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This study examined the effectiveness of the Power Card strategy in increasing social commenting of three children with ASD to their peers while playing a game. The Power Card strategy is an antecedent strategy, which incorporates the child’s special interest into a script and steps to show her or him how to engage in the appropriate target behavior. Previous studies have shown that the Power Card strategy is effective when used to teach social skills. However, there have been mixed findings on the impact the Power Card strategy has on commenting during gameplay. Therefore, additional research is needed to evaluate if the Power Card strategy can increase social commenting. The purpose of this study was to examine the effects of the Power Card strategy on the frequency of comments three children with ASD made to peers during a game. Results can be interpreted to support the Power Card strategy as effective in increasing the frequency of comments made to peers while playing a game. Additionally, response generalization and stimulus generalization occurred across all three participants. Behavioral staff and participants’ parents reported that the Power Card was an effective strategy and noted an increase in independent commenting in other environments. / Applied Behavioral Analysis

Total communication (TC) involves the teaching of a manual sign language response while simultaneously presenting the corresponding vocal stimulus. TC procedures have been shown to increase the acquisition of vocal responding for children with autism spectrum disorder (ASD). This study attempted to systematically replicate the findings in Carbone et al. (2006), who found TC training to have a superior advantage over vocal alone (VA) procedures in the acquisition of vocal tacts. An alternating treatments design with initial baseline was implemented to compare two conditions in teaching vocal mands to children with ASD. In the VA condition, the researcher presented a vocal prompt to evoke vocal behavior. In the modified total communication (MTC) condition, the researcher presented the vocal prompt along with the corresponding manual sign. Participants were only required to vocally respond to produce reinforcement in both conditions. Sign language responses also produced reinforcement. Four children diagnosed with ASD and varying speech delays participated in this study. A multiple stimulus without replacement (MSWO) preference assessment (DeLeon & Iwata, 1996) was used to identify each participants’ preference to 15- 20 different stimuli. Following baseline, one to two highly preferred target stimuli were assigned to each condition. Four sessions were conducted during the intervention phase, two sessions of the VA condition and two sessions of the MTC condition. Conditions were counterbalanced by alternating each session with no more than two consecutive sessions of the same condition introduced first to control for sequential confounds. Sessions included three trial presentations of each stimulus. Sessions took place one to three times a week. Previous research suggested MTC to have an advantage in higher acquisition rates of vocal responses than the VA condition. The study outcome led to mixed results; three participants demonstrated slightly better acquisition of vocal mands in the MTC condition compared to the VA condition. The MTC condition also yielded slightly better acquisition of full word vocalizations and independent vocalizations for two participants. Results of this study were marginal and inconsistent but could suggest MTC training to have a slight advantage in the acquisition of vocal responses in individuals with speech delays. It also appears that teaching sign language to individuals with communication delays does not hinder natural speech development. Keywords: Vocal alone, total communication, modified total communication, manding, vocal prompt, alternating treatments design, autism spectrum disorder / Applied Behavioral Analysis

This current study was an extension of Persicke et al. (2014) and was conducted to evaluate the effectiveness of clicker training on increasing the amount of heel-to-toe strides for three children with Autism Spectrum (ASD). Persicke et al. assessed the effectiveness of TAGteach™ procedures in combination with a correction procedure. This current study used only the clicker training phase. The results of the current study suggest that clicker training can serve as an effective intervention to increase heel-to-toe strides, thereby decreasing toe walking. Baseline levels of all participant’s heel-to-toe strides were below 30% of steps. All three participants increased their heel-to-toe steps above 80% following the implementation of clicker training, and results maintained throughout all fading trials. Social validity measures indicated that clicker training was easy to use and understand. Future research should investigate delivering an auditory stimulus through a device other than a clicker to increase the treatment fidelity and social validity due to a clicker being associated with animal training. This research demonstrated that clicker training can be a viable intervention for children with Autism Spectrum Disorder who exhibit toe walking. / Applied Behavioral Analysis

Background: Obesity is a significant threat to the health of millions of Americans. The disease is strongly associated with a number of conditions that increase the risk of premature mortality, including type 2 diabetes, hypertension, obstructive sleep apnea, and certain cancers. Bariatric surgery, specifically Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (SG), produce significant and durable weight losses. Third-party payers require that patients complete a number of preoperative consultations, typically including a medical assessment and mental health evaluation, as well as medical weight management (MWM), which typically consists of 3-6 months of in-person visits with a primary care provider or registered dietitian (RD). The number of visits and duration of the preoperative consultation and MWM process is often dictated by the patient’s third-party payer. Few studies have investigated if these contacts are associated with greater postoperative weight loss. Further, the relationship of these preoperative contacts to postoperative follow-up, which is associated with weight maintenance, is unknown. Objective: To determine if the frequency of preoperative contacts, and the duration of the preoperative assessment period (and duration of MWM in particular), is associated with percent weight loss in the first two years following bariatric surgery. The relationship between preoperative contacts with postoperative attrition also was explored. Methods: One thousand five hundred bariatric surgery cases from 2009-2014 from a single institution were analyzed. Preoperative contacts were abstracted from the electronic medical record and categorized by type. Weight was collected from postoperative visits with the surgical practice or primary care physician records. Generalized linear mixed models were used to assess the relationship between the frequency of preoperative contacts and duration of preoperative care with the bariatric surgery team and weight loss in the first 24 months after surgery. Logistic regression models were used to assess the association between the number of preoperative contacts and the duration of the preoperative assessment period with completion of postoperative follow up visits. Results: The frequency of preoperative contacts (including individual visits, education sessions, support groups, psychology visits, telephone calls, and electronic messages) and duration of preoperative care were not associated with postoperative percent weight loss. A greater number of individual visits with the bariatric surgery team was associated with 0.26% smaller postoperative weight loss (95% CI -0.47%, -0.05%; P = 0.02). Additional contacts with the psychologist also were associated with 1.46% smaller postoperative percent weight loss (95% CI -2.79%, -0.12%; P = 0.03). Number of preoperative contacts and duration of preoperative care were not associated with postoperative follow up. Conclusion: The frequency of preoperative contacts with the bariatric surgery team, and the duration of preoperative care, were not associated with weight loss in the first two years after bariatric surgery. More individual visits with the bariatric team and additional visits with the psychologist prior to surgery were associated with smaller postoperative weight loss. These results suggest that the intensity and length of the preoperative assessment period, which is often mandated by third party payers, is unrelated to early postoperative weight loss. More extensive preoperative assessment by the multidisciplinary team, and mental health professional, however, may be identifying patients who are at risk for smaller postoperative weight losses. Further research should attempt to determine an appropriate recommendation for MWM in respect to duration and frequency, while also considering the quality and content of these clinical visits. / Public Health

The majority of police departments across the United States are led by part-time police leaders who are expected to provide high quality public safety and policing services. Research results have not been conclusive on best practices for community policing in larger cities, and the community policing model has not been researched for small police organizations staffed by part-time police leaders and police officers. The purpose of this qualitative multiple case study was to explore the community policing experiences of 12 part-time police leaders in a northeastern U.S. state. Ecological theory provided the conceptual framework. The research questions examined the participants' experiences of community policing in rural communities. The data analysis strategies included reading the transcripts from the taped interviews, reading the field notes, and writing preliminary memos to form and understand the data. Open coding was used initially to organize the data, which were assigned labels and grouped into themes or categories. Content analysis resulted in the development of broader themes that were analyzed using a cross-case comparison for each. Results suggested that all of the police leaders believed that they provided services to the community and faced many of the same issues as full-time police leaders, despite having fewer resources. This study may help to address the problems that part-time police leaders experience in balancing the allocation of limited resources and the establishment of public policy regarding policing best practices. The study provides police and community leaders with a better understanding of the resources needed to ensure adequate policing and public safety services for their communities.

The behavior of individuals diagnosed with autism spectrum disorder (ASD) can influence caregiver responses that lead to countertherapeutic outcomes. However, there are few experimental evaluations of variables that can cause potentially undesirable interactions between those with ASD and their caregivers. Specifically, little is known about the effects of listener interest on the restricted topics presented by caregivers. We evaluated the influence of listener responses exhibited by a confederate acting as a person with ASD on the topics presented by three undergraduate students who were interested in working with individuals diagnosed with ASD. Each session consisted of a 5-min conversation, during which the participant was instructed to talk about three topics. We compared the duration of topic presentation across phases in which the confederate behaved as an interested listener for one topic or for all three topics. Results showed that topic presentation was controlled by the confederate’s behavior as an interested or uninterested listener. All participants reported that the simulation was believable, acceptable, and useful. These findings have implications for understanding interactions between caregivers and individuals with ASD that might foster restricted interests and for developing corresponding interventions and caregiver-training programs.

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