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The field of digital therapeutics (DTx), software programs that prevent, manage, and treat medical conditions, continues to grow. DTx offers new treatment options and has the potential to close gaps in care caused by unmet patient needs, provider shortages, or socioeconomic or geographical disparities. However, the field of DTx has not seen steady adoption owing to barriers, particularly related to coverage, payer acceptance of the category, provider use, and integration within existing health care delivery tools. One challenge for payers to effectively evaluate and cover DTx products is ensuring that consistent data elements are listed for these products in traditional drug compendia databases. Managed care organizations will need similar information about DTx product features as are available for traditional medications to inform coverage and reimbursement decisions. The Academy of Managed Care Pharmacy DTx Advisory Group developed and distributed a request for information to the 5 top drug compendia companies to assess how compendia products incorporate DTx and prescription DTx. This article summarizes how DTx are listed within different compendia products and offers insights on future data needs to adequately inform payers. As the DTx sector grows and consumer demand rises, compendia listing services will need to evolve to accommodate these new therapies and treatment modalities and facilitate patient access and efficient claims processing. Recommendations for how compendia companies can support managed care in these efforts are outlined.

In combination with cell-intrinsic properties, interactions in the tumor microenvironment modulate therapeutic response. We leveraged single-cell spatial transcriptomics to dissect the remodeling of multicellular neighborhoods and cell-cell interactions in human pancreatic cancer associated with neoadjuvant chemotherapy and radiotherapy. We developed spatially constrained optimal transport interaction analysis (SCOTIA), an optimal transport model with a cost function that includes both spatial distance and ligand-receptor gene expression. Our results uncovered a marked change in ligand-receptor interactions between cancer-associated fibroblasts and malignant cells in response to treatment, which was supported by orthogonal datasets, including an ex vivo tumoroid coculture system. We identified enrichment in interleukin-6 family signaling that functionally confers resistance to chemotherapy. Overall, this study demonstrates that characterization of the tumor microenvironment using single-cell spatial transcriptomics allows for the identification of molecular interactions that may play a role in the emergence of therapeutic resistance and offers a spatially based analysis framework that can be broadly applied to other contexts., (© 2024. The Author(s), under exclusive licence to Springer Nature America, Inc.)

Previous research has supported selecting development-matched targets rather than age-matched targets to teach play skills to children with autism spectrum disorder. However, few studies have been conducted, and replications and extensions of this research are needed. The current study replicated Pane et al. (2022) by comparing the acquisition of development-matched and age-matched play targets when teaching play skills to four children with autism. No contrived prompts or consequences were used to teach play skills in either condition. Extensions included identifying targets via a newer version of the Developmental Play Assessment, targeting different play categories, assessing additional imitation skills, and conducting a caregiver assessment to identify socially valid toys, play actions, and vocalizations based on each participant's common experiences and preferences as well as their caregiver's values and preferences. As in Pane et al., participants demonstrated a higher level of scripted play actions in the development-matched condition., (© 2024 The Author(s). Journal of Applied Behavior Analysis published by Wiley Periodicals LLC on behalf of Society for the Experimental Analysis of Behavior (SEAB).)

During conversation, people often endeavor to convey information in an understandable way (finding common ground) while also sharing novel or surprising information (exploring new ground). Here, we test how friends and strangers balance these two strategies to connect with each other. Using fMRI hyperscanning, we measure a preference for common ground as convergence over time and exploring new ground as divergence over time by tracking dyads' neural and linguistic trajectories over the course of semi-structured intimacy-building conversations. In our study, 60 dyads (30 friend dyads) engaged in a real-time conversation with discrete prompts and demarcated turns. Our analyses reveal that friends diverge neurally and linguistically: their neural patterns become more dissimilar over time and they explore more diverse topics. In contrast, strangers converge: neural patterns and language become more similar over time. The more a conversation between strangers resembles the exploratory conversations of friends, the more they enjoy it. Our results highlight exploring new ground as a strategy for a successful conversation., (© 2024. The Author(s).)

We evaluated the effects of a discrimination training procedure for establishing praise as a reinforcer for three children with autism spectrum disorder. After establishing two praise words as discriminative stimuli and two nonsense words as S-deltas, we evaluated whether the stimuli then functioned as reinforcers by presenting each stimulus as a consequence for a new response. The results demonstrated that previously neutral praise words functioned as reinforcers and nonsense words did not. As in previous studies on establishing reinforcers, the effects were transitory, and praise words did not continue to function as reinforcers after repeated exposure without discrimination training. Recommendations are provided for future research and maintaining reinforcement effects., (© 2024 Society for the Experimental Analysis of Behavior (SEAB).)

Aims: Anastomosing haemangiomas are benign tumours with anastomosing vascular channels that may mimic angiosarcoma. While anastomosing haemangiomas have been described in diverse locations, particularly the abdominal/paraspinal region, data on anastomosing haemangiomas in the mediastinum remain limited. We report the clinicopathological, radiological and molecular characteristics of the largest single-institutional series of mediastinal anastomosing haemangiomas., Methods and Results: In our pathology archives in 2011-23, we reviewed all vascular lesions involving the mediastinum and identified seven anastomosing haemangiomas. Clinical information was abstracted from medical charts; available radiological imaging was reviewed. Targeted DNA-based next-generation sequencing (447 genes, including GNAQ and GNA11) was performed on five cases. The seven patients included five women and two men, with an age range of 55-77 (median = 72) years. Of the six tumours with available radiology, two each were in the prevascular, visceral and paravertebral mediastinum, with lobulated peripheral enhancement in all tumours examined with contrast enhancement. Six patients underwent tumour resection; one patient received proton radiotherapy. Microscopically, each tumour was solitary and characterised by anastomosing capillary-sized vessels lined by hobnail endothelial cells. Fibrin microthrombi, hyaline globules and extramedullary haematopoiesis were common. In the five tumours analysed by next-generation sequencing, GNAQ p.Q209P was identified in one tumour; no additional reportable alterations were identified in the remaining cases. No recurrence was noted in the four patients with available follow-up of 3-58 (median = 9.5) months after resection., Conclusion: While mediastinal anastomosing haemangiomas can microscopically mimic angiosarcoma, awareness of this entity and radiological correlation may help to circumvent this diagnostic pitfall., (© 2023 John Wiley & Sons Ltd.)

The purpose of this study was to assess whether variations in visual stimulus presentation during tact training would affect efficacy, efficiency, and the emergence of listener responses. Participants included two preschool-aged children diagnosed with autism. We implemented two teaching conditions using an adapted alternating treatment design with intrasubject replications. During successive tact training, the experimenter presented one picture per trial. During simultaneous training, the experimenter pointed to the target picture in a stimulus array. For one participant, both procedures were similarly effective and efficient. For another participant, successive tact training generated fewer errors and better efficiency results. Moreover, both formats resulted in accurate listener responding. Our results suggest that both procedures are effective, and that the simultaneous format may be a viable alternative for teaching tacts., (© Association for Behavior Analysis International 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Recent behavior analytic studies have examined behavioral skills training to teach adults to arrange safe infant sleeping environments. These studies were conducted in an analogue environment and with all training components delivered by an expert staff trainer. The purpose of the current study was to replicate and extend this literature by substituting video-based training for behavioral skills training. We assessed whether expectant caregivers could arrange safe infant sleeping environments following video-based training. The results suggested that video-based training alone resulted in positive outcomes for a portion of participants, whereas a subset of participants required feedback to reach mastery criteria. The social validity data suggest that the participants found the training procedures favorable., (© 2023 Society for the Experimental Analysis of Behavior (SEAB).)

Intraverbal behavior is a type of verbal behavior in which the response form has no point-to-point correspondence with its verbal stimulus. However, the form and occurrence of most intraverbals is under the control of multiple variables. Establishing this form of multiple control may depend on a variety of preestablished skills. The purpose of Experiment 1 was to evaluate these potential prerequisites with adult participants using a multiple probe design. The results suggest that training was not required for each putative prerequisite. In Experiment 2, probes for all skills were conducted following convergent intraverbal probes. The results showed that convergent intraverbals only emerged when proficiency of each skill was demonstrated. Finally, Experiment 3 evaluated alternating training of multiple tact and intraverbal categorization. The results showed that this procedure was effective for half of the participants., (© 2023 Society for the Experimental Analysis of Behavior.)

Sleep-related infant deaths are one of the top causes of infant mortality in the United States. A few behavior analytic studies have examined behavioral skills training to teach adults to arrange safe infant sleeping environments. These studies were conducted in an analogue environment, and no data were collected outside the training setting. The purpose of the current study was to replicate and extend the extant literature. We taught caregivers to arrange safe infant sleeping environments in a community-based organization. Thereafter, we assessed the feasibility and effectiveness of a technology-based contingency management procedure to examine caregivers' adherence with arrangement of a safe sleeping environment for their newborns across a 2-week period. As in previous studies, behavioral skills training resulted in positive outcomes, and follow-up data suggested that the technology-based contingency management procedure may be a promising approach to promoting adherence with infant sleeping environment recommendations., (© 2023 Society for the Experimental Analysis of Behavior (SEAB).)

Background: Mesencephalic astrocyte-derived neurotrophic factor (MANF) is an endoplasmic reticulum (ER) stress response protein that plays an important role in pancreatic functions. As both alcohol and ER stress response proteins are involved in the pathogenesis of pancreatitis, we sought to investigate the expression of MANF in chronic alcoholic pancreatitis (CAP) and chronic non-alcoholic pancreatitis (CNP)., Methods: A cohort of chronic pancreatitis tissues was gathered from routine surgical pathology ( n = 77) and autopsy ( n = 10) cases and tissue microarrays were created. Sampled tissues were reviewed and designated as representing CAP ( n = 15), CNP ( n = 58), or normal pancreatic tissue (NPT) ( n = 27). MANF immunohistochemistry (IHC) and digital image analysis were performed to obtain an estimation of tissue fibrosis and an optical density (OD) of MANF IHC in ducts and acini for each case. The averaged values for these variables among histologic designations were compared., Results: The amount of fibrous tissue of the combined CAP and CNP group (chronic alcoholic and non-alcoholic pancreatitis, CANP) exceeded that of the NPT group (70% vs. 34%, p < 0.0001). The MANF OD in ducts of CANP was significantly higher than that of NPT (0.19 vs. 0.10, p < 0.05). The MANF OD in ducts of CAP was significantly higher than that of CNP (0.27 vs. 0.17, p < 0.05). The MANF OD in acini of CAP was significantly lower than that in CNP (0.81 vs. 1.05, p < 0.05). Finally, there was a statistically significant positive relationship between the amount of fibrosis and MANF OD in ducts ( p < 0.001)., Conclusions: MANF expression was higher in ducts of CAP than CNP. In contrast, MANF expression in acini was lower in CAP than CNP and NPT. There was a positive correlation between fibrosis and MANF levels in the ducts.

Although health care delivery is becoming increasingly digitized, driven by the pursuit of improved access, equity, efficiency, and effectiveness, progress does not appear to be equally distributed across therapeutic areas. Oncology is renowned for leading innovation in research and in care; digital pathology, digital radiology, real-world data, next-generation sequencing, patient-reported outcomes, and precision approaches driven by complex data and biomarkers are hallmarks of the field. However, remote patient monitoring, decentralized approaches to care and research, "hospital at home," and machine learning techniques have yet to be broadly deployed to improve cancer care. In response, the Digital Medicine Society and Moffitt Cancer Center convened a multistakeholder roundtable discussion to bring together leading experts in cancer care and digital innovation. This viewpoint highlights the findings from these discussions, in which experts agreed that digital innovation is lagging in oncology relative to other therapeutic areas. It reports that this lag is most likely attributed to poor articulation of the challenges in cancer care and research best suited to digital solutions, lack of incentives and support, and missing standardized infrastructure to implement digital innovations. It concludes with suggestions for actions needed to bring the promise of digitization to cancer care to improve lives., (©Smit Patel, Jennifer C Goldsack, Grace Cordovano, Andrea Downing, Karen K Fields, Cindy Geoghegan, Upinder Grewal, Jorge Nieva, Nikunj Patel, Dana E Rollison, Archana Sah, Maya Said, Isabel Van De Keere, Amanda Way, Dana L Wolff-Hughes, William A Wood, Edmondo J Robinson. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 04.01.2023.)

Evidence-based procedures, such as computer-based instruction, have been used to train staff to implement behavioral technologies with high treatment integrity. The purpose of the present study was to address the gaps in Romer et al. (2021) by assessing the same computer-based instruction module to train relevant staff to implement discrete trial instruction. Results suggest computer-based instruction is effective, efficient, and a socially valid procedure to use to teach relevant staff to implement discrete trial instruction., Supplementary Information: The online version contains supplementary material available at 10.1007/s40617-022-00731-7., Competing Interests: Conflicts of InterestAll other authors declare they have no conflicts of interest., (© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2022.)

According to the Behavior Analyst Certification Board (BACB), services commonly provided by behavior analysts include writing and revising protocols for teaching new skills. To our knowledge, there are currently no published, peer-reviewed articles or texts focused on developing skill acquisition protocols. The purpose of this study was to develop and evaluate the effectiveness of a computer-based instruction (CBI) tutorial on acquisition of skills related to writing an individualized protocol based on a research article. The tutorial was developed based on a variety of expert samples recruited by the experimenters. Fourteen students enrolled in a university behavior analysis program participated in a matched-subjects group experimental design. The training was separated into three modules on protocol components, identifying important information in a research article, and individualizing the protocol for a learner. Training was self-paced and completed in the absence of a trainer. The training included the following behavioral skills training components: instruction, modeling, individualized pacing, opportunities to actively respond and rehearse skills, and frequent specific feedback. The tutorial resulted in a significant increase in accuracy of protocols during posttest when compared to a textual training manual. This study contributes to the literature by applying CBI training procedures to a complex skill, as well as evaluating training in the absence of a trainer, and provides a technology for clinicians to learn effectively and efficiently to write a technological, individualized, and empirically based protocol., Competing Interests: Conflicts of Interest/Competing InterestsThe authors have no conflicts of interest to declare that are relevant to the content of this article., (© Association for Behavior Analysis International 2022.)

Despite the vast amount of research on increasing independence for individuals with autism spectrum disorder, there is a lack of research on techniques for fostering independent on-task behavior and accuracy in the absence of an instructor. Though increasing distance of the instructor and altering reinforcer delivery have been shown in a few studies to produce independence in the absence of an instructor, no study to date has compared the effects of systematic fading and complete removal of an instructor. In the current study, we evaluated the effects of three conditions on the on-task behavior and accuracy of adolescents with autism spectrum disorder: instructor present (instructor with participant and conditioned reinforcers delivered within session ), instructor absent (instructor not with the participant and no within-session conditioned reinforcers), and instructor fading (gradual, systematic fading of instructor and thinning of within-session conditioned reinforcers). Across all three participants, the intervention was effective in maintaining criterion levels of on-task behavior and accuracy. Responding generalized to novel instructors and remained high during maintenance evaluations for all participants. Clinicians rated the procedures as having high social validity., Competing Interests: Conflict of InterestThe authors declare that they have no conflict of interest., (© Association for Behavior Analysis International 2022.)

Recent data indicate that BACB certificants are largely homogenous with respect to racial and gender identity. There is also evidence that many practitioners do not receive training in culturally responsive service delivery (CSRD). Applied behavior analysis (ABA) graduate programs would therefore benefit from incorporating training on diversity and CSRD. In this pilot investigation, a pre/post design was used to evaluate the effects of providing ABA faculty members with a supplemental diversity/CRSD curriculum on the presence of diversity/CRSD content in course syllabi. Six faculty members, who were collectively responsible for teaching courses in an ABA master's program, participated in this study. All participants were provided with a general list of resources related to diversity/CRSD in ABA. The supplemental curriculum included tailored diversity course objectives and supporting resources for courses assigned to the intervention group. Results suggest that the provision of tailored objectives and supporting resources to faculty may lead to increases in diversity/CRSD content in course syllabi. Despite the methodological shortcomings of this pilot investigation, this study represents a preliminary step toward the development of a line of empirical research on ABA graduate training and diversity/CRSD. Implications for graduate training programs in ABA and future research in this area are discussed., Supplementary Information: The online version contains supplementary material available at 10.1007/s40617-022-00714-8., Competing Interests: All authors declare they have no conflicts of interest. Informed consent was obtained from all individual participants included in the study. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards., (© Association for Behavior Analysis International 2022.)

This was the first study to evaluate procedures for teaching leg shaving to individuals with disabilities. Using a video prompting teaching package in a concurrent multiple baseline design across participants with different diagnoses (i.e., paraplegia, Down Syndrome, and intellectual disability), all participants learned to shave their legs and maintained responding two weeks post-intervention., Competing Interests: Conflicts of InterestThe authors have no conflicts of interest to declare that are relevant to the content of this article., (© Association for Behavior Analysis International 2022.)

Many behavior analysts currently work in school settings or with individuals who may qualify for educational services through federal special education law. However, it remains unclear what training, if any, behavior analysts receive in this law. Behavior analysts have an ethical responsibility to practice within their scope of competency and in compliance with legal regulations. Thus, it is important to determine whether behavior analysts practicing in the United States are adequately prepared and familiar with federal special education law. The current study consisted of a survey wherein respondents answered questions pertaining to the relevance of federal special education law, their familiarity with core terminology, and the alignment between the law and the Professional and Ethical Compliance Code for Behavior Analysts (Behavior Analyst Certification Board, 2016). Respondents' self-report indicates that behavior analysts hold conflicting views on how federal special education law aligns with and influences their role as service providers. As such, practitioners and agencies alike may benefit from explicit clarification of the responsibility Board Certified Behavior Analysts have to seek training in and adhere to federal special education law., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© Association for Behavior Analysis International 2022.)

With the rise in popularity of media pieces depicting alternative sexual/relationship preferences, there has been a rise in interest in kink and BDSM (Sprott & Berkey, 2015), which corresponds with research suggesting that approximately 20% of Americans have been in a consensually non-monogamous relationship (Haupert et al., 2016). Despite this growing popularity, these populations are often stigmatized and misunderstood (Bettinger, 2002). The present study examined the self-reported experiences of individuals who have participated in kink, BDSM, non-monogamy, and/or polyamory. Specifically, the study used qualitative methodology to examine narratives of discrimination, harassment, coming out, being outed, consent violations, and/or sexual assault in a BDSM or non-monogamous encounter. Participants consisted of 67 adults who completed an online survey conducted by the National Coalition for Sexual Freedom and were asked to provide narratives of their experience. Data were analyzed using a modified consensual qualitative research methodology (CQR-M; Spangler et al., 2012). Results indicated 11 categories falling into three domains: navigating incidents (consent issues, negotiation of scenes or relationships, identity/beliefs about coming out, and reporting), contributing factors (role of social media/media, exacerbating factors, and beliefs about the community), and response/prevention (outcome of incident, emotions felt, lessons learned from incident by the participant, and what would be helpful from the community). This study contributes to our understanding of the experiences in this community and elucidates strategies that can be used to intervene and advocate for these populations, including education of the general public and deliberate community support., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objectives: Previous reviews highlight the similarities in teaching healthcare and hygiene routines to individuals with and without intellectual and developmental disabilities. Additionally, similar interventions are used when interfering behaviors occur. Although these routines are topographically distinct, there are enough similarities to suggest effective procedures for one routine may be used to inform another. This scooping review aims to identify effective teaching and intervention procedures for healthcare and hygiene routines specifically for individuals with intellectual and developmental disabilities. We also evaluated the extent to which functional analyses were conducted; a dimension not included in previous reviews., Methods: Eligible articles targeted compliance or tolerance within the context of a defined healthcare or hygiene routine as a dependent variable and used an experimental design with a demonstration of experimental control. Articles were identified through PsycINFO, PubMed, and Academic Search Premier databases. Additionally, a hand search of five related journals was conducted. Data were collected on dependent variables, functional analyses, baseline contingencies, teaching procedures, and additional experimental components., Results: A total of 52 articles met inclusion criteria. Most experiments produced positive outcomes. The findings show all experiments involved a treatment package with multiple components. The most common teaching procedures were graduated exposure and DRA. A lack of functional analyses and social validity was noted., Conclusions: Component analyses are needed to identify the most effective and efficient procedures. Pyramidal training to teach medical professionals how to provide preventative pyramidal training should be explored., Supplementary Information: The online version contains supplementary material available at 10.1007/s41252-022-00249-7., Competing Interests: Conflict of InterestThe authors declare no competing interests., (© The Author(s), under exclusive licence to Springer Nature Switzerland AG 2022.)

Staff training is an important line of research to ensure that clinicians in the field of applied behavior analysis provide quality services. One approach to providing training involves the use of asynchronous training materials in which the trainer and trainee do not need to be physically present at the same time. This allows for training despite limited numbers of trainers or geographic restrictions. The purpose of this study was to train participants to create equivalence-based instruction (EBI) materials in Qualtrics, a commercial survey software package. In the first phase of the study, participants experienced a training package consisting of a video model and task analysis that described how to create EBI materials. Phase 2, evaluated whether the EBI materials created in Phase 1 led to equivalence-based responding. Results indicated that the training was effective for training staff and that staff found the training socially acceptable. Results also demonstrated that the EBI materials resulted in the learning of the trained and derived relations., Supplementary Information: The online version contains supplementary material available at 10.1007/s40732-021-00497-4., (© Association for Behavior Analysis International 2022.)

Prescription opioid misuse remains a significant cause of morbidity and mortality associated with drug overdose. Researchers, government agencies, public health interests, and professional organizations support the benefits of naloxone coprescribing for patients on chronic opioid therapy to prevent deaths from opioid overdose. However, gaps remain in the provision of naloxone to patients at risk. Currently, less than 1% of patients who should be prescribed naloxone with their opioid medications obtain a prescription for naloxone, illustrating an opportunity for health care providers to conduct thorough risk assessments for patients taking opioids and coprescribing naloxone to those at risk. There are documented barriers to the provision of naloxone for primary care providers, pharmacists, and patients. Managed care organizations have also created barriers. To better understand and evaluate trends in treatment, coverage, policies, and needs associated with providing health services to patients with substance use disorders, the Academy of Managed Care Pharmacy (AMCP) Addiction Advisory Group conducted a survey in 2019. Eighty percent of the managed behavioral health organizations and 47% of AMCP payer members who responded to the survey encouraged naloxone coprescribing in patients at high risk of overdose; however, no organizations require coprescribing. Health plans, managed care organizations, prescribers, pharmacists, patients, and others have important roles in decreasing the morbidity and mortality associated with opioid overdose. In particular, managed care organizations can take specific and meaningful actions to implement payment policies that improve naloxone coprescribing for patients at risk. In this article, opportunities have been outlined for managed care leadership that actively support public health policies for naloxone coprescribing, and 7 recommendations are presented. DISCLOSURES: The AMCP Addiction Advisory Group and the development of this article were supported by Alkermes and Precision Toxicology. Sponsors participated in the advisory group, which provided guidance in the development of the manuscript. Dharbhamalla is employed by AMCP. Skelton is a paid consultant working with AMCP.

For most children with autism spectrum disorder (ASD), manding for information is an important skill that must be systematically taught. Although previous studies have evaluated interventions for teaching other mands for information, to date no studies have demonstrated effective procedures for teaching the mand "why?" The purpose of the present study was to teach 3 children with ASD to mand "why?" under relevant establishing operation conditions in 3 distinct scenarios. A trial-unique multiple-exemplar procedure was used to promote generalization and increase the value of information provided across trials. All 3 participants learned to mand "why?" in all 3 scenarios within a mean of 18 sessions (range 14-21 sessions), demonstrated generalization to novel stimuli and settings, and maintained this skill over time. Social validity for the intervention had an overall mean of 5.88 (range 1-7)., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© Association for Behavior Analysis International 2021.)

A number of variables may influence the effectiveness and efficiency of skill acquisition. One variable that may be important is set size. The current study replicated and extended Kodak et al. (2020, "A Comparison of Stimulus Set Size on Tact Training for Children With Autism Spectrum Disorder," Journal of Applied Behavior Analysis , 53 (1), 265-283) by evaluating the stimulus set size that led to the most efficient skill acquisition for 2 adolescents with autism spectrum disorder. More specifically, we evaluated tact acquisition in stimulus set sizes of 3, 6, and 12. The set sizes of 3 and 6 stimuli were associated with the most efficient acquisition, whereas the set size of 12 stimuli was not., Competing Interests: Conflict of interestAll authors report no conflicts of interest., (© Association for Behavior Analysis International 2020.)

Background: In early childhood, the family dietary and activity environment and parent food-related practices have been found to be important predictors of children's weight. However, few studies account for both of these factors, or the interaction between the 2, when assessing BMI in early childhood. This study aims to examine the association between the family-based dietary and activity environment (including intake, physical activity, and structure) and children's BMI z-scores in the context of parent food-related behaviors in low-income families during the preschool years. Methods: Parents ( n  = 111) completed questionnaires assessing the family-based dietary and activity environment, including diet, physical activity, screentime and sleep, and their use of parent food-related behaviors including parent-centered ( i.e. , controlling) and child-centered ( i.e. , autonomy supportive) practices. Children's BMI z-scores were calculated from researcher-measured height and weight. Results: Parent-centered food-related behaviors were directly related to children's BMI z-scores and moderated the association between the family-based dietary and activity environment and children's BMI z-scores. Family-based behaviors were associated with lower BMI only when parents used fewer parent-centered behaviors. Conclusions: Findings indicate that programs working with low-income families to prevent child obesity should stress both the creation of a healthy home environment and the use of positive parent food-related behaviors with preschool aged children.

Infant siblings of children with an autism spectrum disorder (ASD) diagnosis (i.e., infants at risk of ASD) are excellent candidates for early interventions based on the principles of applied behavior analysis. This study replicates and extends behavioral research using contingent social reinforcement procedures (i.e., vocal imitation and motherese speech) to increase both vocalizations and echoics among 3 infants at risk of ASD with their mothers in the natural environment. Results confirmed earlier findings that contingent reinforcement, specifically vocal imitation, reliably produces high rates of vocalizations, echoic approximations, and emerging pure echoic repertoires in at risk infants., Competing Interests: Conflicts of InterestThe authors declare that no relevant conflicts of interest influenced the nature of the present research investigation., (© Association for Behavior Analysis International 2020.)

Video-based instruction has been effective in teaching a range of skills, including functional living skills, to individuals with autism spectrum disorder. Few studies have compared the efficacy and efficiency across video modality-specifically, comparing video modeling to video prompting. Consequently, practitioners have little empirical guidance when selecting between procedural variations of video-based instruction. Using an adaptive alternating-treatments design with a baseline, we evaluated the comparative effectiveness of point-of-view video modeling and video prompting on the percentage of meal preparation tasks completed correctly and on-task behavior with 4 adolescents with autism spectrum disorder. We found video modeling to be effective and efficient in the acquisition of meal preparation skills across 3 of the 4 participants. Across participants, video prompting resulted in more errors than video modeling did. Skills generalized to an untrained location and were maintained at a 3-week follow-up. Stakeholders reported procedures, goals, and outcomes as socially valid., Competing Interests: Conflict of InterestAll authors declare that they have no conflicts of interest related to this pursuit., (© Association for Behavior Analysis International 2020.)

All components of behavioral skills training may not be necessary to effectively train staff to implement behavior-analytic technologies with children with disabilities. This study evaluated manualized instruction to train inexperienced staff to implement a token economy with a confederate and collect data on learner responding. A nonconcurrent multiple-baseline design across staff trainees was used to evaluate the effectiveness of manualized instruction to increase the staff trainees' accurate implementation of a token economy. Additionally, a modified general case analysis was conducted to identify potential child behaviors. Multiple-exemplar training of these behaviors was presented in random order during sessions. Following the use of the manualized instruction, staff trainees' accurate implementation of a token economy and data collection on confederate responding increased, the skills generalized from a confederate to a child with autism spectrum disorder, and the skills maintained 1 month following training., Competing Interests: Conflict of InterestAll authors declare that they have no conflicts of interest., (© Association for Behavior Analysis International 2019.)

People diagnosed with autism spectrum disorder (ASD) may need specific teaching to learn mands for information. Unfortunately, little research has been published on methods for teaching the mand "When?" to this population. The purpose of the current study was to replicate and extend previous research by teaching 3 children diagnosed with ASD to mand "When?" by teaching multiple topographies of the mand, measuring mand variability, assessing social validity, interspersing a previously acquired mand for information, using multiple-exemplar training, employing a different experimental preparation, and including participants with different skill sets. All participants (a) learned to mand "When?" only during establishing operation trials (not during abolishing operation trials) within 8 teaching trials, (b) generalized manding with novel items and a novel person and setting, (c) maintained a previously learned mand for information, and (d) maintained skills at follow-up. Upon mastery, 2 participants varied mand topography. Respondents rated the intervention as having high social validity., Competing Interests: Conflict of InterestThe authors declare that they have no conflict of interest., (© Association for Behavior Analysis International 2019.)

Being familiar with world religions and their diverse practices is referred to as religious literacy . The present study compared the effects of stimulus equivalence-based instruction (EBI) and video lecture (VL) to increase religious literacy in middle-school students; 10 participants were assigned to either the EBI or the VL group. Participants in the EBI group were taught five 6-member equivalence classes using match-to-sample (MTS) software on a computer. Within each class of (1) Judaism, (2) Islam, (3) Christianity, (4) Hinduism, and (5) Buddhism, the visual stimulus members were (A) name of the religion, (B) major religious symbol, (C) sacred text, (D) notable religious figure, (E) name of religious service leader, and (F) notable celebrated holiday. The VL participants were given an opportunity to complete a fill-in written worksheet while viewing a video lecture about the 5 religions using the same stimuli as the EBI group. Participant responding in each group was compared across worksheet, oral, and MTS pretests and posttests. The results showed that 5 of 5 participants in the EBI group formed equivalence classes but only 1of 5 did so in the VL group. Class-consistent responding generalized to oral vignettes to a greater degree for the EBI participants than for the VL participants. In addition, at an approximately 2-week follow-up, EBI participants maintained class-consistent responding to a greater degree than VL participants did. Duration measures showed that even though EBI was more effective, EBI training did require more time than the VL did. Although not explicitly programmed for, social distance survey scores showed that participants improved equally in their ratings of the acceptability of people from other faiths following training, regardless of training type. Thus, EBI may be an effective method to teach schoolchildren about religious literacy., Competing Interests: Conflict of interestThe authors declare that they have no conflicts of interest., (© Association for Behavior Analysis International 2019.)

Providing a choice of reinforcers is a commonly used strategy with children with autism spectrum disorder; however, less is known about the differential effectiveness and efficiency of providing choices before or after responding during acquisition tasks. Therefore, we evaluated reinforcer choice using untaught targets prior to and following responding. Results showed faster acquisition of targets in the consequence condition for 2 of 3 participants. These data provide preliminary support that providing choice prior to responding may not result in the most efficient acquisition for some individuals., Competing Interests: Conflicts of InterestAll authors declare they have no conflicts of interest., (© Association for Behavior Analysis International 2019.)

Mental health on college campuses is a growing issue. Despite a rise in demand for services, counseling centers generally offer assistance during business hours, with a limited number of clinicians. Hotlines can provide an avenue for suicide prevention and intervention while offering training to graduate counseling students. The present study used a qualitative approach to examine the benefits and challenges of using hotlines as a clinical training modality. Interviews with nine graduate students volunteering at a hotline were analyzed using a consensual qualitative research methodology. Several domains were identified, including: three domains related to initial involvement with a clinical training experience at a hotline, four related to the experience of volunteering, and five related to the connection of the clinical training experience to the participant's development as a clinician. Hotlines as a training modality can be used to benefit the community and contribute to the development of future clinicians.

The primary method of data analysis in applied behavior analysis is visual analysis. However, few investigations to date have taught the skills necessary for accurate visual analysis. The purpose of the present study was to evaluate computer-based training on the visual analysis skills of adults with no prior experience. Visual analysis was taught with interactive computer-based training that included written instructions and opportunities for practice with textual feedback. Generalization of participant skills from simulated to handwritten and authentic data graphs was programmed for and assessed during the study. A multiple-baseline design was used across visual analysis properties (i.e., variability, level, and trend), with continuous overall intervention effect generalization probes, replicated across 4 participants to evaluate computer-based training for accurate visual analysis of A-B graphs. The results showed that all participants accurately visually analyzed A-B graphs following the computer-based training for variability, level, trend, and overall intervention effect. These visual analysis skills generalized to handwritten and authentic data graphs and maintained approximately 1 day, 1 week, 2 weeks, and 1 month following mastery of each property for all participants. Implications of the results suggest that computer-based training improved accurate visual analysis skills for adults with no prior experience., Competing Interests: All authors declare that they have no conflicts of interest.All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.Informed consent was obtained from all individual participants included in the study.

Providing students with autism spectrum disorder (ASD) a choice of putative reinforcers during learning trials may confer advantage during skill acquisition programming. However, such advantage should not be assumed and may not be associated with the most efficient instructional arrangement. In the current study, we taught labels of common object or conditional discriminations to participants with ASD and evaluated efficiency of instruction across child- and experimenter-choice instructional conditions. The results indicated that the most efficient acquisition was observed during the experimenter-choice condition for both participants., Competing Interests: Conflict of InterestThe authors declare that they have no conflict of interest., (© Association for Behavior Analysis International 2018.)