Centering Autistic Perspectives: Social Acceptability of Goals, Learning Contexts, and Procedures for Young Autistic Children.

Despite the importance of centering autistic perspectives in educational decision-making for autistic children, few studies have directly assessed autistic perspectives on the social acceptability of early childhood practices. We conducted an online survey to recruit perspectives of autistic adults on a current, comprehensive range of educational practices typically employed with autistic children. We also extended the survey to caregivers and early childhood practitioners, to identify commonalities and discrepancies between shareholder groups. We conducted a descriptive survey study to assess social acceptability of goals, learning contexts, and procedures typically implemented with young autistic children. We received responses from 660 individuals, 226 of whom identified as autistic. For Likert scale and ranked items, we reported median rating and ranking for each item, by shareholder group. For open-ended questions, we conducted open and axial coding, to determine consistent themes within and across shareholder groups. Respondents reported (a) high acceptability for goals promoting self-determination and low social validity for goals promoting masking; (b) high acceptability for antecedent interventions and low social validity for some forms of extinction; (c) that appropriate learning environments are highly context dependent, varying with individual needs; and (d) that the child is the most important shareholder in educational decision-making. We make recommendations to practitioners in response to survey results, including (a) respecting autistic culture and characteristics in selecting goals; (b) considering social, emotional, and psychological needs in selecting procedures; and (c) individualizing goals, learning contexts, and procedures based on the child's perspectives and unique needs.

A practitioner's guide to emphasizing choice-making opportunities in behavioral services provided to individuals with intellectual and developmental disabilities.

Promoting choice is a defining value guiding Positive Behavior Support (PBS) models for serving individuals with intellectual and/or developmental disabilities (IDD). The ability to make independent choices is of paramount importance to self-advocacy and self-determination. Promoting choice is also an essential commitment of trauma-informed care (TIC) in the provision of services to vulnerable individuals, as trauma often involves experiences in which an individual has no control over aversive events that occur, and choice-making opportunities can empower traumatized individuals to regain control over the environments they routinely encounter. However, incorporating meaningful choice making into behavioral programming is often more difficult than it seems. We synthesize the relevant, contemporary literature to provide professionals with actionable suggestions for incorporating choice making into everyday behavioral services. After summarizing the importance of promoting choice into behavioral services based on the values that define both PBS and TIC frameworks, we (a) offer a behavior-analytic interpretation of the skill of making choices, (b) synthesize key literature on how to teach choice making skills, (c) provide recommendations for the situations within one's care in which choice-making opportunities may be most beneficial, and (d) discuss some of the barriers and potential solutions to incorporating choice-making opportunities for individuals with IDD.

On the Reliability and Treatment Utility of the Practical Functional Assessment Process.

Saini et al. (2019) urged caution with respect to the use of practical functional assessment (PFA) procedures to inform behavioral treatment when they found that responses to an open-ended caregiver interview were only somewhat reliable and showed moderate to weak correspondence with analog functional analyses. Because the practitioner's goal in conducting any functional assessment process is to inform the successful treatment of problem behavior, we replicated and extended Saini et al. by (a) evaluating the reliability of hypotheses gleaned from two independent PFA processes for each of four children, (b) conducting treatment informed by a randomly assigned PFA, and (c) determining the extent to which potentially different levels of reliability impacted the treatment utility of the PFA process. Results indicated that the reliability of the PFA process varied depending on the stringency with which it was evaluated. However, treatments developed from randomly determined PFA processes produced efficacious outcomes on problem behavior and targeted social skills that transferred to the context designed from the other PFA process in all evaluations, suggesting that the PFA has strong treatment utility despite parts of the process having ambiguous levels of reliability. We discuss implications for practitioners tasked with treating severe problem behavior.

Minimizing Escalation by Treating Dangerous Problem Behavior Within an Enhanced Choice Model.

To address dangerous problem behavior exhibited by children while explicitly avoiding physical management procedures, we systematically replicated and extended the skill-based treatment procedures described by Hanley, Jin, Vanselow, and Hanratty (2014) by incorporating an enhanced choice model with three children in an outpatient clinic and two in a specialized public school. In this model, several tactics were simultaneously added to the skill-based treatment package to minimize escalation to dangerous behavior, the most notable of which involved offering children multiple choice-making opportunities, including the ongoing options to (a) participate in treatment involving differential reinforcement, (b) "hang out" with noncontingent access to putative reinforcers, or (c) leave the therapeutic space altogether. Children overwhelmingly chose to participate in treatment, which resulted in the elimination of problem behavior and the acquisition and maintenance of adaptive skills during lengthy, challenging periods of nonreinforcement. Implications for the safe implementation of socially valid treatments for problem behavior are discussed.

Toward trauma-informed applications of behavior analysis.

Despite a growing acknowledgement of the importance of understanding the impacts of trauma on therapeutic approaches across human service disciplines, discussions of trauma have been relatively infrequent in the behavior analytic literature. In this paper, we delineate some of the barriers to discussing and investigating trauma in applied behavior analysis (ABA) and describe how the core commitments of trauma-informed care could be applied to behavior analysis. We then provide some examples of how trauma-informed care might be incorporated into ABA practice. We conclude by suggesting opportunities to approach trauma as a viable avenue for behavior analytic research and argue that omitting trauma-informed care from ABA could be detrimental not only to the public perception of ABA, but to the effectiveness of our assessment and treatment procedures.

Contingency-based delay to reinforcement following functional communication training for autistic individuals: A multilevel meta-analysis.

LAY ABSTRACT: Functional communication training, an intervention for challenging behavior rooted in principles of applied behavior analysis, has copious empirical support dating back to the mid-1980s for autistic individuals. Recently, there has been a concerted effort to thin reinforcement delivery during functional communication training using contingency-based delays that, in turn, are designed to enhance practicality and feasibility while not compromising efficacy. In this synthesis, we meta-analyzed the literature base with the goal of investigating both combined and across type effectiveness of contingency-based delays. We also aimed to investigate moderating variables that might impact intervention outcomes. Findings showed that contingency-based delays were effective for individuals with an autism spectrum disorder diagnosis and most effective when the delay incorporated some form of positive reinforcement. In addition, differential reinforcement of alternative-based delays was overall more effective when compared to differential reinforcement of other behavior-based delays. Noteworthy moderating variables found to impact contingency-based delay efficacy included the intervention dosage and the topography of behavior. We discuss these findings and highlight directions where additional empirical research is warranted to improve our understanding about contingency-based delays for individuals diagnosed with autism spectrum disorder.

Understanding the effects of prompting immediately after problem behavior occurs during functional communication training.

When reported, the methods for prompting functional communication responses (FCRs) following problem behavior during functional communication training (FCT) vary. Some researchers have prompted the FCR immediately following problem behavior but doing so may inadvertently strengthen problem behavior as the first link in an undesirable response chain. This study investigated the effects of prompting FCRs following problem behavior during FCT with 4 children who exhibited severe problem behavior. Problem behavior remained low and FCR rates were near optimal when prompts were delivered immediately following problem behavior for 2 participants. Delaying prompts following problem behavior was instrumental for FCR acquisition for 1 participant but led to escalation of problem behavior for a 2nd participant. The conditions under which immediate prompts following problem behavior may improve or worsen FCT are discussed.

An Evaluation of "Balance": a Home-Based, Parent-Implemented Program Addressing Emerging Problem Behavior.

Programs that prevent the development of severe problem behavior in young children with autism spectrum disorder (ASD) are critically needed. We describe a program designed to do this, and we report on a preliminary evaluation of its effects with four 3- and 4-year-old children with ASD. Parents served as the primary implementers, with twice-weekly coaching from a Board Certified Behavior Analyst. Direct measures and Aberrant Behavior Checklist scores reflected decreases in emerging problem behavior. Direct measures also reflected increases in child communication, social, and cooperation skills, and parents rated the process as highly acceptable. A randomized controlled trial will be required to evaluate the extent to which the program prevents the development of problem behavior in young children with ASD. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40617-020-00490-3.

Mand compliance as a contingency controlling problem behavior: A systematic review.

Bowman et al. (1997) described a dynamic contingency in which severe problem behavior was evoked by adult noncompliance with a variety of child mands, which occurred at high rates, and was reinforced by adult compliance with subsequent mands. They discovered this phenomenon with 2 children for whom standard functional analyses were inconclusive. In recent years, similar contingencies have been shown to influence problem behavior, but the manner in which they have been arranged and described has varied across studies. The purpose of this literature review is to (a) describe contingencies involving mand compliance and the circumstances under which they have been evaluated, (b) summarize procedural variations in analysis and treatment, and (c) discuss what is known and yet to be discovered about the contingency as it relates to problem behavior. Future research focused on improving technology for analyzing and treating problem behavior suspected to be sensitive to mand compliance is discussed.

Toward accurate inferences of response class membership.

In their review of synthesis within the functional analysis (FA) literature, Slaton and Hanley (2018) reported that most synthesized contingency analyses have included multiple topographies of problem behavior in the reinforcement contingency class. This leaves the question of whether one, some, or all forms of problem behavior are sensitive to the synthesized reinforcement contingencies in published analyses. To address this ambiguity, all topographies of problem behavior that were reported by caregivers to co-occur with the most concerning problem behavior were analyzed for 10 participants. We implemented extinction across one or more forms of problem behavior to determine whether all forms reported to co-occur were sensitive to the same synthesized reinforcement contingency. For nine of 10 participants, the most concerning topographies were sensitive to the same synthesized reinforcement contingencies as the less concerning topographies (results were inconclusive for one). Implications for inferring response class membership from single analyses are discussed.