Effects of using a photographic cueing package during routine school transitions with a child who has autism

The Efficacy of Visual Activity Schedule Intervention in Reducing Problem Behaviors in Children With Attention-Deficit/Hyperactivity Disorder Between the Age of 5 and 12 Years: A Systematic Review

Objectives

Children with attention-deficit/hyperactivity disorder (ADHD) tend to be noisy and violate rules with their disruptive behaviors, resulting in greater difficulties with off-task behaviors and being at risk for social refusal. The visual activity schedule (VAS) intervention program is a frequently used method to teach multiple skills involving on-task, use of schedules, transition behaviors, social initiation, independent play skills, classroom skills, and academic skills. The current systematic review aimed to examine the efficacy of using VAS intervention in reducing problem behaviors in children with ADHD between 5 and 12 years of age.

Methods

Systematic searches were conducted using two electronic databases (PubMed and Scopus) to identify relevant studies published in English between 2010 and 2020. Four studies met the inclusion criteria: two studies examined the effect of schedule-based tasks and the use of an iPad on classroom skills, while the other two examined randomized clinical trials (RCTs) of psychosocial treatment for ADHD inattentive type and a cross-sectional study examined the impact of the group size on task behavior and work productivity in children with ADHD.

Results

The findings indicate that the interventions used in all four studies could lead to increased satisfaction among participants and parents, as well as a reduction in problem behavior. In terms of the research indicators, the RCT had low quality, while the others were of high quality.

Conclusion

A larger number of studies and the ADHD clinical population would help to increase the generalizability of future reviews of treatments in this context.

Effects of advance notice on transition-related pausing in pigeons

Transitions between tasks can produce behavioral disruptions that are characterized as problematic. Advance notice, a procedure designed to reduce disruptions, involves presenting a stimulus to warn of the end of the ongoing activity and the nature of the upcoming activity. Clinical evaluations of advance notice have produced mixed results. We studied advance notice in a controlled laboratory setting. Pigeons' keypecking was maintained on a multiple schedule with 2 fixed-ratio components. In the lean component, completing the ratio produced brief access to food; in the rich component, completing the ratio produced longer access. Disruptions in operant behavior, measured as pauses in pecking, were reliably produced in the transition from a rich component to a lean one. Advance notice was provided by flashing the houselight before transitions to lean components. Advance notice did not reduce pausing in the rich-lean transition; instead, it tended to increase it. When the flashing houselight warned of a transition but was equally likely to be followed by the rich component as the lean one, the stimulus had no reliable effect on pausing. Despite its limitations as a translational model of clinical settings, this experiment suggests that clinical use of advance notice should be approached with caution.

Case study assessing the feasibility of using a wearable haptic device or humanoid robot to facilitate transitions in occupational therapy sessions for children with autism spectrum disorder

Introduction

Some children with autism spectrum disorder (ASD) have difficulties with transitions that may lead to problem behaviours. Although the use of technologies with children with ASD is receiving increasing attention, no study has looked at their effect on transitions in activities of daily living. This study aimed to document the feasibility of (1) using two intervention technologies (NAO humanoid robot or wearable haptic device) separately to facilitate transitions in occupational therapy sessions for children with ASD and (2) the method used to document changes.

Methods

Using a single case reversal (ABA) design, two children with ASD were randomly assigned to one of the intervention technologies (humanoid robot or haptic bracelet). Each technology was used as an antecedent to stimulate the start of transitions in eight intervention sessions at a private occupational therapy clinic. Data concerning the time required for transitions, child's behaviours during transitions at the clinic and mother's perception of the child's performance in transitions at home were analysed graphically.

Results

When using technology, both children's behaviours were appropriate, quick and relatively stable. Also, both mothers reported improved perceptions of their child's performance in transitions.

Conclusions

This exploratory study suggests no detrimental effect of using these technologies.

Pre-school teachers’ perceptions of challenging behaviours of students with autism spectrum disorder within inclusive settings

Purpose

Students with autism spectrum disorder (ASD) often have challenging behaviours that can create significant teaching challenges in group settings such as in mainstream pre-school inclusive settings. This study aims to identify and understand, from the perspectives of mainstream pre-school teachers in Singapore, the type of common challenging behaviours observed in pre-schoolers (mean age = 4.5 years, SD = 1.1, range = 3-6) with ASD.

Design/methodology/approach

Participants consisted of 62 teachers (mean age = 35.8 years; SD = 10.8) teaching in mainstream pre-school centres located in Singapore completed an open-ended survey. Twelve codes were generated and served as guidelines for coding the qualitative data. Codes with similar themes were then grouped to form four construct categories: social communication, restricted and repetitive behaviours, attention and learning and others.

Findings

Results indicated that difficulty with change/transition and social/peer interaction were the most concerning issues across all settings, whereas “lesson time” and “circle time” were the two most common activities/settings in which the concerns were reported by teachers.

Originality/value

Findings from this paper may add to the limited research looking at the challenging behaviours exhibited by children with ASD in mainstream pre-school settings in Singapore. Understanding the type of challenging behaviours presented in pre-schoolers with ASD and the activities/settings in which these behaviours occur may help the teachers to link the difficulties to specific interventions to further support their inclusion in a mainstream pre-school setting.

From Helpless to Hero: Promoting Values-Based Behavior and Positive Family Interaction in the Midst of COVID-19

Parents managing their home environments during government-ordered stay-at-home periods are likely to need new skills for occupying their children’s time with activities that promote health and emotional well-being. Moreover, parents and children know they need help managing these circumstances. Perhaps for the first time, behavior analysts hold the reinforcers for increasing parental involvement in effective child-rearing practices. In fact, behavior analysts can help parents enlist their children in managing the household by framing their behavior in terms of hidden superpowers. In the current article, we argue that behavior analysts have a range of tools to offer that are grounded in evidence-based principles, strategies, and kernels—or essential units of behavioral influence. When combined into scheduled daily practices and invoked by children taught to see their use of the tools as nothing short of heroic, these practices function as “vaccinations” that inoculate families against toxic and unsafe behaviors.

Considerations of Baseline Classroom Conditions in Conducting Functional Behavior Assessments in School Settings

Research has shown that environmental classroom variables affect academic performance and student behavior, and appropriate behavior is often related to the presence of effective teaching practices and classroom management (Moore Partin, Robertson, Maggin, Oliver, & Wehby Preventing School Failure, 54, 172-178, 2010). For behavior analysts consulting in elementary education, some referrals for assessment and treatment of individual student behavior can be resolved by helping teachers establish effective class-wide practices. For this reason, some researchers suggest that behavior analysts should assess baseline classroom conditions as part of a functional behavior assessment (FBA; Anderson & St. Peter Behavior Analysis in Practice, 6(2), 62, 2013; Sutherland & Wehby Journal of Emotional and Behavioral Disorders, 11, 239-248, 2001). Through a literature review on effective classroom practices, we identified four specific classroom variables that have large effects on both learning outcomes and student behavior; we suggest consultants consider these four variables in baseline classroom assessments: (a) rates of active student responding (ASR), (b) appropriateness of the curriculum, (c) feedback and reinforcement, and (d) effective instructions and transitions. In this article, we will discuss each of these variables, describe how they can affect classroom behavior, and provide recommended targets from the research literature. We also provide a data-collection form for practitioners to use in their assessments of baseline classroom ecology, and for situations when these practices are not in place, we suggest potential resources for antecedent- and consequence-based interventions to decrease challenging classroom behavior.

Preventing Disruptive Behavior via Classroom Management

Evidence suggests that installing a classroom management system known as the Color Wheel reduced inappropriate behaviors and increased on-task behavior in second- and fourth-grade classrooms; however, no systematic studies of the Color Wheel had been disseminated targeting pre-school or kindergarten participants. To enhance our understanding of the Color Wheel System (CWS) as a prevention system, a multiple-baseline design was used to evaluate the effects of the Color Wheel on inappropriate vocalizations (IVs) in three general education kindergarten classrooms. Partial-interval time-sampling was used to record classwide IVs, which were operationally defined as any comment or vocal noise that was not solicited by the teacher. Time series graphs and effect size calculations suggest that the CWS caused immediate, large, and sustained decreases in IVs across the three classrooms. Teacher acceptability and interview data also supported the CWS. Implications related to prevention are discussed and directions for future research are provided.

Evaluating visual activity schedules as evidence-based practice for individuals with autism spectrum disorders

A comprehensive review of the literature was conducted for articles published between 1993 and 2013 to evaluate the quality of the Visual Activity Schedules (VAS) literature using current evidence-based criteria developed by Horner et al. (Except Child 71:165-179, 2005). Authors sought to determine whether VAS can be considered an evidence-based practice by expanding on the findings from previous reviews. A total of 31 studies met inclusion criteria for the use of VAS to various behaviors to students with autism spectrum disorder (ASD). Of these studies, 16 met criteria for acceptable quality. Results suggest that VAS can be considered an EBP for individuals with ASD, especially when used in combination with systematic instructional procedures. VAS can be used to increase, maintain, and generalize a range of skills of individuals from preschool through adulthood in a variety of settings (e.g., general education, community). Implications for practitioners using VAS, limitations, and recommendations for future research are discussed.

Advance Notice for Transition-Related Problem Behavior: Practice Guidelines

Transitions between daily activities can occasion or elicit problem behavior in individuals with intellectual and developmental disabilities (IDD). Providing advance notice to signal an upcoming transition is a common practice in early and special education settings (e.g., Riffel 2010; Sandall et al. 2005). While the literature contains many demonstrations of the efficacy of various advance notice procedures, other studies have shown negative results. Practitioners are faced with the challenge of deciding whether advance notice is a viable treatment option for transition-related problem behavior in light of these contradictory findings. To assist the practitioner in this decision-making process, we provide a brief review of the advance notice literature, concentrating on the studies reporting that advance notice is ineffective at reducing transition-related problems. The goal is to provide practitioners with a better understanding of the environmental conditions under which advance notice is likely to be ineffective at decreasing problem behavior as well as the conditions under which it can be effective at reducing transition-related problem behavior. Discriminating these conditions may yield a useful set of practice guidelines for deciding when advance notice is a viable treatment option for decreasing transition-related problem behavior.

Teaching intraverbal behavior to children with autism: a comparison of textual and echoic prompts

Although echoic prompts may be effective for teaching intraverbal behavior to children with autism, the performance of some children may become dependent on such prompts (i.e., the prompts cannot be eliminated). Recent research suggests that visual rather than echoic prompts may be used to teach children with autism a variety of skills and may facilitate independent performance. In the present study, an adapted alternating treatments design was used to compare the effects of using visual (textual) and echoic prompts on acquisition of intraverbal responses (answering questions) by 2 children with autism. The results indicated that the textual prompts were more effective than the echoic prompts. Implications for the use of visual prompts during instruction with children with autism are discussed.

Use of activity schedule to promote independent performance of individuals with autism and other intellectual disabilities: a review

A literature review was conducted on the effectiveness of activity schedules. Twenty three studies that a) were peer-reviewed, b) were experimental, c) implemented activity schedule as a primary intervention, d) incorporated multiple activities, and e) aimed to teach learners to self-manage individual schedules were included in the review. The results demonstrated the effectiveness of activity schedules for promoting independence and self-management skills for a broad range of individuals with intellectual disabilities. An increase in engagement and on-task behavior was the most frequently cited outcome, followed by independent task initiation or transition and self-scheduling. Failure to include social validity measures and caregivers as interventionists were discussed. A corpus of the reviewed studies supports applications of activity schedule in school and (group) home settings.

Effectiveness of Interventions Designed to Modify the Activity Demands of the Occupations of Self-Care and Leisure for People With Alzheimer’s Disease and Related Dementias

A systematic review of evidence for the effectiveness of modification of activity demands in the care of people with Alzheimer’s disease (AD) was conducted as part of the American Occupational Therapy Association’s Evidence-Based Literature Review Project. The review included 10 articles addressing occupations of self-care and leisure. No reports related to work and social participation were located. Results suggest that evidence for this intervention’s effectiveness is strong. Four practice principles were derived from this appraisal: (1) Occupational therapy programs should be individualized to elicit the person’s highest level of retained skill and interest, (2) cues used while assisting people with AD to complete tasks should be short and provide clear direction, (3) compensatory strategies in the form of environmental modifications and simple adaptive equipment should be specifically implemented on the basis of the unique needs of the person, and (4) caregiver training and involvement are essential in implementing individualized programs.

Context-Based Assessment and Intervention for Problem Behavior in Children With Autism Spectrum Disorder

The present study used a context-based model of assessment and intervention to explore whether interventions that modify context result in reduction of problem behavior in ecologically valid settings (i.e., typical routines implemented by typical education personnel in neighborhood schools). The Contextual Assessment Inventory (CAI) and a postassessment interview were administered to parents and teachers of eight children with Autism Spectrum Disorder to identify problem contexts. Then, environmental modification techniques were implemented in three priority contexts: namely, transitions, termination of preferred activities, and presence of a feared stimulus. Our results demonstrated an almost complete elimination of problem behavior in the priority contexts as well as successful completion of activities and routines related to those contexts. We discuss the value of conceptualizing problem behavior as a function of context with respect to facilitating both assessment and intervention, and the need for enhancing breadth of effects to determine the larger impact of a context-based approach on promoting meaningful behavior change in the community.

Use of Songs to Promote Independence in Morning Greeting Routines For Young Children With Autism

This study evaluated the effects of individually composed songs on the independent behaviors of two young children with autism during the morning greeting/entry routine into their inclusive classrooms. A music therapist composed a song for each child related to the steps of the morning greeting routine and taught the children's teachers to sing the songs during the routine. The effects were evaluated using a single subject withdrawal design. The results indicate that the songs, with modifications for one child, assisted the children in entering the classroom, greeting the teacher and/or peers and engaging in play. For one child, the number of peers who greeted him was also measured, and increased when the song was used.

Speech-language pathologists' roles in the delivery of positive behavior support for individuals with developmental disabilities

Positive behavior support interventions such as functional communication training (FCT) and visual schedules are increasingly being used with individuals with autism and other severe developmental disabilities who engage in problem behavior and use augmentative and alternative communication (AAC). The increasing use of these communication interventions has implications for speech-language pathologists who provide support to these individuals. The purpose of this tutorial is to summarize the research regarding the use of FCT/AAC interventions and visual schedules, and to provide suggestions for the roles that speech-language pathologists can play with regard to assessment, intervention design, and implementation in school and home settings.