Search

We evaluated two procedures to teach auditory-visual conditional discriminations (receptive labeling) to children with autism. The procedures evaluated a modified Structured Mix (SM) procedure and a modified Counterbalanced Random Rotation (RR) procedure. The modified SM procedure was based on the logic of simplifying the task by breaking it down into smaller, successive steps and by requiring mastery of each step before introducing the next. Compared to previous studies, the modified SM procedure contained fewer steps, less prompting, and a less stringent mastery criterion. The modified RR procedure targeted all three stimuli simultaneously by presenting them across consecutive trials, both during training and error correction. Sample stimuli were presented in a counterbalanced random order and the comparison stimuli were presented in counterbalanced random positions. Participants were nine children with autism. An adapted alternating treatments design was used. Results showed that the modified SM procedure was more efficient for four of the nine participants, the modified RR procedure was more efficient for one of the nine participants, both procedures were equally efficient for two participants, and neither procedure was effective for two of the nine participants. The modified SM procedure appeared more efficient than the SM procedure employed in previous studies. Despite results, further research is warranted to examine within subject comparisons between original discrimination training procedures and modified procedures.

Deficits in social referencing have been associated with autism spectrum disorder. It may lead to deficits in language, symbolic abilities, and other social-cognitive behaviors. When deficits in social referencing are detected, teaching such behaviors should be a priority, but effective teaching procedures are lacking. We consider social referencing as a behavior chain and suggest teaching each component in the chain in sequence. We introduce a program to teach the initial component of social referencing, reacting to new and missing objects in the environment through initiating interaction with another present person. Six children with autism spectrum disorder participated. All children acquired the skill within six months and generalized it to new people and materials. Future research could aim to replicate these findings and to develop effective procedures to teach other component skills of social referencing.

We evaluated whether intraverbal and reverse intraverbal behavior emerged following listener training in children with autism spectrum disorder (ASD). Six participants were each taught three sets of three "when?" questions in listener training. A multiple baseline design across behaviors (stimulus sets) was used to assess the effects of listener training. Results showed that intraverbal behavior emerged following listener training for five out of six participants. One participant received additional listener training and intraverbal training before intraverbal behavior emerged. Furthermore, reverse intraverbal responding occurred across all three sets of questions for three of the six participants. Establishing listener behavior may be a pathway for emergent intraverbal and reverse intraverbal responding in children with ASD. Future research could examine what skill repertoire may facilitate such transfer.

The purpose of this study was to validate a procedure for sufficient exemplar training that can potentially lead to generalized responding. Based on this procedure, we taught four children with autism, generalized use of regular past tense verbs. We applied a non-concurrent multiple baseline design across the participants. The dependent variable was the number of verbs that needed to be trained for generalization to untrained verbs to occur. The number of verbs that needed to be trained varied considerably across participants as did the number of trials. We concluded that the procedure was validated and that it was easy to implement and it allows for individualization. We discuss the practical implications of our findings for teaching a wide range of skills using the same type of training procedure and data display strategies we provided in this study.

This individual participant data meta-analysis is the most intensive possible evaluation of the effectiveness of early intensive applied behaviour analysis-based interventions for pre-school autistic children compared with treatment as usual/eclectic interventions. Data from 491 participants (originally collected in 10 studies) were included. Children receiving early intensive applied behaviour analysis-based interventions improved more on the Vineland adaptive behaviour scale (MD = 7.00; 95% confidence interval = 1.95-12.06) and cognitive ability (intelligence quotient) (MD = 14.13; 95% confidence interval = 9.16-19.10) relative to comparators at 2 years; though effects varied considerably across studies. Evidence for other outcomes was inconclusive due to insufficient evidence and there were few data on longer-term effects. All studies were at risk of bias across several domains, often due to the lack of randomisation or blinding of outcome assessors. Given the emerging evidence of modest, albeit short term, effects of a range of pre-school autism interventions and the limitations of the quality of evaluation studies to date, future research should investigate which supports and interventions are most effective for children and families prioritising outcomes measures that are meaningful for the autism community and longer-term follow-up. Further systematic reviews of the existing evidence are unlikely to add to the findings presented here.

A growing evidence base supports early intensive behavioral intervention (EIBI) for young children with autism spectrum disorder. We have found only one study exploring the outcome of EIBI for children with Rett syndrome, which reported little effect. It suggested that future studies should employ more fine-grained outcome measures. We provided EIBI for twin 3-year-old girls with Rett syndrome for a period of 3 years. We analyzed raw scores and standard scores from a measure of adaptive behavior and a detailed assessment of skills across 25 areas. We detected moderate but clinically meaningful gains in areas such as communication and self-help. Gains are discussed from a quality of life perspective and whether the moderate effects can justify the resources required in EIBI.

This study compared the outcome of Early Intensive Behavioral Intervention when supervision was given over videoconference for half of the meetings. This started after 3 months of intervention. The participating children were diagnosed with autism spectrum disorder and were randomly placed in either the videoconference group or in the onsite group. The dependent variables were autism severity, preferences for socially mediated stimuli and problematic behaviors. The independent variable was supervision onsite or by videoconference. The results showed no significant differences between the groups on any of the outcome measures. A limitation of this study was the small group sizes, which limits generalization of the results to other children and settings. Furthermore, the onsite group received some supervision sessions via videoconference due to the COVID-19 pandemic. Nevertheless, our tentative conclusion is that supervision via videoconference has the potential to replace onsite supervision at least partially, but that larger scale research in a variety of settings is needed. [ABSTRACT FROM AUTHOR]

Although still a matter of some debate, there is a growing body of research supporting Early and Intensive Behavioral Intervention as the intervention of choice for children with autism. Learning rate is an alternative to change in standard scores as an outcome measure in studies of early intervention. Learning rates can be displayed graphically as developmental trajectories, which are easy to understand and avoid some of the counter-intuitive properties of changes in standard scores. The data used in this analysis were from 453 children with autism, previously described by Eldevik et al. Children receiving Early and Intensive Behavioral Intervention exhibited significantly steeper developmental trajectories than children in the control group, in both intelligence and adaptive behaviors. However, there was a considerable variability in individual learning rates within the group receiving Early and Intensive Behavioral Intervention. This variability could partly be explained by the intensity of the treatment, partly by children's intake intelligence quotient age-equivalents. Age at intake did not co-vary with learning rate.

Although Discrete-trial Teaching (DTT) is effective in teaching a many skills to children with autism, its proper implementation requires rigorous staff training. This study used an interactive computer simulation program ("DTkid") to teach staff relevant DTT skills. Participants (N = 12) completed two sets of pre-tests either once (n = 7) or twice (n = 5) before brief DTkid training. These evaluated (a) simulated interactive teaching using DTkid and (b) in vivo teaching of three basic skills (receptive and expressive labeling; verbal imitation) to children with autism. Post-tests showed that DTkid training, rather than repeated testing, was significantly associated with improvements in staff's ability to implement DTT both within the simulation and in vivo, and that the skills acquired showed both stimulus and response generalization.

We evaluated outcomes for 31 children with autism (2-6 years of age at intake) who received behavioral intervention in mainstream pre-school settings and a comparison group of 12 children receiving treatment as usual. After 2 years, children receiving behavioral intervention had higher IQ scores (Hedges g = 1.03 (95% CI = 0.34, 1.72) and adaptive behavior composite scores (Hedges g = 0.73 (95% CI = 0.05, 1.36). Despite probably fewer intervention hours, these group level outcomes were comparable to studies providing more intensive intervention. Individual child data also showed positive results with 19.4% achieving change at a reliable level for IQ; but a lower percentage than found in recent meta-analysis research. Strengths and weaknesses of the mainstream pre-school delivery model are discussed. (Contains 4 tables and 1 figure.)

Prevalence of current comorbid DSM-IV disorders was assessed in a special school population of children and adolescents with ASD (N = 71, age 6.0-17.9 years), representing all cognitive levels and main ASD subgroups. Symptoms were assessed through parent interview and association to child characteristics was explored. Seventy-two percent was diagnosed with at least one comorbid disorder. Anxiety disorders (41%) and attention deficit/hyperactivity disorder (31%) were most prevalent. Obsessive-compulsive disorder was more common in older children, and oppositional defiant disorder/conduct disorder more prevalent in pervasive developmental disorder, not otherwise specified. Our results show high rates of comorbid DSM-IV disorders and underscore the importance of such evaluation in children ASD. However, diagnostic challenges are present and future research on the diagnostic validity of comorbid psychiatric disorders is needed. (Contains 2 tables and 1 figure.)

We gathered individual participant data from 16 group design studies on behavioral intervention for children with autism. In these studies, 309 children received behavioral intervention, 39 received comparison interventions, and 105 were in a control group. More children who underwent behavioral intervention achieved reliable change in IQ (29.8%) compared with 2.6% and 8.7% for comparison and control groups, respectively, and reliable change in adaptive behavior was achieved for 20.6% versus 5.7% and 5.1%, respectively. These results equated to a number needed to treat of 5 for IQ and 7 for adaptive behavior and absolute risk reduction of 23% and 16%, respectively. Within the behavioral intervention sample, IQ and adaptive behavior at intake predicted gains in adaptive behavior. Intensity of intervention predicted gains in both IQ and adaptive behavior.

Data from Norway were analyzed to evaluate early behavioral intervention for children with intellectual disabilities. The intervention group (n = 11) received approximately 10 hours per week of behavioral intervention; the eclectic comparison group (n = 14) received treatment as usual. After 1 year, changes in intelligence and adaptive behavior scores were statistically significant in favor of the behavioral intervention group (effect sizes of 1.13 for Intelligence quotient (IQ) change and 0.95 for change in adaptive behavior composite). Approximately 64% of the children in the behavioral intervention group met objective criteria for reliable change in IQ, whereas 14% in the eclectic comparison group did so. These results suggest that children with intellectual disability may profit from behavioral intervention typically provided for children with autism. (Contains 1 table and 1 figure.)

This study investigated the frequency and latency of naturally occurring social interaction with typically developing children and those with autism in inclusive kindergarten settings. The children with autism were also subdivided into two groups according to intellectual functioning in order to analyze frequency and latency of social interaction in relation to degree of disability. The results showed a significant difference in frequency of social interaction between the typical children and those with autism. There was no difference between the groups on latency to initiate interaction. However, shorter latency was associated with higher frequency in the typical group but not in the group of children with autism. Significant differences in IQ and adaptive functioning were found between the children with autism who showed interaction and those who did not. The results for the typical children may be used as benchmark values for the assessment of treatment outcome for children with autism. (Contains 2 tables and 1 figure.)

We retrospectively compared 2 groups of children receiving either behavioral treatment (n=13) or eclectic treatment (n=15) for an average of 12 hours per week. Children were assessed on intelligence, language, adaptive functioning and maladaptive behavior at pretreatment and 2 years into treatment. The groups did not differ significantly at pretreatment. After 2 years of treatment, the behavioral group made larger gains than the eclectic group in most areas. However, gains were more modest than those reported in previous studies with children receiving more intensive behavioral treatment, and it is questionable whether they were clinically significant.

At present, early intensive behavioral intervention (EIBI) for children with autism spectrum disorders is the intervention that has the strongest empirical support. EIBI requires frequent supervision by qualified professionals. Norway, like many other countries, has a shortage of qualified supervisors, particularly in rural regions. This study used a reversal design to investigate how supervisors and supervisees perceive the quality of EIBI supervision and the local team's preparedness when supervision was provided either on‐site or via videoconference. Calculations were made on how much time could be saved on travel when part of the supervision was provided via videoconference. There were no significant differences in the supervisors' and supervisees' ratings of on‐site and videoconference supervision. Moreover, the supervisors found the local EIBI teams to be better prepared when supervision was provided via videoconference, and the videoconference supervision meetings were shorter. The study discusses the implications of these findings for the accessibility of EIBI and case capacity and proposes some areas for further research. [ABSTRACT FROM AUTHOR]

A study compared two approaches for teaching cooperative play to six children (ages 4-12) with autism. In one approach, children observed cooperative play before participating. In the second approach, participants verbally described the modeled play episode before participating. Participants failed to acquire cooperative play until the verbal description was included. (Contains extensive references.) (Author/CR)

A guideline when teaching people with autism spectrum disorder is that delivery of the reinforcer should be immediate or within three seconds, this is especially true in Discrete Trial Teaching. However, there is not much empirical support for this guideline. We explored the effects of delayed reinforcement on the responding in people with an autism spectrum disorder. Two delays were used, 1 second delay and 2 second delay. Fourteen participants ranging from 9 to 21 years of age, with different level of functioning participated. Participants pressed a blue button on a tablet resulting in either immediate or delayed reinforcement in the form of geometric animations. The sessions stopped when the participant did not press the button for 20 seconds. A reversal design was used. Results showed that all participants, except for one, clicked the button more during immediate reinforcement compared to delayed. Participants also had longer sessions during immediate reinforcement. The decrease in response rate from immediate to delayed reinforcement was greater at 2 seconds of delay compared to 1 second. The three participants who had the largest decrease in reponing had comorbid ADHD diagnosis. The results support and supplements previous findings. [ABSTRACT FROM AUTHOR]

We examined whether an interrupting chain procedure with establishing operation (EO)‐absent and EO‐present trials and sufficient exemplar training was effective in teaching three preschool‐aged children with autism to request missing items. Children were taught to request missing items across three different skill domains (play, self‐help, and academic tasks), and audio scripts were used as prompts. We employed a non‐concurrent multiple‐baseline design across participants. All three participants learned to request missing items during EO‐present trials and to refrain from doing so during EO‐absent trials. The behavior transferred to untrained tasks, generalized to new people, and was maintained at follow‐up 3 months after the intervention. [ABSTRACT FROM AUTHOR]

The success of behavior-analytic procedures to teach language to individuals with autism spectrum disorder (ASD) has been well established in the literature. Nevertheless, some individuals may not learn any receptive or expressive language following extensive teaching efforts. We examined the effects of two reinforcement contingencies, functional and arbitrary, on increasing the level of auditory–visual conditional discriminations in children with ASD with a history of having difficulty learning discriminations. We evaluated the effects of the reinforcement contingencies by comparing the number of trials needed to establish discriminations in an adapted alternating treatment design. We found that five out of eight participants showed more rapid acquisition and demonstrated discrimination between more items in the functional reinforcement condition. The remaining three participants did not exhibit any discrimination in either condition within the allotted 500 trials/20 days. These findings suggest that using functional reinforcement procedures may be a helpful alternative for individuals who do not learn discriminations through traditional procedures. [ABSTRACT FROM AUTHOR]

We evaluated the outcome of early behavioral intervention for children with Autism Spectrum Disorders (ASD) as it was provided through public service providers in Norway. A group of 21 children received low-intensity intervention (11.1 weekly hours), a second group of 36 children higher intensity intervention (18.1 weekly hours), and a third group of 17 children received eclectic special education. Group assignment was based on independent referrals. We compared outccromes on adaptive behavior, ASD severity, and intellectual functioning after one year. The lower and higher intensity behavioral intervention groups received fewer hours than what is recommendedbut did significantly better than the eclectic group. Moreover, the higher intensity behavioral group did better than the lower intensity behavioral group. Nevertheless, gains in both groups were more modest than what is reported for intervention that is more intensive. W 3e describe the model of service delivery, discuss challenges with it, and propose improvements. [ABSTRACT FROM AUTHOR]