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A comparison of intensive behavior analytic and eclectic treatments for young children with autism
Abstract
We compared the effects of three treatment approaches on preschool-age children with autism spectrum disorders. Twenty-nine children received intensive behavior analytic intervention (IBT; 1:1 adult:child ratio, 25-40 h per week). A comparison group (n=16) received intensive "eclectic" intervention (a combination of methods, 1:1 or 1:2 ratio, 30 h per week) in public special education classrooms (designated the AP group). A second comparison group (GP) comprised 16 children in non-intensive public early intervention programs (a combination of methods, small groups, 15 h per week). Independent examiners administered standardized tests of cognitive, language, and adaptive skills to children in all three groups at intake and about 14 months after treatment began. The groups were similar on key variables at intake. At follow-up, the IBT group had higher mean standard scores in all skill domains than the AP and GP groups. The differences were statistically significant for all domains except motor skills. There were no statistically significant differences between the mean scores of the AP and GP groups. Learning rates at follow-up were also substantially higher for children in the IBT group than for either of the other two groups. These findings are consistent with other research showing that IBT is considerably more efficacious than "eclectic" intervention.
... In the last third, symptoms worsened. Recent studies suggest that intensive early intervention, particularly applied behavior analysis (ABA), can achieve moderate to large positive effects on cognitive, language, and social skills (e.g., Howard et al. 2005). Comparisons of different early intervention programs have found ABA to produce significant improvements in all measures of children's ability, whereas other intervention programs have produced less pro-nounced changes (Howard et al. 2005). ...
... Howard et al. 2005). Comparisons of different early intervention programs have found ABA to produce significant improvements in all measures of children's ability, whereas other intervention programs have produced less pro-nounced changes (Howard et al. 2005). The crucial factors for success are the intensity and duration of the support. ...
... The crucial factors for success are the intensity and duration of the support. High-intensity support of 25-40 h per week shows the largest improvements in IQ and behavioral measures (Eldevik et al. 2010;Howard et al. 2005). However, not only the intensity but also the duration of the interventions are relevant. ...
A wide variety of physiological processes can be set in motion through interpersonal touch or massage. For example, relaxation massages can reduce depression, anxiety, and fatigue, improve sleep, reduce stress, regulate blood sugar, blood pressure, and the immune system. These effects are in line with extensive research showing that psychological factors such as anxiety or relaxation influence the nervous system, the immune system, and the endocrine system. Accordingly, relaxation induced by interpersonal touch and massage has the potential to be used as a complementary therapy in medicine for both physical and mental disorders.
The chapter also contains information on the effects of weighted blankets and vests and on contraindications and adverse side effects of massage.
... Effect sizes can also be biased, if they are not standardized (as seen in [21]). The use of fixed-effect models while including studies with more than one control group (e.g., [24]) is problematic because these models do not control for the dependence of effect sizes (as seen in [16]). Finally, an underestimation of effect sizes can occur from primary studies that compare two intensive ABAbased treatments, like the study from Sallows and Graupner [25] or the study by Smith, Groen and Wynn [26] (as seen in [14,19,22]). ...
... No study provided a quantification of the extent to which each intervention was applied. One study [24] included two control groups. We only considered one control group, specifically the eclectic educational program, which was more similar to the TAU control groups. ...
... Neither reasons for this lack of participation nor the amount of withdrawals for each group were stated. In the study of Howard and colleagues [24], 22% of participants (17 out of 78) dropped out for unknown reasons. Additionally, some of the remaining children did not complete all outcome measurements. ...
Background
Many studies display promising results for interventions that are based on Applied Behavior Analysis (ABA) in the treatment of autism spectrum disorder (ASD). Methods: This meta-analysis assessed the effects of such treatments on developmental outcomes in children with ASD and on parental stress based on 11 studies with 632 participants. Results: Compared to treatment as usual, minimal or no treatment, comprehensive ABA-based interventions showed medium effects for intellectual functioning (standardized mean difference SMD = 0.51, 95% CI [0.09; 0.92]) and adaptive behavior (SMD = 0.37, 95% CI [0.03; 0.70]). Language abilities, symptom severity or parental stress did not improve beyond the improvement in control groups. Moderator analyses indicate that language abilities at intake could influence the effect sizes and the influence of treatment intensity might decrease with older age. Conclusions: Practical implications and limitations are discussed.
... Among the outcome measures defined in the current review, some records showed significant improvement in some but not all contributing measures (Eikeseth et al., 2002;Reed et al., 2007a;Zachor et al., 2007). Others had statistically significant improvement in all contributing measures of a given outcome (Dixon et al., 2018;Howard et al., 2005;Lovaas, 1987;Novack et al., 2019;Smith et al., 2000;Zachor et al., 2007). ...
... Few (6%) study records compared ABA interventions to control groups or other non-ABA interventions. Study records that did investigate ABA compared to a control group (typically TAU) or other intervention more often measured statistical significance, had larger sample sizes (Kamio et al., 2015;Koenig et al., 2010), and/or used validated measurement tools such as RDLS and BSID-R (Cohen et al., 2006;Eikeseth et al., 2002;Howard et al., 2005;Kovshoff et al., 2011;Remington et al., 2007). It is interesting that more recent meta-analyses have trended towards fewer statistically significant improvements than what has been previously reported (Reichow et al., 2018;Rodgers et al., 2020). ...
... Many of the study records investigated specific tasks, responses, or skills. Thus, improvements in areas such as cognition may be misleading, because both improvements on specific tasks and improvements on full-scale cognitive assessments were scored as improvements in the cognitive outcome category (Grow et al., 2011;Howard et al., 2005). In addition, some of the outcome measures had considerable overlap in definitions, such as the cognition, language, social/communication, and adaptive behavior categories, thus potentially resulting in the coding of multiple outcome measures for a similar task. ...
This manuscript provides a comprehensive overview of the impact of applied behavior analysis (ABA) on children and youth with autism spectrum disorders (ASD). Seven online databases and identified systematic reviews were searched for published, peer-reviewed, English-language studies examining the impact of ABA on health outcomes. Measured outcomes were classified into eight categories: cognitive, language, social/communication, problem behavior, adaptive behavior, emotional, autism symptoms, and quality of life (QoL) outcomes. Improvements were observed across seven of the eight outcome measures. There were no included studies that measured subject QoL. Moreover, of 770 included study records, only 32 (4%) assessed ABA impact, had a comparison to a control or other intervention, and did not rely on mastery of specific skills to mark improvement. Results reinforce the need for large-scale prospective studies that compare ABA with other non-ABA interventions and include measurements of subject QoL to provide policy makers with valuable information on the impacts of ABA and other existing and emerging interventions.
Supplementary information:
The online version contains supplementary material available at 10.1007/s40614-022-00338-x.
... The subanalyses examined the impact of child age at intervention intake (≤35 months vs >35 months) on intervention effectiveness. [96][97][98][99][100][101][102][103] Designs included quasi-experimental and RCT; studies were conducted in Israel, the UK, and the USA. The names of the databases and search dates were not specified; however, the authors noted that an 'extensive search was carried out using search engines, and computerized bibliographic databases', following the example of Smith. ...
... Five studies involved children aged 36 months or younger and focused on behavioral, NDBI (ESDM), and other approaches (Autism 1-2-3). 41,95,97,98,103 Designs included quasi-experimental studies and RCTs; studies were conducted in the USA and Hong Kong. The authors described their search strategy, which included nine databases searched through to 24th June 2013. ...
... Ten studies included children aged 36 months or younger and focused on behavioral and NDBI approaches. 41,46,50,55,[96][97][98]103,105,106 The authors reported overall strength of evidence and study results separately for comprehensive approaches for children aged 24 months or younger. Designs included prospective case series, prospective cohort studies, non-concurrent multiple baseline studies, and RCTs, and were conducted in Israel, the UK, and the USA. ...
Aim:
To identify which interventions are supported by evidence and the quality of that evidence in very young children with or at high likelihood for autism spectrum disorder (ASD) to improve child outcomes.
Method:
We conducted an overview of reviews to synthesize early intervention literature for very young children with or at high likelihood for ASD. Cochrane guidance on how to perform overviews of reviews was followed. Comprehensive searches of databases were conducted for systematic reviews and meta-analyses between January 2009 and December 2020. Review data were extracted and summarized and methodological quality was assessed. Primary randomized controlled trial evidence was summarized and risk of bias assessed. This overview of reviews was not registered.
Results:
From 762 records, 78 full texts were reviewed and seven systematic reviews and meta-analyses with 63 unique studies were identified. Several interventional approaches (naturalistic developmental behavioral intervention, and developmental and behavioral interventions) improved child developmental outcomes. Heterogeneity in design, intervention and control group, dose, delivery agent, and measurement approach was noted. Inconsistent methodological quality and potential biases were identified.
Interpretation:
While many early interventional approaches have an impact on child outcomes, study heterogeneity and quality had an impact on our ability to draw firm conclusions regarding which treatments are most effective. Advances in trial methodology and design, and increasing attention to mitigating measurement bias, will advance the quality of the ASD early intervention evidence base.
... The use of NESTs violates behavior analysts' ethical commitments to maximize client benefits, minimize risk of harm, and use scientifically validated interventions that align with the principles of behavior analysis (BACB, 2020; Code 2.01, 2.14, 2.15). Use of NESTs may also result in significantly poorer client outcomes (e.g., Howard et al., 2005;Howard et al., 2014). Previous comparison has indicated that purely behavioral interventions resulted in greater increases in cognitive abilities, language, and adaptive skills for preschool-aged children on the autism spectrum than intensive and nonintensive eclectic interventions (Howard et al., 2005). ...
... Howard et al., 2005;Howard et al., 2014). Previous comparison has indicated that purely behavioral interventions resulted in greater increases in cognitive abilities, language, and adaptive skills for preschool-aged children on the autism spectrum than intensive and nonintensive eclectic interventions (Howard et al., 2005). Long-term follow up found maintenance of these gains including higher scores on standardized assessments of cognition, language, and adaptive skills for those who received behavioral interventions than for their peers in the eclectic group, with individuals in the behavioral intervention group being more than twice as likely to score in the average range (Howard et al., 2014). ...
Previous surveys revealed the majority of certified behavior analysts reported using applied behavior analysis (ABA) as a
treatment for individuals on the autism spectrum. However, some certificants have also reported using treatments without
evidence (Schreck et al. Behavioral Interventions, 31(4), 355–376, 2016; Schreck & Mazur Behavioral Interventions:
Theory & Practice in Residential & Community‐ Based Clinical Programs, 23(3), 201–212, 2008). The field of ABA has
undergone many changes in the last five years. This survey evaluated trends in the use and variables influencing the use of
autism treatments over that time. Results indicated that study participants (N = 921 BCBA-Ds, BCBAs, BCaBAs, and RBTs)
were significantly less likely to report current use of ABA and some unestablished treatments (e.g., DIR Floortime, sensory
integration therapy) than participants in 2016 (Schreck et al. Behavioral Interventions, 31(4), 355–376, 2016). Participants
frequently cited persuasion by others as an influence for their treatment selections. Because behavior analysts’ use of unestablished
treatments may be detrimental to client outcomes and the reputation and success of the field of ABA, future research
is needed to identify methods for increasing behavior analysts’ use of empirically supported treatments.
... Studies have demonstrated that ABA can have significant effects on IQ gains, adaptive functioning, and later school placement [5]. Experimental research has been conducted in school, home, and community environments with therapy being provided by both therapists and parents [1,5,[53][54][55][56]. ...
... Results from this study showed that the intensity of previous EIBI was not a unique predictor of current autism symptom severity, which is inconsistent with the literature, as research shows that children who received intensive early ABA intervention demonstrated higher skill domains, more positive behaviors, and growth in daily living skills, social behaviors, and language skills [3,5,[53][54][55]57,79]. One possible explanation for this inconsistency may be related to the sample. ...
The current study aimed to understand parents’ perceptions of the effects of early intensive behavioral intervention (EIBI) based on the principles of applied behavioral analysis (ABA) and the lasting outcomes for their children with Autism spectrum disorder (ASD). In particular, this study sought to examine parent perceptions of the relationship between the intensity of ABA interventions and current autism symptom severity, adaptive functioning, and school placement. The current study employed a convergent parallel mixed-methods design, which consisted of collecting, analyzing, interpreting, and combining both quantitative and qualitative data. Overall, results suggested that the intensity of previous ABA interventions was a unique predictor of current school placement. Additionally, results suggested that the intensity of previous ABA interventions was a unique predictor of adaptive skills, which was supported by parent interviews. However, the intensity of previous ABA interventions was not a unique predictor of current autism severity. Parent responses to interview questions revealed the imperative nature of the interventions and their effect on service delivery for their children with ASD. Overall, this study provided an increased understanding of parents’ perceptions of the effectiveness of EIBI, which in turn may be central to understanding service utilization.
... Progress in developmental age, adaptive behaviour, interpersonal relations, play and receptive and expressive language was clinically and reliably significant for the majority of the Low-Intensity Behavioral Treatment group. Howard et al (2005) This was the first trial to demonstrate that early behavioural intervention is associated with normalised patterns of brain activity, which is associated with improvements in social behaviour in young children with an autism spectrum disorder. ...
... A follow-up examination of the same children demonstrated that these improvements were maintained in adolescence [50]. Subsequent studies have shown significant improvements in IQ, language development, educational skills, and adaptive behaviors following EIBI [51][52][53][54][55][56][57][58][59][60]. However, only a few studies have specifically examined the changes in social functioning following EIBI [56,57,61]. ...
Autism spectrum disorder (ASD), a neurodevelopmental disorder typified by differences in social communication as well as restricted and repetitive behaviors, is often responsive to early behavioral intervention. However, there is limited information on whether such intervention can be augmented with pharmacological approaches. We conducted a double-blinded, placebo-controlled feasibility trial to examine the effects of the β-adrenergic antagonist propranolol combined with early intensive behavioral intervention (EIBI) for children with ASD. Nine participants with ASD, ages three to ten, undergoing EIBI were enrolled and randomized to a 12-week course of propranolol or placebo. Blinded assessments were conducted at baseline, 6 weeks, and 12 weeks. The primary outcome measures focusing on social interaction were the General Social Outcome Measure-2 (GSOM-2) and Social Responsiveness Scale—Second Edition (SRS-2). Five participants completed the 12-week visit. The sample size was insufficient to evaluate the treatment efficacy. However, side effects were infrequent, and participants were largely able to fully participate in the procedures. Conducting a larger clinical trial to investigate propranolol’s effects on core ASD features within the context of behavioral therapy will be beneficial, as this will advance and individualize combined therapeutic approaches to ASD intervention. This initial study helps to understand feasibility constraints on performing such a study.
... As crianças no espectro autista são incrivelmente diversas em suas habilidades, desafios e personalidades. Deste modo, enquanto alguns podem se beneficiar enormemente de intervenções intensivas e estruturadas, outros podem se sair melhor com abordagens mais flexíveis e adaptadas às suas necessidades individuais (Howard, Sparkman, Cohen, Green & Stanislaw, 2005). ...
O Transtorno do Espectro Autista (TEA) é uma condição neurodesenvolvimental que afeta a comunicação social e comportamentos repetitivos ou restritos. Com uma prevalência crescente, a necessidade de entender e intervir de forma eficaz no TEA é urgente. Esta revisão foca nos avanços recentes relacionados ao entendimento do desenvolvimento infantil em crianças com TEA e as subsequentes implicações clínicas e terapêuticas. Intervenções comportamentais continuam a ser a espinha dorsal do tratamento, com abordagens intensivas e bem-estruturadas demonstrando melhorias em áreas como comunicação e habilidades sociais. No entanto, terapias baseadas em jogo têm ganhado destaque, proporcionando ambientes naturais para desenvolvimento social. Paralelamente, o campo das intervenções farmacológicas tem evoluído, visando tratar sintomas específicos e comorbidades associadas ao TEA. Apesar das promissoras abordagens individualizadas, combinar múltiplas intervenções se mostra mais eficaz, considerando a natureza multifacetada do TEA. As pesquisas futuras devem continuar focando em tratamentos individualizados e baseados em evidências, com ênfase em uma compreensão profunda dos mecanismos neurobiológicos subjacentes e avaliação de longo prazo das intervenções.
... ABA-based treatments have shown clinically significant improvements inherent in intellectual, social, emotional, and adaptive functioning in the presence of neurodevelopmental disorders. In particular, its systematic application with people with ASD and people with intellectual disabilities has highlighted improvements in socially useful behaviors, communication, and language [33][34][35][36][37][38]. The importance of early and intensive intervention was highlighted already in the last century in numerous further studies [39][40][41]. ...
The applied behavior analysis (ABA) model emphasizes observable and measurable behaviors by carrying out decision making using experimental data (behavioral observation assessment strategies). In this framework, information and communication technology (ICT) becomes highly suitable for enhancing the efficiency and effectiveness of the methodology. This paper aims to delve into the potential of ICT in providing innovative solutions to support ABA applications. It focuses on how ICT can contribute to fostering social inclusion with respect to children with neurodevel-opmental disorders. ICT offers advanced solutions for continuous and context-aware monitoring, as well as automatic real-time behavior assessments. Wireless sensor systems (wearable perceptual, biomedical, motion, location, and environmental sensors) facilitate real-time behavioral monitoring in various contexts, enabling the collection of behavior-related data that may not be readily evident in traditional observational studies. Moreover, the incorporation of artificial intelligence algorithms that are appropriately trained can further assist therapists throughout the different phases of ABA therapy. These algorithms can provide intervention guidelines and deliver an automatic behavioral analysis that is personalized to the child's unique profile. By leveraging the power of ICT, ABA practitioners can benefit from cutting-edge technological advancements to optimize their therapeutic interventions and outcomes for children with neurodevelopmental disorders, ultimately contributing to their social inclusion and overall wellbeing.
... O progresso da criança é monitorado de perto e avaliado regularmente para garantir que as intervenções estejam sendo eficazes e para ajustar o plano de tratamento, se necessário. Além disso, a família da criança é uma parte importante do processo de tratamento e é frequentemente incluída nas sessões de terapia e nas atividades em casa (Howard et al., 2005). Por fim, a criança é incentivada a generalizar as habilidades aprendidas para diferentes ambientes e situações, ajudando a garantir que as habilidades aprendidas sejam úteis em sua vida diária (McEachin et al., 1993). ...
Este artigo teve como objetivo - compreender a contribuição da ABA na inclusão de crianças com TEA no ambiente escolar. O estudo em questão é de natureza qualitativa, do tipo, bibliográfica – narrativa, onde buscou-se realizar um levantamento bibliográfico na ferramenta digital - Google, tendo como descritores de busca – a importância da ABA na escola ou a contribuição da ABA na inclusão dos alunos na escola. Posteriormente, foi considerado apenas as pesquisas que tinham nos títulos as informações compatíveis com objetivo desta pesquisa. Com isso, foi possível reunir oito pesquisas, sendo seis artigos e dois Trabalhos de Conclusão de Curso. Então, chegou-se à conclusão, por meio desse levantamento que, as pesquisas encontradas reforçam sobre a contribuição da ABA no ambiente educacional, ao qual vem gerando inclusão. Essa contribuição está relacionada com o desenvolvimento da autonomia e o desenvolvimento cognitivo da criança autista, como também, da sua participação social. Para tais benefícios, são necessárias mudanças nas estratégias pedagógicas, como a formação continuada dos professores em ABA, currículo adaptado e um trabalho em conjunto e bem articulado com todos os profissionais envolvidos no processo de aprendizagem da criança.
... The result of the spread of misinformation is that a whole science has been branded as controversial (Parker, 2015) when the real controversy should revolve around the deliberate dissemination of misinformation. The misrepresentation is so pervasive in Europe that on one hand it is said that it would be wrong to invest in only one "thing" like ABA, while on the other hand it is argued that it is acceptable to invest in one "thing" called an "eclectic approach," even though there is evidence that ABA-based interventions are more effective than eclectic interventions (Howard et al., 2005(Howard et al., , 2014. Unfortunately, no-one addresses the ethical questions that arise from the role played by the Dunning-Kruger effect (Benzel, 2022;Hofer et al., 2022) when misinformation and the associated caricatures of ABA form the basis of government strategies and policies (Dillenburger et al., 2014). ...
Questions about human behavior and diversity have captured the attention of scientists from a wide range of philosophical stances for centuries. While behavior analysts would argue that natural science is an enlightening perspective when applied to the understanding of the human condition, at times arguments within certain campaigns would prefer Applied Behaviour Analysis (ABA) to be banned or abolished. In this paper we discuss some of the roots of this stance and suggest a way forward based on what are basically complementary views on the goals enshrined in rights-based practice.
... Behavior analytic researchers have a long history of critically and experimentally evaluating alternative treatments that are implemented with autistics/ individuals diagnosed with ASD (e.g., Chok et al., 2010;Howard et al., 2005;Leaf et al. 2018;Lerman et al., 2008;Normand, 2008). These critiques have included such alternative interventions as facilitated communication (Montee et al., 1995), rapid prompting method (Schlosser et al., 2019), Social Thinking™ (Leaf et al., 2018), bonding (attachment) therapies (Chaffin et al., 2006) and sensory integration (Lang et al., 2012). ...
Behavior analysts collaborating within interdisciplinary teams are likely to find themselves at difficult crossroads. Some of these crossroads include implementing alternative treatments, defining and determining risk and harm, and evaluating research and interventions. The purpose of this paper is to highlight some of these crossroads and provide guidelines on successfully navigating them. We contend that it is possible to navigate these crossroads while minimizing harm or risk for the client, adhering to the principles of science and behavior analysis, and remaining respectful of all members of the interdisciplinary team. That is, we can maintain the scientific tenets of philosophic doubt, empiricism, and experimentation, while remaining humble, and ensuring our clients access the most effective interventions available.
... However, several RCTs have shown the effectiveness of ABA based interventions in ASDs. A good example is Howard et al. [9], who evaluated 29 pre-school children who received intensive behaviour analytic intervention (treatment group) and two matched control groups of 16 children each, receiving either intensive or non-intensive ''eclectic'' interventions. While the scores for cognitive, language, and adaptive skills were similar at intake, at follow-up the treatment group had statistically significant higher mean standard scores in all areas. ...
In Sri Lanka, the prevalence and detection of Autism Spectrum Disorders (ASDs) has increased in recent times. Applied Behaviour Analysis (ABA) is an evidence based intervention in ASDs. In Sri Lanka the principals and methods of ABA are used as part of generalized intervention rather than a stand-alone intervention. This paper discusses how an evidence based intervention such as ABA can be adapted, so that it is effective and accepted in a different culture. This is important as concepts that come in ABA such as reinforcement is influenced by culture. Cultural awareness allows the therapist to utilise aspects of culture such as appropriate reframes to increase the acceptability of an intervention. ABA can be a very useful intervention in less resourced and culturally different situations when adapted in an appropriate way.
... In EIBI, target behaviors and the order of which these are introduced in the child's treatment program is informed by developmental psychology, and is tailored to meet the child's idiosyncratic leaning style and developmental profile. EIBI has been evaluated in numerous outcome studies and meta-analyses, and most of these studies suggest that EIBI may be effective in increasing intellectual and adaptive functioning in many preschoolaged children with ASD compared to eclectic treatment and treatment as usual (e.g., Cohen et al., 2006;Eikeseth et al., 2002Eikeseth et al., , 2007Eikeseth et al., , 2012Eldevik et al., 2009Eldevik et al., , 2010Eldevik et al., , 2020Howard et al., 2005Howard et al., , 2014Perry et al., 2009;Reichow et al., 2018;Remington et al., 2007;Rodgers et al., 2021;Sallows & Graupner, 2005;Sandbank et al., 2020;Smith et al., 2000;Waters et al., 2020). ...
This study evaluated the effects of a center-based Intensive Behavioral Intervention (IBI) model for preschool aged children with autism. Outcomes of 25 children receiving IBI was compared to the outcomes of 14 children receiving autism specific, eclectic, special education. Both provisions were described as appropriate treatment options by the professional agency who diagnosed the children, and the decision of where to enroll the child was made by the parents after consultations with the specialists. After 14 months of treatment, children from the IBI group improved significantly on standard scores in intellectual functioning and adaptive behavior and had a significant reduction in autism severity compared to the children in the autism specific, eclectic, special education group. Results suggest that preschool aged children with autism may make large gains in intellectual and adaptive functioning and improvement in autism severity with IBI, and that effects of IBI may be similar to that of EIBI. These findings must be interpreted with caution due to the limitations inherent in the present comparison-controlled design.
... ABA interventions are historically effective [5] and have been shown to improve outcomes such as behaviors, feeding disorders, academics, social functioning, independent living skills, and vocational skills for children ranging in age from one year to adolescence that have been diagnosed with ASD [6][7][8][9]. However, the traditional ABA model is intrinsically disorganized and lacks a uniform approach to treatment delivery. ...
Objective
This study examines the implementation of a hybrid applied behavioral analysis (ABA) treatment model to determine its impact on autism spectrum disorder (ASD) patient outcomes.
Methods
Retrospective data were collected for 25 pediatric patients to measure progress before and after the implementation of a hybrid ABA treatment model under which therapists consistently captured session notes electronically regarding goals and patient progress. ABA treatment was streamlined for consistent delivery, with improved software utilization for tracking scheduling and progress. Eleven goals within three domains (behavioral, social, and communication) were examined.
Results
After the implementation of the hybrid model, the goal success rate improved by 9.7% compared to the baseline; 41.8% of goals showed improvement, 38.4% showed a flat trend, and 19.8% showed deterioration. Multiple goals trended upwards in 76% of the patients.
Conclusion
This pilot study demonstrated that enhancing the consistency with which ABA treatment is monitored/delivered can improve patient outcomes as seen through improved attainment of goals.
... Uma das intervenções recomendadas pelos documentos ministeriais, mas não identificada e explorada pelos estudos que compõem a pesquisa em ambos os períodos, diz respeito à Análise do Comportamento Aplicada (Applied Behavior Analysis -ABA), uma proposta de intervenção baseada em evidências científicas reconhecidamente eficaz como abordagem terapêutica para o TEA, apresentando dados cien-tíficos relevantes na redução dos sintomas e promoção de melhores condições de vida para pessoas com autismo e suas famílias (LOVAAS, 1987;VAUGHN et al., 2003;HOWARD et al., 2005;LANDA, 2007;VIRUÉS-ORTEGA, 2010). ...
O presente estudo tem como objetivo realizar uma revisão dos estudos publicados 5 anos antes e 5 anos depois da publicação da linha de cuidado e das diretrizes para a assistência da pessoa com TEA na rede pública de saúde. A análise bibliográfica foi adotada como estratégia para identificar possíveis impactos das diretrizes na produção de conhecimento e nas práticas profissionais publicadas na literatura brasileira.
... A large evidence base supports the use of behavioral approaches to teach early AAC skills to individuals with intellectual and developmental disabilities who have language delays or impairments (Carnett, et al., 2019;Howard et al., 2005;Iacono et al., 2016;Smith et al., 2000), with a focus on the function of language (i.e., why it occurs; Ganz, 2015;Greer & Ross, 2008;Skinner, 1957;Still et al., 2014). One of the earliest and arguably most important expressive language skills acquired is requesting (mands; Skinner, 1957;Tapp et al., 2021), which is often taught first because it's the only type of communication that contacts direct reinforcement (i.e., the individual receives access to what they request (Sundberg & Michael, 2001) and contributes to autonomy. ...
Rett syndrome is a severe neurodevelopmental disorder that results in both motor and language skill regression with a wide range of severity in symptom presentation. Communication intervention may be particularly challenging for this population due to the decline in speech, motor skills, and motor planning difficulties that characterize the disorder (Townend et al., 2020), often resulting in the need for augmentative and alternative communication (AAC) technology. Very limited research has evaluated communication interventions for individuals with Rett syndrome and even fewer have targeted expressive communication, an important skill required for improved autonomy and quality of life (Sigafoos et al., 2009; Townend et al., 2020). The current study sought to systematically replicate the Simacek et al. (2017) mand training procedures to teach three girls with Rett Syndrome to use AAC to make requests through caregiver coaching by researchers via telehealth. Results suggest that mand training was successful in increasing AAC use for all three participants. Barriers to intervention for this population and implications of results for future research and clinical practice are discussed.
... EIBI uses a specific teaching procedure with a 1:1 adult-to-child ratio and the implementation in either home or school settings for a range of 20 to 40 hours per week, with children from one to four years old. In this model, the analysis of functional behavior is used to develop individualized intervention targets where complex behaviors are broken down into specific steps and reinforced to gradually approximate the desired behavior and ultimately enhance learning [33,34]. ...
Scientific literature suggests the neurobiological value of early intervention for children at risk of ASD and of other neurodevelopmental disorders, because it is based on the promotion of brain plasticity mechanisms in an ecological, noninvasive, and evidence-based way. Moreover, several authors suggest the greatest efficacy of early rehabilitation programs, involving both the parents and the children, is to improve not only sensory-motor and cognitive outcomes but also child-parent interactions and the wellness of the familiar system. In this chapter, the neurobiological fundaments and features for the early intervention and the most recent early approaches for children at risk of ASD (behavioral, developmental, naturalistic developmental behavioral, and parent-mediated interventions) will be explained.
... Children with autism spectrum disorder (ASD) show dramatic improvement when provided with early intensive behavioral interventions (EIBI) grounded in applied behavior analysis (ABA; Howlin 1 ). Several researchers have reported the effectiveness of EIBI (e.g., Ben-Itzchak & Zachor 2 ; Eikeseth et al. 3 ; Eldevik et al. 4 ; Estes et al. 5 ; Lovaas 6 ; Peters-Scheffer et al. 7 ; Reichow et al. 8 ; Sheinkopf & Siegel 9 ; Warren et al. 10 ), whereas others found that EIBI has a "moderate" effect on adaptive behavior in children with ASD [11][12][13][14][15][16][17] . The degree to which these outcomes are sustained over time is largely unknown, and further research is required to include larger and more representative demographic samples [18][19][20] . ...
We examined the sustained effects of early intensive behavioral intervention (EIBI) on 66 children with autism spectrum disorder who participated in the Future Center’s EIBI program. Children were assessed using the childhood autism rating scale (CARS), autism behavior checklist (ABC), and adaptive behavior scale (ABS-Arabic) 3 years after leaving the program. Continued positive effects were observed in several areas, including adaptive behavior and autism symptoms. However, participants’ social skills might have declined on the ABS-Arabic after service withdrawal. Additionally, a significant negative association (p < .001) was found between participants’ performance on the CARS and the number of weekly trials. This is encouraging, given the lack of EIBI services and regional instability. Future research should increase the sample size and use a more rigorous design.
... Por apresentar uma abordagem individualizada e altamente estruturada, ABA torna-se uma intervenção bem sucedida para crianças com TEA que tipicamente respondem bem à rotinas e diretrizes claras e planejadas (SCHOEN, 2003). Sabe-se que o método ABA possui grande suporte científico e tem sido o método de intervenção mais pesquisado e amplamente adotado, sobretudo nos Estados Unidos, para promover a qualidade de vida de pessoas com transtorno do espectro do autismo (GILLIS;BUTLER, 2007;LOVAAS, 1987;VAUGHN et al., 2003; VIRUÉS-ORTEGA, 2010;HOWARD et al., 2005; LANDA, 2007). e-Publicar -Diálogos em educação: Olhares multidisciplinares sobre a aprendizagem, Volume 1 No entanto, uma melhor e mais completa compreensão do ABA, enquanto método de intervenção em todas as suas dimensões e complexidade, requer o claro entendimento de sua base conceitual e dos princípios do comportamento que determinam a sua prática e fazem desta uma abordagem de intervenção efetiva, principalmente para pessoas com autismo. ...
O tema da seguinte pesquisa parte de uma discussão bem atual acerca do transporte de termolábeis em cadeia fria.
O objetivo da pesquisa é revisar a literatura científica disponível na busca da melhor compreensão desse processo de envolvimento, quais metodologias são utilizadas nessas pesquisas, e quais os resultados tem-se até o momento.
Para essa pesquisa, optou-se pela metodologia de pesquisa bibliográfica sistematizada. A busca em diversos bancos de dados proveu um panorama de como o tema é estudado metodologicamente e o estado da arte atual. Percebeuse a maioria dos estudos como de natureza quantitativa e descritiva, chegando a inferências baseando-se nos cenários que foram de desvelando a partir de suas pesquisas. O transporte foi apontado como o maior dos desafios,
mas não por conta do modal e superando mesmo os desafios do uso do serviço público postal e das variações climáticas ao longo do vasto território brasileiro, sendo o conhecimento científico de acondicionamento em diversas embalagens térmicas e o conhecimento técnico dos profissionais sobre o processo de transporte e armazenamento, apontados como lacunas em um sucesso no sistema logístico brasileiro.
... On the other hand, empirical study findings suggest that many CAM treatments have little or no evidence for treating ASD symptoms, incur costs in terms of time and out-of-pocket expense, and take time to show positive outcomes for children with ASD (Lindly et al., 2018). Furthermore, the waste of time, energy, and money may prevent children with ASD from access to intensive and behavioral practices referred to as a cornerstone of treatment for core impairments of ASD (Howard et al., 2005). Despite the lack of scientific evidence on CAM treatments for ASD, there have been a wide array of CAM treatments offering the promise of a cure for ASD (Hanson et al., 2007;Nickel, 1996). ...
We investigated parent reports of use of special education and support services, use of evidence-based practices (EBPs), use of past and current complementary and alternative medicine (CAM) treatments, non-use of CAM treatments, willingness, and unwillingness to use CAM treatments, reasons for use and non-use of CAM treatments, and perceptions of
EBPs and CAM treatments in their children’s functioning. We collected data from a total of 166 parents of children with autism spectrum disorder (ASD) through a web-based survey. 94% of the parents reported lifetime use of at least one CAM treatment. Parents weighed on a wide variety of factors in decision-making. CAM treatments use was positively associated with parental educational level, length of time since ASD diagnosis, and child’s ASD severity.
... The picture is complicated for longitudinal studies due to intervening variables over time. Individuals with ASD and DD often receive a variety of services throughout childhood that may target aspects of sensory features and/or adaptive skills (Howard, Sparkman, Cohen, Green, & Stanislaw, 2005;Schaaf et al., 2014;Uyanik, Bumin, & Kayihan, 2003). Services received often include therapy (i.e., occupational therapy, physical therapy, and speech and language therapy) and educational services. ...
... Nahmias et al. (2019) included a wide range of interventions, not limiting the meta-analysis to interventions with established evidence. Furthermore, the comparison between university-based trials and routine clinical care in Nahmias et al. (2019) is questionable as four of the five university-based trials (Cohen et al., 2006;Howard et al., 2005;Magiati et al., 2007;Remington et al., 2007) in the systematic review by Reichow et al. (2012) that were used as comparison were included as "community-based early intervention studies" in the Nahmias meta-analysis. This means that the comparison is flawed since these studies are counted in both categories of studies. ...
... A further recent study investigating home-based EIBI for young children with autism was reported by a team based at California State University (Howard, Sparkman, Cohen, Green & Stanislaw, 2005). The authors of this study sought to compare the effects of 3 different forms of intervention on the development of young children with autism. ...
p> The variability in outcomes observed in home-based EIBI is likely in part to be the result of the quality of therapist performance during intervention sessions. Therapist behaviour in this context is, however, poorly understood. Perceived therapeutic self-efficacy may be one factor responsible for governing therapist behaviour. Exploration of this factor is, at present, hampered by the lack of a valid and reliable measure of perceived therapeutic self-efficacy; the aim of the present thesis was to devise such a measure. To achieve this, it was necessary to identify barriers that therapists considered to impede their ability to deliver home-based EIBI. In the first study, 19 therapists delivering home-based EIBI to young children with autism in the South of England were interviewed. Barriers to intervention delivery included child factors such as challenging behaviour and lack of progress, supervision factors such as being observed during sessions, therapist factors such as emotional reactions to children’s behaviour, and factors related to the intervention such as advanced skill targets.
Following the identification of barriers to delivering home-based EIBI, two further questionnaire studies sought to clarify the nature of perceived therapeutic self-efficacy and explore predictors of therapists’ beliefs. Factor analyses of therapists’ responses identified two dimensions of perceived therapeutic self-efficacy relating to (i) teaching a child who is difficult to engage with and (ii) teaching a child whilst being observed. Subsequent regression analysis revealed the former dimension was predicted by therapists’ perceptions of their own experiences, general self-efficacy and supervision frequency. There was also evidence to suggest that general self-efficacy beliefs act as a protective factor in this domain when therapists experience difficulties. The latter dimension was predicted by therapists’ perceptions of their own experiences, general self-efficacy beliefs and knowledge of behavioural principles. </p
... Discrete-trial training (DTT) is an instructional method common in early intensive behavioral intervention (EIBI) for young learners with autism spectrum disorder (ASD) or related neurodevelopmental disabilities (e.g., Lovaas, 1987;McEachin et al., 1993;Sheinkopf & Siegel, 1998). Although not typically used as the sole instructional method, DTT alone and in combination with other types of instruction has shown to be an effective method of teaching new skills (Downs et al., 2008;Eikeseth et al., 2002;Howard et al., 2005;Remington et al., 2007;Smith et al., 2000). A discrete trial is a short-duration unit of instruction that is usually delivered by a single therapist (e.g., Carroll et al., 2013), teacher (e.g., Dib & Sturmey, 2007), or parent (Lafasakis & Sturmey, 2007) to an individual learner. ...
Discrete-trial training (DTT) is a common method of instruction used in early intervention amongindividuals with autism spectrum disorder and related neurodevelopmental disorders and is an effective method of teaching different skills such as tacting, listener responding, and matching. Delivery of effective reinforcers is a key component of DTT. Although general recommendations have been made for effective reinforcement delivery in DTT, no review has synthesized the available research on the efficiency of various reinforcer parameters on efficiency of acquisition. The current systematic review assessed the efficiency of various reinforcer parameters on acquisition in DTT. Results were idiosyncratic, and a general paucity of repeated measures examining specific reinforcer parameters within and across studies was observed. In general, (1) maintaining high levels of treatment integrity, (2) delivery of tangible (i.e. leisure items) or edible reinforcers in comparison with contingent praise as a reinforcer, and (3) delivery of edible reinforcers in comparison with other topographies of reinforcement were the most successful reinforcer parameter manipulations and always resulted in more efficient skill acquisition. The results of this review provide clinicians with information regarding what reinforcer parameter manipulations may be more or less likely to support efficient acquisition. The present review also provides considerations and makes recommendations for future research.
... As a result, we were not able to make causal statements as the improvements identified may have been due to maturation or historical variables. However, it is unlikely that the gains made by the children were due to maturation effects alone, as the EIBI intervention effectiveness evaluated in the present study has previously been validated by numerous researchers who were able to implement stronger experimental controls such as randomized control trials, quasi-randomized control trials, or clinical control trials using a comparison group receiving treatment-as-usual (Cohen et al., 2006;Eikeseth et al., 2012;Estes et al., 2015;Howard et al., 2005;Magiati et al., 2007;Remington et al., 2007;Smith et al., 2000). Another limitation resulting from conducting research in a public-based setting is the difficulty in recruiting and retaining participants. ...
The development of appropriate social skills is critical for all children in establishing relationships and being able to successfully participate in their communities. Children with autism spectrum disorder (ASD), however, have pronounced difficulties with social skill acquisition, development, execution, generalization and maintenance, which are characteristic of the disorder. For children with ASD, the development of fundamental social skills (e.g., saying thank you, smiling when seeing their caregiver) to more complex social skills (e.g., expressing empathy and cooperation) represent unique challenges. Yet, little research has focused on complex social skills as an outcome of Early Intensive Behavioural Intervention (EIBI), a well-established intervention for children with ASD. The present study evaluated fundamental and complex social skills in a sample of 16 children with ASD from two community settings in Quebec before and two years after receiving EIBI. Pre-intervention and post-intervention measures included the Social Skills Improvement (SSIS) to screen for complex social skills and problem behaviours, and the Adaptive Behavior Assessment System (ABAS-II) to screen for fundamental social skills. Significant pre- to post-test improvements in social skills were found with the ABAS-II but not with the SSIS. Although preliminary, these findings are suggestive that within EIBI programs, specific social skills should be targeted directly.
... The American Academy of Pediatrics revealed that all children with ASD can be identified and screened at two years of age, which provided strong evidence supporting the early intervention for ASD (Charman, 2014). Therefore, many early intervention programs appeared targeting mean deficient areas in ASD e.g., early intensive behavior analytic treatment which yielded positive outcomes in domains of social communication, behavior, cognitive, and language skills (Howard, Sparkman, Cohen, Green, & Stanislaw, 2005). ...
... Teachers are provided limited information about how and when to individualize based on student needs, as there are limited empirical data to assist with this process ( Stahmer et al., 2011 ). As a result, teachers often adapt EBPs in ways that are not likely to facilitate positive student outcomes ( Howard et al., 2005 ). ...
While there are multiple evidence-based practices (EBPs) available for students with autism, ongoing barriers to use in schools include limited access to training for educators and substantial provider modifications that limit fidelity. This suggests a need for further research to support data-informed adaptations and innovative methods for training and coaching teachers. In response to this need, the objectives of this protocol paper are to (1) describe the development of a data-informed adaptation process for an EBP, and (2) compare the effectiveness of two methods (online virtual and a combination of in-person and online virtual) for training teachers to use the adapted EBP. Outcome measures will include teacher implementation and sustainment of the EBP, teacher/coach relationship, and student outcomes.
The principle of motivation has resurfaced as an independent variable in the field of behavior analysis over the past 20 years. The increased interest is the result of the refinements of the concept of the motivating operation and its application to the learning needs of persons with developmental disabilities. Notwithstanding the increased emphasis upon modification of motivating operations to reduce problem behavior, the autism treatment literature currently reflects limited recognition of this important behavioral variable. This paper provides an overview of antecedent based instructional modifications that lead to a reduction of escape and avoidance behavior of children with autis m during instruction. An analysis of these instructional methods as motivating operations is proposed. A conceptually systematic analysis of the influence of instructional methods is offered as a tool for improving the selection and implementation of effective teaching procedures.
Over the past 15 years there has been a dramatic increase in the incidence of autism. At the same time, the number of professionals qualified to coordinate effective behavioral interventions has been limited and often prohibitively expensive. No one understands this better than parents of children with autism. For these and other reasons, some of these parents have chosen to complete the requirements leading to certification in applied behavior analysis. This paper describes a pilot study into the backgrounds and experiences of six such “autism mothers.” The study utilized qualitative research methods to explore the participants' transition from the role of mother to the additional role of ABA professional. Also explored were the participants' perceptions regarding both sides of the parent-professional partnership and their recommendations for training parents of newly diagnosed children with autism.
Autism spectrum disorder (ASD) has been described in the clinical and research literature for decades and presents many clinical challenges. ASD has been poorly understood, and many misconceptions exist about its nature and etiology and about the components of effective treatment. ASD is characterized by deficits in social and communication skills and by repetitive behaviors. The variability within ASD is significant, but these characteristics are universally present. Effective treatments for the defining features of ASD exist and lead to socially significant changes in the lives of individuals with ASD. Social and communication interventions include the use of discrete trial instruction, incidental teaching and other naturalistic procedures, and video modeling. Functional communication training has led to major behavioral and communicative improvements as well. Challenging behaviors, including self‐injury and aggression, have been successfully treated with a variety of behavior‐analytic interventions. Effective intervention requires an understanding of the function of the challenging behavior, and function‐based treatment is essential. Behavior analysis provides the most effective means of conceptualizing and treating ASD, both in terms of addressing social and communicative skill deficits and in terms of reducing the interference posed by challenging behaviors.
The Early Start Denver Model has historically been implemented primarily within early education as a comprehensive approach with an interdisciplinary perspective. The Denver Model follows the student’s lead and is applied in only naturally occurring opportunities. With a focus on communication, the Denver Model integrates related skills while working concurrently across domains. This model includes assessment, curriculum, activities, and analysis to provide a comprehensive teaching program.
Early Intensive Behavioral Intervention (EIBI) is an empirically validated procedure rooted in the principles and procedures of Applied Behavior Analysis (ABA). EIBI is commonly implemented for young children with autism spectrum disorder (ASD) and a myriad of literature exists which evaluates the effect of EIBI on this population. The purpose of the chapter is to (a) provide a comprehensive review of EIBI, (b) outline the evolution of EIBI and resolve misinterpretations, (c) discuss contemporary outcomes associated with EIBI, and (d) thoroughly describe the defining characteristics of EIBI, components, and methodologies of treatment plans, domains of intervention, and implications for the best outcome. Finally, the chapter will identify populations that benefitted from EIBI.KeywordsAutismApplied behavior analysisBehavioral interventionEarly behavioral interventionEarly intensive behavioral interventionEIBIEarly interventionIntensive behavioral interventionLovaas methodLovaas modelLovaas therapy
Applied behavior analysis (ABA) is best known as an intervention for persons with autism and, currently, behavioral interventions are the most empirically supported treatment for this population. However, the field of behavior analysis, which has its roots in Skinner’s radical behaviorism, includes the domains of basic and applied research as well as service delivery. This chapter describes the history of behavior analysis, and subsequently of ABA, including early influencers, events, and seminal publications. Next, the chapter provides examples of behavioral interventions used with persons with autism and examples of the use of interventions with other populations. The chapter ends with a discussion of the current state of the field as it relates to service delivery, including certification and professional and ethical guidelines.KeywordsApplied behavior analysis ABA Autism Behavior analysis certification History of applied behavior analysis Skinner
Cumulative evidence for several personality traits reflecting
a milder form of autistic characteristics among first-degree
relatives of probands with autism has led to the concept of
the broad autism phenotype (BAP). The present study aims
to describe diagnostic outcomes of 34 school-age siblings
of probands with autism (SIBS-A), aged 9 to 12 years,
compared to 42 matched siblings of children with typical
development (SIBS-TD). The diagnostic outcomes were
derived from the Baby Siblings Research Consortium
categorizations using the Autism Diagnostic Observation
Schedule (ADOS), the Social Communication
Questionnaire (SCQ), and standardized cognitive and
language measures. Results indicated that about 38% of the
SIBS-A group (n = 13) were identified with BAP-related
difficulties (i.e., a SIBS-A-BAP subgroup), significantly
surpassing the 7% of siblings identified with BAP-related
difficulties in the SIBS-TD group. Interestingly, verbal IQ
scores were significantly higher for the subgroup of SIBSA-BAP compared to SIBS-A and SIBS-TD who were
identified with typical development (SIBS-A-TD and SIBSTD-TD, respectively). The current study presents
developmental trajectories of these 13 SIBS-A-BAP as
previously assessed longitudinally from ages 4 months to 7
years. The current results support previous observation of
an increase in BAP-related difficulties in siblings after the
preschool years. Results are discussed in relation to the
developmental trajectories of the BAP in siblings of
children with autism.
In this chapter we present an overview of the research synthesis literature of comprehensive and focused interventions for autism in the field of applied behavior analysis (ABA). Numerous non-randomized controlled trials, one-arm trials, and retrospective observational studies support the effectiveness of early intensive behavioral intervention for autism in the cognitive, language, social, and adaptive outcome domains. Effect sizes in these various outcomes have been reported in the medium-to-large ranges in various meta-analyses. In addition, the emerging field of single-subject experimental design meta-analysis provides a new stream of research synthesis that has been traditionally absent from the outcome research arena. A major limitation to the field of ABA-based interventions for autism is the limited number of randomized controlled trials of both comprehensive and focused interventions. In this chapter we present an overview of the research synthesis literature of ABA-based interventions for autism and a reappraisal of its methodological standards.
O treino por tentativa discreta é um método de ensino frequente para indivíduos com autismo, porém não é simplesmente implementado com fidelidade devido ao seu grau de complexidade. Sendo a literatura rica em procedimentos que ensinam profissionais a aplicar o treino de tentativa discreta, entretanto, esse conhecimento está circunscrito a profissionais que têm o domínio da língua inglesa e têm experiência com treinamento científico. Nesse sentido, o objetivo do presente trabalho foi complicar um conjunto de estratégias e apresentar essas estratégias de uma forma mais didática e em português. Para tanto, nós selecionamos cinco artigos a partir de uma revisão sistemática sobre o assunto e extraímos informações como: Dados dos participantes, definição dos comportamentos-alvo e forma de mensuração, objetivo da pesquisa, objetivo da intervenção, linha de base do comportamento- alvo, descrição da intervenção e resumo dos resultados. Como resultado, nós apresentamos cinco descrições de trabalhos organizados de forma que entende-se que seja apresentadas de maneira mais clara e didática, com a intenção de um ensino que orientem o profissional com pouca experiência, um estudante da área ou um acompanhante terapêutico a realizar a intervenção em DTT. Consideramos que este trabalho seja para uma melhoria na prática profissional.
To distinguish between children with autism spectrum disorder (ASD) and typically developing (TD) children, we have uncovered a new discriminative feature, hemoglobin coupling. Functional near‐infrared spectroscopy (fNIRS) was used to record resting‐state hemodynamic fluctuations in the bilateral temporal lobes in 25 children with ASD and 22 TD children, in which the coupling between low frequency oxygenated hemoglobin (HbO) and deoxygenated hemoglobin (Hb) fluctuations was evaluated by Pearson correlation coefficient. The results showed significantly weak coupling in children with ASD in both the left and right, and throughout the whole temporal cortex. To explain this observation, a simulation study was performed using a balloon model, in which we found four related parameters could impact the coupling. This study suggested that hemoglobin coupling might be applied as a new cerebral hemodynamic characteristic for ASD screening or diagnostics. This article is protected by copyright. All rights reserved.
This innovative textbook is the first to integrate learning and memory, behaviour, and cognition. It focuses on fascinating human research in both memory and learning (while also bringing in important animal studies) and brings the reader up to date with the latest developments in the subject. Students are encouraged to think critically: key theories and issues are looked at in detail; descriptions of experiments include why they were done and how examining the method can help evaluate competing viewpoints. By looking at underlying cognitive processes, students come away with a sense of learning and memory being interrelated actions taken by the same human being, rather than two separate activities. Lively and engaging writing is supported by lots of examples of practical applications that show the relevance of lab-based research to everyday life. Examples include treatments for phobias and autism, ways to improve eyewitness testimony, and methods of enhancing study techniques.
Formal autism diagnosis from a specialist trained in autism assessment is customary prior to a child accessing early, intensive autism-specific services. However, long wait lists for diagnostic evaluations and limited specialty workforce have created substantial delays. Additionally, lengthy multidisciplinary evaluations are costly to insurers, inconvenient to families, and disproportionally impact under-resourced families. Diagnostic delays can impede access to intervention services. These barriers, combined with evidence regarding the importance of receiving early, autism-specific treatment, demand new approaches enabling access to autism specific services before comprehensive evaluation. Pediatric primary care providers (PCPs) are often the only health care professionals with whom a family interacts during early childhood and can play a crucial role in helping children with autism symptoms access services. Many strategies for autism diagnosis in primary care are being developed and tested; however, they have yet to be broadly adopted by PCPs, primarily due to critical implementation barriers in primary care settings. There is also not enough evidence on the accuracy of PCPs' diagnostic impressions without extensive specialty support, resulting in PCP hesitancy in diagnosing ASD, as well as family and service provider hesitancy in accepting a PCP autism diagnosis. In this commentary, we explore the acute need for shortening waitlists for autism evaluations through a tiered diagnostic approach, in which PCPs can rule in or rule out autism in children, for whom diagnosis is clear, and refer more complex cases for specialist evaluations, and explore implementation challenges to this approach.
Sensorische Besonderheiten beeinflussen den Alltag und das Sozialverhalten vieler ASS-Patienten und können Prädiktoren für die Prognose des einzelnen Autisten sein (Thye et al., 2018). In den letzten Jahren hat sich die Studienlage hierzu immens vergrößert. Trotz der großen Bedeutung gibt es im deutschsprachigen Raum kein Screeninginstrument, welches die reine sensorische Wahrnehmung erwachsener ASS-Patienten erfragt, ohne dass affektive Reaktionen des Befragten bei der Beantwortung der Fragen miterfasst werden. Im englischsprachigen Raum wurde dazu bereits der Screeningfragebogen Sensory Perception Quotient (SPQ) von Tavassoli et al. (2014) entwickelt. Die vorliegende Arbeit ist Teil einer Studie, welche das Ziel verfolgt, diesen Fragebogen in einer deutschen Übersetzung zu validieren und optimieren.
Der Fokus dieser Arbeit liegt auf der Strukturanalyse des Fragebogens. Mithilfe einer detaillierten Itemanalyse wurde untersucht, welche Items die reine sensorische Wahrnehmung valide erfassen und welche Items eher ungeeignet für den Fragebogen sind. Außerdem wurde eine Korrelationsanalyse der SPQ-Subscores der fünf Sinnesmodalitäten untereinander durchgeführt, um zu schauen, ob wir die Ergebnisse von Kern et al. (2007) replizieren können. Darüber hinaus wurde eine Faktorenanalyse durchgeführt, um herauszufinden, ob eine gewisse Struktur im SPQ-Fragebogen zu erkennen ist und inwiefern wir Tavassolis Ergebnisse replizieren können.
Die deutsche Version des SPQ wurde von 85 erwachsenen Patienten mit hochfunktionaler ASS und 103 erwachsenen neurotypisch entwickelten Kontrollprobanden ausgefüllt. Die Validierung beinhaltete Faktoren- und Korrelationsanalysen.
Tavassoli et al. (2014) konnten bei ihrer Faktorenanalyse einen gemeinsamen Faktor finden, welcher in der ASS-Gruppe und Kontrollgruppe sensorische Hypersensibilitäten widerspiegelt. Dieses Ergebnis konnte in unserer Studie nicht repliziert werden. Stattdessen haben wir bei der Faktorenanalyse der ASS-Gruppe eine qualitative Dichotomie gefunden, bei welcher der quantitativ dominierende Faktor 1 Hypersensibilitäten in den Nahsinnen Fühlen, Riechen und Schmecken widerspiegelt, und der Faktor 2 Hyposensibilitäten in den Fernsinnen Hören und Sehen darstellt. Bei unserer Kontrollgruppe konnten im Gegensatz zur Studie von Tavassoli et al. (2014) keine schlüssigen Faktoren gefunden werden.
In der ASS-Gruppe haben wir in allen untersuchten Sinnesmodalitäten starke Korrelationen gefunden, vor allem bei den Items, die Hypersensibilitäten erfragen. Auch die sinnesspezifischen SPQ-Subscores korrelierten stark untereinander. In der Kontrollgruppe fielen die Ergebnisse deutlich kleiner aus. Dies deutet darauf hin, dass hochfunktionale Autisten, die in einem Sinnesbereich hyper- oder hyposensibel reagieren, mit großer Wahrscheinlichkeit auch in weiteren Sinnesmodalitäten Hyper- oder Hyposensibilitäten zeigen.
Die Ergebnisse dieser Studie betonen die große Bedeutung sensorischer Anomalien bei ASS und die Notwendigkeit diese zu objektivieren, um angemessene Therapien für den Patienten entwickeln zu können. Ein valides Messinstrument, welches sensorische Besonderheiten der Autisten objektiviert, kann dabei helfen, die Diagnostik und Therapie der Autismus-Spektrum-Störung zukünftig zu verbessern. In weiteren repräsentativen Studien sollte daher untersucht werden, ob sich unsere Ergebnisse replizieren lassen und inwieweit eine optimierte deutsche Version des SPQ klinisch eingesetzt werden kann.
Research has documented inequities in geographic access to board certified behavior analysts (BCBAs) among children with autism spectrum disorder (ASD). Unexplored is geographic access to registered behavior technicians (RBTs), the frontline ABA providers BCBAs supervise. In this study we examined county-level geographic access to RBTs in the United States, including change in their geographic distribution over time, the current distribution of RBTs related to the distribution of BCBAs, and the current distribution of RBTs as a function of children with ASD. The sample included all U.S. counties in all 50 states and the District of Columbia (N = 3,138). County-level ASD/RBT ratios indicate that the number of children with ASD far exceed RBTs, and the geographic accessibility of RBTs appears to be superior to that of BCBAs.
Durch zwischenmenschliche Berührungen u. a. in Form von Massagen können verschiedenste physiologische Prozesse in Gang gesetzt werden. Zum Beispiel können Entspannungsmassagen Depression, Angst und Fatigue reduzieren, Schlaf verbessern, Stress abbauen, Blutzucker und Blutdruck senken und das Immunsystem regulieren. Die Befunde sind im Einklang mit Erkenntnissen der Psychoneuroimmunologie und Psychoneuroendokrinologie. Aus diesen Fachgebieten ist bekannt, dass Psyche und Nervensystem sowohl mit dem Immunsystem als auch dem Hormonsystem in Wechselwirkung stehen. Kurz gesagt bedeutet das, dass Veränderungen in einem der Systeme, Veränderungen in allen anderen Systemen nach sich ziehen. Daraus ergeben sich vielfältige Einsatzmöglichkeiten von zwischenmenschlichen Berührungen und Massagen als unterstützende Therapiemethode im Krankheitsfall.
Außerdem in diesem Kapitel: Gewichtsdecken/ Sandwesten; Kontraindikationen und Nebenwirkungen von Massagen
Many children with Autism Spectrum Disorder (ASD) become frustrated in their attempts to make their feelings, thoughts, and needs known. They may act out their frustrations through inappropriate behaviors. This lack of communication skill needs to be treated early to prevent future developmental delays. Applied Behavior Analysis (ABA) is the most frequently used intervention for children with Autism Spectrum Disorder (ASD). However, many studies have found inconsistent results regarding its effectiveness. This study aims to determine the effectiveness of ABA on the communication skills of children with ASD assessed by Vineland Adaptive Behavior Scales (VABS). Meta analysis method is used in this study. Data is processed through statdirect trial version 3.0 application. This study involved 14 experiments using ABA therapy for children with ASD (total n experiment groups = 304 and total n control groups = 244). Based M, SD, and N on data analysis, the effect size value obtained from the fixed effect (I² = 55.7%) was 0.210 (95% CI = 0.035 to 0.384; small effect size). These results do not support the effectiveness of ABA in improving communication skills in ASD children. We suggests that ABA therapy should be carried out with other interventions that target specific communication skills. Future researchers should conduct research replication to increase references on the effectiveness of ABA therapy.
This custom collection consists of important studies, expert recommendations, and practice pathways that inform pediatricians on practical ways to improve the lives of children with ASD and their families.
https://shop.aap.org/pediatric-collections-autism-spectrum-disorder-paperback/
The University of California at Los Angeles-Young Autism Project (UCLA-YAP) provides one of the best known and most researched comprehensive applied behavior analysis-based intervention models for young children on the autism spectrum. This paper reports a systematic literature review of replication studies over more than 30 years. The data show that the relatively high-intensity UCLA-YAP model can be greatly beneficial for children on the autism spectrum, particularly with regards to their cognitive functioning and adaptive behavior. This review concludes that, while more research is always welcome, the impact of the UCLA-YAP model on autism interventions is justified by more than 30 years of outcome evidence.
Autism is a serious psychological disorder with onset in early childhood. Autistic children show minimal emotional attachment, absent or abnormal speech, retarded IQ, ritualistic behaviors, aggression, and self-injury. The prognosis is very poor, and medical therapies have not proven effective. This article reports the results of behavior modification treatment for two groups of similarly constituted, young autistic children. Follow-up data from an intensive, long-term experimental treatment group (n = 19) showed that 47% achieved normal intellectual and educational functioning, with normal-range IQ scores and successful first grade performance in public schools. Another 40% were mildly retarded and assigned to special classes for the language delayed, and only 10% were profoundly retarded and assigned to classes for the autistic/retarded. In contrast, only 2% of the control-group children (n = 40) achieved normal educational and intellectual functioning; 45% were mildly retarded and placed in language-delayed classes, and 53% were severely retarded and placed in autistic/retarded classes.
Over the last three decades, instructional methods derived from applied behavior analysis (ABA) have shown considerable promise for many young children with autism. The ABA approach establishes a priori that assessment and intervention methods must be based on generally accepted rules of scientific evidence. On one hand, the approach has produced a rich resource of conceptually consistent and scientifically validated techniques that can be applied in various combinations across many different contexts. On the other hand, this diversity has resulted in some confusion regarding the precise characteristics of ABA. In this article, the authors first describe many of the common programmatic and methodologic elements that form the foundation of the approach. A summary of the scope of the behavioral research is provided including greater detail on six studies that demonstrated large-scale interventions. Finally, the authors describe components of program models that share common elements of the ABA approach and use a broad continuum of traditional behavioral techniques. Some specific myths about the approach are simultaneously addressed.
The high-risk infants who initially enrolled in the Abecedarian Project, a longitudinal prospective study of the benefits of early childhood educational intervention within a child care setting, were followed up as young adults (age 21 years). One hundred-eleven infants were in the original sample; 104 took part in the follow up. Treatment was provided in 2 phases: during preschool and in the primary grades. Participants received either both phases, 1, but not both, or neither. Assignment to groups was random. Those in the preschool treatment group earned significantly higher scores on intellectual and academic measures as young adults, attained significantly more years of total education, were more likely to attend a 4-year college, and showed a reduction in teenaged pregnancy compared with preschool controls. Preschool treatment was associated with educationally meaningful effect sizes on reading and math skills that persisted into adulthood. School-age treatment served to maintain preschool benefits for reading, but by itself, the effects were generally weaker than those of the preschool program. Statistically significant differences in the attainment of full economic independence were not found at this stage, but would not be expected among young adults still attending school. The incidence of self-reported violence and lawbreaking was not significantly reduced, although trends in the data favored the treated group. The reported incidence of marijuana use was significantly less among treated individuals. The positive findings with respect to academic skills and increased years of post-secondary education support policies favoring early childhood programs for poor children.
Numerous behavior analytic methods developed since the early 1960s have proved effective for developing a wide range of skills in learners with autism. Recent advances in stimulus control technology, in particular, offer effective methods for teaching many important skills and for promoting independent, generalized performances. This article reviews selected stimulus control techniques, including new methods for teaching conditional discrimination (matching) skills, stimulus equivalence procedures, prompt and prompt-fading techniques, and incidental teaching procedures.
Clinical research and public policy reviews that have emerged in the past several years now make it possible to estimate the cost-benefits of early intervention for infants, toddlers, and preschoolers with autism or pervasive development disorder—not otherwise specified (PDD—NOS). Research indicates that with early, intensive intervention based on the principles of applied behavior analysis, substantial numbers of children with autism or PDD—NOS can attain intellectual, academic, communication, social, and daily living skills within the normal range. Representative costs from Pennsylvania, including costs for educational and adult developmental disability services, are applied in a cost-benefit model, assuming average participation in early intensive behavioral intervention (EIBI) for three years between the age of 2 years and school entry. The model applied assumes a range of EIBI eÄects, with some children ultimately participating in regular education without supports, some in special education, and some in intensive special education. At varying rates of eÄectiveness and in constant dollars, this model estimates that cost savings range from $187,000 to $203,000 per child for ages 3-22 years, and from $656,000 to $1,082,000 per child for ages 3-55 years. DiÄerences in initial costs of $33,000 and $50,000 per year for EIBI have a modest impact on cost-benefit balance, but are greatly outweighed by estimated savings. The analysis indicates that significant cost-aversion or cost-avoidance may be possible with EIBI. #1998 John Wiley & Sons, Ltd.
The goal of the Murdoch Early Intervention Program was to replicate the intensive early intervention program designed by O. I. Lovaas (see record
1987-16420-001) for 24 to 48 mo old children with severe developmental disability and autism. This paper describes the objectives, methods, and the results as of 24 mo. Four of 9 experimental children with autism have shown signs of approaching normal levels of functioning whereas 1 of 5 control children without autism has made significant progress. Improvements in the other Ss are rated as moderate to minimal. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Since 1980, 12 peer-reviewed outcome studies (nine on behavior analytic programs, one on Project TEACCH, and two on Colorado Health Sciences) have focused on early intervention for children with autism. Mean IQ gains of 7-28 points were reported in studies of behavior analytic programs, and 3-9 in studies on TEACCH and Colorado. Cains were also reported on other measures in some studies. Individual children varied greatly in treatment responsivtty. No fully randomized studies have been published, and studies with features such as large sample sizes and blind examiners have been rare. Further progress is likely to require more rigorous clinical trials, more comprehensive pretreatment and follow-up assessments, and greater attention to brain-behavior relationships.
The following review paper describes the outcomes of data-based behavioural intervention strategies for the defining characteristics of autistic disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994). The results of relevant evaluations of behaviour analytic procedures are reviewed for each of the four potential areas of difficulty under each of the main criteria for autistic disorder, which are: (a) impairment in social interaction, (b) impairment in communication, and (c) restrictive, repetitive, and stereotyped patterns of behaviour, interests, and activities (DSM-IV). The current areas of research activity as well as those domains that have received comparatively little attention by behavioural researchers are identified, and suggestions for future research are discussed.
An intervention approach emphasizing development of symbolic thought, communication, and interpersonal relationships was Implemented with 26 children (ages 2 through 6) who had infantile autism, pervasive developmental disorder, or severe emotional handicaps. The main intervention strategy was the use of play in all its interpersonal, cognitive, and structural variety, imbedded in a reactive language environment. Over a six- to eight-month intervention period, the children demonstrated significant changes in several targeted developmental areas, including cognition, perceptual/fine motor, social/ emotional, and language skills. The cognitive complexity of their play skills increased significantly in areas of symbolic complexity, symbolic agent, and symbolic substitutions. Additionally, significant improvement in the communicative and interpersonal characteristics of their play was found. These changes support the efficacy of this approach with young autistic and severely emotionally handicapped children when the children's needs for high levels of structure, intensity, and consistency are met.
The progress made by two different groups of preschool children, those with autism or related disorders and those with other emotional/behavioral and developmental disorders, in a particular instruction model was examined. The model was developmentally based and heavily influenced by Piaget's theory of cognitive development, pragmatics theory of language development, and Mahler's theory of development of interpersonal relationships. Both groups of children made greater progress than was predicted by their initial developmental rates in cognitive and language areas. An important and unexpected finding was the similar amount of progress made by the two groups: Specifically, the groups with autism did not make less progress than the comparison group, which ran contrary to our hypothesis.
Intensive behavioral intervention for very young children with autism has received increased attention in recent years. Researchers have documented unprecedented success in educating some young children with autism, although not every child makes dramatic developmental gains. It might be useful to identify early in treatment those children who will benefit most from the current methodology and who might require slight variations in instructional format or curricular focus. The present study suggests that initial learning rates are moderately correlated with treatment outcomes after two years. Among 20 children receiving early, intensive behavioral intervention, initial acquisition of skills was correlated with later learning rates, severity of autism symptom- atology and adaptive behavior profiles two years into treatment. Implications are discussed, especially in light of the universal need for intensive intervention in this population. Copyright #1999 John Wiley & Sons, Ltd.
Intensive behavioral intervention for very young children with autism has received increased attention in recent years. Researchers have documented unprecedented success in educating some young children with autism, although not every child makes dramatic developmental gains. It might be useful to identify early in treatment those children who will benefit most from the current methodology and who might require slight variations in instructional format or curricular focus. The present study suggests that initial learning rates are moderately correlated with treatment outcomes after two years. Among 20 children receiving early, intensive behavioral intervention, initial acquisition of skills was correlated with later learning rates, severity of autism symptomatology and adaptive behavior profiles two years into treatment. Implications are discussed, especially in light of the universal need for intensive intervention in this population. Copyright © 1999 John Wiley & Sons, Ltd.
Recent research on early brain development holds several implications for parents, teachers, health professionals, and policymakers. This report, based on the proceedings from a 1996 national conference on the importance of early brain development for the nation's future well-being, highlights major findings, summarizes their implications for policy and practice in education and human services, notes areas of debate, and points to future research areas. Part 1, "Breakthroughs in Neuroscience--Why Now?" describes the development of new research tools enabling the study of the brain, the social and ideological context for current research, and new interest in the brain across disciplines. Part 2, comprising the bulk of the report, discusses the following key lessons learned from the research: (1) development hinges on the interplay between nature and nurture; (2) early care has a long-lasting impact on development, the ability to learn, and the ability to regulate emotion; (3) the brain has a remarkable capacity to change, but timing is crucial; (4) there are times when negative experiences or absence of appropriate stimulation are more likely to have serious and sustained effects; and (5) there is substantial evidence for the efficacy of early intervention. Part 3 highlights areas of agreement and debate at the conference and presents implications for policy and practice. The report's glossary defines terms related to the neurosciences. Two appendices list conference speakers and give examples of early intervention programs. Contains approximately 150 references. (KB)
Developed a home-based alternative to preschool for educational programs of young autistic children. The model includes (a) systematic use of behavioral teaching techniques and treatment procedures; (b) intensive training conducted in each child's natural home; and (c) extensive parent training. Most of the 14 18–64 mo old children who participated demonstrated significant gains in language, self-care, and social and academic development, as evidenced by the results of standardized assessments and individual treatment data. Results also indicate a change in parents' ability to teach their handicapped children. Results are compared with previous findings reported in the literature. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Until recently, autism has been considered by many as a hopeless, incurable, and absolute condition. Now, however, research suggests that intensive behavioral intervention, begun when a child is between 2 and 5 yrs old, can have a significant and lasting positive impact. This intervention leads to improvement in virtually all children, and in some cases it leads to complete eradication of any sign of the disorder. While behavioral intervention is also the treatment of choice for older children and adults with autism, research shows that its potential for dramatic improvement is greatest with young children. It is that positive research that inspires and focuses this book.
It is our hope that this manual will offer some assistance to parents, and to the professionals who aid them, in the challenging task of making science-based decisions, and procuring effective early intervention for children with autism. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Discusses the 1st series of landmark studies of infants and young children in orphanages and institutions, begun in the 1930s and 1940s, which raised grave concern about the serious and lasting harm caused by the loss of a mother and subsequent care in a group setting. This research set the stage for vigorous scientific inquiry that sought to identify precisely what young children need—early in life—to ensure healthy growth and development. The 2nd line of research focused on understanding variation in young children's responses to non-optimal settings and the extent to which environmental "habilitation" could reverse or minimize the negative effects of institutionalization or other forms of early deprivation. A 3rd and independent line of inquiry, also grounded in the landmark studies of orphanages and institutions, was a pro-active effort begun in the 1960s to prevent the developmental toll observed all too frequently among children from extremely poor families. These efforts to provide early educational enrichment to infants and young children from low resource families were also fueled by scientific findings from the fields of chid development, mental retardation, and the new field of infant development, as well as a poignant national awareness of devastating conditions of poverty in the US and tremendous inequality of educational opportunity. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Comments on a study by J. J. McEachin et al (see record
1993-22583-001) on long-term outcome for children with autism who received early intensive behavioral treatment. Although the author agrees that the conclusions presented are reliable and correct, one possible weakness may exist in the nonrandom assignment of the Ss. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Evidence is reviewed on the prevalence of sensory and motor abnormalities in autism and the effectiveness of three interventions designed to address such abnormalities—sensory integration therapy, traditional occupational therapy, and auditory integration training. Although sensory processing and motor abnormalities are neither universal nor specific to autism, the prevalence of such abnormalities in autism is relatively high. There is, however, little controlled research on the effectiveness of interventions designed to address these abnormalities. Four objective outcome studies of sensory integration therapy were identified. These were of such small scale that no firm conclusions regarding efficacy could be made. No empirical studies of traditional occupational therapy in autism were found. Five studies of auditory integration training were found. Results of these studies provided no, or at best equivocal, support for the use of auditory integration training in autism.
This study compared the treatment outcomes of nine autistic children who began receiving intensive behavioral intervention prior to 60 months of age with outcomes for nine other children who entered the same intervention program after 60 months of age. The 18 children in the sample included all of the children served by the Princeton Child Development Institute's day school and treatment program during the period 1975–83 who were diagnosed autistic and who had either (a) achieved positive discharge or (b) been enrolled in the program for 24 months or longer and continued to receive program services. Age at program entry was found to be strongly related to positive treatment outcome (i.e., to children's continued residence with their natural parents and attendance at public school classes). This investigation underlines the importance of early behavioral intervention for autistic children.
Performances of two autistic children were recorded in an experimental environment consisting of vending machines delivering food and candy, a trained pigeon, a phonograph, a color kaleidoscope, and a pinball machine. These devices were operated either by keys mounted on them or by coins. Coins were delivered on various schedules when the children operated another key. Performances could be sustained on the coin key for 90-minute experimental sessions to demonstrate the normal effect of two schedules of reinforcement, to develop the coin as a generalized reinforcer, and to control the children's performances by the presence or absence of stimuli correlated with reinforcement or nonreinforcement.
An account is given of the treatment of a pre-school child who had serious behavioural and physical handicaps. In a sense this is a study involving both psychotherapy and rehabilitation. The treatment consisted of applying laboratory-developed techniques through the attendants and the parents over a seven-month period.
Includes abstract. Thesis (M. A.)--California State University, Chico. Bibliography: leaves 16-17.
Since the Denver Developmental Screening Test was first published 23 years ago, it has been utilized worldwide and restandardized in more than a dozen countries. Concerns raised through the years by test users about specific items and features of the Denver Developmental Screening Test, coupled with a need for more current norms, have prompted a major revision and restandardization of the test. For the revision, 336 potential items were administered to more than 2000 children. The average number of times each item was administered was 540. Using regression analysis, composite norms for the total sample and norms for subgroups (based on gender, ethnicity, maternal education, and place of residence), were used to determine new age norms. The final selection of the 125 Denver II items was based on the following criteria: ease of administration and scoring, item appeal to child and examiner, item test-retest and inter-rater reliability, minimal "refusal" scores, minimal "no opportunity" scores, minimal subgroup differences, and a smooth step-like progression of ages at which 90% of children could perform the tasks. The major differences between the Denver II and the Denver Developmental Screening Test are: 1) an 86% increase in language items; 2) two articulation items; 3) a new age scale; 4) a new category of item interpretation to identify milder delays; 6) a behavior rating scale; and 7) new training materials.
Preschool children with autism and their normally developing peers were compared on the Stanford-Binet IV and Preschool Language Scale before and after 1 school year. Both measures showed that although the children with autism functioned at a lower level than their normally developing peers, the children with autism had narrowed this gap after treatment, making a nearly 19-point increase in IQ and an 8-point gain in language quotient. The IQ measure remained stable for the normally developing peers while their language showed a 7.73-point increase. The data support the notion that young children with autism can make very significant developmental gains.
Longitudinal comparisons were made of intelligence and developmental quotient (IQ/DQ) scores for three age groups of 70-72 autistic children aged 2 to 3, 4 to 5, and 6 to 7 years at initial assessment and reassessed at least 2 years later. Stability and predictability over a mean follow-up period of 5 years were related to age, developmental level, and test used at initial assessment. IQ/DQs during preschool years were quite stable and predictive of later IQ scores, except when early scores on the Bayley Scales of Mental Development were compared with later scores on performance or nonverbal tests. As for other populations, predictability for young autistic children was strongest when the same test was used at both assessments, and when children were 4 years or older at initial assessment.
The Autism Diagnostic Observation Schedule (ADOS), a standardized protocol for observation of social and communicative behavior associated with autism, is described. The instrument consists of a series of structured and semistructured presses for interaction, accompanied by coding of specific target behaviors associated with particular tasks and by general ratings of the quality of behaviors. Interrater reliability for five raters exceeded weighted kappas of .55 for each item and each pair of raters for matched samples of 15 to 40 autistic and nonautistic, mildly mentally handicapped children (M IQ = 59) between the ages of 6 and 18 years. Test-retest reliability was adequate. Further analyses compared these groups to two additional samples of autistic and nonautistic subjects with normal intelligence (M IQ = 95), matched for sex and chronological age. Analyses yielded clear diagnostic differences in general ratings of social behavior, specific aspects of communication, and restricted or stereotypic behaviors and interests. Clinical guidelines for the diagnosis of autism in the draft version of ICD-10 were operationalized in terms of abnormalities on specific ADOS items. An algorithm based on these items was shown to have high reliability and discriminant validity.
Studies on the use of sensory integration therapy with mentally retarded persons were critically reviewed. Experimental design and statistical procedures were found inadequate to support the use of this therapy on an empirical basis. In addition, certain methodological and design problems seriously cloud interpretation of research results on this topic. Alternative explanations of positive outcome as well as equivocal findings among studies appear related, in part, to the conceptual foundation of sensory integration therapy. Recommendations for future directions in research and restraint in application were discussed.
Autism is a serious psychological disorder with onset in early childhood. Autistic children show minimal emotional attachment, absent or abnormal speech, retarded IQ, ritualistic behaviors, aggression, and self-injury. The prognosis is very poor, and medical therapies have not proven effective. This article reports the results of behavior modification treatment for two groups of similarly constituted, young autistic children. Follow-up data from an intensive, long-term experimental treatment group ( n = 19) showed that 47% achieved normal intellectual and educational functioning, with normal-range IQ scores and successful first grade performance in public schools. Another 40% were mildly retarded and assigned to special classes for the language delayed, and only 10% were profoundly retarded and assigned to classes for the autistic/retarded. In contrast, only 2% of the control-group children ( n = 40) achieved normal educational and intellectual functioning; 45% were mildly retarded and placed in language-delayed classes, and 53% were severely retarded and placed in autistic/retarded classes. (31 ref)
Vineland Adaptive Behavior Scales represent a revision of the Vineland Social Maturity Scale, which, over the last sixty years, has made major contributions to our knowledge of adaptive behavior assessment and our understanding of mental retardation
characteristics of adaptive behavior / construction of the Vineland Adaptive Behavior Scales / validity assessments of the Vineland Adaptive Behavior Scales / administration / scoring / interpretation / case examples / uses of the Vineland Adaptive Behavior Scales (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Fixed-ratio (FR) discrimination learning in adult male spontaneously hypertensive rats (SHR), methylazoxymethanol-induced microencephalic Sprague-Dawley (MAM), and Sprague-Dawley control rats was examined. SHR and MAM rats had little problem learning incrementally more difficult FR discriminations (FR1 vs. FR16, FR4 vs. FR16, and FR8 vs. FR16) that resulted in parallel increases in errors in all animals, and displayed only modest learning deficits during a subsequent FR4 vs. FR16 position reversal. When training involved nonincremental changes in difficulty (FR8 vs. FR16, FR4 vs. FR16, FR8 vs. FR16, FR12 vs. FR16, and FR14 vs. FR16), SHR and MAM rats evidenced relatively large learning deficits during the initial FR8 vs. FR16 discrimination but had no difficulty with the last two discriminations. Furthermore, training selectively and significantly elevated hippocampal weight in MAM rats. These findings: a) question prior suggestions that MAM and SHR model separate human developmental disabilities; b) indicate that manifestation of learning deficits in even markedly brain-damaged organisms depends on initial task difficulty and can be overcome by experience; and c) are the first indicating that training-induced antagonism of prenatally induced hippocampal hypoplasia and its consequences is possible.
Rats received either vehicle (controls) or 100 micrograms of 6-hydroxydopamine (6HD) base intracisternally on postnatal day 5. At 3 mo of age, striatal and cortical catecholamine and metabolite levels were determined in some animals. Others were subjected to 4.5 mo of training on incrementally more difficult fixed-ratio (FR) discriminations; 2 mo later, their levels were determined. Learning was essentially unaffected by 6HD even though errors in all animals increased with increases in discrimination difficulty and 6HD had markedly depleted levels in the 3-mo-old animals. Moreover, an initial response-rate deficit in 6HD-treated rats disappeared with training. However, after training, levels in 6HD-treated rats were not only not depleted, they were as much as 661% of those in controls. These and others of our findings indicate that FR discrimination training can induce persistent increases in brain catecholamine utilization. They also appear to be the first to suggest that at least some neurochemical effects of neonatal 6HD are not necessarily irreversible, and that such a reversal can be experientially induced and possibly functionally beneficial.
Two siblings whose functioning deteriorated in the second year of life met criteria for autism. They recovered after a form of behavior modification that was successful in a previous study. Follow-up of that study and of the siblings demonstrated that recovery was enduring. It is hypothesized that such therapy succeeds by modifying a still-plastic neural circuitry.
After a very intensive behavioral intervention, an experimental group of 19 preschool-age children with autism achieved less restrictive school placements and higher IQs than did a control group of 19 similar children by age (Lovaas, 1987). The present study followed-up this finding by assessing subjects at a mean age of 11.5 years. Results showed that the experimental group preserved its gains over the control group. The 9 experimental subjects who had achieved the best outcomes at age 7 received particularly extensive evaluations indicating that 8 of them were indistinguishable from average children on tests of intelligence and adaptive behavior. Thus, behavioral treatment may produce long-lasting and significant gains for many young children with autism.
Five-day-old rats received 6-hydroxydopamine (6-HD; 100 micrograms base) or vehicle intracisternally. Striatal and cortical dopamine (DA) and metabolite levels were then determined when animals were three or 8.5 months of age and the latter rats had been weight-reduced for 5.5 months. In the latter animals these determinations were made 1 month following 4.5 months of home-cage confinement (untrained animals) or of food-maintained fixed-ratio (FR) discrimination training involving either a single discrimination (performance animals) or incrementally more difficult discriminations. Striatal DA levels in 3-month-old and 8.5-month-old (untrained) 6-HD-treated rats were, respectively, only 3% and 11% of those in untrained vehicle-treated animals (controls). Despite such large depletions, striatal DA levels in 6-HD-treated performance rats were 3-fold higher than those in untrained age-matched 6-HD-treated rats (i.e., were 32% of values in controls) while those in incrementally trained 6-HD-treated animals were even higher (i.e., were 60% of control values). Related changes occurred in levels of most metabolites. However, in incrementally trained rats, striatal 3-methoxytyramine concentrations were 154% of control values. Cortical DA and metabolite levels were little affected by 6-HD treatment. The present results confirm and extend our earlier observations suggesting that reversal of 'irreversible' neonatal 6-HD-induced striatal dopamine and metabolic depletion can be accomplished by environmental (training) manipulations in adult rats.
Studies evaluating behavioral treatment of autism from 1980 to the present were reviewed. Studies included were published in journal articles and utilized behavioral methodology. A total of 251 studies were included in the review. Each study was analyzed for target behaviors and behavioral techniques implemented. Target behaviors were divided into categories, which included aberrant behaviors, social skills, language, daily living skills, and academic skills. Behavioral techniques were classified as positive, negative, extinction, or combined. Results were presented for each category. Recent trends in the treatment literature were also reviewed, and recommendations for future research were presented.