Deictic Relational Responding and Perspective-Taking in Autistic Individuals: A Scoping Review.

Perspective-taking skills are crucial for successful social interactions and some autistic individuals seem to demonstrate great difficulty in this area. The concept continues to generate clinical and research interest across mainstream psychology and within behavior analysis. Within behavior analysis, relational frame theorists have argued that deictic relational responding is critically involved in perspective-taking. We conducted a systematic search of the behavior analytic studies on deictic relational responding and perspective-taking in autistic individuals to highlight methods used to test perspective-taking and deictic relations, methods to train these if deficits were observed, and evidence for a relationship between deictic relational responding and perspective-taking. Seven studies met inclusion criteria and we conducted a descriptive analysis of these studies. We found some variation in the methods used to test and train perspective-taking through deictic relations. Only three of the studies attempted to demonstrate a link between deictic relational responding and perspective-taking. Overall, our review highlighted a need for more research into deictic relational responding and perspective-taking in autistic individuals, and we discussed specific areas for future research.

Naming: What Do We Know So Far? A Systematic Review.

Although the term naming is used colloquially in the English language, it refers to a specific instance of verbal behavior within behavior analysis. Since Horne and Lowe's (Horne & Lowe, 1996) seminal account on naming, the concept continues to generate clinical and research interest to-date. We conducted a systematic search of the behavior analytic studies on naming to highlight the methods that were used to test naming, the terminology that have been adopted, the conceptual underpinnings, and the methods used to train naming if it was found to be absent. Forty-six studies met inclusion criteria and we conducted a descriptive analysis of these studies. We found that most studies either used the terms naming or bidirectional naming. We found wide variation in the methods used to test and train naming. Nearly one third of these studies attempted to offer evidence that naming facilitated some other type of behavior, and the remaining studies attempted to train naming in individuals when the behavior was found to be absent. Overall, our review highlighted that there exists a rich empirical dataset on testing and training naming within behavior analysis, and we discussed specific areas for future research.

Reducing face touching through haptic feedback: A treatment evaluation against fomite-mediated self-infection.

Fomite-mediated self-infection via face touching is an understudied transmission pathway for infectious diseases. We evaluated the effect of computer-mediated vibrotactile cues (presented through experimental bracelets located on one or both hands of the participant) on the frequency of face touching among eight healthy adults in the community. We conducted a treatment evaluation totaling over 25,000 min of video observation. The treatment was evaluated through a multiple-treatment design and hierarchical linear modeling. The one-bracelet intervention did not produce significantly lower levels of face touching across both hands, whereas the two-bracelet intervention did result in significantly lower face touching. The effect increased over repeated presentations of the two-bracelet intervention, with the second implementation producing, on average, 31 fewer face-touching percentual points relative to baseline levels. Dependent on the dynamics of fomite-mediated self-infection via face touching, treatment effects could be of public health significance. The implications for research and practice are discussed.

An Evaluation of Ethnicity-Matching for Caregiver Telehealth Training in India.

Telehealth has become an increasingly viable service delivery option for function-based treatment of problem behavior (Lindgren et al., 2016). However, few applications have occurred with participants outside the United States and little research exists evaluating the role that culture plays in service delivery. In the current study, we compared functional analyses and functional communication training delivered via telehealth by ethnically matched and ethnically distinct trainers to six participants in India. We measured the effectiveness using a multiple baseline design while collecting supplemental measures of sessions to criterion, cancellations, treatment fidelity, and social validity. We directly assessed preference for the ethnically matched and ethnically distinct trainers using a concurrent chains arrangement. Sessions with both trainers were effective in reducing problem behavior and increasing functional verbal requests for participating children, and treatment fidelity was high across training modalities. There were no major differences in sessions-to-criterion or cancellations across trainers. However, all six caregivers demonstrated greater preference for sessions with the ethnically matched trainer.

Verbal behavior development theory and relational frame theory: Reflecting on similarities and differences.

Relational frame theory and verbal behavior development theory are two behavior-analytic perspectives on human language and cognition. Despite sharing reliance on Skinner's analysis of verbal behavior, relational frame theory and verbal behavior development theory have largely been developed independently, with initial applications in clinical psychology and education/development, respectively. The overarching goal of the current paper is to provide an overview of both theories and explore points of contact that have been highlighted by conceptual developments in both fields. Verbal behavior development theory research has identified how behavioral developmental cusps make it possible for children to learn language incidentally. Recent developments in relational frame theory have outlined the dynamic variables involved across the levels and dimensions of arbitrarily applicable relational responding, and we argue for the concept of mutually entailed orienting as an act of human cooperation that drives arbitrarily applicable relational responding. Together these theories address early language development and children's incidental learning of names. We present broad similarities between the two approaches in the types of functional analyses they generate and discuss areas for future research.

Social referencing training in children with autism spectrum disorder: A randomized controlled study.

Children with autism spectrum disorder (ASD) have been shown to exhibit fewer instances of social referencing compared to their typically developing peers. The current study evaluated the effectiveness of multiple-exemplar training, prompting, and social reinforcement to teach social referencing. We used a single-blind randomized control trial with a multiple-baseline design nested within the experimental group to evaluate treatment effects. Twenty-five children with ASD participated. Participants in the treatment group showed significantly higher social referencing scores. However, there were no statistically significant differences between the groups in the posttraining initiating and responding to joint attention scores. The clinical implications of our findings are discussed.

Nonsimultaneous stimulus presentations and their role in listener naming.

Previous studies on naming have presented the object and its name simultaneously during both training and testing, and thus the training component may establish a transformation of function directly between the object and the name. Successful tests for listener naming may thus not require the emergence of a novel (entailed) transformation of function. The current study aimed to control for this possibility by presenting the object and the name sequentially and nonsimultaneously. Eight typically developing toddlers participated in the current study. During name training, objects and names were presented nonsimultaneously, and all participants failed to emit listener-naming responses during the first test session. Subsequently, 4 participants received multiple exemplar training, which led to improvements in listener naming for all 4; and speaker naming for only 1 participant. As a control condition, the remaining 4 participants were tested repeatedly, without multiple exemplar training, and did not show any consistent improvements in their listener or speaker performances. Multiple exemplar training thus appeared to be effective in establishing generalized listener responses, which involved generating entailed transformation of functions. The strategy of using nonsimultaneous stimulus presentations could allow for greater precision in identifying the behavioral processes involved in listener-naming.

Telehealth mask wearing training for children with autism during the COVID-19 pandemic.

SARS-CoV-2 is the virus causing COVID-19 and is spread through close person-to-person contact. The use of face masks has been described as an important strategy to slow its transmission. We evaluated the effects of coaching caregivers via telehealth technologies to teach face mask wearing to children with autism spectrum disorder. Six participants with a history of challenging behavior associated with mask wearing were recruited from different parts of the world, and trained using graduated exposure, shaping, and contingent reinforcement. By the end of the intervention, all participants wore a face mask for a period of 10 min without exhibiting challenging behavior. The skills generalized to a novel mask or a community setting. Mask wearing did not affect the percentage of oxyhemoglobin saturation of participants, and caregivers found the intervention useful. The findings support previous tolerance training treatment evaluations in children with developmental disorders exhibiting resistance to healthcare routines.

Evaluating the Efficacy and Social Validity of a Culturally Adapted Training Program for Parents and Service Providers in India.

In regions such as India, where one-to-one behavior-analytic intervention is not easily accessible, parents and service providers may advocate for children with disabilities better if they have foundational training in behavioral approaches to problem behavior. The purpose of this study was to evaluate a culturally adapted training delivered in an underresourced region of India. Ten parents and professionals from Chennai completed the training, and the researchers evaluated its effects using a multiple-baseline design. Participants showed improvements in correct responses on a structured form designed to capture skills involved in function-based assessment and intervention, as well as the fidelity of implementation of extinction and functional communication training. Moreover, participants rated the acceptability of training highly on measures of social validity. Guidelines for the education of parents and service providers in underresourced areas outside of the United States are discussed.

A systematic review of cultural adaptations in the global application of ABA-based telehealth services.

With telehealth gaining acceptance as a service delivery method, behavior analysts are now providing services to individuals worldwide. This review highlights the cultural adaptations used in ABA-based telehealth treatments for individuals with ASD outside of the United States. Nine studies met our inclusion criteria and the data were synthesized narratively. All studies reported some type of cultural adaptation, with most studies reporting changes made to the service delivery method. This included using translated materials; training in the language of the client; and matching the trainer in birthplace, ethnicity, or gender with the participants. The adaptations described in published research can serve as a resource for behavior analysts who have interest in global telehealth services. However, given the emerging nature of this area of research, it is challenging to know which adaptations are necessary to achieve optimal outcomes. The review concludes with ideas for research development in this area.

Further Analysis of the Immediate and Subsequent Effect of RIRD on Vocal Stereotypy.

Although numerous studies have shown that response interruption and redirection (RIRD) can decrease vocal stereotypy displayed by children with autism spectrum disorder, relatively few have evaluated the subsequent effects of RIRD. We evaluated the immediate (when a change agent implemented RIRD) and subsequent (after a change agent discontinued RIRD) effects of RIRD on two participants' vocal stereotypy using a nonconcurrent multiple baseline design with an embedded reversal design combined with a multiple schedule. As a part of the analysis, we conducted the fourth component 25 min after the third component. In addition, we compared the effects of RIRD with 5-min and 20-min components on both participants' vocal stereotypy. Results show that (a) RIRD during either 5-min or 20-min components decreased each participant's immediate engagement in vocal stereotypy, (b) only RIRD during 20-min components decreased each participant's subsequent engagement in vocal stereotypy relative to the no intervention component, and (c) the subsequent effects of RIRD did not extend into the fourth component for either participant.

Using Multiple Exemplar Training to Teach Empathy Skills to Children with Autism.

The purpose of the study was to use multiple exemplar training to teach empathetic responding to two children with autism. Three emotions-happiness, frustration and sadness/pain-were chosen for this purpose. Treatment consisted of verbal prompting and reinforcement of empathetic responses. Four experimenter-defined categories with discriminative stimuli were used for each emotion. The multiple exemplar component of the model consisted of teaching responses in the presence of several discriminative stimuli drawn from the predefined categories for each emotion delivered by two persons across two environments. Results were evaluated using a multiple baseline design across behaviours and indicate a systematic increase in responses with the introduction of treatment across each category for both participants. Generalization of responses from training to non-training stimuli in both participants was observed during probe trials and was maintained during follow-up probes.