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. Of these cases, 76% of participants transitioned to technician-delivered telehealth services whereas the rest transitioned to a caregiver-implemented telehealth model. Participants continued to access a similar dosage of treatment hours per week in spite of the treatment model transition (in-person M = 12; telehealth M = 11) and maintained or improved correct independent responding across all targets from in-person treatment (M = 75%) to telehealth treatment (M = 80%). These findings provide initial evidence that some clients with autism benefit from technician-delivered telehealth services.

Perceiving facial affective ambiguity: A behavioral and neural comparison of adolescents and adults

The current study examined perceptual differences between adults and youth in perceiving ambiguous facial expressions. We estimated individuals' internal representation for facial expressions and compared it between age groups (adolescents: N = 108, Mage = 13.04 years, 43.52% female; adults: N = 81, Mage = 31.54, 65.43% female). We found that adolescents' perceptual representation for facial emotion is broader than that of adults', such that adolescents experience more difficulty in identifying subtle configurational differences of facial expressions. At the neural level, perceptual uncertainty in face-selective regions (e.g., fusiform face area, occipital face area) were significantly higher for adolescents than for adults, suggesting that adolescents' brains more similarly represent lower intensity emotional faces than do adults'. Our results provide evidence for age-related differences concerning psychophysical differences in perceptual representation of emotional faces at the neural and behavioral level. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

[Effectiveness of Behavioral Activation for the Treatment of Severe Depression in Clinical Settings]

Objectives Among interventions that have been shown to be efficacious in the treatment of depression, behavioural activation (AC) is receiving increasing attention as the evidence supporting its effectiveness continues to accumulate. Although the efficacy of AC for the treatment of depression has been established through numerous randomized controlled trials, studies evaluating the effectiveness of AC when implemented in mental health settings are rare and there is insufficient supportive data. This step is, however, essential to the validity and the generalization of the treatment to the reality of clinical settings. This study focuses on AC applied to take into account the reality of clinical settings and patients seeking treatment. It evaluates the effectiveness of group-based AC for the treatment of severe depression in a clinical setting in a heterogeneous population in terms of diagnosis (unipolar and bipolar depression) and comorbidity (Axis I and II). Methods A sample of 45 participants with severe depression was recruited in a psychiatric hospital. Participants received a 10 sessions group intervention of AC. Questionnaires were administered to obtain pretreatment, post-treatment and four-week post-treatment data. The impact of the intervention was observed on measures of depression, behavioural activation, reinforcement, anxiety, social adjustment and quality of life. Various moderation effects associated with the heterogeneity of the sample were tested on the evolution of depressive symptoms. The integrity of the treatment administered by the therapists and the acceptability of the intervention by participants were also documented. Results Mixed model analyses of variance were performed to assess whether (a) AC caused a significant change at the end of treatment on depressive symptoms, behavioural activation, reinforcement, anxiety, social adjustment and quality of life and whether (b) gains were maintained after four weeks. A significant change was obtained between the pre-post measures on the average score of all these variables, with the exception of a subscale of the quality of life measure. Analyses were also performed to verify various moderating effects on the evolution of depressive symptoms, level of activation and reinforcement. No interaction effects are observed on depression, activation and reinforcement measures. There is no significant difference according to pretreatment severity category, diagnosis (unipolar vs bipolar), presence of comorbidity (other Axis I and/or Axis II disorder) or co-morbidity of Axis II disorder. As for the activation measure in people with bipolar depression versus unipolar depression, it should be noted that the result is at the threshold of statistical significance. Conclusion The results support the effectiveness of group-based AC for the treatment of severe depression in clinical settings in a heterogeneous population, as well as for the maintenance of gains after four weeks. The effectiveness of AC was also observed across all associated psychosocial measures.

Randomization tests as alternative analysis methods for behavior-analytic data

Randomization statistics offer alternatives to many of the statistical methods commonly used in behavior analysis and the psychological sciences, more generally. These methods are more flexible than conventional parametric and nonparametric statistical techniques in that they make no assumptions about the underlying distribution of outcome variables, are relatively robust when applied to small-n data sets, and are generally applicable to between-groups, within-subjects, mixed, and single-case research designs. In the present article, we first will provide a historical overview of randomization methods. Next, we will discuss the properties of randomization statistics that may make them particularly well suited for analysis of behavior-analytic data. We will introduce readers to the major assumptions that undergird randomization methods, as well as some practical and computational considerations for their application. Finally, we will demonstrate how randomization statistics may be calculated for mixed and single-case research designs. Throughout, we will direct readers toward resources that they may find useful in developing randomization tests for their own data.

Setting global research priorities for child protection in humanitarian action: Results from an adapted CHNRI exercise

BACKGROUND

Armed conflict, natural disaster, and forced displacement affect millions of children each year. Such humanitarian crises increase the risk of family separation, erode existing support networks, and often result in economic loss, increasing children's vulnerability to violence, exploitation, neglect, and abuse. Research is needed to understand these risks and vulnerabilities and guide donor investment towards the most effective interventions for improving the well-being of children in humanitarian contexts.

METHODS

The Assessment, Measurement & Evidence (AME) Working Group of the Alliance for Child Protection in Humanitarian Action (ACPHA) identified experts to participate in a research priority setting exercise adapted from the Child Health and Nutrition Research Initiative (CHNRI). Experts individually identified key areas for research investment which were subsequently ranked by participants using a Likert scale. Research Priority Scores (RPS) and Average Expert Agreement (AEA) were calculated for each identified research topic, the top fifteen of which are presented within this paper.

RESULTS

Intervention research, which aims to rigorously evaluate the effectiveness of standard child protection activities in humanitarian settings, ranked highly. Child labor was a key area of sector research with two of the top ten priorities examining the practice. Respondents also prioritized research efforts to understand how best to bridge humanitarian and development efforts for child protection as well as identifying most effective way to build the capacity of local systems in order to sustain child protection gains after a crisis.

CONCLUSIONS

Rigorous, scientific research that assesses the scope of child protection risks, examines the effectiveness of interventions to improve child well-being, and translates evidence to practice is critical. Findings from this research priority setting exercise offer guidance for a global research agenda on child protection in humanitarian settings, encouraging cooperation among donors, implementers, and academics to pursue a coordinated approach to evidence generation.

Predictors of longitudinal ABA treatment outcomes for children with autism: A growth curve analysis

BACKGROUND

Autism spectrum disorder (ASD) is a developmental disorder that causes lifelong disability. Applied Behavior Analysis (ABA) is one of the most empirically studied and validated approaches for treating children diagnosed with ASD. Due to the heterogeneity of ASD, it is important to ascertain who will most benefit from treatment.

METHODS

In this study, 35 participants, with a mean entry age of 3 years, received ABA therapy. Children were assessed at intake and every 6 months thereafter using the Developmental Profile-3 (DP-3) to measure their communication, social-emotional, adaptive behavior, and physical development (2-6 measures per participant). Using a growth curve analysis, we investigated if age, diagnosis severity, cognitive functioning, treatment hours, gender, parent education level, or primary language spoken at home significantly predicted the growth trajectories of ABA treatment outcomes.

RESULTS

Our findings indicated that higher cognitive functioning significantly predicted faster growth across all four developmental domains, age at entry predicted initial status, and other variables only predicted growth rates in one or two domains.

IMPLICATIONS

Knowing the predictors of treatment outcome is important information for customizing treatment and this study demonstrated how longitudinal analyses can illuminate how participant characteristics affect the course of ABA therapy.

Development and Validation of the Transgender Inclusive Behavior Scale (TIBS)

Transgender-inclusive behaviors are actions and communication supporting transgender individuals. Examples include using language not reinforcing the gender binary, asking for and using correct pronouns, creation of spaces that welcome members of the transgender community, and acknowledging cisgender (non-transgender) privilege. A survey was developed measuring this behavior in individuals to examine the impact of transgender-inclusive behavior and the potential effect of interventions on promoting inclusive behavior. Data were collected utilizing an online survey (N = 1,051). The sample was split in half to run two sets of cases in a principal components analysis. Analysis of the full sample showed Cronbach's alpha to be .93 (n = 918). Findings suggest that the Transgender Inclusive Behavior Scale (TIBS) may be a useful instrument for identifying behaviors related to being inclusive of transgender individuals, groups, and communities. It may also be used to measure behavior change before and after transgender-specific educational and behavioral interventions.

A Positive Behavioral Approach for Aggression in Forensic Psychiatric Settings

Aggression toward self and others by complex patients admitted to forensic psychiatric settings is a relatively common yet extremely difficult behavior to treat. Traditional interventions in forensic inpatient settings have historically emphasized control and management over treatment. Research over the past several years has demonstrated the value of behavioral and psychosocial treatment interventions to reduce aggression and to increase prosocial skill development in inpatient forensic population. Positive behavioral support (PBS) offers a comprehensive approach that incorporates the science of applied behavioral analysis (ABA) in support of patients with challenging behaviors, including aggression and violence. In this article, we describe a PBS model to treat aggression in forensic settings. PBS includes a comprehensive functional assessment, along with four basic elements: ecological strategies, positive programming, focused support strategies, and reactive strategies. Other key components are described, including data collection, staff training, fidelity checks to ensure correct implementation of the plan, and ongoing monitoring and revision of PBS strategies, according to treatment outcomes. Finally, a behavioral consultation team approach within the inpatient forensic setting is recommended, led by an assigned doctoral-level psychologist with specialized knowledge and training in behavioral methods. The behavioral consultation team works directly with the unit treatment team and the identified patient to develop, implement, and track a plan that may extend over several weeks to several months including transition into the community. PBS can offer a positive systemic impact in forensic inpatient settings, such as providing a nonpharmacologic means to address aggression, reducing the incidences of restraint and seclusion, enhancing staff proficiency in managing challenging patient presentations, and reducing recidivism when used as part of the bridge to community re-entry.

Investigation of Collective Behaviour and Electrocommunication in the Weakly Electric Fish, Mormyrus rume, through a biomimetic Robotic Dummy Fish

A robotic fish has been developed to create a mixed bio-hybrid system made up of weakly electric fish and a mobile dummy fish. Weakly electric fish are capable of interacting with each other via sequences of self-generated electric signals during electrocommunication. Here we present the design of an artificial dummy fish, which is subsequently tested in behavioural experiments. The robot consists of two parts: a flexible tail that can move at different frequencies and amplitudes, performing a carangiform oscillation, and a rigid head containing the motor for the tail oscillation. The dummy fish mimics the weakly electric fish Mormyrus rume in morphology, size and electric signal generation. In order to study electrical interactions, the dummy fish is equipped with ten electrodes that record electric signals of nearby real fish and generate electric dipole fields around itself that are similar to those produced by real fish in both waveform and sequence. Behavioural experiments demonstrate that the dummy fish is able to recruit both single individuals and groups of M. rume from a shelter into an exposed area. The development of an artificial dummy fish may help to understand fundamental aspects of collective behaviour in weakly electric fish and the properties necessary to initiate and sustain it in closed-loop feedback experiments based on electrocommunication.

Innate Color Preference of Zebrafish and Its Use in Behavioral Analyses

Although innate color preference of motile organisms may provide clues to behavioral biases, it has remained a longstanding question. In this study, we investigated innate color preference of zebrafish larvae. A cross maze with different color sleeves around each arm was used for the color preference test (R; red, G; green, B; blue, Y; yellow). The findings showed that 5 dpf zebrafish larvae preferred blue over other colors (B > R > G > Y). To study innate color recognition further, tyrosinase mutants were generated using CRISPR/Cas9 system. As a model for oculocutaneous albinism (OCA) and color vision impairment, tyrosinase mutants demonstrated diminished color sensation, indicated mainly by hypopigmentation of the retinal pigment epithelium (RPE). Due to its relative simplicity and ease, color preference screening using zebrafish larvae is suitable for high-throughput screening applications. This system may potentially be applied to the analysis of drug effects on larval behavior or the detection of sensory deficits in neurological disorder models, such as autism-related disorders, using mutant larvae generated by the CRISPR/Cas9 technique.