A Pilot Randomized Clinical Trial of a Multidisciplinary Intervention for Encopresis in Children with Autism Spectrum Disorder.

Children with autism spectrum disorder (ASD) are often delayed in achieving bowel continence, resulting in negative outcomes. In this pilot trial, 20 children with ASD and encopresis were randomly assigned to multidisciplinary intervention for encopresis (MIE; n = 10) or a waitlist control group (n = 10). The MIE group was treated for constipation and received a 10-day behavioral intervention that utilized suppositories to produce predictable bowel movements that were reinforced. Caregivers were trained to implement the intervention. Results support the feasibility of clinical trials of MIE, with high enrolment, competition, attendance, and caregiver acceptability. Preliminary outcomes were positive, with six of 10 in the MIE group achieving continence by the end of treatment compared to 0 in the control group (p = 0.005).Registered at clinicaltrials.gov (https://clinicaltrials.gov); ID: NCT02383732.

An evaluation of group activity schedules to promote social play in children with autism.

Children with autism spectrum disorder (ASD) often have deficits in social skills and may avoid engaging in play activities with typically developing peers. The purpose of this study was to identify the utility of activity schedules, with embedded scripts, to teach three children with ASD to play a complex social game. Specifically, children with ASD were taught to play hide-and-seek with typically developing peers. Once the activity schedules were introduced, participants began engaging in independent hide-and-seek behaviors. A secondary purpose of this study was to systematically fade the activity schedules to the least intrusive version. We faded all of the scripts and the majority of activity schedule components for the three participants. Participants continued to play hide-and-seek with the faded versions of the schedules in a novel environment and 2 weeks after treatment concluded.

Using caregiver report on the impact of challenging behavior exhibited by children with autism spectrum disorder to guide treatment development and outcomes.

Objectives: Evaluations of treatments using applied behavior analysis (ABA) for challenging behavior have relied mostly on direct behavioral observation. While observation is crucial, qualitative information can also be beneficial. In this study, we describe methods for using qualitative information in ABA treatments for challenging behavior. Method: Three participants were undergoing treatment for challenging behavior. Information was collected through caregiver interviews at the start and end of the admission. Directed content analysis identified themes in the interviews and we compared treatment outcomes using qualitative and quantitative measures. Results: Three themes emerged: description, frequency, and impact of the behavior. Quantitative and qualitative measures both suggested successful interventions for two participants. For the third, direct observation suggested treatment was effective while caregiver report did not. Conclusion: Incorporation of qualitative information into outcomes allowed for a more comprehensive view of treatment success and guided assessment and treatment decisions. Treatments based on applied behavior analysis (ABA) are commonly studied for the treatment of challenging behavior, but these studies rely mostly on direct behavioral observation. While observation is crucial, qualitative information is also useful in ensuring meaningful results. In this study, we describe a method of collecting, analyzing, and using qualitative information collected from caregivers and compare qualitative to quantitative outcomes.

Evaluation of interactive computerized training to teach parents to implement photographic activity schedules with children with autism spectrum disorder.

Training parents of children with autism spectrum disorder can be a challenge due to limited resources, time, and money. Interactive computerized training (ICT)-a self-paced program that incorporates instructions, videos, and interactive questions-is one method professionals can use to disseminate trainings to broader populations. This study extends previous research on ICT by assessing the effect of ICT to teach three parents how to implement a photographic activity schedule using a systematic prompting procedure with their child. Following ICT, all parents increased their fidelity to implementation of an activity schedule during role-play sessions with an adult. Fidelity remained high during implementation with their child and maintained during a 2-week follow-up.

An evaluation of photographic activity schedules to increase independent playground skills in young children with autism.

We used photographic activity schedules to increase the number of play activities completed by children with autism during unstructured time on the playground. All 3 participants engaged in more playground activities during and after training, and they continued to complete activities when novel photographs were introduced.

The use of a discrimination-training procedure to teach mand variability to children with autism.

We investigated the effects of a script-fading and discrimination-training procedure on mand variability in preschoolers with autism. Participants were taught to vary their vocal mands in the presence of written scripts, a green placemat, and a lag schedule of reinforcement. They were also taught to engage in repetitive mands in the presence of the same written scripts and a red placemat. When the scripts were removed, all 3 participants continued to engage in varied manding in the presence of the green placemat and lag schedule, and they continued to engage in repetitive manding in the presence of the red placemat. When the lag schedule was also removed, 2 of the 3 participants continued to engage in varied responding in the presence of the green placemat and repetitive responding in the presence of the red placemat. Finally, all 3 participants demonstrated generalization and maintenance of mand variability during snack sessions with their peers.

The use of linked activity schedules to teach children with autism to play hide-and-seek.

Linked activity schedules were used to establish appropriate game play in children with autism during a game of hide-and-seek. All 6 participants demonstrated acquisition of appropriate play skills in the presence of the activity schedules and maintained responding during subsequent phases. When the schedules were removed, responding decreased to baseline levels, demonstrating that the schedules controlled responding. Implications for future research on the use of activity schedules to teach social behavior are discussed.