Case studies of technology for adults with multiple disabilities to make telephone calls independently.

Recent literature has shown the possibility of enabling individuals with multiple disabilities to make telephone calls independently via computer-aided telephone technology. These two case studies assessed a modified version of such technology and a commercial alternative to it for a woman and a man with multiple disabilities, respectively. The modified version used in Study 1 (a) presented the names of the persons available for a call and (b) reminded the participant of the response she needed to perform (i.e., pressing a microswitch) if she wanted to call any of those names/persons. The commercial device used in Study 2 was a Galaxy S3 (Samsung) equipped with the S-voice module, which allowed the participant to activate phone calls by uttering the word "Call" followed by the name of the persons he wanted to call. The results of the studies showed that the participants learned to make phone calls independently using the technology/device available. Implications of the results are discussed.

The Effects of a Teacher-Implemented Video-Enhanced Activity Schedule Intervention on the Mathematical Skills and Collateral Behaviors of Students with Autism.

This study used a multiple probe design to evaluate the effects of a teacher-implemented video-schedule intervention on the mathematical skills and untargeted challenging behaviors of five elementary-school students with autism. Results indicated that the intervention was effective in improving participants' academic performance, and a decrease in the level of challenging behaviors and stereotypy was observed for participants following the introduction of intervention. Additionally, academic gains generalized across academic problems and to a small group setting, suggesting that this technology-based intervention is an efficient use of instructional time. Future research targeting a variety of academic skills and examining intervention implementation by additional practitioners (e.g., teaching assistants) is warranted.

Two persons with multiple disabilities use camera-based microswitch technology to control stimulation with small mouth and eyelid responses.

BACKGROUND: A camera-based microswitch technology was recently developed to monitor small facial responses of persons with multiple disabilities and allow those responses to control environmental stimulation. This study assessed such a technology with 2 new participants using slight variations of previous responses. METHOD: The technology involved a computer with a CPU using a 2GHz clock, a USB video camera with 16-mm lens, and special software. Small colour spots were used under the lower lip of one participant and on the eyelid of the other participant to aid the camera and computer to detect their mouth and eyelid responses. The study involved an ABAB design and included a 3-week post-intervention check. RESULTS: The participants' mouth and eyelid responses increased during the intervention (B) phases and post-intervention check (i.e., when the technology allowed them to control stimulation). CONCLUSIONS: Camera-based microswitch technology can help persons with multiple disabilities control stimulation with small responses.

Telehealth Training in Naturalistic Communication Intervention for Mothers of Children with Angelman Syndrome.

Objectives : Young children with Angelman syndrome have significant delays in expressive communication. Parents of children with Angelman syndrome require training to support their child's communication development. Unfortunately, parent training focused on the needs of families of children with rare genetic syndromes is unavailable to many families. The purpose of this study was to evaluate a telehealth parent training program on naturalistic communication intervention for young children with Angelman syndrome. Methods: Using two single-case multiple baseline designs across a total of six parent-child dyads, we evaluated the effects of a telehealth parent training program on parent implementation fidelity of a naturalistic communication intervention, child communication, and child engagement. Results: With the telehealth parent training program, parent implementation fidelity of naturalistic communication intervention improved, maintained and generalized to untrained home routines. Small effects on child communication and engagement were observed during the program. Conclusions: Parents of children with Angelman syndrome were successfully taught via telehealth to implement a naturalistic communication intervention with their child at home. Additional research is needed to promote positive child communication outcomes through parent-mediated intervention.

Collateral Child and Parent Effects of Function­Based Behavioral Interventions for Sleep Problems in Children and Adolescents with Autism.

This study follows McLay et al., Journal of Autism and Developmental Disorders, (2020) to investigate whether the function-based behavioral sleep interventions received by 41 children and adolescents with autism spectrum disorder (ASD) produced collateral improvements in ASD severity, internalizing and externalizing symptoms and parent relationship quality, ratings of depression, anxiety and stress, and personal sleep quality. Concomitant with reduced sleep problem severity, improvements were found in children's internalizing and externalizing behavior and ASD symptom severity. Small improvements were also found in maternal sleep quality and parental stress. There was little change in parental relationship quality post-treatment, possibly reflecting high baseline scores. Overall, collateral benefits were generally small but positive, consistent with the limited extant research, and underscore the importance of investigating collateral effects across a range of variables.

An Evaluation of Reinforcer Magnitude and Echoic Prompts on Vocal Requesting of Individuals with Autism Spectrum Disorder.

Individuals with autism spectrum disorder (ASD) often have communication support needs and many rely on augmentative and alternative communication (AAC) systems to communicate. Previous research suggests that AAC use does not preclude the acquisition of spoken language and, in some cases, may facilitate improvements in spoken communication in children with ASD. This study systematically applied echoic prompting and manipulated reinforcer magnitude in an effort to increase the spoken requests of 3 children with ASD, ages 10-12 years, who used iPad-based speech generating devices (SGDs). The spoken language (vocal requests) of all 3 participants increased in frequency and 1 participant began using spoken language exclusively, even when the SGD was an option. Implications for practitioners and directions for future research in this area are discussed.

Teaching Children with Autism Abduction-Prevention Skills May Result in Overgeneralization of the Target Response.

We replicated previous research using behavioral skills training (BST) to teach four children with autism to engage in a safety response following lures from civilian strangers. This study extends previous research by (a) employing abduction lures incorporating highly preferred tangible items; (b) assessing for maintenance and generalization across settings and caregivers; and (c) probing for overgeneralization of the safety response. A multiple baseline across participants design demonstrated target behavior acquisition and generalization to novel settings and caregivers. However, children who complied with directions from police officers during baseline emitted the safety response (e.g., running away) when approached by police officers following BST. Overgeneralization of the targeted safety response was corrected with discrimination training procedures. Maintenance of appropriate responses to civilians and officers was inconsistent and booster sessions were required for two participants. Results suggest practitioners should incorporate discrimination training and program for maintenance when teaching abduction-prevention skills to children with autism.

Function-Based Behavioral Interventions for Sleep Problems in Children and Adolescents with Autism: Summary of 41 Clinical Cases.

This case analysis involved 41 clinical cases wherein children and adolescents with autism spectrum disorder (ASD) received a behavioral intervention for sleep problems. This study intended to (a) evaluate the efficacy of function-based behavioral sleep treatments; (b) elucidate variables impacting response to such interventions; (c) inform practitioners addressing sleep problems without a robust evidence-base; and (d) suggest priorities for future sleep research. Interventions included antecedent- and consequence-based modifications, and the teaching of replacement behaviors. Data were analysed using modified Brinley Plots and effect size estimates. Outcomes suggest that multi-component, parent-delivered, function-based interventions may ameliorate sleep problems in children and adolescents with ASD. The need for future research utilizing rigorous experimental designs is supported.

Quantitative-Analysis of Behavioral Interventions to Treat Sleep Problems in Children with Autism.

Sleep is an essential activity for human development. Often, children with autism spectrum disorder (ASD) are affected by a lack of sleep due to various types of sleep problems. We identified and analyzed studies that were aimed at utilizing sleep interventions for children with ASD. A systematic search of databases, reference lists, and ancestral searches identified 18 studies for inclusion. Studies were summarized in terms of (a) participants, (b) targeted sleep problem and measures, (d) intervention components, (e) research design and rigor, and (f) results. The aim of this review was to analyze the literature by evaluating the most commonly treated sleep problems, the various treatment components, and strength of the results using a between case parametric effect size estimate. The most commonly treated sleep problems were night wakings and bedtime disturbance. For interventions, all the studies incorporated multiple treatment components, most often including the use of a consistent bedtime routine. Effect size calculations indicated a moderate effect size, however, limited due to the small number of studies. Results suggest the overall effectiveness of behavioral interventions for the treatment of sleep problems for children with ASD. Based on our analysis, suggestions for practitioners regarding current practices and future directions for research are discussed.

Systematic review of the effectiveness of behaviorally-based interventions for sleep problems in people with rare genetic neurodevelopmental disorders.

Sleep problems are prevalent in people with rare genetic neurodevelopmental disorders (RGND) and, in some cases, RGNDs are associated with specific forms of sleep disturbance that appear relatively unique. Although a notable amount of research has focused on behavioral intervention for sleep problems in people with higher incidence developmental disorders, research focused on potentially modifiable learning and environmental factors for people with RGND has received less attention. This review summarizes empirical evidence from studies providing behavioral interventions for sleep problems in RGND. A systematic search identified nine studies for inclusion. Studies were coded to extract data on participant characteristics, intervention components, dependent variables, research rigor and intervention effects. Study rigor was then evaluated using an established criteria and effects were classified as positive, neutral or mixed. Seven of the nine studies demonstrated positive treatment effects and two mixed results. In most studies, treatment consisted of multiple intervention components and were implemented by parents in the home. However, only three studies met criteria for an adequate level of rigor, thus greatly limiting certainty of conclusions. This review identifies current intervention practices and potential foci for future research.

Manipulating the behavior-altering effect of the motivating operation: examination of the influence on challenging behavior during leisure activities.

We examined the behavior-altering effect of the motivating operation on challenging behavior during leisure activities for three individuals with severe disabilities. Prior functional analyses indicated that challenging behavior was maintained by positive reinforcement in the form of attention or tangible items for all participants. During leisure sessions, each participant played preferred games (cards, jigsaws) with two individuals without disabilities. The discriminative stimuli for challenging behavior were present during leisure sessions but challenging behavior was never reinforced. Immediately prior to leisure sessions, the participants received either access to the reinforcers that maintained challenging behavior or no access. Access versus no access to reinforcers for challenging behavior prior to leisure sessions was alternated in a multi-element design. Results demonstrated higher levels of challenging behavior during leisure sessions when the participants did not have access to the reinforcers prior to the sessions. Little challenging behavior occurred during leisure sessions when the participants had prior access to the reinforcers. Arguments for further examining the behavior-altering effects of the motivating operation in future applied research are presented.

A preliminary comparison of functional analysis results when conducted in contrived versus natural settings.

A preliminary evaluation of the correspondence between functional analysis outcomes across settings was conducted with 2 children who had been diagnosed with autism and who engaged in challenging behavior. Differences across settings (a therapy room and a classroom) were demonstrated in ABAB reversal designs. Three potential patterns of results that may occur when comparing functional analyses across environments are described, and one possible explanation for the occurrence of discrepancies between environments (differing learning histories within separate environments) is offered.

Meta-analysis of Tablet-Mediated Interventions for Teaching Academic Skills to Individuals with Autism.

Portable touch-screen devices have been the focus of a notable amount of intervention research involving individuals with autism. Additionally, popular media has widely circulated claims that such devices and academic software applications offer tremendous educational benefits. A systematic search identified 19 studies that targeted academic skills for individuals with autism. Most studies used the device's built-in video recording or camera function to create customized teaching materials, rather than commercially-available applications. Analysis of potential moderating variables indicated that participants' age and functioning level did not influence outcomes. However, participant operation of the device, as opposed to operation by an instructor, produced significantly larger effect size estimates. Results are discussed in terms of recommendations for practitioners and future research.

The effects of enhanced milieu teaching and a voice output communication aid on the requesting of three children with autism.

The purpose of this study was to evaluate the effects of enhanced milieu teaching when combined with a voice output communication aid on the requesting skills of three children with autism. The research design was a multiple probe across participants. All sessions were conducted during 5-min play sessions in the child's classroom. All three children learned to use the voice output communication aid to request items during play. Additionally, all three children increased their total requesting during play.

Embedding perseverative interest of a child with autism in text may result in improved reading comprehension: A pilot study.

OBJECTIVE: We investigated the effects of embedding the perseverative interest (PI) of a child with autism (i.e. cars) within texts on reading comprehension. METHODS: A PI text condition (text altered to include cars) was compared with a non-PI text condition (same story without cars inserted) in an alternating treatment design. Dependent variables were responses to reading comprehension questions and number of words uttered during an oral retell (i.e. curriculum-based measures [CBMs]). The reading level, instructional routines, and therapist where held constant across the randomly alternated conditions. RESULTS: Both CBMs suggested that reading comprehension was enhanced when the story included the child's PI. CONCLUSIONS: These preliminary findings suggest that embedding the PIs of students with autism spectrum disorder within readings may result in more accurate responses to reading comprehension questions and more detailed oral retelling. These findings are discussed in terms of potential directions for future research.

An examination of within-session responding following access to reinforcing stimuli.

Previous research has shown tangibly maintained challenging behavior can be temporarily decreased by providing presession access to the relevant tangible. However, the duration of this beneficial effect is unknown. We measured the subsequent duration of behavior reduction effects following presession access during extended classroom observation sessions by analyzing within-session patterns of responding in three children with autism. An alternating treatments design was used to analyze within- and across-session responding following presession access and presession restriction conditions. The cumulative frequency of challenging behavior was higher following the presession restriction condition for all participants and lower following presession access. Within-session analysis revealed the same basic pattern of responding across participants. Specifically, the first half of the sessions contained very little, if any, challenging behavior; however, after 60 min, the rate of challenging behavior began to increase rapidly for two of the three participants. Results are discussed in terms of implications for practitioners, satiation, habituation, and behavioral contrast.

Behavioral Skills Training to Improve the Abduction-Prevention Skills of Children with Autism.

A concurrent multiple baseline across participants design evaluated the effects of behavioral skills training (BST) on abduction-prevention skills of four children with autism. Across phases, confederates presented four types of abduction lures: (a) simple requests, (b) appeals to authority, (c) assistance requests, and (d) incentives. During baseline, lures resulted in children leaving with confederate strangers. During intervention, BST targeted a three-step response (i.e., refuse, move away, and report) and the abduction-prevention skills of all participants improved. Improvements generalized to novel settings and confederates and were maintained at 4 weeks. There is currently limited research on abduction-prevention pertaining to individuals with ASD. BST can be used to teach abduction-prevention skills to individuals with ASD. BST can be effective at teaching appropriate responses to multiple types of abduction lures. The effects of BST on multiple responses to multiple types of lures can generalize across settings and people and maintain over time.

Research involving anxiety in non-human primates has potential implications for the assessment and treatment of anxiety in autism spectrum disorder: A translational literature review.

OBJECTIVE: The purpose of this translational review (i.e. moving from basic primate research toward possible human applications) was to summarize non-human primate literature on anxiety to inform the development of future assessments of anxiety in non-verbal individuals with autism spectrum disorder (ASD). METHODS: Systematic searches of databases identified 67 studies that met inclusion criteria. Each study was analysed and summarised in terms of (a) strategies used to evoke anxiety, (b) non-verbal behavioural indicators of anxiety and (c) physiological indicators of anxiety. RESULTS: Eighteen strategies were used to evoke anxiety, 48 non-verbal behavioural indicators and 17 physiological indicators of anxiety were measured. CONCLUSIONS: A number of the strategies used with non-human primates, if modified carefully, could be considered in the ongoing effort to study anxiety in individuals with ASD. Potential applications to the assessment of anxiety in humans with ASD are discussed.

Technology-aided leisure and communication: Opportunities for persons with advanced Parkinson's disease.

OBJECTIVE: This study investigated whether simple technology-aided programs could be used to promote leisure and communication engagement in three persons with advanced Parkinson's disease. METHOD: The programs included music and video options, which were combined with (a) text messaging and telephone calls for the first participant, (b) verbal statements/requests, text messaging, and reading for the second participant, and (c) verbal statements/requests and prayers for the third participant. The participants could activate those options via hand movement or vocal emission and specific microswitches. RESULTS: All three participants were successful in activating the options available. The mean cumulative frequencies of option activations were about five per 15-min session for the first two participants and about four per 10-min session for the third participant. CONCLUSION: The results were considered encouraging and relevant given the limited amount of evidence available on helping persons with advanced Parkinson's disease with leisure and communication.