Evaluation of a telehealth training package to remotely train staff to conduct a preference assessment.

Recent advancements in telecommunication technologies make it possible to conduct a variety of healthcare services remotely (e.g., behavioral-analytic intervention services), thereby bridging the gap between qualified providers and consumers in isolated locations. In this study, web-based telehealth technologies were used to remotely train direct-care staff to conduct a multiple-stimulus-without-replacement preference assessment. The training package included three components: (a) a multimedia presentation; (b) descriptive feedback from previously recorded baseline sessions; and (c) scripted role-play with immediate feedback. A nonconcurrent, multiple-baseline-across-participants design was used to demonstrate experimental control. Training resulted in robust and immediate improvements, and these effects maintained during 1- to 2-month follow-up observations. In addition, participants expressed high satisfaction with the web-based materials and the overall remote-training experience.

Replication and extension of a check-in procedure to increase activity engagement among people with severe dementia.

Engelman, Altus, and Mathews (1999) evaluated a procedure to ensure that staff checked in with elderly residents in a nursing home and offered activity choices. We report findings of a replication, with some additional components, to increase appropriate activity engagement among 5 residents (aged 77 to 83 years) with severe dementia. Evaluated in a concurrent multiple baseline design across participants that incorporated partial withdrawal phases, activity engagement increased for 3 participants, with modest improvement for 1 other participant. The 4 responders all engaged in a wider variety of activities during intervention.

Representativeness of direct observations selected using a work-sampling equation.

Deciding on appropriate sampling to obtain representative samples of behavior is important but not straightforward, because the relative duration of the target behavior may affect its observation in a given sampling interval. Work-sampling methods, which offer a way to adjust the frequency of sampling according to a priori or ongoing estimates of the behavior to achieve a preselected level of representativeness, may provide a solution. Full-week observations of 7 behaviors were conducted for 3 students with autism spectrum disorder and intellectual disabilities. Work-sampling methods were used to select momentary time samples from the full time-of-interest, which produced representative samples. However, work sampling required impractically high numbers of time samples to obtain representative samples. More practical momentary time samples produced less representative samples, particularly for low-duration behaviors. The utility and limits of work-sampling methods for applied behavior analysis are discussed.

Calibration of observational measurement of rate of responding.

The quality of measurement systems used in almost all natural sciences other than behavior analysis is usually evaluated through calibration study rather than relying on interobserver agreement. We demonstrated some of the basic features of calibration using observer-measured rates of free-operant responding from 10 scripted 10-min calibration samples on video. Five novice and 5 experienced observers recorded (on laptop computers) response samples with a priori determined response rates ranging from 0 to 8 responses per minute. Observer records were then compared with these predetermined reference values using linear regression and related graphical depiction. Results indicated that all of the observers recorded rates that were accurate to within ±0.4 responses per minute and 5 were accurate to within ±0.1 responses per minute, indicating that continuous recording of responding on computers can be highly accurate and precise. Additional research is recommended to investigate conditions that affect the quality of direct observational measurement of behavior.

Teaching individuals with profound multiple disabilities to access preferred stimuli with multiple microswitches.

We replicated and extended previous research on microswitch facilitated choice making by individuals with profound multiple disabilities. Following an assessment of stimulus preferences, we taught 6 adults with profound multiple disabilities to emit 2 different responses to activate highly preferred stimuli. All participants learnt to activate both microswitches. Five participants showed a higher overall level of responding when both switches activating preferred stimuli were available concurrently. After completion of microswitch training, a choice assessment was conducted in which participants had access to 2 microswitches concurrently, with 1 connected to the most highly preferred stimulus and the other to a least preferred stimulus. Choice making behavior was shown in 3 participants and provided support for the preference assessment results. The results of the 3 remaining participants showed that both the most highly preferred and the least preferred stimuli may serve as reinforcers for microswitch activation responses.

Continuous recording and interobserver agreement algorithms reported in the Journal of Applied Behavior Analysis (1995-2005).

We reviewed all research articles in 10 recent volumes of the Journal of Applied Behavior Analysis (JABA): Vol. 28(3), 1995, through Vol. 38(2), 2005. Continuous recording was used in the majority (55%) of the 168 articles reporting data on free-operant human behaviors. Three methods for reporting interobserver agreement (exact agreement, block-by-block agreement, and time-window analysis) were employed in more than 10 of the articles that reported continuous recording. Having identified these currently popular agreement computation algorithms, we explain them to assist researchers, software writers, and other consumers of JABA articles.

Assessing observer accuracy in continuous recording of rate and duration: three algorithms compared.

The three algorithms most frequently selected by behavior-analytic researchers to compute interobserver agreement with continuous recording were used to assess the accuracy of data recorded from video samples on handheld computers by 12 observers. Rate and duration of responding were recorded for three samples each. Data files were compared with criterion records to determine observer accuracy. Block-by-block and exact agreement algorithms were susceptible to inflated agreement and accuracy estimates at lower rates and durations. The exact agreement method appeared to be overly stringent for recording responding at higher rates (23.5 responses per minute) and for higher relative duration (72% of session). Time-window analysis appeared to inflate accuracy assessment at relatively high but not at low response rate and duration (4.8 responses per minute and 8% of session, respectively).

Toward the use of a standardized assessment for young children with autism: current assessment practices in the UK.

Little is known about the progress of autistic children following specific interventions in England. Nor do we know how frequently standardized assessments are used to monitor progress or to evaluate specific educational interventions. The reports of 75 children with autism, for whom special educational provision had been determined by a local education authority, were reviewed. Parents were interviewed and educational psychologists were contacted for details of any norm-referenced assessments. Of these children, 39 percent had no standardized assessments before education authorities determined their provision, and only 9 percent had follow-up assessments that could be used to evaluate progress. Children with autism in the UK rarely have sufficient assessments to allow an objective evaluation of their progress. There is currently no standardized assessment protocol to prescribe a specific educational intervention, to evaluate the progress of children or to make comparisons between interventions. We recommend the development of such a protocol.

Progress and outcomes for children with autism receiving parent-managed intensive interventions.

Parent-managed behavioral interventions for young children with autism are under-researched. We analysed data from 66 children served by 25 different early intervention consultants. After a mean of 31.6 months of intervention, IQ scores had not changed (N = 22). Vineland adaptive behavior scores had increased significantly by 8.9 points (N = 21). No children aged >72 months attained normal functioning, i.e., IQ > 85 and unassisted mainstream school placement (N = 42). Progress for 60 children across 12 months was found for mental age (5.4 months), adaptive behavior (9.7 months), and language (5.1 months). The interventions did not reproduce results from clinic-based professionally directed programs. The effectiveness of the parent-managed intervention model as it has developed and the adequacy of professional services in that model are discussed.