How to Administer the Performance Diagnostic Checklist-Human Services.

The Performance Diagnostic Checklist-Human Services (PDC-HS) is a performance analysis tool used to identify barriers to performance in human-service settings. Multiple published studies have used the PDC-HS to determine effective interventions (Wilder et al. Journal of Applied Behavior Analysis 53(2), 1170-1176, 2020). However, in a recent discussion article proposing guidelines for administering the PDC-HS, Brand et al. Behavior Analysis in Practice, 1-7 (2022) noted that procedural descriptions provided for administering the PDC-HS are somewhat ambiguous in the published literature. The purpose of the current systematic review was to compare methods used to administer the PDC-HS. Fifteen articles met inclusion criteria and were coded to evaluate commonalities among PDC-HS components. Authors generally agreed on how the outcomes of the PDC-HS were depicted and discussed but varied in their descriptions of methods used to administer the PDC-HS. Results are discussed in terms of the importance of technological descriptions and directions for future research towards the development of a more standardized tool. Supplementary Information: The online version contains supplementary material available at 10.1007/s40617-023-00848-3.

Caregiver involvement in applied behavior-analytic research: A scoping review and discussion.

We conducted a scoping review to characterize the role of caregiver involvement in behavior-analytic research. We reviewed eight behavioral-learning journals from 2011-2022 for works that included children or caregivers as participants and characterized caregiver involvement as passive (implications for caregivers, input, social validity) and active (implementation, caregiver behavior, training, caregiver-collected data). The review identified 228 studies, and almost all (96.1%; n = 219) involved caregivers in some capacity; 94.3% (n = 215) had passive involvement (26.8% had only passive involvement; n = 61), 69.3% (n = 158) had active involvement (1.8% had only active involvement; n = 4), and 3.9% (n = 9) had neither passive nor active involvement. Involvement generally increased over publication years. The most common types of involvement were implications for caregivers, implementation, and input; caregiver-collected data were rare. We propose considerations when engaging caregivers in research and suggest new avenues of inquiry related to caregivers' treatment objectives and social validity, treatment implementers, and caregiver-collected data.

Feasibility and Acceptability of a Compressed Caregiver Training Program to Treat Child Behavior Problems.

In an effort to address some of the criticisms of Behavioral Parent Training programs (BPT; high attrition, reliance on caregiver report measures), the current study examined the feasibility, acceptability, and outcome of an intensive behavior treatment program (120-minute sessions for 5 days/week over the course of 2 weeks). Using a changing criterion single case experimental design, 12 children (M child age = 4.9 years) and their primary caregivers completed the 2-week function-based intervention procedure designed to increase children's frustration tolerance via a wait training procedure based on the principles of applied behavior analysis. Using both direct observation and standardized measures, results indicated that the treatment was effective in reducing childhood behavior problems, both within and between appointments (Cohen's ds = 3.2 and 1.37, respectively). Preliminary evidence suggests that a compressed treatment package designed to train caregivers in function-based intervention strategies is feasible and acceptable.

Toward an Understanding of Data Collection Integrity.

Data collection is an integral part of the practice of behavior analysis because behavior analysts rely on data to inform their clinical decisions. Data collection integrity (DCI) is the degree to which data are collected as planned, and issues with DCI can lead to misinformed clinical decisions. The current study aims to add to the limited research on DCI by evaluating risk factors and interventions that target DCI. An online survey, conducted through QualtricsTM, was completed by a combined total of 232 Board-Certified Behavior Analysts (BCBAs) and Board-Certified Behavior Analysts-Doctoral (BCBA-Ds). Participants answered questions about their demographics, their data collectors, their concerns about data collection, the systems they use to collect data, the training they provide data collectors, and the strategies they use to address data-collection issues. Results indicated that many risk factors related to DCI issues might be prevalent in behavior analytic practice. Recommendations on how to address DCI issues are provided. Supplementary Information: The online version contains supplementary material available at 10.1007/s40617-022-00684-x.

Collateral Effects of Behavioral Treatment for Problem Behavior on Caregiver Stress.

When individuals with autism and intellectual and developmental disabilities exhibit severe problem behavior, assessment and treatment are often warranted. Parents of such individuals are at high risk for developing parenting stress. In this study, 194 parents completed the Parenting Stress Index-Short Form at their child's time of admission to and discharge from inpatient or outpatient treatment for severe problem behavior. Parent stress was examined in relation to rate and function of child problem behavior as determined via functional analysis. Repeated measures analyses of variance were conducted, and differential effects were observed when child participants exhibited an attention, automatic, or mands function for problem behavior. These findings highlight the importance of considering function of problem behavior in relation to parenting stress.

Rapid Conversion from Clinic to Telehealth Behavioral Services During the COVID-19 Pandemic.

Survival often depends on behavior that can adapt to rapid changes in contingencies, which should be particularly well suited to a contingency-sensitive and data-based discipline such as applied behavior analysis (ABA). The speed and scale with which contingencies shifted in early March 2020 due to the effects of COVID-19 represent a textbook case for rapid adaptation with a direct impact on the survival of many types of enterprises. We describe here the impact, changes, and outcomes achieved by a large, multifaceted ABA clinical program that has (a) ongoing data that forecasted and tracked changes, (b) staff well practiced with data-based shifts in operations (behavior), and (c) up-to-date information (data) on policy and regulations. The results showed rapid shifts in client and staff behavior on a daily basis, shifts in services from in-person services to telehealth, and increases in volumes, revenue, and margins. We detail regulations and provide actionable steps that clinical organizations can take pertinent to this shift now and in the future. The challenges of the COVID-19 pandemic underscore the importance of maintaining robust coordination and communication across our field in order to address crises that affect our field.

Tummy time without the tears: The impact of parent positioning and play.

The American Academy of Pediatrics (AAP) recommends that infants spend supervised time in the prone (tummy) position to foster motor development and prevent cranial deformities. However, infants may not tolerate the position, and consequently, caregivers may avoid placing their infants in the prone position. The AAP recommends that caregivers provide toys or interaction during tummy time. We evaluated the individual and combined effects of a play mat and experimenter interaction on negative vocalizations and head elevation during tummy time-positive effects were limited. Next, we evaluated a parent-led intervention wherein mothers interacted with their infants, using a toy, while lying chest-to-chest. This intervention was associated with a reduction in negative vocalizations and an increase in head elevation for the majority of infants. Additionally, mothers rated the effectiveness of the parent-led intervention more favorably than the experimenter-led intervention, suggesting the effects of the parent-led intervention were also socially valid.

A primer for using multilevel models to meta-analyze single case design data with AB phases.

Meta-analytic methods provide a way to synthesize data across treatment evaluation studies. However, these well-accepted methods are infrequent with behavior analytic studies. Multilevel models may be a promising method to meta-analyze single-case data. This technical article provides a primer for how to conduct a multilevel model with single-case designs with AB phases using data from the differential-reinforcement-of-low-rate behavior literature. We provide details, recommendations, and considerations for searching for appropriate studies, organizing the data, and conducting the analyses. All data sets are available to allow the reader to follow along with this primer. The purpose of this technical article is to minimally equip behavior analysts to complete a meta-analysis that will summarize a current state of affairs as it relates to the science of behavior analysis and its practice. Moreover, we aim to demonstrate the value of analyses of this sort for behavior analysis.

Injury characteristics across functional classes of self-injurious behavior.

Self-injurious behavior (SIB) is inherently problematic because it can lead to injuries, including those that are quite severe and may result in loss of function or permanent disfigurement. The current study replicated and extended Rooker et al. (2018) by classifying the physical characteristics of injuries across groups of individuals with automatically maintained SIB (ASIB Subtypes 2 and 3) and socially maintained SIB. Individuals with Subtype 2 ASIB had the most frequent and severe injuries. Further, an inverse relation was found between the level of differentiation in the functional analysis and the number of injuries across groups. Studying the response products of SIB (the injuries) documents the risks associated with SIB, justifies the need for research and the intensive intervention, and advances knowledge of SIB. Additional research is needed to replicate these findings, and determine the variables that produce different characteristics of injury secondary to SIB.

Differential reinforcement-of-low-rate procedures: A systematic replication with students with autism spectrum disorder.

Becraft, Borrero, Davis, Mendres-Smith, and Castillo (2018) studied the effects of two different types of DRL schedules (full session and spaced responding) under 2 sets of stimulus conditions (with and without signals). Reduced rates of responding maintained under both types of DRL schedules, when signals were included. The present study represents a replication of procedures by Becraft et al. involving learners with autism spectrum disorder (ASD). The results replicated those of Becraft et al. in that responding in both full-session and spaced-responding DRL schedules was low, but not eliminated. These results provide preliminary evidence to suggest that children with ASD are responsive to signals in DRL arrangements, which may set the stage for evaluation of signaled DRL arrangements for socially significant response forms.

The role of signals in two variations of differential-reinforcement-of-low-rate procedures.

Differential-reinforcement-of-low-rate (DRL) schedules are used to decrease the overall rate of, but not eliminate, a target response. Two variations of DRL, spaced-responding and full-session, exist. Preliminary comparative analyses suggest that the two schedules function differently when unsignaled. We compared response rates under these two DRL variations with and without signals. In Experiment 1, five preschool students played a game in which points were earned under DRL schedules. In some sessions, a stimulus signaled when responses would be reinforced (S+) or not reinforced (S-). In others, only an S- was present. Signals (S+/S-) facilitated and maintained responding in both types of DRL schedules. In Experiment 2, we modified the signals with five different preschoolers. Instead of an S- only, we did not present any signals. Elimination and high variability of the target response were observed with the S- only and absence of S+/S-, respectively. Signaled DRL schedules are recommended for application.

Differential reinforcement of other behavior increases untargeted behavior.

Differential reinforcement of other behavior (DRO) is a commonly used technique for behavior reduction, yet there has been little to no emphasis on the possible strengthening effects on other behavior. We included 2 responses (target and other) across 3 treatment schedules (DRO, extinction, and fixed time [FT]) in a human-operant procedure to determine the extent to which reinforcer presentation at the completion of the DRO interval could strengthen other responding. A computer program arranged for unsignaled changes in contingencies to a target response and never provided reinforcers for the other response. All 13 college-student participants exhibited more other responses than target responses during at least 1 exposure to DRO. Although there was a slight increase in other behavior during extinction, overall rates of other responding were never higher than that of the target response. Furthermore, 7 of 13 participants never emitted the other response during the FT condition. The findings provide some support for the response-strengthening effects of DRO.

Further examination of discriminated functional communication.

One child with developmental disabilities was taught to mand for attention by saying "excuse me." Treatment effects were extended to multiple training contexts by teaching the participant to attend to naturally occurring discriminative stimuli through differential reinforcement of communication during periods of the experimenter's nonbusy activities (e.g., reading a magazine). Results are discussed in terms of future research on the generalization and maintenance of functional communication in the natural environment.