Functional Analysis Outcomes and Comparison of Direct Observations and Informant Rating Scales in the Assessment of Severe Behavior Problems of Infants and Toddlers At-Risk for Developmental Delays

Individualized Parent-Mediated Behavioral Treatment for Challenging Behavior: A Program Description

Past research suggests behavioral treatments are effective for challenging behavior in children and young adults with neurodevelopmental disorders, such as autism spectrum disorder (ASD). However, access to these services can be limited and require substantial resources. To address this issue, the current study provides a programmatic description of an individualized parent-mediated service model targeting moderate challenging behavior. In the program, therapists coached parents to implement functional analyses and individualized function-based treatment packages. Forty-one families of children and young adults with neurodevelopmental disorders participated. Most clients (75.6%) met all admission treatment goals and parents reported significant decreases in frequency and severity of challenging behaviors at discharge. Parents also reported less stress at discharge. Outcomes of the study suggest this parent-mediated treatment model is a viable option to treating moderate challenging behavior in children and young adults with intellectual and developmental disorders.

Development and initial testing of the BABY-BISCUIT in an at-risk population

PURPOSE

Early identification of autism spectrum disorder (ASD) via screeners for diagnostic measures are a high priority. At present, there is no consensus on one screener due to the need for better sensitivity and specificity. In this study, we report on the development and utility of the BABY-BISCUIT, a six-item screener based on a modified subset of items from the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT).

METHODS

A sample of 504 children between 17-3 9months of age, who consisted of toddlers identified as at-risk for neurodevelopmental and other health disorders, were tested during an annual screening through the Louisiana EarlySteps program.

RESULTS

An exploratory factor analysis yielded a one-factor solution (X2 = 48.62, df = 9, p = <.001). High sensitivity (i.e., 100.0%) at the cost of reduced specificity (i.e., 33.3%, AUC = 0.957) was found for an optimal screening cutoff score of 1.

CONCLUSIONS

Findings from this study suggest that the BABY-BISCUIT has the potential to be a short and easily administered screener for ASD to inform whether further ASD assessment is necessary. Further investigation of convergent validity with established ASD measures is recommended.

[Risk factors for self-injurious, aggressive, and stereotypic behavior in children and youths with visual impairments]

OBJECTIVE

To increase the limited knowledge concerning the form and risk factors of self-injurious, aggressive, and stereotypic behavior in children and youths with visual impairments.

METHOD

Parents of 83 children and youths with visual impairments report on the characteristics of visual impairment, the social-communicative competence of their children, and the frequency and severity of self-injurious, aggressive, and stereotypic behaviors.

RESULTS

Stereotypic behaviors are reported more often than the other behavioral abnormalities. The frequencies of stereotypic and self-injurious behaviors are correlated with each other. Children with higher social-communicative competence received lower scores in stereotypic and self-injurious behaviors (range of correlation coefficients between –.26 and –.48). Furthermore, the developmental delay of cognitive and adaptive competence is associated with the frequency and severity of these self-injurious behaviors (F = 4.65, p = .012/F > 5.65, p < 0.01). For blind children, the parents describe a higher frequency and severity of stereotypic and self-injurious behaviors. The frequency of self-injurious behavior is lower for children in an integrative setting.

CONCLUSIONS

Frequency and severity of stereotypic and self-injurious behavior varies with characteristics of the child’s visual impairment and additional disabilities. This association is not supported for aggressive behaviors.

Risk factors for self-injury, aggression, and stereotyped behavior among young children at risk for intellectual and developmental disabilities

Before the 1990s, research on the early identification and prevention of severe behavior disorders (SBDs), such as aggression, self-injury, and stereotyped behavior, among young children with intellectual and developmental disabilities (IDD), was mostly done with children 3 years or older. More recent work suggests that signs of SBDs may occur as early as 6 months in some infants. The present study combined a cross-sectional and longitudinal approach to examine SBDs in 180 young children aged 4-48 months recruited through mass screening, then receiving an interdisciplinary evaluation and six-month follow-ups for one year. Twelve potential risk factors related to SBDs were examined. Eight of these risk factors, including age, gender, diagnosis, intellectual and communication levels, visual impairment, parent education, family income, were differentially related to scores for Aggression, SIB, and Stereotyped Behavior subscales on the Behavior Problems Inventory (BPI-01) at initial interdisciplinary evaluation. BPI-01 scores decreased over the year for 57% of the children and increased for 43%. The amount of decrease on each BPI-01 subscale varied with age, gender, and diagnosis.