"On-Time Autism Intervention": A Diagnostic Practice Framework to Accelerate Access.

It is well-documented that autism can be reliably diagnosed by age two and that early signs emerge most often between 18 and 24 months. However, despite the increased awareness and focus on early diagnosis, the average age of diagnosis is over 4 years old; even later for Black children and those who are Medicaid-eligible. In this paper, we will propose a framework for accurate and accelerated autism diagnosis for children before age three. The proposed framework emphasizes a collaborative diagnostic process, which relies heavily on Birth to Three provider knowledge and expertise. Considerations for next steps are presented. This approach could increase access to diagnosis of young children soon after first signs of autism emerge.

Guidance or Compliance: What Makes an Ethical Behavior Analyst?

In 2016, the Behavior Analyst Certification Board (BACB) made effective a new, revised ethical code for behavior analysts, the Professional and Ethical Compliance Code for Behavior Analysts, replacing the code that had been in effect since 2001. In this revised code, the certification board has shifted the language of the code from that of a set of guidelines to that of a set of enforceable rules. This important shift has not been well discussed in the field. This article explores the potential implications and possible consequences of such a shift and describes other ways that ethical behavior has been approached historically. The authors then propose an ethical decision-making process that might provide a better area of focus for the field of behavior analysis in seeking to develop the highest levels of ethical behavior in its professionals and provide a case example using that process to resolve an ethical dilemma.

When asking questions is not enough: an observational study of social communication differences in high functioning children with autism.

This investigation examined communication patterns between high functioning children with autism and their families and typically developing children and their families within traditional dinner time conversation. Twenty families with a child with autism (3.5-7 years.) and ten families with typically developing children (3.5-6 years) were video recorded during dinner and their interactions were coded. Results revealed that children with autism initiated fewer bids for interactions, commented less often, continued ongoing interactions through fewer conversational turns, and responded less often to family member communication bids. Results are interpreted with respect to how communication patterns may be indicative of social communication deficits not previously examined in high functioning children with autism. Strategies for social communication interventions within the family and other natural contexts are discussed.

Alternative seating for young children with Autism Spectrum Disorder: effects on classroom behavior.

A single subject, withdrawal design was used to investigate the effects of therapy balls as seating on engagement and in-seat behavior of young children with Autism Spectrum Disorder (ASD). In addition, social validity was assessed to evaluate teachers' opinions regarding the intervention. During baseline and withdrawal (A phases) participants used their typical classroom seating device (chair, bench or carpet square). During the intervention (B phases) participants sat on therapy balls. Results indicated substantial improvements in engagement and in-seat behavior when participants were seated on therapy balls. Social validity findings indicated that the teachers' preferred the therapy balls. This study suggests therapy balls as classroom seating may facilitate engagement and in-seat behavior and create opportunities to provide effective instruction.

The effects of a contoured foam seat on postural alignment and upper-extremity function in infants with neuromotor impairments.

BACKGROUND AND PURPOSE: Physical therapists and occupational therapists frequently use adaptive seating devices to improve stability in sitting for children with neuromotor impairments. The purpose of this study was to examine the effects of a contoured foam seat (CFS) on postural alignment and on the ability of infants with neuromotor impairments to engage with toys. Parental perceptions regarding the use and effects of the CFS also were assessed via semistructured interviews. SUBJECTS: Subjects were 4 infants, ages 9 to 18 months, who were unable to sit independently. METHOD: A time-series, alternating-treatments design was used, with data collected under 3 conditions: (1) a regular highchair, (2) a regular highchair with a thin foam liner, and (3) a CFS used as an insert in a regular highchair. The primary dependent measures were postural alignment and engagement with toys. Engagement with toys was defined as percentage of intervals with 2 hands on a toy and percentage of intervals with no hands on a highchair tray and 1 or 2 hands on a toy. RESULTS: Results showed a sustained effect of the CFS on improving postural alignment for all subjects. Effects of the CFS on increasing the number of intervals of bimanual play were not demonstrated for any subjects, although some improvement in the infant's ability to free the arms from support was observed for 2 subjects. Mothers reported acceptability of the CFS for everyday use and described benefits for themselves and their infants. DISCUSSION AND CONCLUSION: The results support the use of a CFS for improving postural alignment. Future research on adaptive seating should focus on interventions and outcomes that help children participate in functional activities relevant to them and their families.