Long-term follow-up of telehealth-enabled behavioral treatment for challenging behaviors in boys with fragile X syndrome.

Background: A significant proportion of boys with fragile X syndrome (FXS), the most common known genetic cause of intellectual disability, exhibit challenging behaviors such as aggression and self-injury that can cause significant distress to families. Recent evidence suggests that coaching caregivers to implement functional communication training (FCT) with their child via telehealth can help to ameliorate these behaviors in FXS. In the present study, we followed families who had participated in our previous randomized controlled trial of FCT to evaluate the longer-term effects of FCT on challenging behaviors in this population.

Conducting In-Home Functional Analyses of Aggression and Self-Injury Exhibited by Boys with Fragile X Syndrome.

Objective: Boys with fragile X syndrome (FXS) are at increased risk for exhibiting aggression and self-injury that can be extremely disruptive to families. Few studies, however, have examined the extent to which social-environmental factors can influence these behaviors, particularly in home settings.

Methods: Caregivers of 32 boys with FXS, aged 3 to 10 years, were coached by a board-certified behavior analyst to implement a functional analysis (FA) with their child in their home over 2 days.

The effects of transition to technician-delivered telehealth ABA treatment during the COVID-19 crisis: A preliminary analysis.

Telehealth delivery of applied behavior analysis treatment has focused on supervision or staff and parent training, rather than the direct delivery of treatment to clients. The novel coronavirus (COVID-19) crisis had the potential to significantly disrupt access to direct treatment for individuals with autism. We report a sample of 17 cases that transitioned from in-person to telehealth delivery of treatment when shelter-in-place orders were issued.

Telehealth-enabled behavioral treatment for problem behaviors in boys with fragile X syndrome: a randomized controlled trial.

Background: Children with fragile X syndrome (FXS) are at increased risk for exhibiting problem behaviors such as aggression and self-injury. However, many children with FXS have limited access to behavioral treatments that have known efficacy due to the low availability of treatment providers and the wide geographical dispersion of families with FXS across the country. Telehealth may offer a cost-effective and practical solution to overcome these significant barriers.

The Role of Compassion and Ethics in Decision Making Regarding Access to Applied Behavior Analysis Services During the COVID-19 Crisis: A Response to Cox, Plavnick, and Brodhead.

Cox, Plavnick, and Brodhead (2020, "A Proposed Process for Risk Mitigation During the COVID-19 Pandemic") published a position statement in the emergency section of in response to the COVID-19 crisis. They argued against a blanket interpretation that in-person applied behavior analysis services for all patients should continue during the pandemic. They strongly argued that the risks of continued services are almost always prohibitive and that only in rare cases would the continuation of in-person services be warranted.

Interpreting functional analysis outcomes using automated nonparametric statistical analysis.

Current methods employed to interpret functional analysis data include visual analysis and post-hoc visual inspection (PHVI). However, these methods may be biased by dataset complexity, hand calculations, and rater experience. We examined whether an automated approach using nonparametric rank-based statistics could increase the accuracy and efficiency of functional analysis data interpretation.

Telehealth Delivery of Function-Based Behavioral Treatment for Problem Behaviors Exhibited by Boys with Fragile X Syndrome.

Telehealth is increasingly being employed to extend the reach of behavior analytic interventions to families of children with developmental disorders who exhibit problem behaviors. In this preliminary study, we examined whether function-based behavior analytic interventions could be delivered via telehealth over 12 weeks to decrease problem behaviors exhibited by ten boys with fragile X syndrome (FXS), aged 3- to 10-years. Results showed that for eight children who completed treatment, rates of problem behavior decreased from baseline by 78.

Sibling-Implemented Script Fading to Promote Play-Based Statements of Children with Autism.

We trained three typically developing children to implement a script-fading procedure with their younger siblings with autism. The number of contextually appropriate statements made by the children with autism increased once treatment was initiated. Participants continued to emit higher levels of contextually appropriate statements after the scripts were completely faded and at a 4- or 11-week follow-up.

Interactive computer training to teach discrete-trial instruction to undergraduates and special educators in Brazil: A replication and extension.

Discrete-trial instruction (DTI) is a behavioral method of teaching young children with autism spectrum disorders (ASD) that has received a significant amount of research support. Because of a lack of qualified trainers in many areas of the world, researchers have recently begun to investigate alternative methods of training professionals to implement behavioral teaching procedures. One promising training method is interactive computer training, in which slides with recorded narration, video modeling, and embedded evaluation of content knowledge are used to teach a skill.

An evaluation of photographic activity schedules to increase independent playground skills in young children with autism.

We used photographic activity schedules to increase the number of play activities completed by children with autism during unstructured time on the playground. All 3 participants engaged in more playground activities during and after training, and they continued to complete activities when novel photographs were introduced.

An evaluation of interactive computer training to teach instructors to implement discrete trials with children with autism.

Discrete-trial instruction (DTI) is a teaching strategy that is often incorporated into early intensive behavioral interventions for children with autism. Researchers have investigated time- and cost-effective methods to train staff to implement DTI, including self-instruction manuals, video modeling, and interactive computer training (ICT). ICT combines the best components of self-instruction manuals and video models, and have the same benefits; however, there is limited research on this training method.

The use of linked activity schedules to teach children with autism to play hide-and-seek.

Linked activity schedules were used to establish appropriate game play in children with autism during a game of hide-and-seek. All 6 participants demonstrated acquisition of appropriate play skills in the presence of the activity schedules and maintained responding during subsequent phases. When the schedules were removed, responding decreased to baseline levels, demonstrating that the schedules controlled responding.

Script fading to promote unscripted bids for joint attention in children with autism.

We used a script-fading procedure to teach 3 children with autism to initiate bids for joint attention. We examined the effects of (a) scripts, (b) varied adult scripted responses, and (c) multiple-exemplar script training on promoting unscripted language during bids for joint attention. All 3 participants learned to initiate bids for joint attention, and the response generalized to untrained stimuli, conversation partners, and the classroom environment.

Increasing response variability of mand frames with script training and extinction.

We examined the effects of script training and extinction on response variability of mand frames used by children with autism. Results demonstrated that extinction following script training was effective for increasing variability for 2 of the 3 participants.