C. T. Yu

Prediction of treatment outcomes and longitudinal analysis in children with autism undergoing intensive behavioral intervention

Outcome prediction is an important component of treatment planning and prognosis. However, reliable predictors of intensive behavioral intervention (IBI) have not been clearly established. IBI is an evidence-based approach to the systematic teaching of academic, social, verbal, and daily living skills to individuals with autism spectrum disorder. Incorporating longitudinal analysis to IBI outcome studies may help to identify outcome predictors of clinical value. Twenty-four children with autism underwent on average two years of IBI and completed language, daily living skills, cognitive, and motor assessments (Early Learning Accomplishment Profile and the Learning Accomplishment Profile-Diagnostic, 3rd edition) every six months. We used multilevel analysis to identify potential longitudinal predictors including gender, age, intervention intensity, intervention duration, total intervention time, and pre-intervention functioning. Results indicated that total intervention time, pre-intervention functioning, and age caused the greatest increase in goodness-of-fit of the longitudinal multilevel models. Longitudinal analysis is a promising analytical strategy to identify reliable predictors of the clinical outcome of IBI.

ON THE RELATION BETWEEN REINFORCER EFFICACY AND PREFERENCE

Most research on stimulus preference and reinforcer assessment involves a preference assessment that is followed by a reinforcer assessment. Typically, the most and least preferred stimuli are tested as reinforcers. In the current study, we first quantified the reinforcing efficacies of six food items and then assessed relative preference for each item. Relative preference ranking and reinforcer efficacies showed almost perfect concordance for 1 participant and partial concordance for the other. Discordance tended to occur with the weakest reinforcers.

The hierarchical relationship between several visual and auditory discriminations and three verbal operants among individuals with developmental disabilities.

This study examined the relationship between performance on the Assessment of Basic Leaming Abilities test (ABLA), two auditory matching tasks, and a test of echoics, tacts, and mands with persons with developmental disabilities. It was found that discrimination skill (visual, auditory-visual, and auditoryauditory discriminations) was a better predictor of performance on verbal operant assessments than level of functioning based on diagnosis. The results showed high test-retest reliability for the test of verbal operants and no hierarchical relationship was found among the three verbal operants. The results suggest that the ABLA Level 6 might be a possible bridging task for teaching echoics, tacts, and mands. Further research is needed to ascertain the relation between the auditory matching tasks and the verbal operants.

Predicting the Relative Efficacy of Verbal, Pictorial, and Tangible Stimuli for Assessing Preferences of Leisure Activities

We measured the relationships between choice stimulus modalities and three basic discriminations (visual, visual matching-to-sample, and auditory-visual) using the Assessment of Basic Learning Abilities test. Participants were 9 adults who had moderate to profound developmental disabilities. Their most and least preferred leisure activities, identified by prior preference assessments, were presented using choice stimuli in three modalities (tangibles, pictures, and verbal descriptions) in an alternating-treatments design. For 8 of the 9 participants, discrimination skills predicted the selections of choice stimuli associated with their preferred activities. The results suggest that choice stimulus modalities in preference assessment of leisure activities need to be matched to the discrimination skills of persons with developmental disabilities.

Clinical decision making and preference assessment for individuals with intellectual and developmental disabilities.

Individuals with intellectual or developmental disabilities are able to reliably express their likes and dislikes through direct preference assessment. Preferred items tend to function as rewards and can therefore be used to facilitate the acquisition of new skills and promote task engagement. A number of preference assessment methods are available and selecting the appropriate method is crucial to provide reliable and meaningful results. The authors conducted a systematic review of the preference assessment literature, and developed an evidence-informed, decision-making model to guide practitioners in the selection of preference assessment methods for a given assessment scenario. The proposed decision-making model could be a useful tool to increase the usability and uptake of preference assessment methodology in applied settings.

Visual--Visual Nonidentity Matching Assessment: A Worthwhile Addition to the Assessment of Basic Learning Abilities Test.

The Assessment of Basic Learning Abilities test (ABLA) is a useful tool for choosing appropriate training tasks for persons with developmental disabilities. This test assesses the ease or difficulty with which persons are able to learn six hierarchically positioned discrimination tasks. A visual-visual nonidentity matching prototype task was examined to assess its (a). relation to the ABLA hierarchy, (b). predictive validity, and (c). test-retest reliability. Results from 23 participants with developmental disabilities suggest that visual-visual nonidentity matching is a worthwhile addition to the ABLA test and is positioned in the ABLA hierarchy above Level 4 (visual-visual identity matching) and below Level 6 (auditory-visual discrimination). The prototype visual-visual nonidentity matching task also demonstrated high predictive validity and test-retest reliability.

Teaching Adaptive and Social Skills to Individuals with Autism Spectrum Disorders

The purpose of this chapter is to review intervention strategies that have been researched for teaching adaptive and social skills to children with autism spectrum disorders (ASDs). We hope that the chapter will be useful for practitioners and that it will also stimulate further research. Before beginning our review, we briefly describe ASDs (a more thorough discussion of the characteristics of ASDs can be found in Chapter 1 of this volume).

Predicting Learning Ability of People With Intellectual Disabilities: Assessment of Basic Learning Abilities Test Versus Caregivers' Predictions

Two sets of predictions were compared concerning the ability of 20 adults with profound, severe, or moderate intellectual disabilities to learn 15 everyday tasks. Predictions were made by caregivers who had worked with the participants for a minimum of 24 months and consideration of participant performance on the Assessment of Basic Learning Abilities (ABLA) test. Standardized training procedures were used to attempt to teach each task to each participant until a pass or fail criterion was met. Ninety-four percent of predictions based on ABLA performance were confirmed, and the ABLA was significantly more accurate for predicting client performance than were the caregivers. The utility of these results is discussed.

Does ABLA Test Performance on the ABLA Test Predict Picture Receptive Name Recognition with Persons with Severe Developmental Disabilities

Research has shown that performance on the Assessment of Basic Learning Abilities (ABLA) test correlates with language assessments for persons with developmental disabilities. This study investigated whether performance on ABLA Level 6, an auditory-visual discrimination, predicts performance on a receptive language task with persons with severe developmental disabilities. Five participants who passed ABLA Level 6, and five who failed ABLA Level 6, were each tested on five 2-choice discriminations that required them to point to pictures of common objects after hearing their names. Four of the five participants who had failed ABLA Level 6 failed all of the receptive name recognition tasks. All five participants who had passed ABLA Level 6 passed all of the name recognition tasks. The practical implications of these results are discussed.

A Population-Based Longitudinal Study of Depression in Children With Developmental Disabilities in Manitoba

In this population-based study, prevalence of depression was estimated and compared between children with and without developmental disability (DD). Twelve years of administrative data were linked to identify a cohort of children with DD living in the Canadian province of Manitoba. Children in the study cohort were matched with children without DD as to sex, age, and region of residence. Prevalence of depression was estimated and compared between the two groups using the Generalized Estimating Equations technique. It was found that the estimated prevalence of depression among children with DD was almost twice as high as that of children in the matched comparison group. The estimated relative risk was statistically significant, RR = 2.13 (95% CI: 1.94, 2.33, p < .001). With age, the prevalence of depression among children in both groups increased. These findings suggest an urgent need for the development of mental health promotion programs targeted at children with DD.