Using a Time Timer to increase appropriate waiting behavior in a child with developmental disabilities

The experiences and the meaning of using MyTime in the preschool context from the perspective of children in need of special support, 5-6 years of age

BACKGROUND

Children in need of special support often display delays in time processing ability, affecting everyday functioning. MyTime is an intervention programme for systematic training of time processing ability. To support preschool children's development of time processing ability and everyday functioning, it is necessary to include their perspectives of the MyTime intervention programme. A previous study shows that MyTime is feasible with children in the preschool setting and shows positive effects on time processing ability for older children in special schools. Yet, there is a lack of knowledge regarding how preschool children experience the intervention programme and how they understand its meaning. The aim of this study was to explore the experiences and the meaning of using MyTime from the perspective of children with informal needs of special support (INS) 5-6 years of age in the preschool context.

METHODS

To explore the children's perspectives, video-recorded interviews with 21 children were analysed hermeneutically. To facilitate the interview situation with the children in need of special support, the Talking Mats© was used. Both body and spoken languages were analysed.

RESULTS

The results reveal children as active participants, willing to share their experiences of using the MyTime intervention in the preschool context. The conceptualization of the children's experiences and expressions uncovers their meaning of using the MyTime intervention as to know and to understand time by doing.

CONCLUSIONS

When children are given the opportunity to use concrete tools to understand and measure time, they experience themselves as active participants involved and engaged in the intervention. They reveal meaningful experiences to be able to manage time that facilitate their everyday functioning and participation in the preschool context.

Evaluation of the group intervention "Let's Get Organized" for improving time management, organisational, and planning skills in people with mild intellectual disability

BACKGROUND

Limited time management skills cause problems in daily life for people with mild intellectual disability (ID) and "Let's Get Organized" (LGO) is a promising manual-based occupational therapy group intervention aiming to support management skills.

AIMS/OBJECTIVES

To evaluate the applicability of the Swedish version of LGO-S by i) exploring enhancements in time management skills, satisfaction with daily occupations, and aspects of executive functioning in people with time-management difficulties and mild ID, and ii) describing clinical experiences of using the LGO-S for people with mild ID.

MATERIAL AND METHODS

Twenty-one adults with mild ID were included. Data were collected pre-/post-intervention and at 3- and 12-month follow-ups with: Swedish version of Assessment of Time Management Skills (ATMS-S), Satisfaction with Daily Occupation (SDO-13), and Weekly Calendar Planning Activity (WCPA-SE). There were few follow-up participants (n = 6-9).

RESULTS

Significant change in time management skills that maintained at 12-months follow-ups. Significant increase in regulation of emotions at 12-month follow-up. Results at 12-months follow-up indicated sustainability in outcomes as measured by ATMS-S. A non-significant positive trend was observed in other outcomes between pre- and post-intervention.

CONCLUSIONS AND SIGNIFICANCE

LGO-S seems applicable for improving skills in time management, organisation and planning also for people with mild ID.

Using Delay Fading Procedures to Increase Self-Control

Children and adolescents, relative to adults, disproportionately favor smaller, immediate outcomes over larger, delayed outcomes. From a behavioral perspective, this sensitivity toward immediate rewards constitutes impulsive choice, which characterizes numerous behavioral health problems commonly observed during childhood (particularly among individuals with neurobehavioral disabilities). Accordingly, a variety of behavioral technologies have been developed and are widely implemented in applied settings (e.g., self-monitoring programs, interdependent group contingencies, individualized token reinforcement programs) to reduce impulsive responding and promote self-control. Although there is a plethora of research literature detailing these interventions, several promising delay fading procedures may also have clinical utility in applied treatment contexts. The purpose of the present review is to highlight contemporary behavior-analytic research involving delay fading procedures that may increase self-control among children and adolescents and facilitate additional research in the area of self-control.

Effects of School-Home Communication With Parent-Implemented Reinforcement on Off-Task Behavior for Students With ASD

School-home communication is highly valued for parents of students with autism spectrum disorders (ASD) and other developmental disabilities. However, parents report poor communication as a common barrier to developing partnerships with schools. Using a multiple baseline design, we evaluated the effects of a school-home note intervention with parent-implemented reinforcement for decreasing off-task behavior of students with ASD at school. We also evaluated social validity (i.e., feasibility and acceptability) of the intervention and outcomes. Only two of the four participants showed clear behavior change, which precluded the demonstration of functional relations. However, all participating parents and teachers reported the school-home note and parent-implemented contingent reinforcement were highly feasible and acceptable, and indicated positive outcomes relating to improved family-school partnership and communication. Findings of this study, which meets single-case design standards and quality indicators, are discussed in terms of future research and practice.

Intervention in time-processing ability, daily time management and autonomy in children with intellectual disabilities aged 10-17 years - A cluster randomised trial

BACKGROUND/AIM

Difficulties with management of time are frequently observed in children and youth with intellectual disabilities (IDs). The aim of this study was to evaluate a new intervention programme 'My Time' to improve time-processing ability (TPA) in children with IDs aged 10-17 years (n = 61).

METHODS

Cluster randomised and waiting-list control group design was used. Data collection included the Kit for assessment of TPA, the Time-Parent scale and a self-rating of autonomy to assess occupational performance in daily life. The method was implemented over an 8-week period. Effect size (ES) was calculated and an analysis of covariance on the individual level and a two-stage process on the cluster level.

RESULTS

The estimated mean improvement in the KaTid-Child score from baseline (t1) to t2 was significantly higher in the intervention group compared to the waiting-list group, ES Cohen's d = 0.64.

CONCLUSION

The results present first evidence of the effectiveness of a new occupational therapy intervention programme ('My Time') to facilitate TPA in children with mild to moderate IDs. Children with IDs aged 10-17 years could improve their TPA at a measurable pace when given intervention. The method could complement interventions using time-assistive devices. Children with IDs should be identified to guide intervention. Further research is necessary to establish whether using the intervention programme can facilitate the development of TPA in younger children.

A Study on the Validity of a Computer-Based Game to Assess Cognitive Processes, Reward Mechanisms, and Time Perception in Children Aged 4-8 Years

Background

A computer-based game, named Timo’s Adventure, was developed to assess specific cognitive functions (eg, attention, planning, and working memory), time perception, and reward mechanisms in young school-aged children. The game consists of 6 mini-games embedded in a story line and includes fantasy elements to enhance motivation.

Objective

The aim of this study was to investigate the validity of Timo’s Adventure in normally developing children and in children with attention-deficit/hyperactivity disorder (ADHD).

Methods

A total of 96 normally developing children aged 4-8 years and 40 children with ADHD were assessed using the game. Clinical validity was investigated by examining the effects of age on performances within the normally developing children, as well as performance differences between the healthy controls and the ADHD group.

Results

Our analyses in the normally developing children showed developmental effects; that is, older children made fewer inhibition mistakes (r=−.33, P=.001), had faster (and therefore better) reaction times (r=−.49, P<.001), and were able to produce time intervals more accurately than younger children (ρ=.35, P<.001). Discriminant analysis showed that Timo’s Adventure was accurate in most classifications whether a child belonged to the ADHD group or the normally developing group: 78% (76/97) of the children were correctly classified as having ADHD or as being in the normally developing group. The classification results showed that 72% (41/57) children in the control group were correctly classified, and 88% (35/40) of the children in the ADHD group were correctly classified as having ADHD. Sensitivity (0.89) and specificity (0.69) of Timo’s Adventure were satisfying.

Conclusions

Computer-based games seem to be a valid tool to assess specific strengths and weaknesses in young children with ADHD.

A comparison of general and explicit delay cues to reinforcement for tangible-maintained challenging behaviour

OBJECTIVES

This compares effects of explicit delay cue to reinforcement to general delay cue to reinforcement when attempting to decrease tangible-maintained challenging behaviours of children with autism spectrum disorder (ASD).

METHODS

Two school-age children with ASD participated in this study. In order to evaluate the effects of a general cue versus an explicit cue on the participants' tangibly maintained challenging behaviours, a multiple baseline design across settings with an embedded alternating treatments design was used.

RESULTS

Results suggested that both types of delay cue to reinforcement demonstrated effectiveness on decreasing tangible-maintained behaviours of the participant. For both participants, an explicit delay cue demonstrated slightly better effects on the participants' challenging behaviours then a general delay cue.

CONCLUSIONS

This study adds an evidence to support that delayed reinforcement can be used as an effective strategy to reduce both escape and tangible-maintained challenging behaviours of children with ASD across multiple settings.

Drafting standards on cognitive accessibility: a global collaboration

PURPOSE

The International Organization for Standardization (ISO) is working on accessibility of products to support people with cognitive impairment. Working Group 10, within the technical committee 173 (assistive products for persons with disability) was formed in 2014 to draft standards for assistive products that support people with cognitive impairment.

METHOD

This article explains the scope and purpose of the working group and the context for its formation, and describes the plans and process for drafting and publishing new international standards.

RESULTS

The proposed suite of standards is presented, with examples from a draft standard on daily time management. It draws on international research evidence for the effectiveness of assistive products designed to support time management in people with cognitive impairment. Examples of assistive products and their key features are provided based on domains of time as defined in the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY).

CONCLUSIONS

The proposed standards will provide design recommendations for features and functions that increase the accessibility of products used by people with cognitive impairment. They are intended to be used by designers, manufactures, educators and services providers, to facilitate their commitment to inclusion and demonstrate their willingness to work with accessibility regulation. Implications for Rehabilitation New standards based on universal design (UD) principles can guide the design of more user-friendly assistive products for people with cognitive impairment. Greater usability of assistive products, whether mainstream or specially-designed, will make it easier for practitioners to find and introduce assistive solutions to individuals with cognitive impairment. Greater usability of assistive products for daily time management can decrease the need for user training and support and enable participation.

Best Practices in Utilizing the Changing Criterion Design

The changing criterion design (CCD) has been a recognized format of single-case research for four decades. Published examples of the CCD have been limited and the structure of the design used in the literature has varied to a degree that might engender confusion. This review examines the structure of CCD studies published to date to identify prior implementation practices and identify best practices for future use.

A comparison of the effects of brief rules, a timer, and preferred toys on self-control

Some children make impulsive choices (i.e., choose a small but immediate reinforcer over a large but delayed reinforcer). Previous research has shown that delay fading, providing an alternative activity during the delay, teaching participants to repeat a rule during the delay, combining delay fading with an alternative activity, and combining delay fading with a countdown timer are effective for increasing self-control (i.e., choosing the large but delayed reinforcer over the small but immediate reinforcer). The purpose of the current study was to compare the effects of various interventions in the absence of delay fading (i.e., providing brief rules, providing a countdown timer during the delay, or providing preferred toys during the delay) on self-control. Results suggested that providing brief rules or a countdown timer during the delay was ineffective for enhancing self-control. However, providing preferred toys during the delay effectively enhanced self-control.

Single-case experimental designs: a systematic review of published research and current standards

This article systematically reviews the research design and methodological characteristics of single-case experimental design (SCED) research published in peer-reviewed journals between 2000 and 2010. SCEDs provide researchers with a flexible and viable alternative to group designs with large sample sizes. However, methodological challenges have precluded widespread implementation and acceptance of the SCED as a viable complementary methodology to the predominant group design. This article includes a description of the research design, measurement, and analysis domains distinctive to the SCED; a discussion of the results within the framework of contemporary standards and guidelines in the field; and a presentation of updated benchmarks for key characteristics (e.g., baseline sampling, method of analysis), and overall, it provides researchers and reviewers with a resource for conducting and evaluating SCED research. The results of the systematic review of 409 studies suggest that recently published SCED research is largely in accordance with contemporary criteria for experimental quality. Analytic method emerged as an area of discord. Comparison of the findings of this review with historical estimates of the use of statistical analysis indicates an upward trend, but visual analysis remains the most common analytic method and also garners the most support among those entities providing SCED standards. Although consensus exists along key dimensions of single-case research design, and researchers appear to be practicing within these parameters, there remains a need for further evaluation of assessment and sampling techniques and data analytic methods.

Recent research on aetiology, development and phenomenology of self-injurious behaviour in people with intellectual disabilities: a systematic review and implications for treatment

BACKGROUND

Behavioural interventions conceptualise self-injurious behaviour (SIB) as developing from early repetitive behaviours through acquisition of homeostatic functions in regulating stimulation and subsequent shaping into SIB through socially mediated or automatic operant reinforcement. Despite high success rates, such interventions rarely completely eliminate SIB, and overall effectiveness has not increased since the 1960s.

METHODS

Research (excluding studies of single genetic syndromes) on the early development, functional properties and phenomenology of SIB in persons with intellectual disabilities (IDs) published from 1999 to 2010 inclusive is reviewed.

RESULTS

Despite evidence to support the operant shaping hypothesis, in some cases tissue-damaging SIB, especially head-banging, emerges at a similar or younger age than stereotyped behaviours or 'proto-SIB', often associated with tantrums following frustrative non-reward and/or abrupt situational transitions. Many young children show undifferentiated patterns of responding in functional analyses of SIB, and SIB is associated with aggression and impulsivity as well as with repetitive behaviour.

CONCLUSIONS

One dynamic in the development of SIB may be Pavlovian conditioning of aggression, originally elicited by aversive events or frustrative non-reward, to stimuli associated with such situations. Integration into operant technology of interventions based on Pavlovian principles such as graduated exposure (with or without counterconditioning) to aversive stimuli may enhance the effectiveness of behavioural interventions.