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Psychological Treatments

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Abstract

There are now a very wide range of psychosocial treatments for individuals with intellectual disabilities. Major treatment groups include behavior analysis, behavior modification, sensory interventions, cognitive behavior therapy (CBT), counseling, mindfulness, and psychotherapy. Most outcome research has been behavior analytic research using small N experimental designs and is associated with large effect sizes in many applications. Over the last 30 years, there has been increasing application of CBT that is associated with modest outcomes and questionable quality of research, although the application of anger management is associated with more robust effect sizes than application to anxiety and depression. In addition, recent research on mindfulness is another relatively new promising approach. Research on sensory interventions has proven to be negative when well-conducted and otherwise weak and absent, suggesting that sensory treatments are not recommended. Finally, there continues to be little outcome research on counseling and psychotherapy with individuals.

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The incidence of Autism Spectrum Disorder (ASD) is constantly increasing, in which 6 of 1000 ASD children are from Asia. Music therapy as a developing alternative is believed to improve communication and expression skills in children with ASD. Unfortunately, no specific meta-analysis has evaluated social interaction and verbal communication skills in children with ASD. Therefore, the aim of this meta-analysis was to evaluate music therapy in children with ASD. We performed a comprehensive literature review on PubMed, Scopus, Embase, Wiley, and Proquest to study the efficacy of music therapy as an ASD management therapy until October 20th, 2022. Twenty-three randomized controlled trials involving patients with ASD, where 1129 patients were assigned in the intervention group and 759 patients – in the control group, were included in qualitative and quantitative analysis. The pooled estimates revealed that music therapy increased the social interaction score with mean difference (MD)=2.08 (95% confidence interval [CI]: 0.35–3.81; p<0.02), social interaction score based on Autism Diagnostic Observation Schedule with MD: 0.77 (95% CI: 0.03–1.51; p<0.04), verbal communication skill based on Autism Diagnostic Interview-Revised with MD=0.90 (95% CI: 0.79–1.00, p<0.01). In conclusion, music therapy has excellent efficacy and strong potency as a part of ASD management. Nevertheless, more clinical trials with similar parameters are still required to confirm these findings.
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School‐wide positive behavior interventions and supports (SWPBIS) is a multitiered support framework for preventing problem behaviors and increasing prosocial behaviors. There has been an increasing number of experimental group design research studies focused on the impacts of SWPBIS. Therefore, we conducted a systematic review to update and extend prior reviews by including both published and unpublished studies and conducting a robust variance estimation meta‐analysis to examine the magnitude of the effect of SWPBIS on all available school‐level outcomes. A total of 29 studies were identified across the United States and Europe, including seven randomized controlled trials and 22 quasi‐experimental group design studies. Overall, statistically significant reductions in school discipline and increased academic achievement were found. Effect sizes were small to medium. Limitations and implications are discussed.
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Individuals diagnosed with intellectual and developmental disabilities (IDD) frequently exhibit self-injurious behavior (SIB). Previous research has examined the published literature on behavioral treatments of SIB from 1964–2000. Results suggested that these treatments were highly efficacious at decreasing SIB, particularly when based on the results of a functional assessment. The purpose of this review is to update, replicate, and extend the previous research. The current findings indicate an increase in studies reporting automatically maintained SIB as well as less efficacious treatments overall. Discussion of our conclusions and methods of SIB assessment and treatment are discussed, both as they relate to the previous review and for future directions.
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Functional communication training (FCT) is one of the most common treatments for challenging behavior and is considered an empirically supported practice for children and adolescents with autism spectrum disorder (ASD). However, no previous systematic review has evaluated the quality of FCT for adults with ASD, and the empirical support for this practice among adults is unknown. The purpose of the current review was to synthesize the extant research, including a quality appraisal of the literature on the use of FCT to treat challenging behavior for adults with ASD. We identified 20 studies that evaluated the efficacy of FCT in reducing challenging behavior for adults with ASD. The quality of each article was evaluated based on the What Works Clearinghouse design and evidence standards. Following the quality and evidence evaluations, eight studies, including eight experiments, were found to have moderate or strong evidence of effectiveness. The current body of literature provides some evidence for the efficacy of FCT in reducing challenging behavior for adults with ASD, but additional research in this area is warranted.
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The purpose of this meta-analysis was to summarize single-case intervention studies in which Functional Communication Training (FCT) involving augmentative and alternative communication (AAC) was implemented in school settings. Overall, the findings suggest that FCT involving AAC was effective in reducing challenging behaviour and promoting aided or unaided AAC use among participants with disability. FCT was more effective for the participants who engaged in less severe forms of challenging behaviour prior to intervention. Additionally, FCT was more effective when informed by a descriptive functional behaviour assessment and delivered within inclusive school settings. Implications for practice and directions for future research related to FCT for students who use AAC are addressed.
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To investigate the effects of music therapy on mood, language, behavior, and social skills in children with autism.
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This review considers both the content and methodologies of 5 single-subject and 2 group experimental design studies investigating the effects of cognitive strategy instruction on the mathematical problem solving of students with disabilities, using quality indicators proposed by Horner et al. (2005) and Gersten et al. (2005). Findings indicated that the research base of both single-subject and group experimental studies did not meet the methodological criteria to support cognitive strategy instruction as an evidence-based practice for improving mathematical problem solving of students with disabilities. The shortcomings identified in the empirical literature supporting cognitive strategy instruction, however, can be addressed in future intervention studies bearing in mind the quality indicators and standards for determining evidence-based practices.
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This meta-analysis examines the effectiveness of functional mathematics instruction, specifically purchasing skill instruction, for individuals with disabilities. Twenty-eight intervention studies were identified and reviewed. Because all studies employed single-subject research designs, a nonparametric procedure, the percentage of nonoverlapping data (PND), was used to estimate treatment effects. Results indicated a moderately positive effect for purchasing skill instruction (median PND = 87%). Maintenance (median PND = 100%) and generalization effects (median PND = 86%) revealed large and moderate effects, respectively. Further categorical comparisons indicated that variables such as participants' entry skills, money skill adaptations, type of purchase, error correction procedure, and instructional setting were related to the treatment effectiveness.
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Self-injurious behavior (SIB) among children and youth with developmental disabilities has not diminished in prevalence despite the availability of effective interventions, and the impact on quality of life for people and their families is devastating. The current meta-analysis reviews SIB intervention research between 2011 and 2021 using single-case experimental designs with children and youth up to 21 years old and provides a quantitative synthesis of data from high-quality studies including moderator analyses to determine effects of participant and study characteristics on intervention outcomes. Encouraging findings include a high level of effectiveness across studies in the decrease of SIB (Tau- U = −0.90) and increase of positive behavior (Tau- U = 0.73), as well as an increase in studies (relative to prior reviews) reporting intervention fidelity, generalization, maintenance, and social validity. However, our findings shed limited light on potential moderating variables in the development of interventions for children and youth who exhibit SIB. Of the potential moderators of intervention effects, only implementer (researcher/therapist vs. parent/caregiver) and setting (clinic vs. home) were significantly associated with improved outcomes. We discuss the need for more robust involvement of natural communities of implementers in SIB intervention research to better equip them to effectively and sustainably meet the needs of people they care for. We also discuss the importance of creating systems enabling broad access for children with SIB to effective interventions in service of reducing burden for people, families, and society over time.
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Background Snoezelen focuses on multisensory stimulation in an adapted environment and was originally developed for people with severe and profound intellectual (and multiple) disabilities. Snoezelen has been used for many years with various target groups and for different purposes. Variation in its application has resulted in a lack of understanding of snoezelen's application characteristics and of how they may relate to effects. Objective The aim of this review was to provide an overview of the application and effects of snoezelen in people with intellectual disability or dementia in order to analyse the relationship between application characteristics and effects. Design A systematic review. Methods Five databases were searched for snoezelen studies that took place in a specially adapted environment. The methodological quality of the included studies was assessed using the Mixed Methods Appraisal Tool. The application characteristics (that is, the stimuli used, environment, and support given) and the effects were extracted. Reported effects were categorized into different human functioning dimensions using the model of intellectual disabilities of the American Association on Intellectual and Developmental Disabilities. Results In total, 62 studies involving people with intellectual disability (n = 30) or dementia (n = 32) were included. An overview of snoezelen used in other target groups (n = 24) is provided as supplementary material. Details on the application of snoezelen were often lacking. A total of 10 application characteristics (for example, frequency, role of the support person) were extracted. All studies reported the presence of a support person (n = 62; 100%). Effects were found in all five human functioning dimensions. The most-reported effects (61.3% overall) related to mental health, such as a reduction in challenging behaviour and improved mood. In a minority of studies (n = 10, 16.1%), effects on the support person were also reported. Due to limited details about the application of snoezelen and the large variation in measured effects, analysing the relationship between these was impossible. Conclusions The majority of studies lacked details on application characteristics during snoezelen. Reported effects varied, although most related to mental health. Future research should analyse in detail the relationship between application and effects.
Article
Aim: This review aimed to evaluate the effects of multisensory environments/stimulation (MSE/MSS) therapy, on the behavior and psychological symptoms in adults with cognitive impairment and/or special needs. Methods: Online database searches were performed to identify studies reporting on the effects of MSS/MSE therapy in adults (>18 years). Data were extracted for the following investigated outcomes including anxiety, depression, mood, behavioral attributes, biomedical parameters, cognition, motor skills, quality of life (QoL), pain, and end of life quality. Two reciprocally blinded investigators extracted the data. Inter-investigator reliability (𝝹) was calculated. A meta-analysis and a qualitative analysis were performed on the information extracted. Results: Thirty-six studies were included for data extraction and analysis. Meta-analysis of the included studies revealed a significant improvement with the MSE/MSS therapy, for agitation (p = .018), anxiety (p = .023), cognition (p < .001), and depression (p < .001). MSS/MSE therapy demonstrated a tendency for the improvement of the QoL in adults (p = .05). Conclusion: MSE/MSS therapies are beneficial in cognitively impaired adults and improve their anxiety, depression, cognitive and other behavioral attributes such as agitative behaviors. Promoting these therapies in geriatric care may help to improve/reduce the challenging/care-resistant behaviors in adults and facilitate effective provision of the necessary care.
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Functional communication training (FCT) is a well-established, evidence-based practice used to address challenging behavior among individuals across settings, ages, and disability categories. However, the research is limited on the implementation of FCT in inclusive school settings for students with intellectual and developmental disabilities. The purpose of this review was to summarize FCT intervention studies implemented in inclusive K–12 school settings for students with intellectual and developmental disabilities. We synthesized studies to summarize study characteristics, quality, and intervention effectiveness. Our findings suggest that FCT was most often implemented as part of a multi-component intervention package and delivered by educational team members. Furthermore, the quality of most studies was either acceptable or strong. The overall effect size estimate for primary dependent measures as measured by Tau-U suggested large to very large changes in student behavior. We present implications for practice specific to educational teams that support the behavioral needs of students with intellectual and developmental disabilities in inclusive settings and offer avenues for future research.
Article
Background: Social interaction and social communication are among the central areas of difficulty for autistic people. Music therapy uses music experiences and the relationships that develop through them to enable communication and expression, thus attempting to address some of the core problems of autistic people. Music therapy has been applied in autism since the early 1950s, but its availability to autistic individuals varies across countries and settings. The application of music therapy requires specialised academic and clinical training which enables therapists to tailor the intervention to the specific needs of the individual. The present version of this review on music therapy for autistic people is an update of the previous Cochrane review update published in 2014 (following the original Cochrane review published in 2006). Objectives: To review the effects of music therapy, or music therapy added to standard care, for autistic people. Search methods: In August 2021, we searched CENTRAL, MEDLINE, Embase, eleven other databases and two trials registers. We also ran citation searches, checked reference lists, and contacted study authors to identify additional studies. Selection criteria: All randomised controlled trials (RCTs), quasi-randomised trials and controlled clinical trials comparing music therapy (or music therapy alongside standard care) to 'placebo' therapy, no treatment, or standard care for people with a diagnosis of autism spectrum disorder were considered for inclusion. Data collection and analysis: We used standard Cochrane methodological procedures. Four authors independently selected studies and extracted data from all included studies. We synthesised the results of included studies in meta-analyses. Four authors independently assessed risk of bias (RoB) of each included study using the original RoB tool as well as the certainty of evidence using GRADE. MAIN RESULTS: We included 16 new studies in this update which brought the total number of included studies to 26 (1165 participants). These studies examined the short- and medium-term effect of music therapy (intervention duration: three days to eight months) for autistic people in individual or group settings. More than half of the studies were conducted in North America or Asia. Twenty-one studies included children aged from two to 12 years. Five studies included children and adolescents, and/or young adults. Severity levels, language skills, and cognition were widely variable across studies. Measured immediately post-intervention, music therapy compared with 'placebo' therapy or standard care was more likely to positively effect global improvement (risk ratio (RR) 1.22, 95% confidence interval (CI) 1.06 to 1.40; 8 studies, 583 participants; moderate-certainty evidence; number needed to treat for an additional beneficial outcome (NNTB) = 11 for low-risk population, 95% CI 6 to 39; NNTB = 6 for high-risk population, 95% CI 3 to 21) and to slightly increase quality of life (SMD 0.28, 95% CI 0.06 to 0.49; 3 RCTs, 340 participants; moderate-certainty evidence, small to medium effect size). In addition, music therapy probably results in a large reduction in total autism symptom severity (SMD -0.83, 95% CI -1.41 to -0.24; 9 studies, 575 participants; moderate-certainty evidence). No clear evidence of a difference between music therapy and comparison groups at immediately post-intervention was found for social interaction (SMD 0.26, 95% CI -0.05 to 0.57, 12 studies, 603 participants; low-certainty evidence); non-verbal communication (SMD 0.26, 95% CI -0.03 to 0.55; 7 RCTs, 192 participants; low-certainty evidence); and verbal communication (SMD 0.30, 95% CI -0.18 to 0.78; 8 studies, 276 participants; very low-certainty evidence). Two studies investigated adverse events with one (36 participants) reporting no adverse events; the other study found no differences between music therapy and standard care immediately post-intervention (RR 1.52, 95% CI 0.39 to 5.94; 1 study, 290 participants; moderate-certainty evidence). AUTHORS' CONCLUSIONS: The findings of this updated review provide evidence that music therapy is probably associated with an increased chance of global improvement for autistic people, likely helps them to improve total autism severity and quality of life, and probably does not increase adverse events immediately after the intervention. The certainty of the evidence was rated as 'moderate' for these four outcomes, meaning that we are moderately confident in the effect estimate. No clear evidence of a difference was found for social interaction, non-verbal communication, and verbal communication measured immediately post-intervention. For these outcomes, the certainty of the evidence was rated as 'low' or 'very low', meaning that the true effect may be substantially different from these results. Compared with earlier versions of this review, the new studies included in this update helped to increase the certainty and applicability of this review's findings through larger sample sizes, extended age groups, longer periods of intervention and inclusion of follow-up assessments, and by predominantly using validated scales measuring generalised behaviour (i.e. behaviour outside of the therapy context). This new evidence is important for autistic individuals and their families as well as for policymakers, service providers and clinicians, to help in decisions around the types and amount of intervention that should be provided and in the planning of resources. The applicability of the findings is still limited to the age groups included in the studies, and no direct conclusions can be drawn about music therapy in autistic individuals above the young adult age. More research using rigorous designs, relevant outcome measures, and longer-term follow-up periods is needed to corroborate these findings and to examine whether the effects of music therapy are enduring.
Article
Mindfulness-based programs are a promising intervention modality for reducing disruptive behavior, and Soles of the Feet (SOF) is one program that teaches internal awareness of personal events (e.g., unpleasant emotions) and a self-regulation strategy to decrease disruptive behaviors. This study conducted a meta-analysis of single-case research design (SCRD) studies that implemented SOF to decrease disruptive behaviors. Existing SOF studies were evaluated using high-quality SCRD standards, resulting in 15 studies included in the analysis (49 participants; mean age 23.12 years ( SD = 15.87); highly heterogeneous backgrounds). Studies were analyzed to calculate effect sizes using Tau-U, an innovative non-parametric statistical approach for estimating effect sizes in SCRD studies. The aggregated weighted Tau-U effect size of SOF across all studies was −0.87. Moderator analyses indicated SOF’s effectiveness was robust across participant characteristics and delivery formats. This meta-analysis suggests that SOF is a moderately effective evidence-based practice for reducing disruptive behavior.
Article
The purpose of this study was to examine the effects of special educators’ delivery of training that included an initial training session and follow-up coaching on paraprofessional implementation of an evidence-based practice for students with autism spectrum disorder (ASD). Three special educators each trained a paraprofessional in their classroom to implement functional communication training (FCT) to address the challenging behavior of a student with ASD. The training procedures incorporated the following aspects of behavioral skills training: instruction, modeling, rehearsal, and feedback. Training from special educators resulted in high levels of paraprofessional FCT implementation that maintained over time for two paraprofessionals. Special educators and paraprofessionals found the training to be practical and effective. We present implications for practice and future research directions for paraprofessional training models focused on challenging behavior interventions.
Article
Background: Subjects with intellectual disability (ID) are vulnerable to experience psychiatric disorders. The present authors performed a systematic review and meta-analysis to estimate the prevalence of co-occurring psychiatric disorders, excluding co-occurring autism spectrum disorders, in subjects with intellectual disability. Method: The present authors performed a random-effects meta-analysis of the prevalence of psychiatric disorders in adults and adolescents with intellectual disability. Results: Twenty-two studies were included. The pooled prevalence of any co-occurring psychiatric disorders in intellectual disability was 33.6% (95% CI: 25.2%-43.1%) with high heterogeneity but no publication bias. Prevalence was lower in population-based studies, in studies that used ICD criteria for the psychopathology and in studies with low risk of bias. The prevalence was higher in mild, moderate and severe intellectual disability than in profound intellectual disability. Conclusions: Psychiatric disorders are common in subjects with intellectual disability, and the present authors found that clinical and methodological moderators affect the pooled prevalence.
Article
Promoting self-determination is critical to enabling young people to achieve education-related goals and positive postschool employment, community participation, and quality of life outcomes. By developing skills associated with self-determination such as choice-making, decision-making, problem solving, goal setting and attainment, planning, self-management, self-advocacy, self-awareness, and self-knowledge, students with disabilities are better prepared to make purposeful decisions and choices. We conducted a meta-analysis of the literature on interventions to promote self-determination and associated skills with students with disabilities in the school context. We analyzed the types of interventions, populations of students with whom they were implemented, outcomes, and rigor of research. Results demonstrated that interventions to promote self-determination can be effective for students across grade levels, disability labels, and settings. There remains a need for increased focus on promoting self-determination within inclusive, general education settings with students with and without disabilities and of diverse backgrounds. Future researchers should also focus on the rigor of methodological design and associated reporting when conducting school-based research. Additional implications for research and practice are discussed.
Article
Background: Functional communication training (FCT) is considered an evidence-based practice for treating problem behavior in individuals with developmental disabilities (e.g. autism, intellectual disabilities, down syndrome, etc.). However, there is little known on how to sustain behavioral change following FCT interventions. This systematic and quality review synthesizes the current literature base evaluating the maintenance and generalization of behavioral effects following FCT. Method: A systematic review identified 37 studies that met the pre-set inclusion criteria. Those studies were summarized in terms of: (a) generalization dimension, (b) generalization assessment design, (c) maintenance assessment design, (d) maintenance and generalization teaching strategy, and (e) latency to maintenance probes. All studies employed single-case research designs and were evaluated using the What Works Clearinghouse pilot single-case research standards (Kratochwill et al., 2013) as adapted by Maggin, Briesch, and Chafouleas (2013). Maintenance and generalization data were evaluated using a researcher-developed rubric based on the WWC standards. Results and discussion: Results indicate that 30 studies met standards or met standards with reservations while only six studies also met all of the maintenance and generalization standards. Of the six studies, five did not implement any additional strategies beyond the contacting natural contingencies that is inherent in the FCT intervention. Implications for future research and practice are discussed.
Article
Supporting parents in reducing challenging behavior of children with autism spectrum disorder (ASD) requires the identification of effective, feasible, and sustainable interventions. Functional communication training (FCT) is one of the most well-established interventions in the behavioral literature and is used increasingly by parents. However, there is a need for additional evaluation of the literature related to parent-implemented FCT. In the present review, we identified 26 peer-reviewed studies on parent-implemented FCT. We conducted systematic descriptive and social validity analyses to summarize the extant literature. Across studies, parent-implemented FCT was effective in reducing child challenging behavior, and in some cases, intervention outcomes maintained and generalized to novel settings and implementers. However, few studies reported fidelity data on parent implementation of FCT, and data regarding sustained use of FCT by parents were limited. Results of the social validity analysis indicate that while FCT is often implemented by natural change agents in typical settings, parent training is often provided by professionals not typically accessible to parents. These findings suggest that future research is warranted in the areas of parent training and long-term sustainability of parent-implemented FCT.
Article
This review summarizes the literature regarding differential reinforcement of other behaviors (DRO) to treat challenging behavior among children with autism spectrum disorder (ASD) and determines the quality of studies among the current literature according to the 2014 Council for Exceptional Children (CEC): Standards for Evidence-Based Practices in Special Education. Studies that focused on the use of DRO in the treatment of challenging behavior for individuals with ASD were included for systematic analysis. Forty-five studies were identified for inclusion in this review and were evaluated using the eight quality indicators described by the CEC. To the authors’ knowledge, this is the only systematic review of the literature that evaluates DRO as an intervention for individuals diagnosed with ASD. Principle findings, practical recommendations, and areas of future research are discussed.
Article
Importance Music therapy may facilitate skills in areas affected by autism spectrum disorder (ASD), such as social interaction and communication. Objective To evaluate effects of improvisational music therapy on generalized social communication skills of children with ASD. Design, Setting, and Participants Assessor-blinded, randomized clinical trial, conducted in 9 countries and enrolling children aged 4 to 7 years with ASD. Children were recruited from November 2011 to November 2015, with follow-up between January 2012 and November 2016. Interventions Enhanced standard care (n = 182) vs enhanced standard care plus improvisational music therapy (n = 182), allocated in a 1:1 ratio. Enhanced standard care consisted of usual care as locally available plus parent counseling to discuss parents’ concerns and provide information about ASD. In improvisational music therapy, trained music therapists sang or played music with each child, attuned and adapted to the child’s focus of attention, to help children develop affect sharing and joint attention. Main Outcomes and Measures The primary outcome was symptom severity over 5 months, based on the Autism Diagnostic Observation Schedule (ADOS), social affect domain (range, 0-27; higher scores indicate greater severity; minimal clinically important difference, 1). Prespecified secondary outcomes included parent-rated social responsiveness. All outcomes were also assessed at 2 and 12 months. Results Among 364 participants randomized (mean age, 5.4 years; 83% boys), 314 (86%) completed the primary end point and 290 (80%) completed the last end point. Over 5 months, participants assigned to music therapy received a median of 19 music therapy, 3 parent counseling, and 36 other therapy sessions, compared with 3 parent counseling and 45 other therapy sessions for those assigned to enhanced standard care. From baseline to 5 months, mean ADOS social affect scores estimated by linear mixed-effects models decreased from 14.08 to 13.23 in the music therapy group and from 13.49 to 12.58 in the standard care group (mean difference, 0.06 [95% CI, −0.70 to 0.81]; P = .88), with no significant difference in improvement. Of 20 exploratory secondary outcomes, 17 showed no significant difference. Conclusions and Relevance Among children with autism spectrum disorder, improvisational music therapy, compared with enhanced standard care, resulted in no significant difference in symptom severity based on the ADOS social affect domain over 5 months. These findings do not support the use of improvisational music therapy for symptom reduction in children with autism spectrum disorder. Trial Registration isrctn.org Identifier: ISRCTN78923965
Article
Behavioral interventions are prevalent in addressing non-suicidal self-injury (NSSI). This manuscript examines the effects of behavioral interventions on diminishing self-injurious behaviors. Eight single-case experimental designs published between 1999 and 2013 were reviewed and evaluated for participants, data collection procedures, self-injurious behaviors, diagnosis, and treatment setting. The interventions were then examined for effectiveness by calculating Percent of Non-overlapping Data (PND) and Percentage of Data Exceeding the Mean (PEM). Results indicate significant decreases in NSSI for interventions such as combinations of differential reinforcement (DRO), extinction, blocking, and positive behavior support (PBS). Implications for practice and future research directions are reported.
Book
This book provides a comprehensive overview of the clinical phenomenon of pica. It focuses specifically on the disorder as it presents in children, adolescents, and adults with autism spectrum disorder (ASD) and intellectual disabilities (ID). Initial chapters introduce current theories and definitions, followed by a more detailed examination of how developmental disabilities complicate diagnosis and intervention. The volume describes evidence-based and clinically sound approaches to the treatment and prevention of pica in school and adult clinical settings, ranging from behavioral treatment to function-based interventions. In addition, it discusses common diagnostic, client, and provider issues that result in pica remaining undetected among individuals with ASD and ID. Featured topics include: • Definition of pica in accessible terms, differentiating between various forms of the disorder. • Issues and practical methods of prevention and treatment of pica in developmentally disabled persons. • Functional and behavioral assessment methods for pica in individuals with ASD and ID. • A range of effective behavioral and nonbehavioral treatments for pica. • Illustrative cases and service delivery challenges. • Areas for future research and practice. Pica in Individuals with Developmental Disabilities is an invaluable resource for researchers, clinicians and other professionals, and graduate students in clinical child and school psychology, behavior analysis/therapy, and social work as well as child and adolescent psychiatry, pediatrics, family studies, and special education.
Article
Background: Despite considerable advance and growth in the evidence base for psychological interventions as treatment for sex offenders with intellectual disabilities (ID), there remains limited evidence to support their effectiveness. This systematic review seeks to evaluate the effectiveness of psychological interventions on reducing reoffending rates for sex offenders with ID. Methods: A search of ten electronic databases, grey literature and reference lists was conducted using PRISMA methodology. Results: A number of studies appeared to establish positive treatment outcomes, demonstrated by improvements in attitudinal change, victim empathy and sexual knowledge. However, reductions in sexual reoffending during the follow-up period were not consistent across the studies. No studies with an adequate control comparison were identified during the search. Conclusions: The current review provides limited evidence on the effectiveness of psychological interventions for sex offenders with ID, while also highlighting the need for further research.
Article
Objectives: This systematic review aimed to critically appraise the literature on the efficacy and effectiveness of psychoanalysis, psychoanalytic and psychodynamic psychotherapy in adults with intellectual and developmental disabilities (IDD). Method: A systematic search of electronic databases was carried out. The methodological quality of the studies was assessed using a quality assessment tool and comparisons were made with a review of the quality of research on the effectiveness of cognitive behavioural therapy (CBT) for people with IDD. Results: The search yielded 13 papers which provided evidence for the effectiveness but not efficacy of psychoanalytic and psychodynamic psychotherapy; but none were found for psychoanalysis. The quality of the research was generally poor compared to the current research on the effectiveness of CBT. Conclusions: Positive outcomes have been indicated for psychoanalytic and psychodynamic psychotherapy with people with IDD. Larger scale, more controlled research is necessary to advance the evidence base.
Article
Background: Many individuals with autism spectrum disorders (ASD) show deficits in functional living skills, leading to low independence, limited community involvement, and poor quality of life. With development of mobile devices, utilizing video modeling has become more feasible for educators to promote functional living skills of individuals with ASD. Aims: This article aims to review the single-case experimental literature and aggregate results across studies involving the use of video modeling to improve functional living skills of individuals with ASD. Methods and procedures: The authors extracted data from single-case experimental studies and evaluated them using the Tau-U effect size measure. Effects were also differentiated by categories of potential moderators and other variables, including age of participants, concomitant diagnoses, types of video modeling, and outcome measures. Outcomes and results: Results indicate that video modeling interventions are overall moderately effective with this population and dependent measures. While significant differences were not found between categories of moderators and other variables, effects were found to be at least moderate for most of them. Conclusions and implications: It is apparent that more single-case experiments are needed in this area, particularly with preschool and secondary-school aged participants, participants with ASD-only and those with high-functioning ASD, and for video modeling interventions addressing community access skills.
Article
Numerous researchers have employed functional communication training (FCT) to address both the communication and behavioral needs of children with autism. Thus, the purpose of this review is to examine FCT, particularly, the environments and individuals involved in the training and the effectiveness of FCT with children who have a diagnosis of Autism Spectrum Disorder (ASD) and to provide suggestions for practitioners and researchers. FCT consistently reduces challenging behavior and increases communication; however, the majority of research is clinically based and focuses on one communication mand. Future research teams should address maintenance and generalization by training teachers in classrooms and parents in homes while collecting data across time.
Article
This research synthesis verifies the effectiveness of the Picture Exchange Communication System (PECS) for improving the functional communication skills of individuals with autism spectrum disorders (ASD). The research synthesis was focused on the degree to which variations in PECS training are associated with variations in functional communication outcomes (Dunst, Trivette & Cutspec, 2002). The communication consequences of PECS were examined in 13 studies, which included 125 participants with ASD who had been identified as having limited or no functional communication skills. Claims that PECS is an effective intervention for improving functional communication skills appeared to be supported by the available research evidence.
Article
Thirteen studies were reviewed that were conducted using activity schedules with persons with autism to improve social interaction skills and decrease problem behaviors. Results across studies indicate that activity schedules enhanced social interactions and on-task and transition behaviors. Also, investigators in some studies used activity schedules to decrease students' tantrums and other problem behaviors during transitions. Furthermore, researchers in several studies that reported generalization indicated that behaviors learned through activity schedules generalized across settings and persons. Implications for practitioners and for future researchers are discussed.