9% [27.2-37.1]), "my child was coping well" (46/335, 13.4% [10.5-17.8]), and "I was anxious" (47/335, 14.0% [10.7-18.2]). Most of the parents in the parental presence at induction of anesthesia cohort (66/67, 98.5% [95.6-101.2]) reported that they believed their child benefited/would have benefited from their presence during induction of anesthesia compared to those in the no-parental presence at induction of anesthesia cohort (137/335, 40.9% [35.8-46.2]), P < 0.001. Overall, 51/335 (14.7%) parents in the no-parental presence at induction of anesthesia cohort and 3/67 (4.5%) of those in the parental presence at induction of anesthesia cohort felt that offering parental presence at induction of anesthesia should depend on factors including child's age as well as the level of coping and anxiety. More patients in the no-parental presence at induction of anesthesia cohort felt that parental presence at induction of anesthesia should also depend on the child's age and whether the child was coping. Parents felt that face-to-face discussions with clinicians are most effective for discussing future parental presence at induction of anesthesia. Conclusions We have shown that most parents at our institution do not undergo parental presence at induction of anesthesia and are for the most part comfortable with their child going unaccompanied into the operating room. Administrators and clinicians seeking to implement parental presence policies should consider navigating parental presence at induction of anesthesia with evidence-based approaches tailored to each parent and their child.

Evaluating caregivers arrangement of infant sleeping environments in the home.

Sleep-related infant deaths are one of the top causes of infant mortality in the United States. A few behavior analytic studies have examined behavioral skills training to teach adults to arrange safe infant sleeping environments. These studies were conducted in an analogue environment, and no data were collected outside the training setting. The purpose of the current study was to replicate and extend the extant literature. We taught caregivers to arrange safe infant sleeping environments in a community-based organization. Thereafter, we assessed the feasibility and effectiveness of a technology-based contingency management procedure to examine caregivers' adherence with arrangement of a safe sleeping environment for their newborns across a 2-week period. As in previous studies, behavioral skills training resulted in positive outcomes, and follow-up data suggested that the technology-based contingency management procedure may be a promising approach to promoting adherence with infant sleeping environment recommendations.

Training medical students to teach safe infant sleep environments using pyramidal behavioral skills training.

Medical personnel play a critical role in caregiver safe infant sleep education. However, training outcomes in the safe infant sleep training literature have been mixed. Promising approaches that warrant further investigation are the use of behavioral skills training and pyramidal training. The current study consisted of two experiments. Experiment 1 extended Carrow et al. (2020) and Vladescu et al. (2020) by teaching medical students safe infant sleep practices using behavioral skills training. Discriminated responding was examined across trained and untrained environmental arrangements using a multiple-baseline design. All participants arranged safe sleep environments following behavioral skills training. In Experiment 2, we used pyramidal behavioral skills training to train medical students to teach others safe sleep practices. Results indicated high procedural integrity scores following training and generalization of skills.

"It made me feel like a bigger part of the STEM community": Incorporation of Learning Assistants Enhances Students' Sense of Belonging in a Large Introductory Biology Course.

Large introductory science courses are a particularly important and challenging target for creating inclusive learning environments. In this study, we examined the impact of incorporating learning assistants (LAs) on the learning environment in an introductory biology course taught with two different structures: an in-person lecture with intermittent active-learning components and an online setting taught with a flipped instructional approach. Using a survey that measured sense of belonging in a single class, we found that students in sections with LAs reported greater sense of belonging than students in sections without LAs in both class structures. Further, student focus groups revealed that LAs promoted learning and engagement in the class by answering questions and providing clarity; allowing more use of active- and interactive-learning structures; and serving as accessible, approachable, and immediate sources of help. Student responses also indicated that LAs promoted a sense of belonging in science, technology, engineering, and mathematics (STEM) by decreasing feelings of isolation, serving as inspirational role models, clarifying progression through the STEM educational system, and helping students become more engaged and confident in their STEM-related knowledge and skills. These findings indicate that LAs can support multiple elements of inclusive STEM learning environments.

Using Adaptive Computer-based Instruction to Teach Staff to Implement a Social Skills Intervention.

This study evaluated the effectiveness of an adaptive, computer-based staff training software program called Train-to-Code (TTC) to teach the administration of a social skills intervention. The software program actively trained participants to identify whether video models illustrated each step of the procedure effectively or ineffectively. Multiple exemplars of each step of the social skills task analysis were represented. Most-to-least prompting as well as feedback and error correction were embedded into the software program and prompts were faded through seven levels as the participant reached criterion accuracy. A multiple-probe across participants design was used to evaluate the effectiveness of this program by comparing pre- and post-training in vivo probes conducted with a confederate learner. All participant scores increased from pre-training to post-training, indicating that Train-to-Code was effective at teaching administration of the social skills intervention. These results have implications for training staff in applied community settings. Due to Train-to-Code's ability to be internet-based and to measure actual viewing performance, it has the potential for "distance training" deliveries.

Safe to sleep: Community-based caregiver training.

Annually, thousands of infant deaths are classified as sudden unexpected infant deaths (SUIDs). In an effort to reduce the risk of SUIDs, the American Academy of Pediatrics has made a number of recommendations to educate caregivers, childcare providers, and healthcare professionals on safe infant sleep practices. The purpose of the current study was to extend the literature on safe infant sleep practices by teaching caregivers to arrange safe infant sleep environments using a mannequin and common infant items. We partnered with community-based agencies to evaluate the effectiveness of behavioral skills training delivered in a single training session as part of the ongoing pre- or postnatal care these agencies provided. Following training, all participants demonstrated a substantial change in responding and returned favorable social validity ratings. We discuss these outcomes in light of previous studies, limitations, and future directions.

Infant positioning: A brief review.

The American Academy of Pediatrics (2016a) has made several recommendations regarding the safe positioning of infants by caregivers, including placing infants in a supine position for sleep and in prone for supervised periods of tummy time. However, caregivers may have difficulty adhering with these recommendations. A small, but growing, number of behavior analytic studies have examined these infant safety recommendations and strategies for increasing adherence. This review describes behavior analytic research on infant positioning and provides suggestions for future research.

Teaching an Adult With Autism Spectrum Disorder to Use an Activity Schedule During a Vocational Beekeeping Task.

Recent federal legislation passed supports investment in sustainable green jobs. Beekeeping is one type of sustainable vocation. Activity schedules have shown effectiveness in increasing the independence of children with autism engaged in various tasks. This study investigated the effects of a treatment package consisting of an activity schedule plus contingent reinforcement on increasing the number of steps completed independently by an adult with autism employed at an apiary. The data demonstrate that the treatment package led to a higher percentage of steps completed correctly.

Behavior Skills Training with Voice-Over Video Modeling.

The present study used behavior skills training (BST) to teach three adult participants to implement a video modeling intervention aimed at teaching social skills to adults with autism spectrum disorder (ASD). During baseline trials, participants were given access to written instructions before role-play with two actors (who simulated a quiet conversation) and one confederate (who played the role of an adult with ASD). During treatment, participants were given a video model with voiceover instruction depicting how to implement the video modeling intervention to teach social skills, repeated roleplay trials, and feedback following their performance. All participant scores (percentage of steps correctly implemented in each session) increased from baseline to treatment, and generalization was demonstrated with an actual consumer diagnosed with ASD. Additionally, after training participants to use a video model to teach one social skill, there was generalization to teaching as many as three additional novel social skills. Participants showed maintenance of skills during a treatment study that involved training adult clients with ASD to engage in the social skills.

A randomized controlled trial of amitriptyline versus gabapentin for complex regional pain syndrome type I and neuropathic pain in children.

BACKGROUND: Treatment of neuropathic pain in children is challenging, and requires a multimodal approach of pharmacologic, physical, and psychological therapies; however there is little evidence to guide practice. Amitriptyline and gabapentin are first-line drugs for treating neuropathic pain in adults, yet no studies have examined their efficacy, or compared them directly, to determine which might be better for pain relief and sleep disturbance in children. METHODS: After informed consent was obtained, 34 patients aged 7-18 years diagnosed with complex regional pain syndrome type I (CRPS I) or a neuropathic pain condition were randomly allocated to receive either amitriptyline or gabapentin. Patients were followed for 6 weeks and assessed for pain intensity, sleep quality and adverse events. We blinded study personnel, including health-care providers, participants, parents, the research coordinator and the data analyst. Patients then completed quantitative sensory testing (QST) and a psychosocial pain assessment with the team psychologist, within 1-3 days of the start of the trial. RESULTS: At the end of the 6-week trial, patients on both drugs had important reductions in pain, having surpassed the minimally important difference (MID) of 1. The difference between the groups however was not statistically significant. For the secondary outcomes, we found no statistically significant difference between the two drugs in sleep score or adverse events suggesting that both drugs improve sleep score to a similar degree and are equally safe. CONCLUSIONS: Amitriptyline and gabapentin significantly decreased pain intensity scores and improved sleep. There were no significant differences between the two drugs in their effects on pain reduction or sleep disability. IMPLICATIONS: Although larger, multi-centred trials are needed to confirm our findings, including long-term follow-up, both drugs appear to be safe and effective in treating paediatric patients in the first-line treatment of CRPS I and neuropathic pain over 6-weeks.

Teaching helping to adolescents with autism.

This study is a replication and extension of Reeve, Reeve, Townsend, and Poulson (2007) evaluating the effects of a treatment package that included multiple-exemplar training, video modeling, prompting, and reinforcement on helping of 3 adolescents with autism. Results demonstrated that all participants acquired the helping responses. Probes before and after intervention also demonstrated generalization of helping across settings and categories of helping behavior.

Are inner context factors related to implementation outcomes in cognitive-behavioral therapy for youth anxiety?

Among the challenges facing the mental health field are the dissemination and implementation of evidence-based practices. The present study investigated the relationships between inner context variables (i.e., adopter characteristics and individual perceptions of intra-organizational factors) and two implementation outcomes-independently rated therapist fidelity on a performance-based role-play (i.e., adherence and skill) and self-reported penetration of cognitive behavioral therapy for youth anxiety following training. A significant relationship was found between inner context variables and fidelity. Specifically, adopter characteristics were associated with adherence and skill; individual perceptions of intra-organizational factors were associated with adherence. Inner context variables were not associated with penetration. Future directions are discussed.

Context dependence of students' views about the role of equations in understanding biology.

Students' epistemological views about biology--their ideas about what "counts" as learning and understanding biology--play a role in how they approach their courses and respond to reforms. As introductory biology courses incorporate more physics and quantitative reasoning, student attitudes about the role of equations in biology become especially relevant. However, as documented in research in physics education, students' epistemologies are not always stable and fixed entities; they can be dynamic and context-dependent. In this paper, we examine an interview with an introductory student in which she discusses the use of equations in her reformed biology course. In one part of the interview, she expresses what sounds like an entrenched negative stance toward the role equations can play in understanding biology. However, later in the interview, when discussing a different biology topic, she takes a more positive stance toward the value of equations. These results highlight how a given student can have diverse ways of thinking about the value of bringing physics and math into biology. By highlighting how attitudes can shift in response to different tasks, instructional environments, and contextual cues, we emphasize the need to attend to these factors, rather than treating students' beliefs as fixed and stable.

Electrospinning of poly(ethylene-co-vinyl alcohol) fibers.

Solutions of poly(ethylene-co-vinyl alcohol) or EVOH, ranging in composition from 56 to 71 wt% vinyl alcohol, can be readily electrospun at room temperature from solutions in 70% 2-propanol/water (rubbing alcohol). The solutions are prepared at 80 degrees C and allowed to cool to room temperature. Interestingly, the solutions are not stable at room temperature and eventually the polymer precipitates after several hours. However, prior to precipitation, electrospinning is extensive and rapid, allowing coverage of fibers on various substrates, including a grounded metal plate, dielectrics interposed between the charged jet and the metal ground, and on the human body. Fiber diameters of ca. 0.2-8.0 microm were obtained depending upon the solution concentration, an attractive range for tissue engineering, wound healing, and related applications. Electrospun EVOH mats have been shown to support the culturing of smooth muscle cells and fibroblasts.