Behavior Analytic Interventions Research Articles

A component analysis of ABC assessments as demonstrated through function based interventions

AbstractResearch demonstrates that in order to implement a successful behavior analytic intervention, one must first identify the maintaining contingencies of the target behavior. Descriptive assessments are the most commonly used functional assessment used by behavior analysts (Oliver et al., 2015), although, comparative research further supports the use of analog functional analyses over descriptive assessments. As a way to assess the components of descriptive assessments to increase their accuracy, antecedent‐behavior‐consequence (ABC) assessments and functional analysis procedures were used to analyze the key components of descriptive assessment and were then verified with the implementation of a function‐based intervention. Results indicated that conditional probabilities from the antecedent condition were verified as the function in the functional analysis and treatment. Implications for clinicians and researchers are reviewed.

A Practitioner's Guide to Measuring Procedural Fidelity.

Ensuring high levels of procedural fidelity during behavior-analytic interventions is a crucial component of providing effective behavior-analytic services. However, few resources are available to help guide practitioners through measuring procedural fidelity. In fact, most published behavior-analytic research on procedural fidelity analyzes a single treatment procedure, which might not completely reflect the process of monitoring and addressing the procedural fidelity of a robust treatment package that might be necessary in clinical settings. The purpose of this article is to guide behavior analysts through the process of creating and using procedural fidelity measurement systems, with a focus on direct observation of implementation as a means of fidelity data collection. This process consists of six steps: (1) task analyze treatment procedures into measurable units; (2) assign measures to each treatment component; (3) plan the direct observation; (4) collect procedural fidelity data; (5) analyze and interpret procedural fidelity data; and (6) take action to improve procedural fidelity. Each step is described and discussed in the article.

Caregiver-Implemented Behavior Analytic Treatment Package for Skin Picking in PWS: A Pilot Study

Caregiver-Implemented Behavior Analytic Treatment Package for Skin Picking in PWS: A Pilot Study

AN OVERVIEW OF TECHNOLOGY USE FOR PARENT TRAINING IN BEHAVIOR ANALYTIC INTERVENTIONS

The efficacy of Applied Behavior Analytic (ABA) interventions for children who display problematic behavior has been well-documented and repeatedly demonstrated, however, global access to these interventions is restricted due to their limited availability. A promising strategy to attend a greater number of children in need of behavioral intervention is to train parents using various means of technology. The purpose of this overview is to present the process of incorporating technology into training parents in ABA interventions from a chronological perspective. A total of 65 studies were identified using an electronic search in eleven databases. The information collected is presented synthetically in tables and figures with data related to the content of training, the methods used, and the technological resources employed, as well as a narrative analysis of the information around four themes: technological advances on parent training, problems addressed, research methods and reported findings. The findings showed that technology has facilitated parent training in ABA interventions and thus contributed to advances in behavioral science and promoted the expansion of ABA services.

Preventing Insurance Denials of Applied Behavior Analysis Treatment Based on Misuse of Medically Unlikely Edits (MUEs)

Preventing Insurance Denials of Applied Behavior Analysis Treatment Based on Misuse of Medically Unlikely Edits (MUEs)

Evaluating the Impact of PWS Smart-Start: A Behavior Analytic Caregiver Training Program for Prader-Willi Syndrome

PWS Smart-Start is a behavioral caregiver training program developed specifically for caregivers of children with Prader-Willi syndrome (PWS) aged 3 to 14. The purpose of the current study was to evaluate the acceptability and preliminary efficacy of the program. Thirty-four caregivers of children with PWS received the PWS Smart-Start training using online live video-coaching across a 10-week period. The impact of the training on a variety of variables including caregiver and child behavior, caregiver stress and burnout, and family functioning were evaluated using a quasi-experimental pretest posttest design. Results indicated statistically significant decreases across child behavior challenges and parental stress and burnout following the training. Statistically significant improvements were also seen in parenting practices, the quality of the parent–child relationship, and family quality of life. Results of social validity measures indicated caregiver satisfaction with the program. These preliminary results indicate that the PWS Smart-Start program has the potential to not only support children with PWS through behavioral challenges but also reduce caregiver stress and burnout and improve a variety of aspects of family life. Future research is needed to replicate and further validate these results and to extend the exploration of other behavior analytic interventions for this population.

Applied behavior analytic intervention services for children with autism spectrum disorders: an investigation of Chinese parents

Introduction Applied behavior analysis (ABA)-based interventions have been used worldwide for several decades to improve socially significant behaviors of individuals with autism. However, as the utilization of the ABA-based interventions in the Chinese mainland is relatively new, it remains unclear about some fundamental aspects of using these interventions in this region. Method This study investigated the use of ABA-based interventions in Beijing and surrounding areas by using a quantitative survey (N = 85) and a qualitative semi-structured interview (N = 10) to collect data from parents of children with autism. Results This study found that (a) the ABA-based intervention service was the most popular one chosen by parents, and the majority of these parents reported improvements in children’s behaviors and gave positive evaluations for the work of professionals; (b) this service was mainly delivered at autism organizations (i.e. autism clinics/schools) or children’s homes, but rarely used in mainstream school settings; (c) the high cost of ABA interventions was a financial burden for families; and (d) a high proportion of parents were involved in interventions as assistant therapists. Furthermore, some aspects of the use of this service varied with families’ socioeconomic levels. The qualitative interviews expounded upon motivations for parents’ choices and evaluations for this service. Conclusion These findings provided valuable insights for service providers, policymakers, and researchers to optimize ABA-based intervention services for Chinese children with autism.

Evaluation of a rapport‐building intervention for early interventionists working with children on the autism spectrum

AbstractRapport, or the therapeutic relationship between a therapist and client, is essential for successful intervention. In behavior analytic interventions for autistic children, practitioners commonly use pairing to establish rapport. A limited body of research has evaluated how to train interventionists to pair with their child clients. Furthermore, fewer studies have examined the effects of pairing on client behavior. Therefore, we implemented behavioral skills training to teach interventionists pairing skills and assessed the effects of presession pairing on child interfering behavior using a concurrent multiple probe design (with replication). We implemented a pairing protocol before early intensive behavioral intervention sessions with four children (3–5 years old) on the autism spectrum. Interventionists mastered pairing skills during training sessions, which were generally maintained when working with child clients. When interventionists implemented presession pairing, child participants demonstrated fewer interfering behaviors. We discuss implications of our preliminary findings and future directions.

Increasing Face Mask Wearing in Autistic Individuals Using Behavior Analytic Interventions: A Systematic Review and Meta-analysis.

The current review aimed to evaluate the effectiveness of behavior-analytic procedures in increasing face mask-wearing in autistic individuals. This comes following recommended guidance during the COVID-19 pandemic. A systematic review and meta-analysis were completed of peer-reviewed and grey literature. Six databases were searched and seven studies using single-case experimental designs met the eligibility criteria which were then quality appraised. Data were extracted on participant characteristics, study design, independent and dependent variables, fidelity, generalization, maintenance, and social validity outcomes. Both the non-overlap of all pairs and Baseline Corrected TAU were used to estimate effect size. Two studies were rated strong and borderline strong quality and five were rated as adequate or below. All studies showed positive outcomes for mask-wearing, with an average of 0.92 for non-overlap of all pairs and 0.47 for Baseline Corrected Tau effect sizes. The most common and effective procedures for increasing mask-wearing were graded exposure and differential and positive reinforcement. Factors such as mode of delivery, implementer, and setting did not appear to influence study outcomes. Procedures were found to be rated as acceptable by parents and professionals in five of the studies. The existing literature on increasing face mask-wearing in autistic individuals provides promising findings to add to existing literature around increasing tolerance to medical equipment and hygiene practices in autistic populations. However, these findings are based on a small sample size, with six of the studies taking place in the United States with varying study quality.

User-Centered Development and Pilot Test of a Virtual Reality Training Prototype for Parents of Children with Autism

Children with autism spectrum disorder (ASD) frequently engage in severe destructive behavior that presents significant risks to themselves and others, poses substantial barriers to community integration, and results in high familial and societal financial impact. Despite the efficacy of behavior analytic (BA) interventions for decreasing destructive behavior, to produce meaningful outcomes in the natural environment, treatment effects must transfer to parents. Parents often experience in-person training barriers, such as time, financial burden, transportation, and childcare, as well as concerns with the quality of training delivered, such as unrealistic and uncomfortable training with therapists. This paper presents preliminary results from a pilot test of a prototype of a virtual reality parent training tool intended to reduce access and quality barriers for parents with children with ASD who engage in severe destructive behavior.

Applied behavior analysis interventions for autism spectrum disorders

Applied behavior analysis (ABA) has been considered the gold standard intervention for individuals diagnosed with autism spectrum disorder (ASD) for over 60 years. ABA, as a therapeutic intervention, dates to the 1960s and first appeared in studies conducted by Ole Ivar Lovaas. ABA gained the attention of many practitioners in 1987 when Lovaas reported children who received 40 hours or more of ABA treatment per week had significantly better outcomes than children who received 10 hours or less of ABA treatment per week after 2 or more years of intervention (Lovaas, 1987). Lovaas and his team of trained student therapists used interventions informed by behaviorism to target self‐stimulatory behaviors, play skills, and expressive language skills among other targeted goals and found that 47% of children in the experimental group achieved a normal score for intellectual and educational functions compared to 2% of children in the control group (Lovaas, 1987).

Report of the ABAI Task Force on Contingent Electric Skin Shock.

As a task force appointed by the Executive Council of the Association for Behavior Analysis International (ABAI), we investigated the clinical use of contingent electric skin shock (CESS) in behavior analytic treatments for severe problem behavior. We studied how CESS is used in contemporary behavior analysis, reinforcement-based alternatives to CESS, and current ethical and professional guidelines for applied behavior analysts. We recommended that ABAI uphold clients' right to receive CESS when it is restricted to extreme cases and used under rigorous professional and legal oversight. Our recommendation was rejected by a vote of the full members of ABAI, who instead endorsed an alternative recommendation, developed by members of the Executive Council, that opposed the use of CESS under any condition. Here we present for the record our report and initial recommendations, the formal statement that was rejected by the members of ABAI, and the statement that was endorsed.

Behavior Analytic Technologies Mediated via Augmented Reality for Autism: A Systematic Review

This review synthesizes the literature base evaluating the effects of behavior analytic interventions delivered via augmented reality (AR) technology for individuals with autism. We also conducted a quality review. We identified 14 studies with a majority of the studies (n = 11; 79%) utilizing single-case research design. Of the 14 studies, three met the quality criteria to be classified as “strong” and can offer evidence on the integration of AR technology into the practice of behavior analysis. All three studies taught a functional skill (i.e., tooth brushing and navigation). The remaining studies focused on skill acquisition with zero studies utilizing AR within the context of behavior assessment or behavior reduction interventions. This literature base is emerging with additional research required.

Beyond the Task List: A Proposed Integration of Naturalistic Developmental Behavioral Interventions to BCBA Training.

Naturalistic developmental behavioral intervention (NDBI) is firmly rooted in both the science of ABA as well as developmental science. Research indicates that many practicing board certified behavior analysts (BCBAs) are unfamiliar with NDBI models and do not implement these approaches when working with young autistic children (Hampton and SandbankAutism, 26(4), 875-888,2022). In this article we align NDBI to the seven dimensions of ABA, describe their compatibility with the ABA service system, and urge community agencies andinsurance funders to support NDBI use. Finally, we provide a roadmap for BCBAs who provide behavior analytic intervention to young autisticchildren and for Verified Course Sequence faculty to effectively align the 6th edition BCBA Test Content Outline with the principles and application of NDBI.

Reading comprehension intervention for students with autism spectrum disorder level 1 using the iPad graphic organizer app

Research has found that students with autism spectrum disorder (ASD) may face difficulties in reading comprehension. This study explored the functional relationship between the use of a graphic organizer (GO) app on the iPad and the number of correct independent responses to reading comprehension questions by one student with ASD Level 1. The study used an applied behavior analysis intervention that used an ABAB design. Aseven-question reading comprehension questionnaire was used to collect data Strong evidence was found of a functional relationship between the use of the graphic organizer (GO) on the iPad and an increase in correct independent responses by the student. Future research can develop to replicate the results and further explore how the use of a GO app on the iPad affects reading comprehension in students with ASD.

A scoping review of the caregiver training literature for individuals with autism spectrum disorder

AbstractBoth caregiver training and the collection of social validity data are considered to be important and integral part of applied behavior analytic treatment for individuals with autism spectrum disorder. Previous reviewers have offered repeated calls for increased frequency of social validity data collection but recently, the increased understanding and focus on equitable and culturally responsive behavior analytic treatment have again highlighted the importance of social validity data collection. One recent review of behavior analytic treatments for children of culturally and linguistically diverse backgrounds conducted an in‐depth analysis of social validity data collection. The authors found generally vague descriptions of social validity provided as well as data collected primarily after a study was conducted. No previous caregiver training reviews have specifically evaluated socially validity data collection within the context of caregiver training nor have they evaluated cultural responsiveness of the treatments. The current scoping review evaluated general findings on caregiver training as well as expanded the scope of previous reviews by providing an analysis of social validity data collection in caregiver training and variables to consider when providing culturally responsive treatment.

Grandparent-Implemented Interventions to Reduce Challenging Behavior of an Adult With Autism: A Pilot Telehealth Case Study

Adults with autism spectrum disorder (ASD) often engage in challenging behavior that requires individualized intervention to remediate. However, access to high-quality services is limited for adults, leaving this population without necessary behavioral healthcare. This study addressed the needs of a 22-year-old man with ASD and intellectual disability (ID) who lived with his grandmother and engaged in tangibly maintained challenging behavior. The interventionist coached his grandmother via telehealth in the implementation of two behavior analytic interventions: signaled multiple schedule arrangement and a modified contingency contract. The effects of the interventions were evaluated using an alternating treatments design with baseline. While both interventions were effective at decreasing challenging behavior when compared to baseline, the signaled multiple schedule arrangement resulted in zero instances of challenging behavior. Both the participant and the grandparent completed post-intervention social validity assessments and reported overall positive satisfaction with the interventions. Practice recommendations are presented.

Applied Behavior Analysis and the Abolitionist Neurodiversity Critique: An Ethical Analysis.

The behavior analytic literature on neurodiversity remains limited. This article aims to begin filling the lacuna. We will introduce the neurodiversity perspective and demonstrate an important congruence between the behavior analytic and neurodiversity perspectives on autism. Despite this congruence, applied behavior analysis is often targeted for criticism by proponents of the neurodiversity perspective. A central concern raises questions about the aims of behavior analytic interventions for clients with autism. Is it appropriate to teach clients with autism to behave as if they were neurotypical? Concerns about the aims of behavior analytic interventions mirror concerns that have been raised about the aims of language education in schools. Drawing on the literature regarding linguistically diverse classrooms, we will critically evaluate the abolitionist neurodiversity critique of ABA. We conclude by considering both concrete and theoretical implications for the ethics of behavior analytic work with autistic clients.

Dignity and Respect: Why Therapeutic Assent Matters.

During therapeutic treatment and research in psychology and related fields, informed consent by the client or participant is required when they are over the age of 18; assent is required when a client or participant is under the age of 18 or a conserved adult. During both research and treatment, behavior analysts often work with neurodiverse individuals who have language deficits, and these clients may require unique assent procedures. This article will outline reasons behavior-analytic research and therapy require field-specific assent procedures. Furthermore, the goals of research and therapy are different and therefore assent may need to differ as well. This article will also argue that therapeutic assent during behavior-analytic treatment requires a unique set of guidelines and procedures that may differ from the behavior-analytic research.

The fundamental role of social validity in behavioral consultation in school settings

AbstractSocial validity refers to the extent to which applied behavior analytic (ABA) treatment goals, methods, and/or outcomes are acceptable and meaningful to stakeholders. The aim of this conceptual paper is to suggest how social validity may be promoted during behavioral consultation in school systems and how the assessment of various aspects of social validity contributes to this throughout the consultation process. Literature pertaining to the concept of social validity, rapport‐building, collaboration with stakeholders in behavioral school consultation, and the assessment of social validity are reviewed and synthesized. Social validity may be promoted in several domains: communication with consultees, collaborative selection of treatment methods and student objectives, consultee training, and measurement of outcomes meaningful to stakeholders. Social validity assessment can occur in all of these domains and is ideally a continuous process that informs all phases of consultation. There is a particular need for direct measurement of the social significance of behavioral consultation services. Social validity is integral to all aspects of the behavioral school consultation process, and it may be facilitated by incorporating valid social validity assessments into every stage of the consultation process.