Laura Rojeski

Comparisons of intervention components within augmentative and alternative communication systems for individuals with developmental disabilities: a review of the literature.

Decisions regarding augmentative and alternative communication (AAC) for individuals with developmental disabilities (e.g. what AAC to use and how to teach a person to use a specific AAC modality) should involve consideration of different intervention component options. In an effort to elucidate such decisions and options, this review synthesized 14 studies, published between 2004 and 2012, comparing different AAC intervention components including different symbol sets, instructional strategies, or speech output within aided AAC systems, and different verbal operants within unaided AAC. Evidence supported the following: (a) different instructional strategies such as building motivation, using errorless learning, or adding video models to picture exchange interventions may improve the acquisition or rate of acquisition of picture exchange mands, (b) limited data supports training mimetic (imitated) or mand signs over tacts and (c) differences in symbol sets and speech output levels appeared to have little effect on AAC-based mand acquisition, but listener-based differences should be considered. These findings have implications for future research and clinical practice.

Comparing Acquisition of AAC-Based Mands in Three Young Children with Autism Spectrum Disorder Using iPad ® Applications with Different Display and Design Elements

Augmentative and alternative communication (AAC) applications may differ in their use of display and design elements. Using a multielement design, this study compared mand acquisition in three preschool-aged males with autism spectrum disorder, across three different displays in two iPad® AAC applications. Displays included a Widgit symbol button (GoTalk), a photographical hotspot (Scene and Heard), and a Widgit symbol button along with a photograph (Scene and Heard). Applications had additional design differences. Two participants showed more rapid and consistent acquisition with the photographical hotspot than with the symbol button format, but did not master the combined format. The third participant mastered all three conditions at comparable rates. Results suggest that AAC display and design elements may influence mand acquisition.

Effects of tangible and social reinforcers on skill acquisition, stereotyped behavior, and task engagement in three children with autism spectrum disorders

Children with autism spectrum disorders (ASDs) are more likely to engage in inappropriate play (e.g., stereotypy, repetitive behavior) with their preferred items given as reinforcers. Considering the stereotyped behavior is a core characteristic of ASD aimed to reduce, it is necessary to identify alternative reinforcers that does not encourage problematic behavior as well as is still effective. In this respect, the present study evaluates a possible alternative reinforcer: social interaction. The study compared the effects of preferred tangible and social reinforcers on skill acquisition, stereotyped behavior, and task engagement during the instruction period in three children, 3-8 years of age, with ASDs. This study had two phases: in the first phase, preference assessments and reinforcer assessments were conducted to identify the most highly preferred items and relative preferred type of reinforcers. In the second phase, teachers taught the target skills using two different reinforcers and the three dependent variables were compared between two reinforcer conditions. The results suggest that the reinforcers were equally effective; however tangible reinforcers resulted in high levels of stereotyped behavior. The results indicate that social reinforcers can be efficient reinforcers for the population. The study discussed making an efficient reinforcement decision for individuals with ASD.

Increasing the Vocalizations of Individuals with Autism during Intervention with a Speech-Generating Device.

This study aimed to teach individuals with autism spectrum disorder (ASD) and limited vocal speech to emit target vocalizations while using a speech-generating device (SGD). Of the 4 participants, 3 began emitting vocal word approximations with SGD responses after vocal instructional methods (delays, differential reinforcement, prompting) were introduced. Two participants met mastery criterion with a reinforcer delay and differential reinforcement, and 1 met criterion after fading an echoic model and prompt delay. For these participants, vocalizations initiated before speech outputs were shown to increase, and vocalizations generalized to a context in which the SGD was absent. The 4th participant showed high vocalization rates only when prompted. The results suggest that adding vocal instruction to an SGD-based intervention can increase vocalizations emitted along with SGD responses for some individuals with ASD.

Assessing the acquisition of requesting a variety of preferred items using different speech generating device formats for children with autism spectrum disorder

ABSTRACT Five children with autism spectrum disorder (ASD) were taught to request preferred items using four different augmentative and alternative communication (AAC) displays on an iPad®-based speech-generating device (SGD). Acquisition was compared using multi-element designs. Displays included a symbol-based grid, a photo image with embedded hotspots, a hybrid (photo image with embedded hotspots and symbols), and a pop-up symbol grid. Three participants mastered requesting items from a field of four with at least three displays, and one mastered requesting items in a field of two. The fifth participant did not acquire requests in a field of preferred items. Individualized display effects were present, and the photo image appeared to have provided the most consistent advantages for three participants. Some errors were more or less common with specific displays and/or participants. The results have important implications for AAC assessment and implementation protocols.

Assistive Technology for People with Behavior Problems

This chapter provides a selective overview of the use of assistive technology used to support persons with diverse abilities who engage in problem behavior. By it is nature this is a very broad topic and incorporates a wide array of populations and assistive technologies strategies. The chapter begins with a description and definition of problem behavior. Next is an overview of the characteristics of the populations that have received assistive technology interventions to treat problem behavior. This overview of population characteristics will enhance the reader’s understanding of the nature of problem behavior and also provide a deeper understanding of the rationale for the use of various assistive technologies in the following section of the chapter. The next section of the chapter provides a selective overview of the assistive technologies used to manage problem behavior. Assistive technology strategies will be divided into two general categories—those that focus on (a) antecedent cue or self-control strategies (enhancing stimulus control of adaptive behavior and/or teaching persons to monitor their own behavior) and (b) consequence strategies (providing consequences contingent upon problem behavior or teaching persons to use appropriate communication to access desired consequences). The final section provides an overview of the clinical and academic implications of the use of assistive technologies to support persons with behavior problems.

Research involving anxiety in non-human primates has potential implications for the assessment and treatment of anxiety in autism spectrum disorder: A translational literature review

Abstract Objective: The purpose of this translational review (i.e. moving from basic primate research toward possible human applications) was to summarize non-human primate literature on anxiety to inform the development of future assessments of anxiety in non-verbal individuals with autism spectrum disorder (ASD). Methods: Systematic searches of databases identified 67 studies that met inclusion criteria. Each study was analysed and summarised in terms of (a) strategies used to evoke anxiety, (b) non-verbal behavioural indicators of anxiety and (c) physiological indicators of anxiety. Results: Eighteen strategies were used to evoke anxiety, 48 non-verbal behavioural indicators and 17 physiological indicators of anxiety were measured. Conclusions: A number of the strategies used with non-human primates, if modified carefully, could be considered in the ongoing effort to study anxiety in individuals with ASD. Potential applications to the assessment of anxiety in humans with ASD are discussed.

Functional Assessment of Problematic Forms of Prelinguistic Behavior

Autism spectrum disorder is associated with communication impairment and problem behavior such as aggression and self-injury. Researchers have found an inverse relation between problem behavior and communicative competence, suggesting that some problem behavior might have a communicative basis. Additional support for this relation emanates from studies aimed at identifying variables that control problem behavior with experimental-functional analysis methodology. In this chapter, we review the results of current research that has used experimental-functional analyses of problem behavior among individuals with autism spectrum disorder. Results suggest that a substantial percentage of individuals with autism spectrum disorder present with problem behavior controlled by (a) attention from another person, (b) access to preferred objects/activities, and/or (c) escape from or avoidance of non-preferred objects/activities/people. Problem behavior controlled by these variables might be conceptualized as prelingusitic forms of intentional communication related to (a) recruiting attention, (b) requesting access to preferred objects/activities, and/or (c) rejecting non-preferred objects/activities/people. In such cases, intervention aimed at replacing the problematic forms by teaching appropriate communication alternatives has proven to be effective. Challenges in conducting experimental-functional analyses and interpreting their results are discussed, as are directions for future research related to replacing problematic prelinguistic forms with more acceptable alternatives.

Evaluation of functional communication training as a satiation procedure to reduce challenging behavior in instructional environments for children with autism

Objectives: For individuals with challenging behavior, antecedent interventions such as modifying the motivation for the behavior have shown to be effective. In this study, we examined the effects of giving the participants the opportunity to continuously request tangible items (e.g. toys and activities) prior to instruction to determine if allowing them to satiate on the item would serve as an effective intervention to reduce challenging behavior maintained by access to the items. Method: Functional analyses identified that access to tangible items maintained the challenging behavior of four children with autism spectrum disorder. The children were then trained using Functional Communication Training (FCT) to request the items. Prior to 15 mins academic and/or functional skill instructional sessions, participants were exposed to either an FCT session and allowed to request the tangible items or did not receive an FCT session. The no FCT condition consisted of the child’s typically scheduled activities, without access to the preferred items maintaining challenging behavior for at least one hour prior to instruction. Following the FCT or no FCT conditions, we measured challenging behavior and academic engagement during 15-mins sessions of one-on-one instruction. Results: When instruction was preceded with FCT as a satiation intervention, we observed lower levels of challenging behavior and higher levels of academic engagement compared to no FCT conditions for two of four participants. Conclusion: Overall, the results of this study appear to support the use of FCT as a viable satiation procedure to reduce challenging behavior in instructional settings.

Inborn and Acquired Brain and Physical Disabilities

Abstract In this chapter, we describe the application of interventions, based on the principles of applied behavior analysis (ABA), to individuals with a variety of intellectual and physical disabilities. ABA has an extensive and successful record in terms of developing evidence-based effective interventions for individuals with a variety of disabilities. In fact, the application of ABA with these populations is so diverse it would warrant several volumes to describe it in adequate detail. Within the confines of this chapter we have elected to give just a flavor of the wide variety of applied issues addressed with this broad population. The chapter is divided into four sections to reflect four broad categories of disability—inborn brain disorders, acquired brain disabilities, inborn physical disabilities, and, finally, acquired physical disabilities. Each of the four sections begins with a definition of the disability and then describes three or four empirically evaluated applied behavioral interventions.