Do Naturalistic Developmental Behavioral Interventions improve family quality of life? A systematic review and meta-analysis.

LAY ABSTRACT: Naturalistic Developmental Behavioral Interventions have been described as culturally responsive and family-friendly interventions, with research demonstrating improvements in children's development following the receipt of these interventions. Given the child-directed nature of Naturalistic Developmental Behavioral Interventions and the intervention's integration within families' daily routines, many studies have examined the impact of Naturalistic Developmental Behavioral Interventions on family and family member quality of life. We conducted a systematic review and meta-analysis to explore the relationship between Naturalistic Developmental Behavioral Interventions and family quality of life. Results suggest that the provision of a Naturalistic Developmental Behavioral Intervention neither improved nor worsened family or family member quality of life. For those involved in delivering Naturalistic Developmental Behavioral Intervention services, there is an immediate need to convey to families that children's improvements will likely not translate into improvements in family quality of life.

NCLB Alternate Assessment Policies and Postschool Employment Outcomes for Individuals With Significant Cognitive Disabilities.

The participation of students with significant cognitive disabilities in accountability assessments aligned with general education standards is a heavily debated topic in the field of special education. Attempts to understand the impact of these assessments have generally been limited to correlational methods. We employed a difference-in-differences approach using select waves of the National Longitudinal Transition Study-2 dataset to estimate the impact of alternate assessment policies from the No Child Left Behind Act of 2001 on the employment outcomes of individuals with significant cognitive disabilities. Our hypothesis was that these policies would produce a detrimental effect. Analyses suggested that alternate assessment policies resulted in descriptively positive employment outcomes, yet estimates were highly imprecise, which yields a complicated picture requiring more research.

Exploratory Time-Series Analysis of Consecutive Case Series Data: A Quality Improvement and Adherence Study of a Behavior Analytic Service Provider.

Program evaluation is an essential practice for providers of behavior analytic services, as it helps providers understand the extent to which they are achieving their intended mission to the community they serve. A proposed method for conducting such evaluations, is through the use of a consecutive case series design, for which cases are sequentially gathered following the onset of a specific occurrence. Given the sequential nature in which data are collected within a consecutive case series, analytic techniques that adopt a time-series framework may be particularly advantageous. Although such methods are commonly used for program evaluation in medicine and economics, their application within the field of applied behavior analysis is largely absent. To serve as a model for providers undertaking evaluation efforts, I conducted a program evaluation of an outpatient severe behavior clinic, in which I employed quasi-experimental methods using an interrupted time-series analysis.

Evaluation of a Brief Family-Centered Service Provision Model for Treating Children's Severe Behavior: A Retrospective Consecutive Case Series Analysis.

This article serves as an initial program evaluation of a service provision model for providing applied behavior analysis services to families with severe behavior needs. A retrospective consecutive case series design was used to evaluate the effectiveness, feasibility, and cost of the model. We analyzed records for all families served through the model from summer 2017 to fall 2018. A total of 55 families received services, with 87% of children having autism and 63% having an intellectual disability. Within-participant single-case experimental designs were used to evaluate the clinic's assessment procedures, and caregiver interviews were used to evaluate the feasibility and effectiveness of developed and implemented treatments. Conclusive assessment results were obtained for approximately 69% of children. For families that received treatment, 92% reported improved child behavior. Intent-to-treat analyses that included families that withdrew from services prior to receiving treatment indicated that 61% of families experienced improved child behavior. Assessment and treatment outcomes for families that attended all appointments are commensurate with those of other similar clinics reported in the literature; however, the percentage of families that withdrew from services is substantially higher. For families adhering to the clinic's services, children's challenging behavior may be effectively assessed and treated through brief outpatient contacts utilizing services based on applied behavior analysis.

Rationale, Development, and Description of a Brief Family-Centered Service Provision Model for Addressing Children's Severe Behavior.

For families with children with autism that engage in severe behavior, the American Academy of Pediatrics recommends that functional assessment and management of environmental variables contributing to severe behavior occur prior to the prescription of psychopharmacologic treatment. Despite the inclusion of this recommendation in guidance articles published in pediatric journals for more than a decade, access to such services may not be feasible, in particular for families living in rural and geographically isolated communities. Given that families often view pediatricians as their first line of professional guidance for addressing challenges surrounding child development, the inaccessibility of appropriate services for managing healthcare is a concern for many pediatricians. To address this issue, a brief family-centered service provision model was developed through a collaboration between healthcare providers at a university-based hospital and Applied Behavior Analysis program faculty of the affiliated university. The hospital served many families living in rural areas of the state; therefore, the model utilized research-based practices with evidence of ecological validity for providing function-based assessment and treatment services. Within this manuscript we present a description of the model and its current implementation at a university-based hospital. For a data-based evaluation of the clinic and model, we refer readers to https://osf.io/qx8ak.

Modifying a naturalistic language intervention for use in an elementary school classroom.

Background and aims: We evaluated a naturalistic language intervention (NLI) targeting expanded forms of expressive communication (e.g., two-word phrases) for elementary-aged children with autism spectrum disorder (ASD) and/or intellectual disability (ID). This study extends the findings of a previous study that evaluated an NLI for preschool-aged children who displayed social communication delays. In the previous study, one child was considered a non-responder to the original intervention; children with similar pre-intervention profiles to the non-responder were recruited for this study to evaluate a modified version of the NLI with a new participant group. Methods: The NLI was evaluated within the context of a multiple probe design across children, with sessions conducted in a public school classroom. The modifications to the NLI resulted in varying dosages of the intervention provided across sessions and children. To analyze the moderating influence of the variation in dosage, we graphed each dosage variable to allow for a formative analysis of changes within and across study conditions. Results: Results indicated increases in the target behavior for all three children when compared to probe sessions; however, for one child the consistency of changes were variable and, as such, may not be socially significant. Conclusions and implications: This study extends the literature on conducting NLIs with minimally verbal children with ASD and ID in dynamic settings, like classrooms. Educators and related professionals can capitalize on natural opportunities for social communication in children who are minimally verbal but imitative by using naturalistic procedures to promote verbalizations during age-appropriate activities.

Applied Behavior Analysis in Early Childhood Education: An Overview of Policies, Research, Blended Practices, and the Curriculum Framework.

In this manuscript we attempt to provide a narrative history of the relationship between applied behavior analysis and early childhood education by examining the policies and research that have collaboratively shaped both fields. In addition, given the rapid pace at which early childhood education has changed in the last 25 years, we provide an overview of a recommended model for delivering early childhood education services, to illustrate its congruence with the practices and principles of applied behavior analysis. Lastly, we hope that this manuscript may be used as a bridge between the fields of early childhood education and applied behavior analysis given their similarities and shared purpose, to improve the lives of all recipients of their services.

Towards a Meaningful Analysis of Behavior Analyst Preparation Programs.

Numerous universities and colleges offer coursework approved by the Behavior Analyst Certification Board. Despite uniform requirements for approval, many differences exist among programs. To provide the field of behavior analysis with information about these differences, we conducted an initial analysis of programmatic variables and their relationship to pass rates on the Board Certified Behavior Analyst examination.Given the variety of preparation programs currently approved by the certification board, behavior analysts from different programs will likely differ with regard to their training and experiences.It is imperative that graduates from programs preparing behavior analysts are passing the examination to become board certified to fill specified jobs.Statistically significant variables associated with increased examination pass rates for programs include on-campus course delivery and accreditation by the Association for Behavior Analysis International.Variables lacking statistical significance with regard to impact on examination pass rates include the provision of supervision experience and the number of individuals from a program sitting for an exam.

Promoting Expressive Language in Young Children with or At-Risk for Autism Spectrum Disorder in a Preschool Classroom.

Young children with autism spectrum disorder (ASD) often demonstrate delays in expressive communication, impacting their ability to independently function in typical environments. Individuals with ASD who develop expressive language during early childhood experience better outcomes later in life; therefore, examination of naturalistic language interventions (NLIs) remain an important area of investigation. The current study used a multiple probe design across participants to examine the effects of a classroom-based NLI on various expressive language targets in three preschool-aged children demonstrating characteristics of ASD. Findings suggest the intervention had positive and maintained effects on trial-based use of language targets, as well as concomitant changes in commenting, requesting, and phrase complexity. Implications regarding implementation of NLIs within typical classroom play activities are discussed.

Initiation and Generalization of Self-Instructional Skills in Adolescents with Autism and Intellectual Disability.

Self-instruction using videos or other supports on a mobile device is a pivotal skill and can increase independence for individuals with disabilities by decreasing a need for adult supports. This study evaluated the effects of progressive time delay (PTD) to teach four adolescents with autism and intellectual disability how to initiate self-instruction in the presence of a task direction for an untrained task. Participants were screened for imitating video models prior to the study and were taught to navigate to videos on an iPhone(®) in history training. A multiple probe design across settings embedded in a multiple probe design across participants was used to evaluate the effects of PTD on initiation of self-instruction. All participants learned to self-instruct. Two participants generalized self-instruction to two novel settings. Two participants required instruction in two settings before generalizing to the third. Three participants generalized self-instruction in the presence of a task direction from the researcher to a task direction from their classroom teacher in all three settings. One participant generalized to a task direction presented by the classroom teacher in one setting, but not in the other two. All participants maintained self-instruction behaviors assessed 1 week after all participants met criteria in all settings. Self-instruction using videos or other supports on a mobile device is a pivotal skill and can increase independence for individuals with disabilities by decreasing a need for adult supports.