An Internal and Critical Review of the PEAK Relational Training System for Children with Autism and Related Intellectual Disabilities: 2014-2017.

The PEAK Relational Training System was designed as an assessment instrument and treatment protocol for addressing language and cognitive deficits in children with autism. PEAK contains four comprehensive training modules: Direct Training and Generalization emphasize a contingency-based framework of language development, and Equivalence and Transformation emphasize an approach to language development consistent with Relational Frame Theory. The present paper provides a comprehensive and critical review of peer-reviewed publications based on the entirety PEAK system through April, 2017. We describe both psychometric and outcome research, and indicate both positive features and limitations of this body of work. Finally, we note several research and practice questions that remain to be answered with the PEAK curriculum as well as other many other autism assessment and treatment protocols that are rooted within the framework of applied behavior analysis.

Near Misses in Slot Machine Gambling Developed Through Generalization of Total Wins.

The purpose of the present study was to evaluate the development of the near miss effect in slot machine gambling as a product of stimulus generalization from total wins. The study was conducted across two experiments. Twelve college students participated in the first experiment, which demonstrated that greater post-reinforcement pauses followed losing outcomes that were formally similar to total wins, relative to losing outcomes that were formally dissimilar [F (5, 7) = 5.24, p = .025] along a generalization gradient (R (2) = .96). Additionally, 11 out of 12 participants showed greater response latencies following near-misses than following total wins. Thirteen college students participated in the second experiment, which demonstrated that symbols that more saliently indicated a loss resulted in lower response latencies than functionally equivalent but visually dissimilar losing symbols [F (3, 10) = 15.50, p = .01]. A generalization gradient was observed across winning symbols (R (2) = .98), and an inverse of the gradient observed across winning symbols was observed across symbols that were the least formally similar (R (2) = .69). The present study replicates and extends previous research on near misses in slot machine gambling, and provides discussion around the clinical utility of such findings on the prevention of problem gambling.

Trends in Behavior-Analytic Gambling Research and Treatment.

The purpose of the present review was to analyze research outcomes for all gambling studies reported in the behavior analysis literature. We used the search term "gambling" to identify articles that were published in behaviorally oriented journals between the years 1992 and 2012 and categorized the content of each article as empirical or conceptual. Next, we examined and categorized the empirical articles by inclusion of an experimental manipulation and treatment to alleviate at least some aspect of pathological gambling, participant population used, type of gambling task employed in the research, whether the participants in the study actually gambled, and the behavioral phenomena of interest. The results show that the rate of publication of gambling research has increased in the last 6 years, and a vast majority of articles are empirical. Of the empirical articles, examinations of treatment techniques or methods are scarce; slot machine play is the most represented form of gambling, and slightly greater than half of the research included compensation based on gambling outcomes within experiments. We discuss implications and future directions based on these observations of the published literature.

Almost winning: induced MEG theta power in insula and orbitofrontal cortex increases during gambling near-misses and is associated with BOLD signal and gambling severity.

In slot machine gambling, the "near-miss effect" (when a losing display physically resembles an actual win display) has been implicated in pathological gambling (PG). Functional magnetic resonance imaging (fMRI) with PG and non-PG participants shows that near-misses recruit reward-related circuitry, but little is known about the temporal dynamics and oscillatory changes underlying near-misses. The present multi-modal imaging study investigated the near-miss effect by combining the spatial resolution of blood oxygen-level dependent (BOLD)-fMRI with the spatial and temporal resolution of magnetoencephalography (MEG) during a slot machine task in PG and non-PG groups. Given previous findings on outcome (win and near-miss) processing, functional overlap was hypothesized between induced changes in temporal oscillations and BOLD response to wins and near-misses in PG. We first validated our task in a sample of varying gambling severity using BOLD-fMRI and then compared PG and non-PG participants using MEG to investigate changes in induced oscillatory power associated with win and near-miss, relative to loss, outcomes. Across both modalities, near-misses recruited similar brain regions to wins, including right inferior frontal gyrus and insula. Using MEG, increased theta-band (4-7Hz) oscillations to near-misses were observed in the insula and right orbitofrontal cortex (OFC). Furthermore, this theta-band activity was positively associated with gambling severity. These findings demonstrate that the near-miss effect in insula and OFC is associated with induced theta oscillations. The significance of these findings for theories of PG and the development of potential biomarkers and therapeutic targets is discussed.

Effects of mental imagery on gambling behavior.

The influence of a brief mental imagery task was examined to determine if imagining engaging in gambling behaviors would satiate the participant on gambling-related reinforcers and subsequently reduce gambling behavior. Thirty-one participants underwent a mental imagery task consisting of either imagining gambling on a slot machine 30 times and placing quarters into a laundry machine 3 times, or imagining gambling on a slot machine 3 times and placing quarters in a laundry machine 30 times. Following the imagery task, participants were allowed to play a real slot machine and stop whenever they wanted to be finished. The results showed that those who imagined playing the slot machine 30 times before actually gambling played significantly fewer trials than those who imagined playing only 3 times. Clinical implications and future directions are discussed.

Establishing Foundational Nonarbitrary Distinctive and Categorical Relational Responding in Children with Autism.

The present study sought to evaluate a sequence of training procedures on the emergence of foundational relational responses that underly more complex distinctive (i.e., difference) and hierarchical (i.e., categorical) relational frames. In a multiple baseline design, an initial baseline period with three children with autism showed that the participants did not select nonidentical stimuli from an array when presented the contextual cue "different." Simple discrimination training was efficacious in establishing this response and the skill transferred to a novel set of stimuli without reinforcement. In a second baseline period, participants did not demonstrate conditional identical/nonidentical relational responses when provided the contextual cues "same" and "different." Conditional discrimination training with all three participants was again efficacious in establishing the conditional reflexive and distinctive responses and the skill transferred to untrained stimuli. In a third baseline period, participants did not demonstrate correct conditional categorization/sorting. Like in the prior two training conditions, training was efficacious in establishing the target response with a generalized transfer to untrained stimuli.

Relational Behavior and ACT: A Dynamic Relationship.

Acceptance and commitment therapy (ACT) and its counterpart, relational frame theory (RFT), represent emerging areas of research and professional interest for behavior analysts. We extend traditional RFT approaches by emphasizing relational framing as a dynamic pattern of behavior with implications for ACT-based strategies implemented by behavior analysts in practice and in research. We borrow from emerging approaches within affective dynamics, relational density theory, and the hyper-dimensional multilevel model to develop some immediate considerations for practitioners. We then extend an approach grounded in relational dynamics to the six core processes of the ACT hexaflex not only to influence negative affective patterns of relational behavior but also to promote greater psychological flexibility and well-being. Finally, we turn this account inward to discuss our own rigidity as a field and the necessity to engage more flexibly with our own science, ultimately to improve the lives of clients whom we serve.

An Examination of the Intervention-Enhancing Effect of Acceptance and Commitment Therapy-Based Training on Direct Service Professionals' Performance in the Workplace.

Direct service professionals (DSPs) provide treatment to individuals with developmental disabilities; however, high levels of performance are not always prevalent among these professionals. The present study examined the effect of an intervention package with verbal and written performance feedback and a performance-based lottery alone as part of a treatment package including an acceptance and commitment therapy (ACT)-based training program on the frequency and technical competence of active treatment for individuals with disabilities provided by DSPs. Both intervention groups performed significantly better than the control group on all observational measures (p < .05). The performance enhancement intervention (PEI) plus ACT group outperformed the PEI group significantly in frequency of active treatment at posttest (p < .05). Self-reported levels of psychological flexibility, workplace stress, and job satisfaction remained stable for all three groups from pre- to posttest despite the increased performance among DSPs in the two intervention groups.

Utilizing the AIM Curriculum to Improve Job Performance in an Educational Setting for Children With Autism and Related Disabilities.

The current study evaluated the effect of brief, daily present moment awareness activities on the work performance of paraprofessionals working at a school for children with disabilities. A nonconcurrent multiple-baseline design across three participants evaluated changes in staff-initiated interactions with students and staff's accuracy of data collection on student behavior. Relative to baseline, participants demonstrated an average increase in staff-initiated interactions and an increase in the average percentage accuracy of data collection. Participants averaged 10.02 (range 3.4-16.67) staff-initiated interactions during baseline and 15.38 (range 9.75-24.4) during the intervention phase. Relative to baseline, two of the three participants demonstrated an increase in their average accuracy of data collection on student behavior. Participants' average data collection accuracy was 56.9% (range 40%-86.67%) during baseline and 91.98% (range 86.41%-100%) during intervention. The average percentage of nonoverlapping data was 61.67% (range 25%-100%) for staff-initiated interactions and 33.33% (range 0%-100%) for data collection accuracy. Implications and possibilities for future research related to acceptance and commitment training interventions in workplace environments are discussed.

Correction to: A Large-Scale Naturalistic Evaluation of the AIM Curriculum in a Public-School Setting.

[This corrects the article DOI: 10.1007/s40617-021-00569-5.].

A Large-Scale Naturalistic Evaluation of the AIM Curriculum in a Public-School Setting.

This study evaluated the effectiveness of the AIM curriculum when implemented in a public-school setting by schoolteachers and direct care staff. Three hundred eighteen students took part in this quasiexperimental design where all received the AIM curriculum every day for an entire school year. The participants completed a series of self-assessments (the Avoidance and Fusion Questionnaire for Youth, the Child and Adolescent Mindfulness Measure, and the Strength and Difficulties Questionnaire) at the onset of the study and at the end of the school year to assess psychological flexibility, mindfulness, and emotional behavioral skills. Results suggest that at the end of the school year, participants increased psychological flexibility and mindfulness. State standardized testing scores also showed increases school-wide as compared to the previous 2 years. These results suggest that the AIM curriculum may be effective in large school settings, appeared easy to implement by school staff to address the needs of both the individual student and the entire student body, and likely participated in improving school-wide academic success.

Transformation of Hierarchical Multiply Controlled Verbal Relations in Children With Autism in a Game of I Spy.

We evaluated the development of mutually entailed arbitrary hierarchical relations and associated transformations of stimulus function across 3 children with autism in a game of I Spy. Top-down hierarchical relational training was efficacious in establishing 4 relational categories (A) containing a total of 5 stimuli (B), where 3 of the stimuli were contained in 2 different categories. Following relational training, all participants demonstrated a transformation of function by identifying the stimuli when provided a multiple verbal stimulus with two category names during I Spy. The procedures were adapted from the PEAK Relational Training System.

Using Relational Training to Improve Performance During Acceptance and Commitment Training Sessions.

The current study investigated the effect of relational training on improving engagement during acceptance and commitment training (ACT) sessions that aimed to reduce maladaptive behavior. Three female children diagnosed with autism participated in the current research. The relational training protocol involved eight programs designed to improve participants' ability to engage in relational responding. A concurrent multiple-baseline across-participants design was used, and participants' maladaptive behavior during ACT sessions was recorded. Results indicated a decrease in maladaptive behavior for one of the three participants, with a medium to large treatment effect. A secondary measure also showed improvement in all three participants' performance during ACT sessions. The percentage of nonoverlapping data and Cohen's d suggest a small to moderate treatment effect. Implications for implementing ACT with individuals diagnosed with autism are discussed.

Effectiveness of Environmental Manipulation to Enhance Engagement and Ecological Validity at an Agency Serving Individuals With Autism Spectrum Disorder and Other Disabilities.

The ecological validity of interventions can be enhanced when we first consider the environment in which our students participate. Antecedent interventions such as environmental manipulations can be easily and effectively implemented to enhance student engagement and decrease challenging behaviors in classrooms. The current study explored the use of a measurement system developed for widespread use within a school for students with autism spectrum disorder that helped to inform a classroom-wide environmental manipulation in the form of classroom arrangements. Baseline data across three classrooms suggested high, variable rates of challenging behavior and low rates of engagement with staff and materials. After the introduction of the antecedent intervention, engagement increased and challenging behavior decreased. Helping practitioners develop environmental and systems changes may help to complement individual behavior intervention plans.

Top-Down Attentional Processing and Relational Density Evident in Word Search Performance of Children.

Relational frame theory and extensions (e.g., relational density theory; Belisle & Dixon, 2020a, 2020b) provides a behavioral model for top-down attentional processing, where attention is oriented in terms of arbitrarily applicable verbal relations through the transformation of stimulus function. Children's games may provide a strategy for testing transformations of stimulus function when developing new language skills, such as when working with children with autism. Three children with autism underwent relational training to establish lean and dense arbitrary classes. Prior-to relational training, participants were more likely to locate familiar words over unfamiliar words within a word-search task. Following relational training, participants were more likely to locate words that participated in high-density relational classes over neutral or low-density relational classes. These results support the use of common games to supplement relational training with children with autism and provide evidence that top-down attentional processing may involve transformations of stimulus function and can be predicted and influenced through relational training to establish high-density relational classes.

Selection by consequence: A response to Hayes and Fryling (2019).

The paper by Hayes and Fryling (2019) seeks to inform readers that the Kantorian system of Interbehaviorism has been misunderstood and misrepresented by contextual behavior scientists. Furthermore, these authors suggest that much is to be gained by embracing the system developed by Kantor, most importantly that being large scale system building efforts. We disagree with this position, and find the Kantorian system to be of questionable relevancy and at risk of potential extinction within the behavioral community. We also have concerns that perhaps the insights provided by Hayes and Fryling will fail in recruitment of additional members to the Interbehavioral cause. Although the overarching theme of Interbehaviorism is present within emerging dynamical approaches to behavior science, adopting the vernacular of Kantor may be unnecessary to continue his tradition. We recommend allowing empirical selection to run its course in determining the eventual fate of Kantor's Interbehaviorism.

Developing and Enhancing Adherence to a Telehealth ABA Parent Training Curriculum for Caregivers of Children with Autism.

The current COVID-19 pandemic poses unique challenges to the delivery of applied behavior analysis (ABA) services, and there has been a growing demand for evidence-based practices on how to develop a telehealth ABA service model. The current article provides a detailed technological guide on how to develop a telehealth ABA parent training curriculum. Our model also includes a series of brief acceptance and commitment training (ACT) protocols to enhance parental adherence. We provide the details for replicating our telehealth model and also demonstrate its effectiveness. To begin, a step-by-step guide on how to develop this curriculum is presented, as well as protocols used in a 60-day telehealth ABA parent training program. Afterward, we describe a randomized controlled trial design to examine the effectiveness of this protocol. Thirteen families from the southern Illinois region participated in the curriculum before the COVID-19 outbreak. Obtained data indicated training was effective to teach skills, and parents with supplemental ACT material made significantly more progress than those in the control group, t(11) = 2.36, p = .038. Halfway through the training, the outbreak of COVID-19 occurred, and parents in the ACT group were more likely to continue the program, whereas parents in the control group were significantly more likely to postpone their participation, χ2 = 6.96, p = .008. Social validity measures indicated that parents rated the curriculum favorably. Limitations and suggestions for practitioners are discussed.

Evidence From Children with Autism that Derived Relational Responding is a Generalized Operant.

We conducted an empirical examination of derived relational responding as a generalized operant and concurrently evaluated the validity and efficacy of program items contained in the Promoting the Emergence of Advanced Knowledge - Equivalence (PEAK-E) curriculum. A first study utilized a multiple-baseline across-skills experimental arrangement to determine the efficacy of equivalence-based instruction guided by PEAK-E, replicated across 11 children with autism. A total of 33 individualized skills were taught, and the subsequent emergence of untrained relations was tested throughout the investigation. The mastery criterion was achieved for 29 of the 33 instructional targets. Additionally, for 3 participants, results were again replicated with a novel set of stimuli. A second study evaluated the degree to which multiple-exemplar equivalence-based instruction led to the emergence of derived relational responding as a generalized operant. The organized nature of the PEAK curriculum allowed the impact on derived relational responding to be compared to that produced by earlier PEAK models that are focused on the direct training of traditional verbal operants. PEAK-E instruction was introduced in a multiple-baseline design across two participants, with a third staying in a training baseline throughout. Increases in derived relational responding using novel, untrained stimuli were only observed when multiple-exemplar equivalence-based instruction was introduced. Taken together, these results provide support for derived relational responding as a generalized operant and demonstrate the utility of conducting larger scale evaluations of higher order behavioral phenomena in single-case experimental arrangements.

Adolescent gambling: current trends in treatment and future directions.

Adolescent problem gambling is a growing cultural concern and this paper reviews the various research findings and treatment options that are available. Scientists have discovered a number of biological factors that may contribute to the development of adolescent gambling, including specific brain states, neurochemical levels, physiological arousal tendencies, and genetic predispositions. Additionally, a number of psychological processes have been revealed, including the need to escape from psychological stress, the possession of certain cognitive fallacies, and the construction of incorrect rules about the gambling event itself. Effective treatment can be developed through the incorporation of empirically-based research into the clinical approach. Current treatment options include pharmaceutical prescriptions, changing cultural practices, and the delivery of psychodynamic, cognitive, and behavioral therapy models. An analysis of the gap between science and practice is described, and possible solutions to bridge this gap are provided.

Relational Density Theory: Nonlinearity of Equivalence Relating Examined through Higher-Order Volumetric-Mass-Density.

We propose relational density theory, as an integration of stimulus equivalence and behavioral momentum theory, to predict the nonlinearity of equivalence responding of verbal humans. Consistent with Newtonian classical mechanics, the theory posits that equivalence networks will demonstrate the higher order properties of density, volume, and mass. That is, networks containing more relations (volume) that are stronger (density) will be more resistant to change (i.e., contain greater mass; mass = volume * density). Data from several equivalence experiments that are not easily interpreted through existing accounts are described in terms of the theory, generating predictable results in most cases. In addition, we put forward the higher-order properties of relational acceleration and gravity, which follow directly from the theory and may inspire future researchers to evaluate the seemingly self-organizing nature of human cognition. Finally, we conclude by describing avenues for real-world translation, considering past research interpreted through relational density theory, and call for basic experimental research to validate and extend core theoretical assumptions.