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Background Embedded instruction and discrete-trial training are both recommended for teaching children with autism, but there is little research available comparing the two. The present study compared embedded instruction with discrete-trial training for a 12-year-old boy with autism.Method An initial functional analysis indicated that the boy's self-injury was maintained by escape from task demands. Instructional sessions to teach adaptive behaviours were conducted under two conditions: (i) during embedded instruction, learning trials were inserted into ongoing activities at a rate of approximately 1.5 per minute; (ii) during discrete-trial training, instructional opportunities were incorporated into structured sessions at a rate of 4 per minute. In both conditions, the system of least prompts was used to teach relevant target responses. Effects of the two teaching formats were evaluated using an ABABA design.Results Higher rates of self-injury and fewer correct responses occurred during discrete-trial training. Mood ratings were also lower during discrete-trial training.Conclusions The results suggest that self-injury, correct responding, and mood may be sensitive to the type of instructional format. Although discrete-trial training can be highly effective, it may be preferable to start with embedded instruction when the child presents with self-injurious escape behaviour. [ABSTRACT FROM AUTHOR]

This study assessed microswitch and computer technology to enable two participants with multiple disabilities, 32 and 19 years of age, to choose among environmental stimuli and request their repetition whenever they so desired. Within each session, 18 stimuli (12 preferred and 6 nonpreferred) were available. For each stimulus, a computer system provided a sample of 3 sec. duration. During the intervention, participants' vocal responding in relation to a stimulus sample activated a mi- croswitch and a computer system turned on that stimulus for 15-30 sec. When participants did not vocally respond, the computer system paused briefly and then presented the next scheduled stimulus sample. When participants vocally responded at the end of a stimulus presentation, the stimulus was repeated. Intervention data showed that the participants learned to choose preferred stimuli and bypass nonpreferred ones as well as to request repetitions of the preferred stimuli. This performance was maintained at a 1-mo. postintervention check and transferred to sets of stimuli not used in the intervention. The implications of these results were discussed. [ABSTRACT FROM AUTHOR]

This study assessed a writing program with word prediction, which completed the writing of a word and spoke it Out only when there was certainty that such a word was the correct one. The assessment was carried out with a young man with multiple disabilities, who typically used a word-processing program without word prediction. The two programs were compared on the time required by the participant for writing general sentences, through a social validation assessment, and eventually a check on the participant's preference. Analysis showed the program with word prediction was significantly more effective in terms of the writing time, which was halved, and was deemed preferable by 40 raters (psychology students) involved in the social validation assessment and by the participant himself. Implications of the findings are discussed. [ABSTRACT FROM AUTHOR]

Purpose. The present study assessed a microswitch-based programme designed to enable a nine-year-old boy with multiple disabilities and minimal motor behaviour to choose among environmental stimuli.Method. The programme relied on the boy's eyebrow movements, a microswitch to detect such movements, and a computer system to handle sets of allegedly preferred and non-preferred stimuli. For each of the 30 stimuli available in every session, the computer system provided a sample/preview of 2 – 3 seconds. During intervention, the boy's responding to a stimulus sample (i.e., moving the eyebrow and activating the microswitch) led the computer system to turn on that stimulus for 25 seconds. The boy's lack of responding led the computer system to present the next stimulus sample.Results. Intervention data showed that the boy's choice making (i.e., responding to a stimulus sample or avoiding to do so) was largely consistent with the alleged preference value of the stimuli, that is, he tended to choose the stimuli that were considered preferred and to bypass those considered non-preferred for him. The same performance was maintained during post-intervention checks, occurring 6 and 10 weeks after the end of the intervention, and over sets of stimuli not used during the intervention.Conclusions. The present microswitch-based programme may be considered useful to allow students with multiple disabilities an active choice (control) role in a stimulation-enriched environment. [ABSTRACT FROM AUTHOR]

Self-determination applied to augmentative and alternative communication (AAC) interventions suggests the need to assess students' preferences for various communication devices. We describe a potentially promising methodology for enabling students to indicate preference for communication devices. Implementation of this methodology is illustrated in two controlled demonstrations. In the first demonstration, two adolescents with developmental disabilities were taught to use each of three voice-output communication aids (VOCAs) to request snacks. Following acquisition, all three VOCAs were simultaneously available across repeated opportunities and the student could select which one of the three devices to use. Both students demonstrated a consistent preference for one of the VOCAs. In the second demonstration, these same two students were provided with a choice between their preferred VOCA and a communication board containing line drawings. Both students demonstrated a preference for the VOCA over the communication board. These cases illustrate a potentially useful methodology that might enable non-speaking students with developmental disabilities to participate in communication device selection. [ABSTRACT FROM AUTHOR]

PURPOSE: To evaluate parent use of functional communication training (FCT) to replace and enhance prelinguistic behaviours in six young children with developmental and physical disabilities. METHOD: Initially, the communicative functions of the children's prelinguistic behaviours were assessed by parent interviews. Three communication functions were identified for each child and intervention goals to replace or enhance the child's existing prelinguistic behaviours were developed in consultation with parents. After a baseline phase, parents received training on implementation of FCT. Intervention was staggered across the three communicative functions in a multiple-probe design. RESULTS: Intervention was associated with increases in the replacement communication behaviour. Treatment gains were generally maintained at the monthly follow-ups. CONCLUSION: The results suggest that parents can use FCT to enhance communication skills in children with developmental and physical disabilities. [ABSTRACT FROM AUTHOR]

PURPOSE: To assess the effectiveness of a computer system used as a microswitch for word utterances of two adults with multiple disabilities. The system combined a new control software programme with a commercially available speech recognition programme. METHOD: Nine word utterances were targeted for each participant. The participant's emission of those utterances triggered the occurrence of related (favourite) stimuli during the intervention and the post-intervention check. RESULTS: Intervention data showed that (1) the participants increased the frequencies of the target utterances and (2) the computer system recognized about 80% of those utterances correctly, providing the participants with high levels of favourite stimulation. The post-intervention check showed comparable data with both participants. CONCLUSIONS: The computer system proved an adequate microswitch for word utterances. Based on this evidence, microswitch programmes could be extended beyond the use of conventional motor responses. [ABSTRACT FROM AUTHOR]

Children with severe disabilities typically require systematic instruction to develop their communication abilities. Intervention can begin by teaching functional communication skills related to requesting and rejecting. Although a considerable amount of research has focused on teaching requesting, there is an emerging literature on teaching rejecting. The aim of this tutorial is to review the emerging literature on teaching communicative rejecting to children with severe disabilities. This review considers (a) the definition of communicative rejecting, (b) reasons for teaching communicative rejecting, (c) types of communicative rejecting, and (d) empirically validated strategies for teaching communicative rejecting to children with severe disabilities. The authors include a case study to illustrate the major steps in teaching communicative rejecting to children with severe disabilities. [ABSTRACT FROM AUTHOR]

There is emerging evidence to suggest individuals with intellectual disability and psychiatric disorder may be at risk for criminal offending. To explore this issue further, we reviewed 276 referrals to the New South Wales Mental Health Review Tribunal (MHRT), which evaluates offenders suspected of having psychiatric disorders. Seventeen cases (6.15%) were identified with intellectual disability and psychiatric disorder. Individuals were diagnosed with a variety of psychiatric disorders (e.g., schizophrenia personality disorder, psychotic depression) and 60% had mild to borderline intellectual disability. These individuals had been charged with a range of serious crimes including sexual assault, murder, physical assault, armed robbery, and kidnaping. Most had a history of psychiatric disturbance, criminal activity, and alcohol and drug abuse. The study suggests an urgent need to develop early screening and intervention services focused on preventing criminal behavior in cases of intellectual disability and psychiatric disorder. [ABSTRACT FROM AUTHOR]

The researchers report the results of a survey of 140 deaf and hard of hearing students attending integrated or self-contained high school classrooms in the state of New South Wales, Australia. The survey was designed to gather information about educational experiences and preferences for various types of educational placements. There were no gender differences in placement, but there were hearing status differences (81.6% of the students in segregated placements had severe or profound hearing losses, compared to 52.4% of the students in integrated settings). Even though students were aware of the advantages and disadvantages of the different placement options, 80% indicated that they were generally satisfied with their current placement. One implication is that a range of options seems to be more appropriate than a one-size-fits-all model, at least from students' perspectives. The views and preferences of students should be considered when educational provisions are designed for students who are deaf or hard of hearing. [ABSTRACT FROM AUTHOR]

BACKGROUND: Effective communication with patients is critical to effective nursing practice. Surprisingly, there is little information on nurses' experiences in caring for patients who are unable to speak. PURPOSE AND METHOD: This study provides descriptive information from interviews with 20 nurses who cared for patients with severe communication impairment. The interview protocol explored positive and negative experiences of nursing patients with severe communication impairment. Frequency counts and descriptive analyses were conducted to identify the major themes emerging from the interviews. RESULTS: The results suggest that nurse-patient communication is difficult when the patient has severe communication impairment, although some nurses discovered effective strategies to facilitate communication with such patients. Many of the difficulties could be viewed as a breakdown in understanding arising from the lack of a readily interpretable communication system that could be used by nurse and patient. CONCLUSIONS: The results suggest a need for training nurses in the use of alternative modes of communication. Nurses also need access to a variety of simple augmentative communication devices for use with patients who are unable to speak. Finally, nurses should collaborate with speech pathologists on the development of preadmission information and bedside training for people who are admitted to hospital with severe communication impairment. [ABSTRACT FROM AUTHOR]

A survey was conducted on aggressive behaviour within a population of 2412 persons with intellectual disability in Queensland, Australia. Two hundred and sixty-one individuals were identified who engaged in at least one form of aggressive behaviour, yielding an overall prevalence of 11 %. The relative prevalence of aggressive behaviour was higher among institutionalized persons (35%) when compared to those living in group homes (17%) or other community-based facilities (3%). The aggressive behaviour sample included a higher percentage of males (64%). Most were described as functioning in the severe/profound (54%) or moderate (31%) range of intellectual disability with one-third having no intelligible speech. Two-thirds of the sample received medication for their challenging behaviour, while only one-third had behavioural programmes. Eighty per cent engaged in three or more forms of aggression. Many also displayed self-injury (34%) or property destruction (30%). Surveys of aggressive behaviour may prove useful for coordinating services. [ABSTRACT FROM AUTHOR]

Summarizes the article `Functional Communication Training for the Treatment of Multiply Determined Challenging Behavior in Two Boys With Autism,' published in the 1996 issue of the journal `Behavior Modification,' by J. Sigafoos and B. Meikle.