A Comparison of Telehealth-Based Instruction with or without Instructive Feedback.

Language delays are commonly displayed by children on the autism spectrum. To help facilitate the development of verbal behavior, practitioners often implement intensive one-on-one, face-to-face instruction. However, the COVID-19 pandemic hindered typical face-to-face service delivery and caused practitioners to assess alternative approaches to facilitate clients' continued progress. Instructive feedback (IF) is one teaching strategy to enhance instruction or make it more efficient. During this teaching procedure, instructors provide formal teaching of target responses and embed demonstrations of secondary target responses within sequences of instruction. In the current study, we investigated the efficacy of IF provided within telehealth instruction. Four participants on the autism spectrum participated in the study. Participants received two forms of telehealth instruction that targeted speaker-responding. The first form consisted of discrete trial instruction (DTI), and the second form combined DTI with IF. These results indicate that both forms of instruction improved speaker-responding of primary targets for all participants. Additionally, a secondary analysis of secondary targets indicated that two of the four participants acquired some secondary targets. These results suggest that including IF within DTI might be beneficial for some participants receiving DTI via telehealth.

Caregiver-Implemented Digital Activity Schedules With Virtual Coaching.

During the COVID-19 pandemic, many insurance companies approved the funding of telehealth-based behavior analytic services for both training and direct-care purposes. Activity schedules are a simple and effective intervention that can be used in the home environment to improve independence for children with ASD. Recent efforts have shifted the format of activity schedules from paper-based schedules to digital platforms that make the schedules more portable and provide easier access for both the caregiver and the Board Certified Behavior Analyst (BCBA). Google Slides® is a readily available web-based platform that has been used to design and deliver behavior analytic instruction during the COVID-19 pandemic. A non-concurrent multiple baseline design across three child-caregiver dyads was used to evaluate the effectiveness of a caregiver-implemented digital activity schedule intervention on the independent play behaviors of children with ASD. The activity schedule was created and shared on the Google Slides® platform and caregivers received bug-in-ear (BIE) coaching from practitioners to implement the intervention. Regardless of some minor treatment implementation difficulties attributed to the remote service delivery and the digital format, the digital platform and coaching intervention were effective in increasing independent schedule following with minimal training on the part of the caregiver. We hope that the results of this study provide BCBAs with additional guidance on effective interventions and procedures for remote service delivery.

Using generic picture cues to promote verbal initiations during play.

Children with autism spectrum disorder often demonstrate difficulty communicating with others, and this may affect the extent to which they can engage in contextually appropriate language during play. This study examined the effects of a social script-training intervention using generic picture cues on the number of contextually appropriate play statements for children with autism spectrum disorder. We also examined the extent to which responding generalized to novel toy sets and analyzed play statement types. A nonconcurrent multiple-baseline-across-participants design with embedded reversal components was used to evaluate the effects of the generic picture-cue intervention on contextually appropriate play statements. Three participants demonstrated a higher number of contextually appropriate play statements in the training condition as compared with the baseline and no-cue conditions. Further, two out of three participants continued to emit a similar number of contextually appropriate play statements when we introduced novel toy sets.

The effect of photographic activity schedules on moderate-to-vigorous physical activity in children with autism spectrum disorder.

Regular moderate-to-vigorous physical activity (MVPA) has been linked to improved bone health, muscular fitness, cognitive function, sleep, and a reduced risk of depression and obesity. Many children are not engaging in the recommended amount of physical activity. Furthermore, children with autism spectrum disorder (ASD) were found to engage in less physical activity than their peers of typical development. We extended previous research by conducting a physical activity context assessment, which included a comparison of indoor to outdoor activities to evaluate which environment produced the lowest percent of MVPA as recorded by the Observational System for Recording Physical Activity in Children. Given the utility of activity schedules to increase self-management and independent engagement during unstructured and low-preferred tasks, we then taught 3 preschool children diagnosed with ASD to use photographic activity schedules to increase the number of different activities that met the definition of MVPA in the 2 lowest-responding conditions of the physical activity context assessment. MVPA remained low during baseline sessions for all participants and immediately increased with the introduction of activity schedule teaching. All participants quickly met activity schedule teaching mastery criterion and demonstrated high levels of MVPA in generalization and maintenance probes without additional teaching.

Choice for reinforced behavioral variability in children with autism spectrum disorder.

Although individuals with autism spectrum disorder (ASD) tend to behave repetitively, certain reinforcement contingencies (e.g., lag schedules) can be used to increase behavioral variability. In a lag schedule, reinforcers only follow responses that differ from recent responses. The present study was designed to promote variable play behavior in preschoolers with ASD interacting with playsets and figurines and to assess preference for variability and repetition contingencies. Data have shown a preference for variability in pigeons and college students, but this effect has not been explored in clinical populations. In this experiment, preschoolers with ASD were taught to discriminate between variability and repetition contingencies. Only play behaviors that met a lag schedule were reinforced in the presence of one color, and only repetitive behaviors were reinforced in the presence of another. After differential performance was established, participants experienced a concurrent chains schedule. Participants chose between the colors taught in training and then completed a play session with the selected contingency. One participant selected variability and repetition equally. The other participants showed a slight preference for variability. These results indicate that some individuals with ASD may play repetitively, not because they prefer repetition, but because they require additional teaching to play variably.

Creating Digital Activity Schedules to Promote Independence and Engagement.

Photographic activity schedules have been demonstrated to be effective in helping individuals with autism and other developmental disabilities learn how to complete both simple and complex sequences of activities without prompting from adults. Although the majority of research studies demonstrating the effectiveness of activity schedules have used schedule books composed of static printed pictures attached to physical pages, recently researchers have begun to demonstrate the effectiveness of technology-based activity schedules. In the current article, we provide a task analysis for creating both simple and complex digital activity schedules using Google Slides, a freely available, web-based technology that operates on a variety of digital platforms. We also provide suggestions for how behavior analysts can train parents to use this technology with their children using telehealth procedures.

Creating and Sharing Digital ABA Instructional Activities: A Practical Tutorial.

Board Certified Behavior Analysts (BCBAs) may encounter situations, such as the current COVID-19 pandemic, that preclude them from providing traditional in-person applied behavior-analytic services to clients. When conditions prevent BCBAs and behavior technicians from working directly with clients, digital instructional activities designed by BCBAs and delivered via a computer or tablet may be a viable substitute. Google applications, including Google Slides, Google Forms, and Google Classroom, can be particularly useful for creating and sharing digital instructional activities. In the current article, we provide task analyses for utilizing basic Google Slides functions, developing independent instructional activities, developing caregiver-supported instructional activities, and sharing activities with clients and caregivers. We also provide practical recommendations for implementing digital instructional activities with clients and caregivers.

An evaluation of a stimulus preference assessment of auditory stimuli for adolescents with developmental disabilities.

Previous researchers have used stimulus preference assessment (SPA) methods to identify salient reinforcers for individuals with developmental disabilities including tangible, leisure, edible and olfactory stimuli. In the present study, SPA procedures were used to identify potential auditory reinforcers and determine the reinforcement value of preferred and non-preferred auditory stimuli. The results from this study suggest that the paired stimulus procedure utilized was effective in identifying preferred and non-preferred auditory stimuli, as the contingent application of the identified auditory stimuli produced higher rates of correct responding than did non-preferred auditory stimuli for all participants.

Using joint activity schedules to promote peer engagement in preschoolers with autism.

We assessed the use of a joint activity schedule to increase peer engagement for preschoolers with autism. We taught 3 dyads of preschoolers with autism to follow joint activity schedules that cued both members of the pair to play a sequence of interactive games together. Results indicated that joint activity schedules increased peer engagement and the number of games completed for all dyads. Schedule following was maintained without additional prompting when activities were resequenced and when new games were introduced for 2 of the 3 dyads.

Caregiver-conducted experimental functional analyses of inappropriate mealtime behavior.

The purpose of the current study was to replicate the use of parents as therapists for experimental functional analyses of inappropriate mealtime behavior with multiple participants while measuring procedural integrity. Clear functions were identified, and high percentages of procedural integrity were obtained.

An evaluation of group activity schedules to promote social play in children with autism.

Children with autism spectrum disorder (ASD) often have deficits in social skills and may avoid engaging in play activities with typically developing peers. The purpose of this study was to identify the utility of activity schedules, with embedded scripts, to teach three children with ASD to play a complex social game. Specifically, children with ASD were taught to play hide-and-seek with typically developing peers. Once the activity schedules were introduced, participants began engaging in independent hide-and-seek behaviors. A secondary purpose of this study was to systematically fade the activity schedules to the least intrusive version. We faded all of the scripts and the majority of activity schedule components for the three participants. Participants continued to play hide-and-seek with the faded versions of the schedules in a novel environment and 2 weeks after treatment concluded.

Sibling-Implemented Script Fading to Promote Play-Based Statements of Children with Autism.

We trained three typically developing children to implement a script-fading procedure with their younger siblings with autism. The number of contextually appropriate statements made by the children with autism increased once treatment was initiated. Participants continued to emit higher levels of contextually appropriate statements after the scripts were completely faded and at a 4- or 11-week follow-up. The typically developing siblings were able to implement the script-fading procedure with high levels of fidelity.

Evaluation of interactive computerized training to teach parents to implement photographic activity schedules with children with autism spectrum disorder.

Training parents of children with autism spectrum disorder can be a challenge due to limited resources, time, and money. Interactive computerized training (ICT)-a self-paced program that incorporates instructions, videos, and interactive questions-is one method professionals can use to disseminate trainings to broader populations. This study extends previous research on ICT by assessing the effect of ICT to teach three parents how to implement a photographic activity schedule using a systematic prompting procedure with their child. Following ICT, all parents increased their fidelity to implementation of an activity schedule during role-play sessions with an adult. Fidelity remained high during implementation with their child and maintained during a 2-week follow-up.

Effects of Simultaneous Script Training on Use of Varied Mand Frames by Preschoolers with Autism.

Young children with autism may fail to mand using a range of frames (e.g., "I want," "May I have," "Please give me"). We examined the effects of simultaneous script training and script fading on acquisition and maintenance of varied mand frames with six preschool children with autism. For participants who did not demonstrate increased mand variability under fixed-ratio (FR) 1 conditions, we assessed the effects of post script-training extinction on response variability. Following training of up to four different mand frames, three of six participants emitted more varied mands under FR1 conditions relative to baseline. Posttraining extinction resulted in increased mand variability for two of the three remaining participants. Results are discussed in terms of considerations for both establishing and ensuring the persistence of varied verbal behavior among children with autism.

The use of a discrimination-training procedure to teach mand variability to children with autism.

We investigated the effects of a script-fading and discrimination-training procedure on mand variability in preschoolers with autism. Participants were taught to vary their vocal mands in the presence of written scripts, a green placemat, and a lag schedule of reinforcement. They were also taught to engage in repetitive mands in the presence of the same written scripts and a red placemat. When the scripts were removed, all 3 participants continued to engage in varied manding in the presence of the green placemat and lag schedule, and they continued to engage in repetitive manding in the presence of the red placemat. When the lag schedule was also removed, 2 of the 3 participants continued to engage in varied responding in the presence of the green placemat and repetitive responding in the presence of the red placemat. Finally, all 3 participants demonstrated generalization and maintenance of mand variability during snack sessions with their peers.

Interactive computer training to teach discrete-trial instruction to undergraduates and special educators in Brazil: A replication and extension.

Discrete-trial instruction (DTI) is a behavioral method of teaching young children with autism spectrum disorders (ASD) that has received a significant amount of research support. Because of a lack of qualified trainers in many areas of the world, researchers have recently begun to investigate alternative methods of training professionals to implement behavioral teaching procedures. One promising training method is interactive computer training, in which slides with recorded narration, video modeling, and embedded evaluation of content knowledge are used to teach a skill. In the present study, the effectiveness of interactive computer training developed by Pollard, Higbee, Akers, and Brodhead (2014), translated into Brazilian Portuguese, was evaluated with 4 university students (Study 1) and 4 special education teachers (Study 2). We evaluated the effectiveness of training on DTI skills during role-plays with research assistants (Study 1) and during DTI sessions with young children with ASD (Studies 1 and 2) using a multiple baseline design. All participants acquired DTI skills after interactive computer training, although 5 of 8 participants required some form of feedback to reach proficiency. Responding generalized to untaught teaching programs for all participants. We evaluated maintenance with the teachers in Study 2, and DTI skills were maintained with 3 of 4 participants.

An evaluation of photographic activity schedules to increase independent playground skills in young children with autism.

We used photographic activity schedules to increase the number of play activities completed by children with autism during unstructured time on the playground. All 3 participants engaged in more playground activities during and after training, and they continued to complete activities when novel photographs were introduced.

An evaluation of a brief multiple-stimulus preference assessment with adolescents with emotional-behavioral disorders in an educational setting.

Brief multiple-stimulus-without-replacement (MSWO) preference assessments were conducted with 3 adolescent boys with emotional-behavioral disorders in the context of their public school educational program. The reinforcing effects of stimuli identified as high, medium, and low preference were then evaluated using an alternating treatments design in which, following an initial baseline, stimuli were delivered contingent on on-task behavior. High-preference stimuli produced the highest percentages of on-task behavior for all 3 participants.

Increasing play-based commenting in children with autism spectrum disorder using a novel script-frame procedure.

Children with developmental disabilities may engage in less frequent and more repetitious language than peers with typical development. Scripts have been used to increase communication by teaching one or more specific statements and then fading the scripts. In the current study, preschoolers with developmental disabilities experienced a novel script-frame protocol and learned to make play-related comments about toys. After the script-frame protocol, commenting occurred in the absence of scripts, with untrained play activities, and included untrained comments.

The effects of interpolated reinforcement on resistance to extinction in children diagnosed with autism: a preliminary investigation.

Studies on the "interpolation of reinforcement" effect (IRE) suggest that switching from an intermittent (INT) to a continuous (CRF) reinforcement schedule may result in less resistance to extinction than if extinction had followed INT alone. The finding has been examined with both human and animal participants using both free- and restricted-operant research preparations with equivocal results. In the present study, the IRE was examined in four young children diagnosed with autism using a free-operant preparation. Participants were matched into pairs and were exposed, in a counterbalanced order, to extinction following CRF "interpolated" between INT and extinction, and to extinction following INT alone. Resistance to extinction was examined by comparing the number of responses emitted during extinction and the number of sessions required to reach an extinction criterion. Responding may be less resistant to extinction following interpolated CRF reinforcement than following INT alone. Methodological refinements necessary for more conclusively demonstrating the IRE are discussed.