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1.
J ECT ; 39(1): 53-55, 2023 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-35462379

RESUMO

ABSTRACT: We report the case of a 30-year-old man diagnosed with autism spectrum disorder who received electroconvulsive therapy (ECT) over a 4-year period to treat catatonia associated with life-threatening self-injury, aggression, major depression, and associated self-care, daily living, and communication skills deficits. A systematic schedule of maintenance ECT (m-ECT) was associated with elimination of challenging behavior, catatonic and depressive symptom remission, removal of protective equipment, and reduced dosages of psychotropic medications.


Assuntos
Transtorno do Espectro Autista , Catatonia , Transtorno Depressivo Maior , Eletroconvulsoterapia , Comportamento Autodestrutivo , Masculino , Humanos , Adulto , Catatonia/terapia , Transtorno do Espectro Autista/terapia , Transtorno Depressivo Maior/complicações , Comportamento Autodestrutivo/terapia
2.
J Intellect Disabil ; : 17446295231213436, 2023 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-37922940

RESUMO

Frailty is a health concern for many adults with intellectual disability and should be measured to detect at-risk conditions, monitor disease, plan treatment, and gauge mortality. This descriptive pilot study evaluated measurement consistency (inter-rater agreement) of the Intellectual Disability-Frailty Index Short Form among multiple assessors with 20 adults (M age = 48.3 years) who had intellectual and multiple disabilities. Agreement percentages were computed for (a) non-frail, pre-frail, and frail categories derived from total index scores, and (b) each of 17 deficits listed on the form. Low average inter-rater agreement (<85%) was obtained on the index frail categories, several of the assessed deficits had acceptable inter-rater agreement (84.2-100%), while the majority of deficits were associated with moderate-to-low agreement percentages. Though research supports the Intellectual Disability-Frailty Index Short Form as a valid and practical frailty assessment instrument, our findings suggest that full-scale inter-rater agreement must be improved by adding more specificity to the form, clarifying instructions for assessors, and providing competency-based training in assessment implementation.

3.
J Intellect Disabil ; 25(1): 5-12, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31064265

RESUMO

We report the effects of peer-mediated training as a performance improvement intervention on recording of well-body checks by classroom instructors at a specialized school for children and youth. The instructors were trained as peer mediators and then assumed performance monitoring responsibilities in the classroom. Compared to baseline phases in a withdrawal design, peer-mediation increased recording of well-body checks to near-100% among the instructors. Results of the study document positive training effects on a critical health and wellness objective, support and expand the limited research base concerning the effects of peer-mediated training, suggest further application of such training in human services settings.


Assuntos
Deficiência Intelectual , Adolescente , Criança , Humanos , Grupo Associado , Instituições Acadêmicas
4.
Int J Dev Disabil ; 70(4): 625-631, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38983490

RESUMO

Some children with autism spectrum disorder (ASD) experience seizures and associated staring episodes, loss of consciousness, weakened muscle tone, and myoclonic jerking. Data recording of seizure frequency, duration, and co-occurring behavior is necessary to document the effects of anti-epileptic medications, identify contextual influences on seizure expression, and differentiate seizures from other movement disorders. We describe the design and operation of a computer-assisted system for recording seizures among children with ASD in a social validity study that revealed uniform approval and acceptance of the system from practitioners, clinicians, and nurse (N = 22), parents (N = 11), and neurologists (N = 7). The objectives and benefits of targeting the social validity of technology-based seizure tracking are discussed are discussed.

5.
J Appl Behav Anal ; 56(4): 745-756, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37492968

RESUMO

Behavior analysts frequently collaborate with interdisciplinary colleagues to share information and make decisions about client services. This study evaluated the effects of behavioral skills training on preparation for and presentation during interdisciplinary review team meetings by clinicians (n = 4) and nurses (n = 4) at a residential school for students with intellectual and neurodevelopmental disabilities. The primary dependent measure was the percentage of preparation and presentation steps from task-analyzed behavior checklists that the participants implemented correctly. As evaluated by multiple-baseline designs, the participants improved their preparation and presentation skills to nearly 100% following behavioral skills training, maintained performance 1 month after the study, and rated training positively. We discuss elements of the training program, practice implications, and research directions.

6.
J Appl Behav Anal ; 55(4): 1342-1348, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35854406

RESUMO

From 2016 to 2022, the Journal of Applied Behavior Analysis published 7 studies that evaluated the effects of habit reversal training on speech disfluencies (filled pauses) during public speaking. This review summarizes the participants, dependent variables, procedures, experimental design, and outcomes from this research including practice implications and suggested areas of inquiry.


Assuntos
Análise do Comportamento Aplicada , Fala , Coleta de Dados , Hábitos , Humanos , Projetos de Pesquisa
7.
Adv Neurodev Disord ; 6(3): 340-348, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35005217

RESUMO

Objectives: This report describes a model of training and performance management that was designed for and implemented with care providers at a residential school for children with neurodevelopmental and intellectual disabilities in response to the COVID-19 pandemic. The model focused on health and safety concerns, risk mitigation, and intervention integrity. Methods: Procedures followed an applied behavior analysis (ABA) and organizational behavior management (OBM) framework. Action plans addressed (a) critical COVID-19 protocols, (b) behavior-specific implementation guidelines, (c) remote and in-person training formats, (d) in vivo supervision, and (e) knowledge and performance assessments. Results: A competency evaluation (field study) revealed that participant care providers (N = 25) acquired and maintained COVID-19 protocols at near 100% proficiency immediately following and 1-month post-training. Supervisors had uniformly positive approval and acceptance ratings of school responsiveness to the COVID-19 pandemic. Conclusions: Integrated and evidence-based care provider training and supervisory practices can promote risk mitigation and performance effectiveness during health crises such as the COVID-19 pandemic. More controlled research that includes multiple dependent measures is needed to replicate and extend our findings to similar human services settings.

8.
Int J Dev Disabil ; 68(5): 624-632, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36210902

RESUMO

Faded bedtime has been evaluated as a behavioral intervention for delayed sleep-onset principally with children and youth who have intellectual and developmental disabilities in hospital and home settings. The present case report describes behavioral assessment and faded bedtime intervention in a 21-year old adult man with autism spectrum disorder at a community-based group home. The study also documented the effects of family home visits on the man's sleep when he returned to the group home. Compared to a pre-intervention (baseline) phase, faded bedtime was associated with increased intervals of recorded sleep and a decrease in sleep-onset latency over several months of implementation. We discuss clinical implications of the case and generality of findings across populations and settings.

9.
Behav Anal Pract ; 15(4): 1337-1347, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35371414

RESUMO

Children with autism spectrum disorder (ASD) are often prescribed psychotropic medications but pharmacotherapy is typically conducted and evaluated based on clinical judgement without reference to objective measurement of treatment effectiveness and combined efficacy of pharmacological-behavioral interventions. We describe an interdisciplinary review team (IRT) model at a human services organization for children with ASD that was designed to standardize a process of psychotropic medication monitoring through (1) coordinated involvement of medical, nursing, behavior analyst, and special education professionals, (2) parent-guardian participation, (3) data-driven decision making, and (4) high-level administrative support. Our description includes case illustrations of medication reduction-elimination trials with five students and social validity assessment of IRT clinicians, nurses, and parent-guardians. Key components of the IRT model are emphasized with associated practice and research recommendations.

10.
Adv Neurodev Disord ; 6(3): 349-359, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34746374

RESUMO

Objectives: The COVID-19 pandemic posed many challenges to human services organizations serving persons with pre-existing conditions and health concerns. Study objectives were to assess organizational responsiveness to the pandemic through training, safety, and risk mitigation initiatives at community-based group homes for adults with intellectual disability (ID) and acquired brain injury (ABI). Method: This was a two-phase mixed methods study with human services care providers. In phase 1, 54 focus group participants responded to standardized interviews about leadership actions in the early months of the COVID-19 pandemic and discussed implementation effectiveness. These qualitative findings informed the design and distribution of a multi-item questionnaire in phase 2 that quantified acceptance and approval of leadership actions among 498 participants. Results: Both focus group and questionnaire participants identified several consistent leadership actions that had a positive impact on risk mitigation, health promotion, and participant satisfaction. Participants also converged on priority needs and recommendations for performance improvement. Conclusions: The study supports previous research on the effects of pandemic health crises among frontline healthcare workers and more definitively the impact on direct care providers of adults with ID and ABI during COVID-19. Care providers were able to judge organizational effectiveness and provide feedback to aide strategic planning. Mixed methods research provides an approach to large-scale program evaluation through integrated qualitative and quantitative analyses.

11.
J Dev Phys Disabil ; : 1-8, 2022 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-36311269

RESUMO

We designed and distributed a survey that assessed safety concerns experienced by direct service providers (DSPs) (N = 59) of adults with intellectual and developmental disabilities (IDD) in community-based group homes at a single human services organization. Results indicated relatively few safety concerns among the respondents from a list of 25 survey statements. Possible influences on the findings are presented such as safety training of the DSPs, comprehensive safety guidelines in place at the group homes, and conditions occasioned by the COVID-19 pandemic. Current safety research in IDD supports the necessity of assessment to inform prevention and intervention strategies.

12.
J Intellect Disabil ; 15(2): 93-9, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21750212

RESUMO

We analyzed incidence and implementation patterns of physical restraint (PR) among 448 adults with intellectual disability within community-based day habilitation programs and group homes. PR was implemented exclusively as a consequence for self-harming, aggressive, and environmentally disruptive behaviors. Less than 10% of adults received PR and more than 90% of documented restraints occurred as a planned intervention procedure. Several adults accounted for the majority of PR. The clinical implications of these findings are discussed.


Assuntos
Centros Comunitários de Saúde Mental/normas , Pessoas com Deficiência Mental/reabilitação , Restrição Física/estatística & dados numéricos , Adulto , Idoso , Centros Comunitários de Saúde Mental/estatística & dados numéricos , Humanos , Incidência , Pessoa de Meia-Idade , New England , Adulto Jovem
13.
J Appl Behav Anal ; 54(2): 654-667, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33016330

RESUMO

This discussion article considers applied behavior analysis measurement, assessment, and treatment of sleep and sleep-related problems among infants, children, and youth who are typically developing and have neurodevelopmental disabilities. Measurement has concentrated on designing practitioner-implemented methods and improving fidelity of data recording through sleep-monitoring instrumentation. The emphasis of assessment is identifying antecedent and consequence variables that promote sleep and evoke and maintain sleep-related problems. Treatment research has evaluated several effective interventions for problems such as delayed sleep-onset, night and early morning waking, bedtime resistance, and unwanted co-sleeping. Early and contemporary applied behavior analysis research is reviewed relative to function-based treatment formulation, intervention integrity, social validity, and research-to-practice translation.


Assuntos
Análise do Comportamento Aplicada , Transtornos do Sono-Vigília , Adolescente , Criança , Humanos , Lactente , Sono , Transtornos do Sono-Vigília/terapia
14.
J Appl Behav Anal ; 53(4): 2081-2089, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32320076

RESUMO

We describe intervention with 2 adolescent male students who had autism spectrum disorder (ASD) and resisted haircutting performed by care providers at a residential school. The students were exposed to a graduated hierarchy of steps including the presence of hair clippers, and increased duration of hair clippers against their scalp and hair. Edible reinforcement was presented contingent on completion of a step without interfering behavior. Both students learned to tolerate all of the steps in the graduated hierarchy and a full haircut with maintenance at 2-, 4-, and 6-month follow-up. The study supports previous tolerance-training research with children and youth who have intellectual and developmental disabilities and resist personal care and hygiene routines.


Assuntos
Transtorno do Espectro Autista/psicologia , Terapia Comportamental , Cabelo , Higiene , Adolescente , Humanos , Masculino , Comportamento Problema/psicologia , Reforço Psicológico , Instituições Acadêmicas , Estudantes/psicologia
15.
Behav Anal Pract ; 12(2): 430-434, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31976250

RESUMO

This study evaluated the effects of a supervisory intervention on maintenance of appearance and organization in classrooms at a human services program for children and youths. The intervention combined performance feedback to classroom staff, public posting of performance outcomes, and eligibility for a performance-based incentive. Conducted in a multiple-baseline design, intervention was immediately and consistently effective in all classrooms. These findings support organizational behavior management applications within human services programs to improve performance that is related to environmental care.

16.
Behav Modif ; 31(6): 847-55, 2007 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17932239

RESUMO

The present study evaluates a training program with paraprofessional service providers at a community-based habilitation setting. Four staff were taught to implement alternative and augmentative communication instruction with an adult who had autism and mental retardation through a combination of instruction, demonstration, behavior rehearsal, and performance feedback. Training was conducted under natural conditions at the adult's group home residence. Three of the four staff were able to maintain near-100% instructional accuracy following initial training. The results add to the limited research literature concerning community-based training of direct-care personnel.


Assuntos
Serviços Comunitários de Saúde Mental/organização & administração , Pessoal de Saúde , Relações Interpessoais , Aprendizagem , Padrões de Prática Médica , Competência Profissional , Relações Profissional-Paciente , Reabilitação , Ensino/métodos , Ensino/estatística & dados numéricos , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador
17.
Behav Modif ; 31(4): 454-65, 2007 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17548540

RESUMO

Previous research suggests that performance feedback improves treatment integrity. This study compared the effects of verbal performance feedback and verbal plus graphic performance feedback on implementation of a student-specific behavior support plan (BSP) by members of a second-grade teaching team at a public elementary school. A consultant to the school delivered feedback following regularly scheduled classroom observations. Results indicated that combining verbal and graphic performance feedback was more effective than verbal performance feedback alone in improving treatment integrity. Informal data collected on student performance also suggested that appropriate behavior increased with better implementation of the BSP. Clinical and research issues are discussed.


Assuntos
Terapia Comportamental/métodos , Transtornos do Comportamento Infantil/terapia , Gráficos por Computador , Retroalimentação , Instituições Acadêmicas , Comportamento Verbal , Criança , Docentes , Feminino , Humanos , Masculino , Setor Público , Serviços de Saúde Escolar , Resultado do Tratamento
18.
J Appl Behav Anal ; 40(4): 743-7, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-18189110

RESUMO

Rumination is a serious problem demonstrated by some people with developmental disabilities, but previous research has not included a functional analysis and has rarely compared intervention methods during the assessment process. We conducted functional analyses with 2 children who displayed postmeal rumination and subsequently evaluated a supplemental feeding intervention following meals. Results showed that noncontingent food or liquid presentation effectively reduced rumination with both children.


Assuntos
Terapia Comportamental/métodos , Deficiências do Desenvolvimento/complicações , Comportamento Alimentar/psicologia , Transtornos de Alimentação na Infância/etiologia , Transtornos de Alimentação na Infância/terapia , Adolescente , Criança , Humanos , Masculino
19.
Adv Neurodev Disord ; 6(3): 235-236, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35966766
20.
Behav Anal Pract ; 10(2): 189-194, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28630825

RESUMO

We evaluated the effects of abbreviated (i.e., one-session) video modeling on delivery of student-preferred attention by educational care-providers. The video depicted a novel care-provider interacting with and delivering attention to the student. Within a concurrent multiple baseline design, video modeling increased delivery of the targeted attention for all participants as well as their delivery of another type of attention that was not trained although these effects were variable within and between care-providers. We discuss the clinical and training implications from these findings.

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