Katherine Ledbetter-Cho

Enhanced Milieu Teaching

This chapter provides a detailed description of Enhanced Milieu Teaching (EMT) beginning with a discussion of the theoretical underpinnings of the intervention. Ten EMT studies investigating the effects of EMT with children with autism spectrum disorder and other developmental or language delays are then summarized and discussed. Next, each of the EMT intervention components and strategies are described and clarifying examples are provided. Common issues when implementing EMT and possible solutions are presented as considerations for practitioners and parents. Finally, recommendations for effective EMT implementation are extrapolated from the overview of intervention research studies and future directions for EMT investigations are suggested to address areas in need of additional research.

Evidence-Based Social Communication Interventions for Children with Autism Spectrum Disorder

Adapting communication styles is important

Effects of Script Training on the Peer-to-Peer Communication of Children with Autism Spectrum Disorder.

A multiple baseline design across participants was used to demonstrate the effects of a script-training procedure on the peer-to-peer communication of 3 children with autism spectrum disorder during group play with peers. Both scripted and unscripted initiations as well as responses to peers increased for all 3 participants. Stimulus generalization across novel toys, settings, and peers was observed. Novel unscripted initiations, responses, and appropriate changes in topics during peer-to-peer exchanges were analyzed by considering the cumulative frequency of these behaviors across phases of the study. Treatment gains were maintained during 4-week follow-up sessions. Results are discussed in terms of recommendations for practitioners, response variability, and potential future avenues of research.

Systematic review of collateral effects of focused interventions for children with autism spectrum disorder

A collateral intervention effect refers to changes in behaviors which were not directly targeted during intervention. Using predetermined search and inclusion procedures, this systematic review identified 46 studies involving children with autism spectrum disorder and 14 desirable collateral effects across multiple domains of functioning. Collateral effects were associated with: (a) interventions involving naturalistic behavioral strategies; (b) participants with limited communication and/or cognitive deficits; (c) performance deficits (i.e. there was some evidence of the collateral behavior in baseline); and (d) interventions directly targeting play, communication, joint attention, and/or stereotypy. Overall, this systematic review indicates that collateral effects arising from focused interventions warrant consideration by practitioners during intervention planning and require additional research to identify mechanisms responsible for the observed changes.

Should Heritage Languages be Incorporated into Interventions for Bilingual Individuals with Neurodevelopmental Disorders? A Systematic Review

Special education policies recognize the need for developing and preserving the heritage languages of individuals with disabilities. Yet there seems to be a disconnect between policy and practice. Should the heritage languages of bilingual individuals with neurodevelopmental disorders be incorporated into interventions? This review evaluated 18 studies that examined the effects of heritage language instruction on treatment outcomes for individuals with neurodevelopmental disorders. Overall, results suggest a small effect favoring interventions delivered in the heritage language versus interventions delivered solely in the majority language. In general, studies were also found to be of high-quality according to What Works Clearinghouse Standards. Findings are discussed in terms of recommendations for future research and practice.

Meta-analysis of Tablet-Mediated Interventions for Teaching Academic Skills to Individuals with Autism

Portable touch-screen devices have been the focus of a notable amount of intervention research involving individuals with autism. Additionally, popular media has widely circulated claims that such devices and academic software applications offer tremendous educational benefits. A systematic search identified 19 studies that targeted academic skills for individuals with autism. Most studies used the device’s built-in video recording or camera function to create customized teaching materials, rather than commercially-available applications. Analysis of potential moderating variables indicated that participants’ age and functioning level did not influence outcomes. However, participant operation of the device, as opposed to operation by an instructor, produced significantly larger effect size estimates. Results are discussed in terms of recommendations for practitioners and future research.

An interest-based intervention package to increase peer social interaction in young children with autism spectrum disorder: SOCIAL SKILLS INTERVENTION FOR CHILDREN WITH ASD

The literature suggests that children with autism spectrum disorder (ASD) educated in inclusive settings generally do not interact with typically developing classmates during social activities. This study assessed whether an intervention package consisting of interest-based structured play activities involving adult instruction, modeling, and response to child questions would result in an increase in social interaction with typically developing peers. A multiple baseline design across four participants with an embedded reversal was used to demonstrate the effects of the intervention on social interaction during structured play sessions. Initiations, responses, and interactive play increased for all participants. Generalization to novel peers was observed, and treatment gains were maintained during 6-week follow-up sessions. Recommendations for practitioners working with children with ASD in inclusive settings and potential areas of future research are discussed.

Functional communication training plus extinction is effective in reducing problem behavior maintained by environmental rearrangement

Design: First, a functional analysis was conducted within the context of a multielement design in order to identify the variables maintaining problem behavior. One of the specialized functional analysis conditions measured the occurrence of problem behavior when requests (mands) to reinstate previous environmental conditions were not honored. The rate of problem behavior in this “denied-mand” functional analysis condition then served as the baseline phase of the subsequent intervention study. The intervention was evaluated in an ABAB reversal design.

Complications and Side Effects Associated with a Lack of Toileting Skills

Individuals who do not acquired toileting skills during early childhood are at an increased risk for medical complications, social exclusion, and an overall diminished quality of life. Persistent toileting skill deficits may be caused by physiological abnormalities that complicate or prevent successful voiding of the bowel and bladder. Additionally, an individual may learn to withhold stool or urine or to engage in other behaviors that preclude successful elimination in the toilet. Frequently, physiological and learning factors act in tandem to create toileting difficulties. This chapter first addresses medical issues that may contribute to and/or arise from toileting difficulties. The remainder of the chapter focuses on the psychological and social domains that may be negatively impacted by the failure to acquire hygienic toileting skills.

Effects of video-enhanced activity schedules on academic skills and collateral behaviors in children with autism

Objectives: The effects of iPod-based visual activity schedules with embedded video models (video-enhanced activity schedules) on the academic skills and challenging behavior of children with autism spectrum disorder (ASD) were evaluated. Methods: A multiple baseline design across three target skills was used with two participants, ages 9 and 11, to assess the effects on academic skill acquisition (e.g. calculating fractions and percentages, identifying synonyms). Additionally, we assessed for potential iatrogenic effects of using a highly preferred electronic device in intervention by measuring engagement in stereotypy and challenging behavior. Results: Video-enhanced activity schedules were effective in teaching both participants to independently complete a variety of academic skills. Generalization across untaught stimuli and four-week maintenance of academic skill improvement was observed. Undesirable increases in stereotypy were not observed and challenging behavior improved over the course of the study. Conclusion: Video-enhanced activity schedules may represent an efficient treatment option for teaching new skills which reduces the need for teacher-delivered prompts and increases the independence of children with ASD.