Using Antecedent and Functional Analyses to Conduct a Treatment Comparison on Echolalia

Inner speech has been linked to higher-order cognitive processes including 'theory of mind', self-awareness and executive functioning, all of which are impaired in autism spectrum disorder (ASD). Individuals with ASD, themselves, report a propensity for visual rather than verbal modes of thinking. This study explored the extent to which children with ASD used inner speech or visual imagery to support recall from short-term memory. Twenty-five children with ASD and 20 comparison children with moderate learning disabilities completed an immediate serial recall task, in which stimuli consisted of items with either phonologically similar features, visuo-spatially similar features or control items which were neither visuo-spatially nor phonologically similar. ASD and comparison participants, with verbal mental ages above 7 years, recalled phonologically similar stimuli less well than control stimuli, indicating that both groups were using inner speech to recode visually presented information into a phonological code. In contrast, those participants with verbal mental ages below 7 years, whether with ASD or not, recalled visuo-spatially similar stimuli less well than control stimuli, indicating visual rather than phonological coding. This developmental pattern mirrors that found in typically developing children. Under experimental conditions, individuals with ASD use inner speech to the same extent as individuals without ASD of a comparable mental age.

Crianças com Transtorno do Espectro Autista (TEA) costumam apresentar déficits em diversos repertórios, incluindo brincar de forma funcional. Na literatura da Análise do Comportamento Aplicada, destacaram-se pesquisas que investigaram efeitos do uso de roteiros fotográficos, representando ações com brinquedos, e outros tipos de pistas sobre o estabelecimento de desempenhos independentes em crianças com TEA. O responder sob controle de fotos foi demonstrado a partir de diferentes níveis de pistas, como instruções verbais e modelação. No entanto, os estudos prévios não isolaram os efeitos de cada uma delas. O presente estudo teve como objetivo comparar os efeitos de pistas do tipo instrução verbal e modelação em duas crianças com TEA de 10 anos, e mediante um delineamento de tratamentos alternados, quanto ao estabelecimento de ações de brincar na presença de roteiros fotográficos. As intervenções foram eficazes para o desenvolvimento de desempenhos independentes em ambas as crianças. No caso de uma delas, diferenças foram mais acentuadas, com maior eficiência da pista de modelação. Para a outra criança, não houve diferenças entre as pistas quanto a eficiência do ensino. Sondas de controle de estímulos com diferentes sequências de apresentação de fotos indicaram estabelecimento do responder sob controle das fotos.

The impairment of inhibitory control is often assumed to be the core deficit of several neurodevelopmental disorders characterized by poor impulse control. However, could the same deficit explain different clinical phenotypes? Evidence from behavioural studies is very mixed. This is partly because inhibition is a highly complex executive function. Thus, the different types of tasks that generically tap into inhibitory control are likely to provide different outcomes. Additionally, sample inhomogeneity in terms of age, comorbidity, and medical treatment are confounding factors. Therefore, to make a reliable assessment of the deficit of inhibitory control in a given disorder, the same task and samples with similar characteristics must be employed. This article reviews and discusses studies on five neurodevelopmental disorders with impaired impulse control where these criteria have been used: Tourette syndrome; obsessive-compulsive disorder; attention-deficit/hyperactivity disorder; primary motor stereotypies; and autism spectrum disorder. Overall, they suggest that the mechanisms underlying the inability to control urges are extremely heterogeneous and cannot be ascribed to a general impairment of inhibition. These findings do not support the hypothesis that inhibitory deficits represent a transdiagnostic feature of neurodevelopmental disorders with poor impulse control. WHAT THIS PAPER ADDS: The mechanisms underlying the inability to control urges in neurodevelopmental disorders are heterogeneous. Inhibition impairments cannot generally explain all neurodevelopmental disorders characterized by poor urge control.

Increasing numbers of transition-age youth with autism spectrum disorder (ASD) are pursuing postsecondary education and may benefit from interventions to support them in the college environment. The purpose of this study was to examine the efficacy of a self-monitoring application (app) to increase on-task classroom behavior of a postsecondary student with ASD. An alternating treatment design with a baseline and best treatment condition was utilized to examine the efficacy of a technology-based self-monitoring app, I-Connect. One 19-year-old male postsecondary student with ASD used the I-Connect app in a large, lecture-style introductory-level course at a public university. Self-monitoring prompts were delivered via a handheld tablet, and on-task behavior was measured using momentary time sampling. The participant demonstrated an increase in on-task behavior when using the I-Connect app. However, a functional relation between the use of the app and on-task behavior cannot be concluded due to limitations in the research design. Implications and suggestions for future research related to supporting postsecondary students with ASD using technology-based self-monitoring interventions are discussed.

All children with autism spectrum disorder (ASD) experience social difficulties but they differ with regard to the type and severity of their challenges. Potentially powerful interventions targeting social skills in children with ASD may have limited effectiveness if they are not tailored to the child's specific needs. One factor that may influence social competence is executive functioning (EF). EF may impact social competence by facilitating higher-order strategies such as emotional and cognitive regulation which are necessary for social interactions. Participants included 132 children and adolescents, aged 7-13, including 77 with ASD (M = 10.11, SD = 1.94), and 55 without ASD (M = 9.54, SD = 1.67). Caregivers completed the Behavior Rating Inventory of Executive Functioning, Version 2 (BRIEF-2) Parent Form, assessing everyday EF skills, and the Multidimensional Social Competence Scale (MSCS). Hierarchical multiple regression analyses were conducted separately for the group without ASD and the group with ASD, with MSCS entered as the dependent variables and EF indices and scales of the BRIEF-2 as the main predictor variables. EF deficits in emotional control predicted poor emotion regulation for both children with and without ASD. For the group without ASD, better emotional control and initiation skills predicted empathic concern and social knowledge, respectively. Challenges in self-monitoring significantly predicted difficulties with social inferencing and social knowledge for children with ASD. The findings highlight the importance of targeting specific EF skills that contribute to various aspects of social competence to increase the effectiveness of interventions for children with ASD. Autism Res 2020, 13: 1856-1866. © 2020 International Society for Autism Research and Wiley Periodicals LLC LAY SUMMARY: We examined whether parents' ratings of their children's higher-order thinking skills (e.g., paying attention, organizing and planning, initiating tasks, regulating emotions, self-monitoring) predicted social competence among children with and without autism spectrum disorder (ASD). For children without ASD, emotional control and initiation skills were strongly linked to their displays of empathy and social knowledge, respectively. For children with ASD, their abilities to be aware of their own behaviors and its impact on others were strongly related to their ability to interpret social cues and their social knowledge. For both groups, the ability to regulate their emotions were important predictors of their ability to modulate their emotions in social contexts.

<p>本研究旨在探究語言行為教學及語言行為結合音樂教學對三位學前泛自閉症兒童之互動式語言能力提升的成效。研究方法使用單一受試研究法之序列交替處理設計（即組合跨參與者多探測設計和交替處理設計）。本研究包括基線期、交替介入期、最佳介入期與追蹤期四階段，並依序將上述教學介入運用於三位研究參與者，以探討教學介入對目標行為的成效。研究結果顯示，兩種教學皆具有立即及短期維持互動式語言之成效，且具社會效度。就短期維持成效上而言，語言行為教學之成效較語言行為結合音樂教學佳。依研究結果所延伸的運用及建議如下：首先，教學者可應用語言行為教學及語言行為結合音樂教學，教導泛自閉症兒童互動式語言，以增進溝通及人際互動之能力；再者，設計前除應先確認學生之語速、反應速度等語言相關能力外，也應依據學生學習風格與習慣，逐步拓展互動式對話主題腳本內容；最後，將音樂作為提示時，應依學生的能力選擇適合的提示類型或方式。</p> <p> </p><p>Purpose</p> <p> Skinner regarded language as functional communicative verbal behaviors which are closely related to the environment, and thus are affected by the interaction of speakers and listeners. Different verbal behaviors obtain different specific functions, so verbal behavior can also be called verbal operants. (Barbera 2007/2012 Goldsmith, et al., 2007; LeBlanc, et al., 2006). DeVries et al. (2015) and James et al. (2015) reviewed relevant research and pointed out that using music as an intervention strategy will help children with autism to improve communication skills, language development, and social interaction. However, it is found that most studies using music as an intervention strategy focus on oral narration or active response, …etc., and there is a lack of ""thematic/topic"" interval research. When comparing international and domestic research, research in Taiwan is mostly qualitative research, quantitative research is relatively few. Feng and colleagues (2015) used the verbal behavior teaching approach to explore its effectiveness in improving the ""topic"" intraverbals of the participants. However, it was part of the behaviors focused. According to the results of social validity, there was still room for further exploration. Lim and Draper (2011) compared the effects of the verbal behavior approach, verbal behavior combined with music, and no teaching training on intraverbal behavior in preschool children with autism. However, verbal behavior combined with music was not superior to using the verbal behavior teaching approach alone. In addition, the dependent variable was the ability to continue the teacher’s unfinished sentences rather than full-sentence back-and-forth interactions. Given the above reasons, the objectives of this study included: (a) exploring the effect of the verbal behavior approach on improving thematic interactive skills of children with autism, (b) examining the effect of verbal behavior combined with music teaching approach on improving the above-mentioned behaviors, and (c) investigate which approaches (verbal behavior teaching alone or when that combined with music) would generate better results. </p> <p> Methods</p> <p> A sequential alternating treatments design (multiple probe design across participants merged with modified alternating treatment design) of single-case research was adopted in this study. The research contained baseline, alternating intervention, best intervention, and follow-up phases. The two intervention schemes are alternated according to fixed rules, and it should be collected until one of the interventions first reached 70% and was stable for 3 consecutive points. When the curves of the two teaching programs separate, the program that has not reached the standard and was not stable was stopped, and the best intervention period will be entered. The reason why the above-mentioned 70% was the decided standard was that after the researchers finished writing the dialogue scripts, they conducted tests on ordinary students and found that although most of the children could follow the scripts, not all of them could answer the rhetorical questions. In addition, taking into account that the study participant scored 1 point as long as he was able to repeat it at the second echoic prompt, so 9 points for self-response with 3 sentences (3 points * 3 = 9 points ). Besides, at least two sentences were recited for the second time. The calculation of 1/15*100% is about 70% or more, so the standard of 70% was set. For the best intervention, continue teaching with the teaching plan that first meets the standard among the two teaching plans, until it reaches the predetermined standard of 70% for three consecutive points (that is, the topic dialogue is maintained up to three rotations or more), the research participant would stop receiving the intervention and entered the follow-up one week after the end of the optimal intervention. During follow-up, the purpose of it was to confirm whether it had short-term maintenance effects following the alternating treatment period. One week after the cessation of the teaching intervention, another four weeks were conducted with the topic script of intraverbal behaviors, and then four probe assessments were also conducted. When the third research participant’s target behaviors were probed and found to reach the predetermined goals, the follow-up period assessments and the study was stopped. The participants were three preschoolers with autism. They were 5, 6, and 6 years old with suspected autism, suspected autism combined with intelligence impartment, and autism combined with attention deficit hyperactivity disorder respectively. The first two were boys and the last was a girl. Based on initiate probes, the percentage correction of interval behaviors of all participants was around forty percent. Four themes, ""games"", ""food"", ""shopping"" and ""routine"", were used to train the participants’ intraverbal behaviors. Each theme has two copies with similar dialogue content difficulties. When one copy was randomly assigned to receive verbal behavior approach alone, the other extra copy was used when the verbal behavior approach was combined with music. In addition, because preschool children may not have sufficient literacy, the three-step prompts and fading procedure were also used to facilitate the acquisition of the participants’ intraverbal behaviors. The researcher selected the melody that the participants are familiar with, integrated it into the theme dialogue script, and had the dialogue by humming. The dependent variable of this study was intraverbal behaviors, which were defined as when the research participants could make a ""correct or reasonable response"" to any questions or dialogue of the researcher. Use the theme interactive verbal correct response percentage record to score the correct response as 3 points, and circle 3 points on the record sheet when the participant emerged target behavior independently. If the research participants repeated the same/similar error or do not respond after the first echoic prompt, 2 points were scored. If the research participants repeated the same/similar error or do not respond after the second echoic prompt (stressed the key words), 1 point were scored. After the second echoic prompt, those who repeat inappropriately or had no responses were scored as 0 point.</p> <p> Results</p> <p> The results revealed that both of verbal behavior approach and verbal behavior combined with music prompts approach had immediate and short-term maintenance effects to increase intraverbal skills for all three preschool children with autism spectrum disorder. The verbal behavior approach seems to have better effect in short-term maintenance. </p> <p> Discussions and suggestions</p> <p> The results of this study carried the following implications: First, the educators may design the verbal behavior approach and verbal behavior combined with music prompts approach to teach intraverbal of preschool children with autism spectrum disorders, which may improve these children’s communication and social interaction. Second, educators need to evaluate learners’ prerequisite language ability before conducting any potential interventions. Educators also need to consider the students’ learning styles to gradually expand the contents of dialogue themes and scripts. Finally, depending on learners’ individual differences, educators may choose more appropriate types of prompts or forms when combining music as part of the intervention.</p> <p> </p>

This study examines the levels of social interaction of students with high-functioning autism spectrum disorders during collaborative robotics projects. An alternating treatments design was used to observe the duration of social interaction of two middle school children with autism spectrum disorders across robotics and nonrobotics instruction as well as structured versus nonstructured activities. Results show that both participants with autism spectrum disorders engaged in higher levels of social interaction during robotics instruction when compared with nonrobotics instruction sessions. However, one participant displayed significantly higher levels of social interaction during nonstructured activities, indicating that the instructional setting may serve as a conditioned punisher for the student's social interactions.

A comparison of fluency training and discrete trial instruction to teach letter sounds to children with ASD: Acquisition and learning outcomes

Several recent studies have demonstrated reduced visual aftereffects, particularly to social stimuli, in autism spectrum disorder (ASD). This putative impairment of the adaptive mechanism in ASD has been put forward as a possible explanation for some of the core social problems experienced by children with ASD (e.g., facial emotion or identity recognition). We addressed this claim in children with ASD and typically developing children by using an established methodology and morphed auditory stimulus set for eliciting robust aftereffects to vocal expressions and phonemes. Although children with ASD were significantly worse at categorizing the vocal expressions compared with the control stimuli (phoneme categorization), aftereffect sizes in both tasks were identical in the two participant groups. Our finding suggests that the adaptation mechanism is not universally impaired in ASD and is therefore not an explanation for the social perception difficulties in ASD.

Interventions aimed at increasing communicative response variability hold particular importance for individuals with autism spectrum disorders (ASD). Several procedures have been demonstrated in the applied and translational literature to increase response variability. However, little is known about the relationship between reinforcer magnitude and response variability. In the basic literature, Doughty, Giorno, and Miller evaluated the effects of reinforcer magnitude on behavioral variability by manipulating reinforcer magnitude across alternating relative frequency threshold contingencies, with results suggesting that larger reinforcers induced repetitive responding. The purpose of this study was to translate Doughty et al.'s findings to evaluate the relative effects of different magnitudes of reinforcement on communicative response variability in children with ASD. A Lag 1 schedule of reinforcement was in place during each condition within an alternating treatments design. Magnitudes of reinforcement contingent on variable communicative responding were manipulated across the two conditions. Inconsistent with basic findings, the results showed higher levels of variable communicative responding associated with the larger magnitude of reinforcement. These outcomes may have potential implications for interventions aimed at increasing response variability in individuals with ASD, as well as future research in this area.

Video modeling is a time- and cost-efficient intervention that has been proven effective for children with autism spectrum disorder (ASD); however, the comparative efficacy of this intervention has not been examined in the classroom setting. The present study examines the relative efficacy of video modeling as compared to the more widely-used strategy of in vivo modeling using an alternating treatments design with baseline and replication across four preschool-aged students with ASD. Results offer insight into the heterogeneous treatment response of students with ASD. Additional data reflecting visual attention and social validity were captured to further describe participants' learning preferences and processes, as well as educators' perceptions of the acceptability of each intervention's procedures in the classroom setting.

This study aimed to investigate the effects of removing synthetic speech output from speech-generating devices (SGDs) and incorporating delayed reinforcement on verbal requests in children with autism spectrum disorder (ASD) and intellectual disabilities. Additionally, we examined how participants' receptive and expressive language abilities influenced vocal requests by comparing items categorized as easier or more difficult to name based on pre-assessment results. Three children with ASD and intellectual disabilities participated. An alternating treatment design was used to compare two conditions: (1) synthetic speech output with immediate reinforcement and (2) no synthetic speech output with delayed reinforcement. Preferred items were classified into two sets based on pre-assessed receptive and expressive language abilities. The dependent variable was the number of verbal and SGD-based requests. Results showed that verbal requests increased in the no synthetic speech output with delayed reinforcement condition across both item sets, while SGD-based requests remained high. Post-intervention language assessments indicated significant improvements in expressive language abilities. These findings suggest that removing synthetic speech output and incorporating delayed reinforcement may effectively promote vocal requests in children with ASD and intellectual disabilities. This intervention provides a novel approach to facilitate speech communication while continuing the use of AAC tools.

The incidence of children identified as having autism spectrum disorders (ASD) is increasing (U.S. Department of Education, Office of Special Education Programs, 2003). Many of these children are enrolled in general education settings, posing an ever-groWing challenge for the teachers in those settings. There is a critical need to develop interventions for students With ASD that can be used in general education classrooms. The current case study addressed this issue by implementing and evaluating the effectiveness of an antecedent-based intervention on the stereotypic behavior of a student With ASD Who Was fully included in a kindergarten classroom. FolloWing a functional analysis indicating that the stereotypic behavior Was maintained by automatic reinforcement, an antecedent intervention Was designed that included the use of visual cues to indicate activity times When it Was acceptable and When it Was not acceptable for the student to engage in stereotypic behavior. Effectiveness of the intervention Was examined using an alternating treatment design (BarloW & Hayes, 1979). FolloWing implementation of the intervention, the student's stereotypic behavior decreased during the times indicated by the visual cue that it Was unacceptable to engage in stereotypy. A replication Was conducted transferring the implementation of the intervention to the teacher's assistant in the classroom.

Social engagement is critical to the personal and social development of children. Individuals with Autism Spectrum Disorder (ASD) often exhibit low levels of social engagement with peers and adults, with clearly fewer instances of eye contact, initiation, joint attention, and empathy. Given the pivotal role of social engagement, procedures that naturally evoke higher rates of social engagement may be critical. Prior research suggests that cartoons and other animated characters are more appealing to children with ASD than traditional face-to-face interactions with adults. However, this assertion lacks consistent empirical support. In this study, five elementary age students with ASD participated in a series of interactions with adults and live animation avatars. An alternating treatments design was used to evaluate participants’ social engagement comparing their interactions with avatars to those with humans. Data show all five participants were consistently more attentive to the avatar than to human interventionists. In addition, all participants and their parents indicated the procedures were socially valid (i.e., preferred, feasible, and effective).

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by social communication deficits and repetitive behaviors. Eye movement abnormalities are common in ASD, suggesting underlying cognitive impairments such as working memory and response inhibition. However, several investigations suggest deficits in inhibitory control and working memory among individuals with ASD, whereas others indicate performance levels similar to typically developing individuals. The variability observed in executive function (EF) profiles across various tasks and age cohorts underscores the intricate interplay between ASD and cognitive functioning. Therefore, to bridge these gaps and gain a comprehensive understanding of the specific components of EF affected by ASD, this study used eye-tracking technology to analyze cognitive processing. In the working memory task, the clinical group comprised adults with ASD (N = 52), aged between 25 and 47 years (M = 31.65 years, SD = 6.05), while the control group (non-ASD) included individuals (N = 53), aged between 25 and 55 years (M = 33.15 years, SD = 5.92). For the response inhibition task, the clinical group consisted of adults with ASD (N = 50), aged between 25 and 47 years (M = 31.66 years, SD = 6.153), and the control group comprising individuals (N = 56), aged between 25 and 55 years (M = 33.03 years, SD = 5.80). The study revealed that individuals with ASD demonstrate notable impairments and increased errors in EF, encompassing inhibitory control and working memory when compared to non-ASD individuals. Additionally, individuals with ASD exhibited differences in fixation duration, saccade count, and fixation count compared to their non-ASD counterparts, further highlighting the distinct cognitive profile associated with ASD. Analyzing EF in adults with ASD through eye movement patterns provides valuable insights into the underlying cognitive processes and attentional mechanisms at play.