Background: Currently, there is a paucity of data that describes the length of time required to realize improvement in pain and function following surgery for patients with metastatic cancer to bone.
Methods: One hundred patients with impending or completed pathologic fractures due to metastatic cancer to bone were enrolled in this prospective cohort study. Outcomes were measured with a Computer Adaptive Test of Patient Reported Outcomes for Pain Interference and Physical Function domains, to determine the time required to achieve a Minimal Clinically Important Difference (MCID) in the tested domains.
Many individuals with Down syndrome are diagnosed with obstructive sleep apnea (OSA), a medical condition that substantially affects health and quality of life. The most common treatment for OSA is positive airway pressure (PAP) therapy. Few studies have examined interventions to improve PAP therapy adherence for adults with developmental disabilities or have recruited the assistance of caregivers to improve adherence with this therapy in the home.
View Article and Find Full Text PDFSocial challenges in the work place can serve as an obstacle to regular employment for many individuals with neurodevelopmental disabilities (NDD). Nonetheless, few studies have focused on interventions to improve job-related social skills or included residents of countries outside of the United States. This study replicated and extended prior research by evaluating the acquisition of job-related social skills with three individuals with NDD residing in Italy.
View Article and Find Full Text PDFClinicians report primarily using functional behavioral assessment (FBA) methods that do not include functional analyses. However, studies examining the correspondence between functional analyses and other types of FBAs have produced inconsistent results. In addition, although functional analyses are considered the gold standard, their contribution toward successful treatment compared with other FBA methods remains unclear.
View Article and Find Full Text PDFBehavior analysts have much to offer nonbehavioral professionals who work with the communities that we serve. Successful dissemination of behavior-analytic technologies to these professionals could potentially improve their practice. Although the literature contains some exemplary examples of successful dissemination, our discipline would benefit from a blueprint for conducting this important work.
View Article and Find Full Text PDFPercutaneous pelvic stabilization is an emerging technique that provides mechanical stability to pathologic fractures of the pelvic ring and acetabulum. Variability exists in procedural technique among institutions; however, early case series consistently demonstrate an acceptable complication profile and significant improvement in patients' pain and function. This minimally invasive approach is less morbid than traditional, open acetabular and pelvic reconstructions.
View Article and Find Full Text PDFAs a task force appointed by the Executive Council of the Association for Behavior Analysis International (ABAI), we investigated the clinical use of contingent electric skin shock (CESS) in behavior analytic treatments for severe problem behavior. We studied how CESS is used in contemporary behavior analysis, reinforcement-based alternatives to CESS, and current ethical and professional guidelines for applied behavior analysts. We recommended that ABAI uphold clients' right to receive CESS when it is restricted to extreme cases and used under rigorous professional and legal oversight.
View Article and Find Full Text PDFPerspect Behav Sci
June 2023
Evidence presented in the ABAI Task Force Report on Contingent Electric Skin Shock (CESS) revealed serious ethical, clinical, and practical problems with the contemporary use of CESS. As a member of the task force, I ultimately concluded that our recommended position statement ("Position A") was a misguided attempt to uphold the field's commitment to client choice. Furthermore, information gathered by the task force supports an urgent call to find solutions to two additional troubling issues: a severe shortage of treatment services for severe problem behavior and the near-absence of research on treatment-resistant behavior.
View Article and Find Full Text PDFSchool environmental conditions have immediate and long-term effects on student health and learning. Relying on disconnected, inconsistent, voluntary, or unenforced environmental standards has not resulted in sufficient protection of students from toxic insults. Furthermore, the United States public school system was not prepared to navigate a potentially deadly infectious disease like COVID-19.
View Article and Find Full Text PDFWhen (BAP) was founded 15 years ago, questions were raised about whether a practitioner-focused journal was really needed to complement our field's well-established applied research periodicals. Like research journals, BAP publishes primary research reports for which scholarly citations are one measure of impact. Unlike most research journals, it also was intended to achieve dissemination impact, which implies influence on people who may not conduct research or leave behind citations.
View Article and Find Full Text PDFBackground: Pathologic fractures of the pelvis/sacrum due to metastatic bone disease (MBD) cause pain and dysfunction due to mechanical instability of the pelvic ring. This study presents our multi-institutional experience with percutaneous stabilization of pathologic fractures and osteolytic lesions from MBD throughout the pelvic ring.
Methods: The records of patients undergoing this procedure from 2018 to 2022 were reviewed retrospectively from two institutions.
Synchronous schedules of reinforcement are those in which the onset and offset of a reinforcer are synchronized with the onset and offset of a target behavior. The current study replicated and extended Diaz de Villegas et al. (2020) by comparing synchronous reinforcement to noncontingent stimulus delivery while evaluating on-task behavior of school-age children.
View Article and Find Full Text PDFPatients with neurodevelopmental disabilities generally have less access to necessary medical care compared to those without disabilities. Barriers to adequate care include patient fear and uncooperative behavior during routine medical procedures and inadequate preparation of medical professionals to treat this population. Researchers have identified multiple behavior-analytic procedures for promoting comfort and cooperation during medical treatments.
View Article and Find Full Text PDFAdults with intellectual and developmental disabilities (AIDD) experience significant oral health disparities, partially due to perceived behavioral issues. This article describes the preliminary outcomes of a developing interdisciplinary (dental, medical, behavioral) program involving a behavioral intervention for AIDD previously receiving preventative dental care with sedation, general anesthesia, or protective stabilization (SAS). After a baseline assessment, a board-certified behavior analyst implemented increasingly complex behavioral interventions during simulated dental visits.
View Article and Find Full Text PDFStroke is the leading cause of neurological disability in people over 40 years of age and the fourth leading cause of death in Argentina. In the last ten years, the indexed publications related to the treatment of ischemic stroke were more numerous than those of hemorrhagic stroke. The objective of this material is to provide local and updated recommendations for the management of patients with spontaneous intracerebral hemorrhage during hospitalization.
View Article and Find Full Text PDFRecent studies evaluating the effectiveness of using telehealth to train caregivers across large geographical distances in the United States and internationally indicate that this modality can increase families' accessibility to evidence-based interventions for problem behavior. In this study, experimenters and interpreters in the United States remotely coached nine caregivers of children with disabilities residing in three countries in Asia to implement functional analyses (FA) and functional communication training (FCT). Five of the nine families were culturally matched to either the experimenter or the interpreter.
View Article and Find Full Text PDFUnlabelled: Literature has demonstrated the successful application of various prompts and prompt-fading procedures for teaching clients with intellectual and developmental disabilities. However, few practical resources exist to guide behavior analysts in the evaluation and selection of a prompting strategy for a given client and a targeted skill. In this article, we describe the development of a decision-making tool for selecting and evaluating prompting strategies, highlighting steps needed prior to evaluating clinical outcomes associated with the use of the tool.
View Article and Find Full Text PDFMany individuals diagnosed with intellectual and developmental disabilities (IDD) are uncooperative during routine dental exams, leading to poor oral health in this population. Few studies have evaluated methodologies for preparing dental students and professionals to work effectively with patients diagnosed with IDD. In this study, experimenters used remote behavioral skills training (BST) to train dental students and professionals how to implement a practical intervention that included tell-show-do, contingent praise, and noncontingent reinforcement.
View Article and Find Full Text PDFPast research has demonstrated the effectiveness of teacher-implemented, function-based treatments for problem behavior, but no studies have evaluated the impact of distractions on teachers' procedural integrity. In this proof-of-concept study, the experimenters employed a laboratory analog to examine the impact of distractions on levels of integrity when 5 teachers implemented 3 different treatments. Although integrity was similar across treatments when the setting was free of distractions, integrity declined for all teachers in the presence of student-driven distractions.
View Article and Find Full Text PDFAs a result of the COVID-19 pandemic, individuals with neurodevelopmental disabilities (NDD) are engaging more with others in virtual group formats for social, educational, and professional reasons. This study extends prior research by evaluating the efficacy of common behavioral interventions, including behavioral skills training, provided via group video conferencing to teach skills that are important when interacting with others in a virtual format. Four adults with NDD were taught to use their cameras and microphones appropriately and to make encouraging statements to one another while discussing current events and social skills-based lessons via Zoom™.
View Article and Find Full Text PDFInt J Environ Res Public Health
February 2022
Functional analyses (FA) and functional communication training (FCT) are the most commonly used behavioral assessment and treatment approaches via telehealth for children with autism spectrum disorder (ASD) who display challenging behavior. The FA + FCT telehealth model has been shown to maintain treatment effectiveness (i.e.
View Article and Find Full Text PDFThe COVID-19 pandemic has led to a dramatic increase in behavior analysts' use of telehealth services. Nonetheless, no research has evaluated the skills or training needed for therapists to provide these services effectively. The purpose of this study was to develop and evaluate a curriculum for providing high-quality, parent-training telehealth services.
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