Early intensive behavioral intervention (EIBI) is currently the most studied and most practiced intervention for children with autism spectrum disorder. There has been increasing evidence supporting the use of EIBI, but there have been limited evaluations of the effectiveness of EIBI intensity. The current study addressed this gap using data obtained from St.Amant Autism Program and comparing children receiving an average of 22 and 30 hours per week for a period of one year. Significant main effects of time were found for standardized measures of cognitive functioning, adaptive functioning, and autism severity. Future research should aim to address this research question with a larger sample size and a low-intensity control group. / May 2016

The use of disciplinary measures to deal with student behavior brings with it the responsibility to educate the student, not only academically, but socially. It is the social or behavioral component of education that is lacking in most Texas Disciplinary Alternative Education Program (DAEP) settings. The current DAEP model does not provide the means nor the method by which students’ behavior can be remediated, so students’ need for learning positive behaviors goes unmet. The Texas Education Code (TEC Chap. 37) mandates that DAEPs provide instruction in “self-discipline,” but it does not specify how this instruction is to be delivered. In addition, it does not provide for oversight or evaluation, so these requirements may be inconsistently fulfilled, or not fulfilled at all. Many of the students who attend DAEPs have behavioral and emotional difficulties, and are considered at risk for academic failure. Although there have been programs to compensate for and remediate academic skill deficits, there is not one comprehensive program to help students learn appropriate behaviors and overcome risk factors. The Thinking Errors program was developed to help students become aware that the choices they make every day are influenced by poor patterns of thinking. It is designed to help students correct these thinking patterns and learn to take responsibility for their own decisions and behaviors. The purpose of this study is to evaluate the effectiveness of the Thinking Errors program in helping students change their behavior.

The purpose of this study was to examine the similarity of outcomes from three different treatment integrity (TI) methods, and to identify the method which best corresponded to the assessment of a child’s behavior. Six raters were recruited through individual contact via snowball sampling. A modified intervention component list and 19 video clips were derived from Stahr’s (2005) study, “An Intervention for Children with Autism Spectrum Disorders (ASD) who Have Food Selectivity.” The raters, randomly and evenly assigned to three dyads. Each dyad received an average of six hours training and reached 85% interobserver agreement (IOA) with a 0.60 kappa score. After training, each dyad watched 5 video clips per day and measured both the child’s behavior and TI. The percentages of IOA, kappas, and indices of dependability for assessment of the child’s behavior and TI were analyzed. The data revealed that all raters reached over 80% IOA and the whole interval (WI) and yes/no (Y/N) dyads reached .60 kappa, but the two raters in the Likert-type (LIK) dyad could not reach .60 kappa. The indices of dependability indicated that the six raters consistently observed and rated both the child’s behavior and TI, but there was a discrepancy in scores (i.e., percentages of TI) between the two raters in the two indirect measure dyads (i.e., Y/N and LIK). An analysis of the percentages of total variance showed that the two indirect TI methods may affect the discrepancy between the two raters’ rating scores. A comparison of the three different TI methods and correlation between the child’s behavior and TI were examined using the PASW Statistics 18 software program. There was no significant difference between the WI and the Y/N dyads, while the assessments from the LIK dyad indicated a significant difference from the other two dyads. Both the WI and the Y/N dyads showed correlations between the degree of the child’s behavior and the degree of TI, but there was no significant difference between the two correlation coefficients. Questions about reliability with the indirect TI measures suggest one should be careful in considering these results.

Autism spectrum disorders (ASD) are associated with many different levels of language and social impairment, differences in levels of cognitive impairment, varying levels of aberrant behavior, and discrepancies in the presence or amount of restrictive and repetitive behavior. The heterogeneity found within the ASD population is coupled with significant heterogeneity in outcome for these individuals. Although interventions based on the principles of applied behavior analysis have been repeatedly cited as evidence-based for individuals with autism, significant discrepancies in outcome are evident within the literature. The heterogeneity in treatment outcome has been hypothesized as related to the heterogeneity of children included within the autism spectrum as well as differences related to treatment variables. The current study evaluated individual child characteristics and differences related to intervention intensity and fidelity as predictors of outcome after one year of exposure to a behaviorally based intervention. The primary goal of this study was to identify individual and treatment level characteristics that were predictive of differences in outcome for children with ASD. Information was gathered from a total of 368 students with autism spectrum disorders in kindergarten through second grade classrooms in the School District of Philadelphia. Correlational analyses and multiple regression analyses indicated that increased levels of expressive language skills at the start of the intervention year were correlated with and predictive of improved outcome. However, no other child level variables were related to differential outcomes. Additionally, higher levels of treatment intensity and treatment fidelity were associated with improved outcome. / School Psychology

Over the last 35 years, the disproportionate use of discipline by gender, race/ethnicity, and disability status has been consistently documented. Specifically, Black males receive the majority of suspensions and expulsions. Discipline for Native American and Hispanic students, while often showing overrepresentation, is less consistent. There is however consistent evidence of disproportionate discipline for students with disabilities. Experiencing disproportionate discipline often leads to poor academic outcomes, drop out, and involvement in the juvenile justice system. The literature on disproportionate discipline does point to practices that may mitigate its occurrence. These include: shifting from reactive policies and practices to prevention frameworks, developing consistency for how consequences are delivered, reviewing behavioral data, and using graduated support. School-Wide Positive Behavioral Interventions and Supports (SWPBIS) is a systems approach focusing on whole-school prevention of problem behavior through teaching and acknowledgement of appropriate behavior, consistent consequences, and data for decision-making within graduated levels of support. The purpose of this study was to investigate the extent of disproportionate discipline in Oregon middle schools and explore the potential impact that SWPBIS may have on discipline rates. Results from descriptive analysis of discipline data by gender, race/ethnicity, and disability status across 181 middle schools in Oregon showed that Black, Native American, and Hispanic students were overrepresented for suspension and expulsion. Specifically, Black students were 2.58 times more likely to receive out-of-school suspension and 2.79 times more likely to be expelled as all other students. In addition, Native American and Hispanic students were over 1.5 times more likely to be suspended or expelled as all other students. In contrast, White and Asian students were less likely to be suspended and half as likely to be expelled as all other students. Also, students with disabilities were nearly two times more likely to be suspended and 1.55 times more likely to be expelled as students without disabilities. Lastly, ANOVA results for a causal-comparative matched group design with SWPBIS level of implementation as the independent variable showed no statistically significant differences between groups for suspension or expulsion. Possible reasons for these findings are explored and implications for future research and policy are provided.

No description available.

The research literature has repeatedly emphasized the importance of parent involvement and parent training in the early intervention of young children with autism spectrum disorder (ASD). In fact, parent mediated Early Intensive Behavioral Intervention (EIBI) programs have become a popular method of treatment in recent years. Studies examining these programs have demonstrated that a number of variables may significantly impact the outcomes of EIBI. Moreover, an examination of the psychotherapy literature underscores the importance of a strong parent-therapist alliance as a correlate of positive processes and outcomes in child therapy; while there is very little research examining the working alliance as a factor in parent consultation.The purpose of the present study was to examine the relationship between the working alliance and the consultation process in parent-mediated EIBI for young children with ASD. Forty-four parents of children with an ASD, who were also conducting home-based EIBI programs, completed the Working Alliance Inventory (WAI) (Horvath & Greenberg, 1989) plus other measures that assessed treatment process and outcome. In addition, eight independent consultants completed similar measures to assess perceptions of alliance, process, and outcomes of their consultees.The results showed parent ratings of the working alliance were significantly correlated with parent ratings of treatment acceptability for child treatment as well as for parent consultation. Parent ratings of alliance also correlated significantly with parent ratings of parent progress in consultation and child progress in treatment. Consultant ratings of alliance were significantly correlated with both parent progress and parent improvement in consultation. This suggests that the working alliance may be a contributing factor to the process and outcome of consultation with parents of children with ASD.The results of the present study were compared to the current literature on the therapeutic alliance and relationship factors in consultation. The limitations of the present study and suggestions for future research are also discussed.

Background: This article presents findings from qualitative interviews conducted as part of a research study that trained Acupuncture, Massage, and Chiropractic practitioners' in Arizona, US, to implement evidence-based tobacco cessation brief interventions (BI) in their routine practice. The qualitative phase of the overall study aimed to assess: the impact of tailored training in evidence-based tobacco cessation BI on complementary and alternative medicine (CAM) practitioners' knowledge and willingness to implement BIs in their routine practice; and their patients' responses to cessation intervention in CAM context. Methods: To evaluate the implementation of skills learned from a tailored training program, we conducted semistructured qualitative interviews with 54 CAM practitioners in Southern Arizona and 38 of their patients. Interview questions focused on reactions to the implementation of tobacco cessation BIs in CAM practice. Results: After participating in a tailored BI training, CAM practitioners reported increased confidence, knowledge, and motivation to address tobacco in their routine practice. Patients were open to being approached by CAM practitioners about tobacco use and viewed BIs as an expected part of wellness care. Conclusions: Tailored training motivated CAM practitioners in this study to implement evidence-based tobacco cessation BIs in their routine practice. Results suggest that CAM practitioners can be a valuable point of contact and should be included in tobacco cessation efforts.

Falls are a significant public health problem with serious consequences. Fall related consequences have the potential to drastically and negatively impact the quality of life of patients who fall, and the care for fall patients is already putting a significant strain on the health care system. Advanced age has long been associated with falls. The fraction of the population represented by those of such an advanced age is increasing rapidly, subsequently the number of persons at risk for falling is also rapidly increasing. While advanced age is non-modifiable, there are many risk factors for falls which can be modified to potentially and ideally decrease the prevalence of falls. Physical inactivity is one such risk factor. Efforts to increase the amount of physical activity performed by a population at risk of falling could reduce number of falls in that population, and in turn could reduce the negative impact of fall related consequences in that population and have significant public health benefits. A particular set of exercises called the Otago exercise has already demonstrated efficacy at reducing fall rates in the elderly. Prior studies of the Otago exercise program were limited by poor compliance. There is evidence that behavioral interventions, particularly social cognitive theory, can be an effective means of increasing compliance with recommended physical activity regimens. Smartphones have the potential to be used as more cost effective means of delivery for social cognitive theory. The effectiveness of such a strategy has not been evaluated in the elderly population at risk for falling however. The following proposal is for a randomized controlled trial to investigate the effectiveness of a smartphone application designed to utilize the principles of social cognitive theory to increase compliance with the Otago exercises in an elderly population at risk of falling compared to the standard delivery of the Otago exercise. Patients from the Boston Medical Center geriatric practice will be enrolled to the protocol. Outcomes will include compliance with the prescribed exercises, falls, and engagement with the application.

Children diagnosed with autism spectrum disorder often require early intensive behavioral interventions (EIBI) to learn new skills and decrease maladaptive behaviors. Discrete trial instruction (DTI) is a strategy behavior analysts often incorporate in EIBI programs. Researchers have demonstrated that DTI is very effective, but it requires intensive training for teachers to implement the strategy with high fidelity. Therefore, researchers have recently begun to investigate more time-efficient methods to train instructors to implement DTI. One method, e-learning, is a multi-media, computer-based training that typical includes audio narration, videos, and graphics. E-learning is a lowcost, time-efficient alternative to the traditional face-to-face training method. Very little research has been conducted thus far to evaluate the effectiveness of e-learning for teaching behavioral intervention techniques. Therefore, the purpose of this study was to investigate the use of e-learning to teach university students to implement discrete trial instruction with children with autism. Four participants completed the e-learning training package and we found that all participants’ fidelity when implementing DTI increased in role plays with an adult. All participants also were able to accurately implement DTI when teaching a child with autism and we observed generalization to untrained instructional programs. All participants were able to complete the training in an average of 2 hours and the social validity questionnaire indicated that participants felt the training was interesting and useful to help them learn how to implement DTI.