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Childhood language delays and language impairments negatively impact educational outcomes and quality of life. In spite of previously prevailing views to the contrary, evidence suggests that children’s language acquisition is affected by contingent responses of caregivers and conversation partners, as well as by the other consequences of speaking. In other words, reinforcement contingencies play a role in language acquisition. Decades of ongoing research have documented how to arrange reinforcement contingencies to support acquisition of language and communication skills in children with varying degrees of language impairment. The existing expertise in this area should be leveraged in the design of service delivery models that provide opportunities for effective reinforcement contingencies to operate throughout the day and support acquisition of skills that have failed to develop through naturally occurring interactions.

The health benefits of consuming fruits and vegetables (FVs) are clear, but most children do not eat them regularly. At school, FVs are available, but children often refuse them or throw them away. This review article illustrates the evidence for and against behavioral–economic approaches to increasing FV consumption in schools. Simple but effective interventions include prompting children to take FVs and serving vegetables before other foods are available. Also effective is reducing their handling costs (e.g., serving sliced fruit) and opportunity costs (e.g., scheduling lunch after recess). Still larger improvements can be achieved by improving the taste of FVs, or by incentivizing consumption. Although controversial, even small incentives can produce immediate and lasting effects. Game-based virtual incentives can reduce the costs of incentive systems, while minimizing concerns that children are being bribed into healthy habit formation.

Dysfunctional health behavior is a contemporary challenge, exemplified by the increasingly significant portion of health problems stemming from people’s own behavior and decision making. The challenge not only includes the direct consequences of unhealthy behavioral patterns but also their origins and the creation of policies that effectively decrease their frequency. A framework rooted in behavioral economics identifies the processes and mechanisms underlying poor health. Two behavioral economic processes, economic demand and delay discounting, are discussed in detail. Through continued development, this behavioral economic framework can guide improved outcomes in treatment and policies related to dysfunctional health behavior. Approaches are evolving to alter demand and discounting. Current and prospective policies aimed at decreasing unhealthy behavior may profit from such research.

Although evidence supports the efficacy of biofeedback for treating a number of disorders and for enhancing performance, significant barriers block both needed research and payer support for this method. Biofeedback has demonstrated effects in changing psychophysiological substrates of various emotional, physical, and psychosomatic problems, but payers are reluctant to reimburse for biofeedback services. A considerable amount of biofeedback research is in the form of relatively small well-controlled trials (Phase II trials). This article argues for greater payer support and research support for larger trials in the “real life” clinical environment (Phase III trials) and meta-analytic reviews.

Environmental levels of hazardous chemicals, including methylmercury (MeHg), are manyfold higher now than during the preindustrial era. Behavior analysis and other basic and clinical sciences have contributed significantly to identifying and characterizing the neurobehavioral effects of these chemicals, often well before knowing the biological mechanisms of toxicity. The study of MeHg illustrates how our contemporary understanding of the motor, sensory, and cognitive effects of exposure has come from experimental laboratory models using advanced behavioral techniques, as well as carefully planned studies of exposed populations. These have informed environmental policies related to MeHg’s release into the environment and human consumption of this contaminant. Toxicity assessments based on only existing approaches to human cognitive testing, however, might underestimate its adverse effects because they do not reflect the complete picture of MeHg’s behavioral toxicity. Basic and applied behavioral science should have a future role in environmental policy decisions.

Identifying individuals at risk for psychotic disorders is now a major focus of research. The key objectives of this work are to identify mechanisms underlying the emergence of psychosis and predict impending illness, with the goal of developing preventive interventions. Despite notable progress, there is a dearth of ethically informed policies to guide disclosure, documentation, and treatment practices. The limited predictive validity of psychosis-risk criteria and stigma surrounding psychotic disorders hinder such policy development. Thus, several challenging questions remain: Does the psychosis-risk designation achieve an adequate predictive power to indicate risk for a more serious disorder? When and how should individuals learn that they are at risk for a psychotic illness, and should such information be included in medical records? What, if any, treatment recommendations should be made? This article addresses these challenges and frames the central issues confronting ethically informed policies and practices for identifying and treating psychosis-risk syndromes.

Individuals diagnosed with autism spectrum disorder (ASD) and other developmental disabilities are at risk of engaging in severe problem behavior, including aggression and self-injury. Severe problem behavior is an obstacle to proper education and integration into society. Therefore, eliminating severe problem behavior is key to long-term academic and social success. However, problem behavior can be persistent in the face of interventions and likely to relapse following successful intervention. This article describes basic and translational research relevant to understanding what influences the persistence and relapse of severe problem behavior in individuals diagnosed with ASD and other developmental disabilities. Investing in research to better understand persistence and relapse will pay dividends for clients, parents, clinicians, and society in general.

Although marijuana (MJ) has been used for thousands of years, the public’s opinion of MJ has shifted drastically over the past century, leaving many wondering about its potential risks and benefits. This article summarizes research detailing the impact of recreational MJ and related variables (frequency, magnitude, potency, and mode of MJ use) on cognition, brain structure, and brain function. MJ use, particularly at young ages, has been reported to undermine cognition, as well as alter brain structure and function. Furthermore, we discuss how data from recreational MJ studies, as well as more recent medical marijuana (MMJ) research findings, relate to legalization efforts. Considerations for policymakers, such as age limits, guidelines for safe use, and the therapeutic potential of certain constituents of MJ (i.e., cannabidiol), are also outlined. In recent years, policy has outpaced science; important areas in need of further research are noted.

Problem behavior (e.g., noncompliance, hitting) is common among young children but, depending on the child’s environment, potentially can lead to future social, emotional, and academic problems. Research in applied behavior analysis has identified many contextual variables that support appropriate behavior and provides clear suggestions for preventing frequent and persistent problem behavior. Although many empirically supported recommendations derive from the current research base, future research needs to fine-tune some of the strategies, and policy support is required to put those recommendations in place. Specific recommendations support parents and early child care professionals/teachers in preventing, assessing, and treating problem behavior in young children.

Substantial reductions in U.S. cigarette smoking and associated chronic diseases over the past 50 years have benefited health. Unfortunately, those reductions have distributed unevenly throughout the population. Smoking remains prevalent and even increasing among certain vulnerable populations: economically disadvantaged groups, those with other substance-use disorders or mental illness, certain ethnic and racial minorities, and gender and sexual minorities. Moreover, other unhealthy behavior patterns (physical inactivity, unhealthy food choices, risky sexual behavior, poor adherence to medical preventive regimens) and associated chronic diseases are also overrepresented in many of these same populations. Disparities in unhealthy behavior patterns contribute to health disparities and escalating health care costs, underscoring the need for more effective behavior-change strategies. This report reviews research on the efficacy of financial incentives for reducing smoking in vulnerable populations, while also touching on applications of that behavior-change strategy for promoting other health-related behavior changes in vulnerable populations.

Autism spectrum disorders (ASDs) are usually lifelong with wide ranging functional outcomes. Intensive behavioral intervention, implemented early, can improve outcome significantly. Some individuals, often with milder symptoms, if treated early, can attain social, cognitive, educational, and vocational functioning in the typical range. To qualify, children must be detected and diagnosed as early as possible. Without universal screening, many children from all backgrounds are not detected until past early childhood; children from economically disadvantaged and ethnic minority families are diagnosed and treated, on average, 2 years later than others. Primary care physician surveillance should incorporate parental concerns and be supplemented by universal ASD screening at 18 and 24 months. ASD screening in other community settings could detect risk in children who may not have primary or consistent medical care. Effective ASD diagnostic systems should encompass mildly affected children. Although universal screening can reduce inequities in identification, outcome disparities will persist while intervention funding remains local.

Available data have demonstrated the clinical benefits and cost-effectiveness of multi-component treatment packages for individuals early in the course of psychotic-spectrum disorders. In response, an unprecedented effort aims to disseminate such multi-component treatment programs—referred to as Coordinated Specialty Care (CSC)—throughout the United States. We review the evidence in support of CSC care for first-episode psychosis and highlight specific policy reforms that may facilitate the successful dissemination and eventual improvement of CSC programs for first-episode psychosis. Among proposed reforms are novel financing strategies for CSC services and incentivizing of continued collaboration between academic and community agencies to facilitate sustained dissemination and refinement of CSC.

Depression and anxiety are undertreated and represent a growing health crisis and economic burden. Current treatment approaches (medications, psychotherapy) appear insufficient to resolve these problems. Difficulties with current treatment approaches include cost, side effects, and stigma. Given that depression and anxiety share significant features and a common etiology in chronic stress, an effective approach to reduce depression and anxiety may be to reduce chronic stress. Chronic stress is on the rise, with more than one third of Americans reporting high levels of stress with which they feel they cannot adequately cope. Treating chronic stress at the population level has the potential to reduce the rising tide of depression and anxiety. Biofeedback and mindfulness are two interventions that demonstrably reduce stress and negative mood, are cost and time-effective, have no side effects, and have minimal stigma relative to medications and psychotherapy.

Treatments based on applied behavior analysis (ABA)—an applied science of human behavior—have been increasingly recognized in public policy, both at the federal and state levels. Despite this recognition, however, the relative newness of the science often raises questions about the nature of the treatment approach and the qualifications and regulation of its practitioners. Thus, the present article is a primer on the features of ABA most relevant to public policy stakeholders, including professional certification, licensure, and workforce expansion.

Graesser, A. C. (2015). Deeper learning with advances in discourse science and technology. Policy Insights from the Behavioral and Brain Sciences, 2, 42-50. doi:10.1177/2372732215600888