Robert H. LaRue

Serving the needs of immigrant families of children with autism

The growing influx of immigrant families into the USA necessitates an understanding of how these families manage mental health disorders. Few studies have documented the ways in which autism spectrum disorders (ASD) are understood across different immigrant groups. This lack of knowledge creates barriers for practitioners who are encountering immigrant families in their practice. The present paper provides a conceptual framework of how cultural values and beliefs shape the way diagnosis, etiology and treatment of ASD is perceived by both immigrant families and western practitioners and how differences in perspectives may create obstacles in treatment planning. A review of the literature describing practical and cultural barriers to mental health access and research among immigrant populations is also presented. Finally, recommendations are offered to practitioners, families and individuals with ASD to aid in increasing understanding and collaboration among these populations when designing and implementing treatment interventions.

Comparison of traditional and trial-based methodologies for conducting functional analyses

Functional analysis represents a sophisticated and empirically supported functional assessment procedure. While these procedures have garnered considerable empirical support, they are often underused in clinical practice. Safety risks resulting from the evocation of maladaptive behavior and the length of time required to conduct functional analyses may deter practitioners from using models of assessment with considerable empirical support. The current study evaluated a trial-based model of functional analysis that limited opportunities to engage in problem behavior and used 1-2 min sessions to shorten analysis time. The results from the trial-based analysis were then compared to the results of traditional functional analyses. Correspondence between both models of assessment was strong. Exact correspondence was observed for 4 of the 5 participants. In addition, the trial-based procedure did not require the repeated reinforcement of maladaptive behavior and results were obtained in 84.8% less time.

ESCAPE AS REINFORCEMENT AND ESCAPE EXTINCTION IN THE TREATMENT OF FEEDING PROBLEMS

Given the effectiveness of putative escape extinction as treatment for feeding problems, it is surprising that little is known about the effects of escape as reinforcement for appropriate eating during treatment. In the current investigation, we examined the effectiveness of escape as reinforcement for mouth clean (a product measure of swallowing), escape as reinforcement for mouth clean plus escape extinction (EE), and EE alone as treatment for the food refusal of 5 children. Results were similar to those of previous studies, in that reinforcement alone did not result in increases in mouth clean or decreases in inappropriate behavior (e.g., Piazza, Patel, Gulotta, Sevin, & Layer, 2003). Increases in mouth clean and decreases in inappropriate behavior occurred when the therapist implemented EE independent of the presence or absence of reinforcement. Results are discussed in terms of the role of negative reinforcement in the etiology and treatment of feeding problems.

Social Skills and Autism: Understanding and Addressing the Deficits

Social behavior is a core deficit area of autism spectrum disorders (ASD). Therefore, considerable literature in the ABA field has been developed to address this problem area. Specific behaviors treated and ABA techniques used will be the focus of the chapter. A critical appraisal of current status and future directions will also be provided.

Central GABA Activation and Behaviors Evoked by Tail-Pinch Stress in the Rat

Experiments were conducted to evaluate the possibility that central GABA(A) receptors are involved in the stress response of rats. Separate groups of animals were implanted bilaterally with cannulae in the lateral cerebral ventricle, substantia nigra, and anterior to the rostral margin of the substantia nigra. Microinjections of the GABA(A) agonist muscimol into each of these areas augmented the stress response evoked by moderate tail pinch. Although consistent changes in the amount of food eaten in response to stress were not observed, stress-evoked gnawing was significantly increased by muscimol at all three sites. Additionally, intraventricular muscimol resulted in an enhancement of stress-evoked oral stereotypy, revolution (escape behavior), and vocalization. The data suggest that a GABAergic component exists in the central mediation of stress. The results are discussed in regard to possible interactions between GABA and central dopamine systems.

Assessing the value of token reinforcement for individuals with autism

The use of token systems has been supported across a variety of populations, but little research has evaluated the reinforcing value of token systems for individuals with autism. We used progressive-ratio schedules to compare the reinforcing value of an established token system, primary reinforcement, and tokens unpaired with reinforcement. Token systems were variably reinforcing for 2 students with autism and more so than primary reinforcement for 1 student. Results support formal assessment of the effectiveness of token systems.

Correspondence between traditional models of functional analysis and a functional analysis of manding behavior

Functional analysis procedures have been effectively used to determine the maintaining variables for challenging behavior and subsequently develop effective interventions. However, fear of evoking dangerous topographies of maladaptive behavior and concerns for reinforcing infrequent maladaptive behavior present challenges for people working in applied settings. The present investigation sought to evaluate the utility of an adjunctive functional analysis model that involved the reinforcement of mands rather than problem behavior and compared the results to traditional functional analyses. The results from the manding analysis yielded results similar to the traditional FA in 3 of 4 cases. These findings suggest that manding analyses may represent a useful assessment tool for difficult to assess problem behavior or for individuals in settings where consultative support is limited.

Sound attenuation and preferred music in the treatment of problem behavior maintained by escape from noise: ESCAPE FROM NOISE

We examined the extent to which different sounds functioned as motivating operations (MO) that evoked problem behavior during a functional analysis for two participants. Results suggested that escape from loud noises reinforced the problem behavior for one participant and escape from arguing reinforced problem behavior for the other participant. Noncontingent delivery of preferred music through sound-attenuating headphones decreased problem behavior without the use of extinction for both participants. We discuss the results in terms of the abolishing effects of the intervention.

A brief assessment for selecting communication modalities for individuals with Autism Spectrum Disorders

Abstract Individuals with autism spectrum disorders (ASD) have impairments in their ability to communicate with others. Estimates indicate that about 25–50% of children with ASD are nonvocal. To address these deficits, a number of augmentative and alternative communication strategies have emerged. Commonly used communication responses have included vocal speech, picture exchange, and manual signs. While these communication strategies have all been shown to be effective in specific clinical instances, the selection of communication topography has generally been based on philosophical preference, rather than on empirical analyses. Relatively little research has evaluated procedures to determine which modality represents a “best fit” with individual learning styles. The purpose of the current investigation was to design a brief assessment model to evaluate the rate of acquisition and preference for different communication modalities for three individuals with ASD. The results show that participants acquired different modalities of communication at different rates and displayed clear preferences for different styles of communication. These findings suggest that this procedure may help to empirically determine which communication system represents a best fit for individual learners.

Assessment and Intervention for Individuals with Attention-Deficit Hyperactivity Disorder

Attention-deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed childhood psychiatric disorders. As our understanding of ADHD has evolved, so have assessment and intervention strategies. Several assessment instruments have been developed to properly diagnose individuals with ADHD. Over the years, a number of intervention strategies have emerged for the treatment of ADHD. Considerable empirical support exists for the use of behavioral interventions and medications. Behavioral interventions have sought to address the symptoms of ADHD by targeting the core deficits of the disorder (i.e., impulsivity, hyperactivity, and inattentiveness) and identifying environmental causes of the behavior. Medications have been used to treat the deficits associated with ADHD by influencing neurotransmitters in the brain. Both approaches have evidence to support their use. Evaluation procedures should be used to determine the effectiveness of any intervention strategies (i.e., behavioral intervention, medication, or a combination).