Wendy Machalicek

Computer-based interventions to improve social and emotional skills in individuals with autism spectrum disorders: A systematic review

Objective: To review studies involving the use of computer-based interventions (CBI) to improve the social and emotional skills (e.g. emotional recognition) of individuals with autism spectrum disorders (ASD). Methods: The use of computer-based intervention (CBI) in the treatment of autism spectrum disorders (ASD) may offer some advantages to traditional one-to-one or group instruction including easier differentiation of instruction, decreased distractions and the incorporation of an individuals relative visual learning strengths. However, the results of past research suggest varying outcomes for CBI with individuals with ASD. This review provides a systematic analysis of studies investigating CBI to improve social and emotional skills (e.g. emotion recognition) of individuals with ASD. Electronic database searches and ancestral searches were used to identify studies that met pre-determined inclusion criteria. The included studies were then summarized in terms of: (a) participant characteristics, (b) social and emotional skills targeted, (c) details of the CBI, (d) results, and (e) certainty of evidence. Results: The results of these studies indicated that CBIs effect on social and emotional skills was mixed, with the majority of studies reporting unacceptable outcomes following intervention. Conclusions: Overall, this review suggests that the use of CBI to improve the social and emotional skills of individuals with ASD is a promising practice. A comparison of CBI plus tutoring and face-to-face social skills training suggests that CBI can be as effective as face-to-face instruction. Practitioners should carefully consider the preferences and existing abilities of individuals with ASD and the customizability of the software when deciding to use CBI and selecting a software program.

The effects of an abolishing operation intervention component on play skills, challenging behavior, and stereotypy.

The purpose of this study was to reduce stereotypy and challenging behavior during play skills instruction by adding an abolishing operation component (AOC) to the intervention strategy. An alternating treatments design compared one condition in which participants were allowed to engage in stereotypy freely before beginning the play skills intervention (AOC condition) to a second condition without this free access period (No AOC condition). Across 4 participants with autism spectrum disorders (ASD), levels of stereotypy and challenging behavior were lower and functional play was higher during play intervention sessions that followed the AOC. These data provided support for the inclusion of an AOC in interventions aimed at increasing the play skills of children with ASD who present with stereotypy.

ENHANCING THE EFFECTIVENESS OF A PLAY INTERVENTION BY ABOLISHING THE REINFORCING VALUE OF STEREOTYPY: A PILOT STUDY

An alternating treatments design compared one condition in which a child with autism was allowed to engage in stereotypy freely prior to the intervention (abolishing operation component) to a second condition without the free-access period. Levels of stereotypy and problem behavior were lower and levels of functional play were higher in the condition with the abolishing operation component. These data provide preliminary support for the use of abolishing operations in interventions to increase the play skills of children with autism.

Parent assessments of self-determination importance and performance for students with autism or intellectual disability

Fostering student self-determination is now considered an essential element of special education and transition services for children and youth with intellectual disability and/or autism. Yet, little is known about the pivotal role parents might play beyond the school campus in fostering self-determination among their children with developmental disabilities. We examined how 627 parents of children with intellectual disability or autism attending one of 34 randomly selected school districts (a) rated the importance of 7 component skills associated with self-determination, (b) assessed their childrens performance in relation to those 7 skills, and (c) evaluated the overall self-determination capacities of their children. Although parents highly valued all of the self-determination skills, the degree to which their children were reported to perform the skills well was fairly low. Several factors predicted higher levels of self-determination, including educational setting, the presence of challenging behaviors, and perceived disability severity. We conclude by offering recommendations for equipping parents to better support their childrens self-determination development.

Training parents to implement communication interventions for children with autism spectrum disorders (ASD): A systematic review

This review identifies procedures used to train parents to implement communication interventions to children with autism spectrum disorders. Systematic search procedures identified 11 studies that met predetermined inclusion criteria. Across studies, 60 parents were trained to implement Pivotal Response Training, Enhanced Milieu Teaching, Natural Language Paradigm, or Early Start Denver Model. The mean time spent training parents was 17 hours. Training procedures used most often included: (a) verbal instruction and/or instruction manuals, (b) in vivo practice, (c) role playing, (d) modeling by trainer, and (e) reviewing videos of intervention sessions. Improvements in parent ability to implement intervention and child communication were ubiquitous. However, a paucity of studies in which baseline parent behavior was measured, coupled with the absence of studies evaluating individual training procedures, precludes definitive statements regarding the most effective and efficient approach to parent training and, therefore, warrant future research.

Treatment of elopement in individuals with developmental disabilities: A systematic review

We reviewed studies involving the treatment of elopement in individuals with developmental disabilities. Systematic searches of three electronic databases, journals, and reference lists identified 10 studies meeting the inclusion criteria. These studies were evaluated in terms of: (a) participants, (b) procedures used to assess elopement, (c) intervention procedures, (d) results of the intervention, and (e) certainty of evidence. Across the 10 studies, intervention was provided to a total of 53 participants aged 3-47 years. Assessment procedures included anecdotal staff reports, participant interviews, direct observation, and modified analog functional analysis. Intervention approaches included differential reinforcement, extinction, functional communication training, response blocking, non-contingent reinforcement, shaping, and scheduled exercise. Positive outcomes were reported in 80% of the reviewed studies. The evidence base suggests that function-based assessment (e.g. functional analysis procedures) and function-based treatments (e.g. functional communication training) may be most effective in the treatment of elopement in this population. Directions for future research are offered.

A SYSTEMATIC EXAMINATION OF DIFFERENT PARAMETERS OF PRESESSION EXPOSURE TO TANGIBLE STIMULI THAT MAINTAIN PROBLEM BEHAVIOR

We examined the effects of three different presession conditions on tangibly maintained problem behavior for 2 students with autism, using individual-participant multielement designs. First, an analogue functional analysis demonstrated that problem behavior was maintained by access to tangible items. Next, topographies of item rejection were identified. Finally, students were exposed to (a) brief access, (b) no access, and (c) satiation to the tangible items prior to tangible sessions. The results demonstrated high levels of problem behavior following the brief-access and no-access presession conditions and low levels of problem behavior following the satiation condition. The findings are discussed in the context of how satiation might best be defined for these sorts of evaluations.

Behavioral treatment of chronic skin-picking in individuals with developmental disabilities: A systematic review

Skin-picking is a type of self-injurious behavior involving the pulling, scratching, lancing, digging, or gouging of ones own body. It is associated with social impairment, and increased medical and mental health concerns. While there are several reports showing that skin-picking is common in individuals with developmental disabilities, knowledge about effective treatment approaches is sparse. We therefore reviewed studies involving the treatment of chronic skin-picking in individuals with developmental disabilities. Systematic searches of electronic databases, journals, and reference lists identified 16 studies meeting the inclusion criteria. These studies were evaluated in terms of: (a) participants, (b) functional assessment procedures and results, (c) intervention procedures, (d) results of the intervention, and (e) certainty of evidence. Across the 16 studies, intervention was provided to a total of 19 participants aged 6-42 years. Functional assessment procedures included direct observations, analog functional analyses, and functional assessment interviews. The most commonly identified function was automatic reinforcement. Treatment approaches included combinations of differential reinforcement, providing preferred items and activities stimuli (e.g., toys), wearing protective clothing (e.g., helmets or gloves), response interruption and redirection, punishment, and extinction. Improvements in behavior were reported in all of the reviewed studies. Suggestions for future intervention research are offered.

Functional Analysis and Treatment of Elopement across Two School Settings.

The elopement of a child with Asperger syndrome was assessed using functional analyses and was treated in two school settings (classroom and resource room). Functional analyses indicated that elopement was maintained by access to attention in the resource room and obtaining a preferred activity in the classroom. Attention- and tangible-based interventions were compared in an alternating treatments design in both settings. Results validated the findings of the functional analyses. Implications for the assessment and treatment of elopement are discussed.

A preliminary comparison of functional analysis results when conducted in contrived versus natural settings

A preliminary evaluation of the correspondence between functional analysis outcomes across settings was conducted with 2 children who had been diagnosed with autism and who engaged in challenging behavior. Differences across settings (a therapy room and a classroom) were demonstrated in ABAB reversal designs. Three potential patterns of results that may occur when comparing functional analyses across environments are described, and one possible explanation for the occurrence of discrepancies between environments (differing learning histories within separate environments) is offered.