William H. Ahearn

An Assessment of Food Acceptance in Children with Autism or Pervasive Developmental Disorder-Not Otherwise Specified

Some children with autism and pervasive developmental disorder-not otherwise specified (PDD-NOS) have been reported to have atypical feeding behavior, such as sensitivity to food texture and selective preferences for particular foods. No systematic studies of feeding behavior in this population have been published. Munk and Repp (1994) developed methods for assessing feeding problems in individuals with cognitive and physical disabilities that allow categorization of individual feeding patterns based on responses to repeated presentations of food. In this study, we systematically replicated the Munk and Repp procedures with children with autism and PDD-NOS. Thirty children, ages 3 to 14 years, were exposed to 12 food items across 6 sessions. Food acceptance, food expulsion, and disruptive behavior were recorded on a trial-by-trial basis. Approximately half of the participants exhibited patterns of food acceptance, indicating selectivity by food category or food texture. Others consistently accepted or rejected items across food categories. Whether these patterns of food acceptance are atypical remains to be determined by comparison with the feeding patterns of typically developing children and other children with developmental delays.

USING VIDEO MODELING TO TEACH RECIPROCAL PRETEND PLAY TO CHILDREN WITH AUTISM

The purpose of the present study was to use video modeling to teach children with autism to engage in reciprocal pretend play with typically developing peers. Scripted play scenarios involving various verbalizations and play actions with adults as models were videotaped. Two children with autism were each paired with a typically developing child, and a multiple-probe design across three play sets was used to evaluate the effects of the video modeling procedure. Results indicated that both children with autism and the typically developing peers acquired the sequences of scripted verbalizations and play actions quickly and maintained this performance during follow-up probes. In addition, probes indicated an increase in the mean number of unscripted verbalizations as well as reciprocal verbal interactions and cooperative play. These findings are discussed as they relate to the development of reciprocal pretend-play repertoires in young children with autism.

Toward a behavioral analysis of joint attention.

Joint attention (JA) initiation is defined in cognitive-developmental psychology as a child’s actions that verify or produce simultaneous attending by that child and an adult to some object or event in the environment so that both may experience the object or event together. This paper presents a contingency analysis of gaze shift in JA initiation. The analysis describes reinforcer-establishing and evocative effects of antecedent objects or events, discriminative and conditioned reinforcing functions of stimuli generated by adult behavior, and socially mediated reinforcers that may maintain JA behavior. A functional analysis of JA may describe multiple operant classes. The paper concludes with a discussion of JA deficits in children with autism spectrum disorders and suggestions for research and treatment.

A Comparison of Most-to-Least and Least-to-Most Prompting on the Acquisition of Solitary Play Skills

Two studies are presented in which common prompting procedures were evaluated while teaching children with autism to build Lego® play structures. In the first study, most-to-least (MTL) and least-to-most (LTM) prompting were compared. All participants learned to build the play structures when the teacher used MTL, which was associated with fewer errors than LTM. Nonetheless, three participants learned more quickly with LTM. This finding suggests that MTL may prevent errors, but it sometimes slows learning. The second study compared LTM to MTL without and with a delay (MTLD). MTLD provided an opportunity for the child to independently initiate responding but still minimized the likelihood of errors. Results showed that acquisition was nearly as rapid when the teacher used MTLD as LTM but it produced fewer errors than LTM. Best practice guidelines for choosing prompting procedures are proposed.

Assessing progress and outcome of early intensive behavioral intervention for toddlers with autism

Intensive behavioral intervention for young children diagnosed with autism can produce large gains in social, cognitive, and language development. Although several studies have identified behaviors that are possible indicators of best outcome, changes in performance are typically measured using norm-referenced standardized scores referencing overall functioning level rather than via repeated observational measures of autism-specific deficits (i.e., social behavior). In the current study, 83 children with autism (CWA), aged 1, 2 and 3 years, and 58 same-aged typically developing children (TDC) were directly observed in the areas of cognitive skills, joint attention (JA), play, and stereotypic behavior using a measure called the Early Skills Assessment Tool (ESAT; MacDonald et al., 2006). CWA were assessed at entry into an EIBI program and again after 1 year of treatment. Changes in performance were compared pre- and post-treatment as well as to the normative data by age. Results indicate significant gains on the ESAT across all age groups with the greatest gains seen in the children who entered treatment prior to their second birthday. Increases were seen on direct measures of JA, play, imitation and language while decreases were seen in stereotypy regardless of level of performance at entry into EIBI. The ESAT, a direct measurement tool, served as a sensitive tool to measure changes in autism symptomatology following EIBI treatment.

THE EFFECTS OF RESPONSE INTERRUPTION AND REDIRECTION AND SERTRALINE ON VOCAL STEREOTYPY

Although response interruption and redirection (RIRD) has been shown to be successful in reducing vocal stereotypy, recent reports have suggested that selective serotonin reuptake inhibitors (SSRIs) may also reduce these behaviors. The purpose of the current investigation was to examine the effects of RIRD with and without sertraline on automatically maintained vocal stereotypy of a 4-year-old boy with autism. Results suggested that vocal stereotypy decreased when RIRD was implemented and that sertraline did not affect the participants vocal stereotypy.

ESTABLISHING DERIVED TEXTUAL CONTROL IN ACTIVITY SCHEDULES WITH CHILDREN WITH AUTISM

Activity schedules are often used to facilitate task engagement and transition for children with autism. This study evaluated whether conditional discrimination training would serve to transfer the control from activity-schedule pictures to printed words (i.e., derived textual control). Two preschoolers with autism were taught to select pictures and printed words given their dictated names. Following training, participants could respond to printed words by completing the depicted task, match printed words to pictures, and read printed words without explicit training (i.e., emergent relations).

RESISTANCE TO DISRUPTION IN A CLASSROOM SETTING

Substantial experimental evidence indicates that behavior reinforced on a denser schedule is more resistant to disruption than is behavior reinforced on a thinner schedule. The present experiment studied resistance to disruption in a natural educational environment. Responding during familiar activities was reinforced on a multiple variable-interval (VI) 7-s VI 30-s schedule for 6 participants with developmental disabilities. Resistance to disruption was measured by presenting a distracting item. Response rates in the disruption components were compared to within-session response rates in prior baseline components. Results were consistent with the predictions of behavioral momentum theory for 5 of 6 participants.

THE EFFECTS OF VERBAL OPERANT TRAINING AND RESPONSE INTERRUPTION AND REDIRECTION ON APPROPRIATE AND INAPPROPRIATE VOCALIZATIONS

Past research has shown that response interruption and redirection (RIRD) can effectively decrease automatically reinforced motor behavior (Hagopian & Adelinis, 2001). Ahearn, Clark, MacDonald, and Chung (2007) found that a procedural adaptation of RIRD reduced vocal stereotypy and increased appropriate vocalizations for some children, although appropriate vocalizations were not targeted directly. The purpose of the current study was to examine the effects of directly targeting appropriate language (i.e., verbal operant training) on vocal stereotypy and appropriate speech in 3 children with an autism spectrum disorder. The effects of verbal operant (i.e., tact) training were evaluated in a nonconcurrent multiple baseline design across participants. In addition, RIRD was implemented with 2 of the 3 participants to further decrease levels of vocal stereotypy. Verbal operant training alone produced slightly lower levels of stereotypy and increased appropriate vocalizations for all 3 participants; however, RIRD was required to produce acceptably low levels of stereotypy for 2 of the 3 participants.

A Procedure for Identifying Precursors to Problem Behavior.

We describe a procedure for differentiating among potential precursor responses for use in a functional analysis. Conditional probability analysis of descriptive assessment data identified three potential precursors. Results from the indirect assessment corresponded with those obtained from the descriptive assessment. The top-ranked response identified as a precursor according to the indirect assessment had the strongest relation according to the probability analysis. When contingencies were arranged for the precursor in a functional analysis, the same function was identified as for target behavior, supporting the utility of indirect and descriptive methods to identify precursor behavior empirically.