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The number of Board Certified Behavior Analysts (BCBAs) available outside of the United States is significantly lower than the number of individuals with a diagnosis of autism spectrum disorder (ASD) requiring services. Research on alternative delivery platforms, such as telehealth, to disseminate interventions to those in need is of paramount importance. The current study evaluated the effectiveness of training professionals working with individuals with ASD in behavior-analytic procedures through telehealth. Four professional-child dyads took part. Data were collected on the professional’s treatment fidelity and number of independent steps performed by the children for three functional daily living skills. The study employed a multiple probe design across participants and included a cost analysis. All four professionals met the mastery criterion and all four children demonstrated increases in independence.

Autism Spectrum Disorder is diagnosed when individuals demonstrate repetitive behaviours and restricted interests, especially in relation to social stimuli, that make it difficult for them to access socially reinforcing environments. Consequently, in most cases, behaviour analytic interventions initially have to focus on the establishment/conditioning of effective reinforcers. A systematic review was conducted of the literature on conditioned reinforcement that identified 33 relevant articles (published between 2002 and 2017). This article reports on the content analysis and quality of evidence and offers a summary of the findings reported in these papers. Four lines of research were identified: classical conditioning, operant conditioning, observational learning, and comparison studies. Differences and similarities are reported concerning procedures, type of stimuli to be conditioned, responses measured, reported effectiveness, and quality of evidence. Recommendations for future research and clinical practice are provided.

Pre-diagnostic intervention for autism spectrum disorder (ASD) allows symptoms to be addressed as they emerge, often between six to 18 months, rather than after the full onset of the disorder. A systematic literature review, spanning the previous six years was conducted in order to provide an updated review looking at the earliest behavior symptoms of ASD. All included studies used a prospective experimental design, reported on symptoms that emerged before 18-months of age, exclusively in children who would later receive a diagnosis, and were assessed for quality. This review is the first to address this research question through the use of a systematic research design and extends the literature by following up on recommendations for future research from previous findings. Electronic supplementary material The online version of this article (10.1007/s10803-020-04618-w) contains supplementary material, which is available to authorized users.

The present study aimed to replicate the findings of Dounavi (Journal of Applied Behavior Analysis, 47(1), 165–170 2014) by evaluating the effects of foreign tact and bidirectional intraverbal training on emergent verbal relations. Training involved teaching three English-speaking adults to tact visual stimuli according to their foreign (French) referents, and to vocally emit the reverse relation following the presentation of written words in native-to-foreign (English-to-French) and foreign-to-native (French-to-English) intraverbal relations. A modified multiple probe design using pre- and posttraining probes was used to assess the efficacy of each training method in teaching a small foreign language vocabulary and to probe for emergent relations following training. The findings showed that foreign tact and native-to-foreign intraverbal training was more efficient and resulted in greater emergent responding than training in the foreign-to-native relation. Follow-up probes were conducted 4 weeks after the posttraining probes to evaluate the levels of responding for each of the trained and emergent relations. Results from maintenance probes were varied across the trained and emergent relations; it is interesting that the levels of responding in the emergent relations was greater.

Over the past 10 years, very early detection of ASD has opened the way to establishing much needed evidence-based interventions for infants under 18 months of age. A Behavior Skills Training package developed in a verbal behavior framework was the foundation for a parent-mediated service delivery model for 12-16 month infants presenting ASD symptoms. Training consisted of 12 weekly coaching sessions conducted with each parent-infant dyad in the family’s home with the aim to increase social, communication and play skills. A battery of assessment tools was used pre and post-training, while parent and infant target behaviors were scored through videos taken during weekly sessions. Results indicate that social communication behaviors increased in all infant-parent dyads, while severity and number of autism symptoms decreased. By beginning intervention during infancy, brain neuroplasticity is leveraged maximizing the child’s developmental trajectory. This is the first prospective study that provides a verbal behavior analytic framework to treat symptomatic infants.

Background: Supervision of behavior analysts seeking certification and supervision of service delivery are key processes in the provision of quality behaviour analytic services to individuals with developmental disabilities. Our study is the first to examine international supervisory practices within the field of applied behaviour analysis. Method: An online survey was distributed to 92 professionals internationally, assessing supervisory practice, supervisor support, work demands, job satisfaction, and burnout. Results: Findings indicate high satisfaction with the supervisor and supervisory experience. Excessive work demands positively correlate with high burnout and low job satisfaction. Half of all professionals only worked with one or two clients before certification. Supervisor and collegial support seem to decrease the likelihood of suffering burnout and increase job satisfaction, although relationships were not statistically significant. Conclusions: Supervisor and collegial support warrant further research as protective factors. Implications for an evidence-based supervisory practice that produces ethical and competent supervisees are discussed.

ContextWeight management is an effective strategy for controlling chronic disease and maintaining physical health, and research on this topic has risen dramatically over the past four decades. The present systematic literature review aimed to identify existing evidence on the efficacy of mobile health technology in facilitating weight management behaviors, such as healthy food consumption and physical activity.Evidence acquisitionA systematic search was conducted in Ovid MEDLINE and Ovid PsycINFO databases with the aim to identify studies published in peer-reviewed journal articles between 2012 and 2017.Evidence synthesisA total of 39 studies were analyzed in spring 2018 and are presented here in terms of participant characteristics, effective technology components, additional treatments, impact on health-related behaviors, and treatment efficacy. Indicators of study quality and social validity are also provided.ConclusionsMobile health apps are widely considered as satisfactory, easy to use, and helpful in the pursuit of weight loss goals by patients. The potential of mobile health apps in facilitating weight loss lies in their ability to increase treatment adherence through strategies such as self-monitoring. These findings indicate that satisfactory treatment adherence and consequent weight loss and maintenance are achieved in the presence of high levels of engagement with a mobile health app. The research quality assessment of RCTs reveals a great need for following international standards both when conducting and reporting research.

Interventions based on applied behaviour analysis are considered evidence based practice for autism spectrum disorders. Due to the shortage of highly qualified professionals required for their delivery, innovative models should be explored, such as telehealth. Telehealth utilises technology for remote training and supervision. The purpose of our study was to systematically review the literature researching telehealth and ABA. We analysed intervention characteristics, outcomes and research quality in 28 studies and identified gaps. Intervention characteristics were: (1) research design (2) participants (3) technology (4) dependent variables (5) aims. Outcomes were favourable with all studies reporting improvements in at least one variable. Quality ratings were significantly low. Implications for future research and practice are discussed in light of identified methodological downfalls.

This article was migrated. The article was marked as recommended. Objectives: Intravenous fluid (IV) therapy is an important component of care for many hospital patients, especially in perioperative and acute care settings. However, errors in fluid composition and dosing can be life-threatening. To achieve competent professional performance, i.e., accurate and fluent, it is vitally important that medical students receive effective training in IV fluid therapy. Methods: In this study, we explored how Precision Teaching (PT), a behaviour analytic teaching method, can enhance outcomes of usual medical education techniques.A total of 178 third-year medical students participated in the study during the IV fluid therapy training week. All students completed a multiple-choice test pre- and post-training. In addition to standard IV fluid therapy teaching, the experimental intervention group (n=83 students) used SAFMEDS (Say All Fast MinuteEvery Day Shuffled) cards approximately 3-5 times per day for 5 days. The other 95 students (control group) received teaching as usual, but did not undergo the additional training. Results: Results show that the SAFMEDS boosted performance of the intervention group on the MCQ by 20 percentage points when compared to the control group. Fluency (accuracy and speed) of performance on SAFMED trials increased markedly during the intervention week and there was evidence that weaker students benefitted in particular. Conclusions: Implications for medical education are outlined.

Sleep disorders affect a large portion of those with autism spectrum disorder. Behavioural interventions have been found to increase appropriate sleep behaviours. This study sought to examine the efficacy of two stimulus control interventions (bedtime fading and positive routines) on total sleep duration, sleep onset latency and frequency and duration of night wakings for children with autism using two multiple baseline designs. Secondary dependent variables, namely, educational opportunities, challenging behaviours, parent acceptance and social validity were also analysed. Results suggest some efficacy for both interventions. Increased total sleep duration and decreased sleep onset latency were achieved with bedtime fading. Positive routines showed mixed results with decreased sleep onset latency and increased total sleep duration for two of three participants.

Low job satisfaction and burnout are common occurrences among those providing behavioral services potentially leading to absenteeism, turnover, low standards of service, and poor health outcomes. The current study explored the occurrence of low job satisfaction and burnout in this population. We disseminated a web-based survey composed of a series of sociodemographic and job-related variables, the Job Satisfaction Survey, and the Maslach Burnout Inventory. A diverse incidental sample of 183 practitioners currently providing behavioral services completed the survey. The results indicated that about two in every three participants were experiencing moderate to high burnout levels and about one in every three were experiencing little to no job satisfaction. A series of logistic models showed that social support in the work environment and supervision opportunities for trainees were key predictors of burnout and job satisfaction. We defined a socially supportive work environment as one with (a) several team members, (b) certified professionals, (c) frequent and positive interactions among team members, and (d) frequent and relevant staff training opportunities.

Individuals with autism and intellectual disability (ID) have complex learning needs and often have difficulty in acquiring reading comprehension skills using conventional teaching tools. Evidence based reading interventions for these learners and the use of assistive technology and application of behaviour analysis to develop user-centered teaching is discussed in this paper.

The current study involved an evaluation of the emergence of untrained verbal relations as a function of 3 different foreign-language teaching strategies. Two Spanish-speaking adults received foreign-language (English) tact training and native-to-foreign and foreign-to-native intraverbal training. Tact training and native-to-foreign intraverbal training resulted in the emergence of a greater number of untrained responses, and may thus be more efficient than foreign-to-native intraverbal training.

This review provides a summary and appraisal commentary on the standard-comparison study by Strid, K., Heimann, M., Gillberg, C., Smith, L., & Tjus, T. (2012). Deferred Imitation and Social Communication in Speaking and Nonspeaking Children With Autism. Focus Autism Other Developmental Disabilities, DOI: 10.1177/1088357612468030Source of funding and disclosure of interest: The study was supported by a number of grants from the Swedish Council for Working Life and Social Research and the European Science Foundation Cooperation in Science and Technology Action (ESF COST Action). No conflicts of interests were disclosed.

Education can have a powerful and long-term effect on people's lives and therefore should be based on evidence of what works best. This assertion warrants a definition of what constitutes good research evidence. Two research designs that are often thought to come from diametrically opposed fields – single-subject research designs and randomised controlled trials – are described and common features, such as the use of probabilistic assumptions and the aim of discovering causal relations, are delineated. Differences between the two research designs are also highlighted and this is used as the basis to set out how these two research designs might better be used to complement one another. Recommendations for future action are made accordingly.

This article was migrated. The article was not marked as recommended. BackgroundEducators have been challenged to provide more effective dermatology teaching methods. Drawing from the discipline of Applied Behaviour Analysis, Precision Training (PT) (e.g. using flashcards during timed learning sessions) can promote fluency i.e. accuracy and speed in a particular skill. We aimed to determine the impact of PT on medical students' dermatology diagnostic skills.MethodsA between-groups controlled interventional study was conducted. Third year medical students were allocated to an intervention (PT + traditional teaching) or control (traditional teaching) group. For the PT group, we designed 50 dermatological image flashcards. Flashcard practice (using the Say All Fast Minute Each Day Shuffle method) took place 2-3 times/day and students' data on accuracy recorded over 5 days. Pre / post-training tests were carried out to determine the impact of PT on students' diagnostic skills.ResultsIn total, 70 students (intervention group) / 65 (control group). Analysis of covariance was used to calculate the change score (comparing pre- and post-test). A statistically significant improvement of 8.8% (95% CIs; 4.9-12.7, p

Multidisciplinary practice has become an accepted approach in many education and social and health care fields. In fact, the right to a multidisciplinary assessment is enshrined in the United Nations Convention of the Rights for Persons with Disabilities (United Nations, 2007). In order to avert a ‘one size fits all’ response to particularly heterogeneous diagnoses, such as autism spectrum disorders (ASD), the National Institute for Clinical Excellence (NICE) recommends multidisciplinary input. Yet, multidisciplinarity lacks empirical evidence of effectiveness, is fraught with conceptual difficulties and methodological incompatibilities, and therefore there is a danger of resorting to an ill-defined eclectic ‘hodgepodge’ of interventions. Virtually all evidence-based interventions in autism and intellectual disabilities are behaviourally based. Not surprisingly, therefore, professionals trained in behaviour analysis to international standards are increasingly becoming key personnel in multidisciplinary teams. In fact, professionals from a range of disciplines seek training in behaviour analysis. In this article we brought together a multidisciplinary group of professionals from education, health, and social care, most of whom have a dual qualification in an allied health, social care, or educational profession, as well as in behaviour anlaysis. Together we look at the initial training in these professions and explore how behaviour analysis can offer a common and coherent conceptual framework for true multidisciplinarity, based on sound scientific knowledge about behaviour, without resort to reifying theories. We illustrate how this unifying approach can enhance evidence-based multidisciplinary practice so that ‘one size’ will fit all.

The current study involved an evaluation of the emergence of untrained verbal relations as a function of 3 different foreign-language teaching strategies. Two Spanish-speaking adults received foreign-language (English) tact training and native-to-foreign and foreign-to-native intraverbal training. Tact training and native-to-foreign intraverbal training resulted in the emergence of a greater number of untrained responses, and may thus be more efficient than foreign-to-native intraverbal training.