Behavioral parent training is a common approach to addressing externalizing behavior, which is among the most frequent and costly reasons for children's referral to mental health settings (Kazdin, 1997). Parent training focuses on promoting positive interactions and reducing misbehavior by teaching parents to rearrange the social contingencies for their children's behavior. Systematic research beginning several decades ago showed the promise of this approach (e.g., Budd, Green, & Baer, 1976; Eyberg & Johnson, 1974; Forehand & King, 1977; O'Dell, 1974; Patterson & Reid, 1973; Wahler, Winkle, Peterson, & Morrison, 1965). Reviews (Eyberg, Nelson, & Boggs, 2008) and meta-analyses (Maughan, Christiansen, Jenson, Olympia, & Clark, 2005; Serketich & Dumas, 1996) of several contemporary behavioral parent training models indicate that using parents as therapists is efficacious in treatment of disruptive child behavior. Although 95% of parents report beneficial changes following parent training (Atkeson & Forehand, 1978), the strongest evidence of treatment effects comes from independent observations of parent-child interactions. The meta-analysis by Maughan and colleagues (2005) found that parent-report data indicate more positive outcomes than data collected through independent observers. Maughan et al. speculated this discrepancy may be due to an expectation bias on the part of parents. Patterson and Forgatch (1995) found that changes in parents' interactions with their children, as independently observed after parent training, were better predictors of children's future adjustment than parent or teacher reports. These findings suggest that behavioral parent training is an effective intervention; however, its effects may not be as robust as parent reports would lead us to believe. The current research focuses on one model, Parent-Child Interaction Therapy (PCIT), with strong empirical support in the treatment of 2- to 7-year-old children (Gallagher, 2003; Thomas & Zimmer-Gembeck, 2007). PCIT is a manualized, individual intervention, which draws from attachment, social learning, and developmental theories (Brinkmeyer & Eyberg, 2003; Eyberg & Robinson, 1982). Treatment proceeds in two phases: Child-Directed Interaction (CDI), in which parents learn to provide positive attention while following their child's lead in play, and Parent-Directed Interaction (PDI), in which parents use positively-stated commands and behavior management strategies to enhance compliance. As the parent and child play, the therapist provides immediate feedback and support, typically via a bug-in-the-ear device from behind a one-way observation mirror, to refine the parent's use of target skills. The transition from CDI to PDI and from PDI to termination is dictated by parental skill acquisition and child behavior change, as measured by a set of standardized assessment tools. Studies have demonstrated PCIT's effectiveness both immediately following treatment and at follow-up (e.g., Boggs et al., 2004; Nixon, Sweeney, Erickson, & Touyz, 2004; Schuhmann, Foote, Eyberg, Boggs, & Algina, 1998). The extension of behavior changes from the therapy setting to new situations and circumstances is a universal goal of clinical intervention. Conceptually, the transfer of a response to situations beyond those in which training occurs exemplifies stimulus generalization, often referred to as transfer of training (Kazdin, 2001). Presumably, the positive effects of parent training accrue from parents' transfer or generalization of skills (e.g., positive attention, limit setting, consistent use of behavior management procedures) outside the therapy setting. In 1977, Forehand and Atkeson reviewed research on the generality of treatment effects with parents as therapists across time, settings, behaviors, and siblings. They found that, the more rigorous the method of assessment, the less positive the results had been. …
An empirically supported treatment for children with disruptive behavior disorders, Parent-Child Interaction Therapy (PCIT), has received increased interest from policymakers and mental health administrators regarding its cost-effectiveness (i.e., ratio of treatment costs to behavior gains).This paper examines the projected costs and treatment outcomes associated with implementing and completing PCIT and demonstrates favorable cost-effectiveness ratios.For example, start up costs of PCIT, including equipment and training, were estimated at approximately $14,000 and the average cost of providing PCIT from intake to termination was estimated at approximately $1,000 per client.Benefits include clinically significant improvements on multiple measures of disruptive behavior and strong maintenance data, suggesting the PCIT is an effective and financially viable form of treatment for child disruptive behavior disorders.
For more than thirty years empirical studies have been conducted and published in numerous peer-reviewed journals showing the efficacy of applied behaviour analysis (ABA) in the treatment of autism spectrum disorders. It is not surprising given the years of dedication by many well respected researchers that ABA has more empirical support than any other treatment or therapy for children diagnosed with autism. It incorporates numerous teaching strategies, each of which have an empirical basis demonstrating their effectiveness. (Matson, Benavidez, Compton, Paclawskyj, & Baglio, 1996). Applied Behaviour Analysis is a science-based approach to education. Numerous governmental and private agencies in the U.S.A. have endorsed it as the preferred therapy for children with autism (e.g., Surgeon-General, 1999; Maine Administrators of Service for Children With Disabilities, 2000; New York State Department of Health, 1999). There are hundreds of objective research studies that have shown applied behavior analysis to be an effective method for teaching language and communication, social and leisure skills, and independent functioning, as well as reducing, replacing and eliminating challenging behaviours (Matson et al., 1996.) There are a number of comparison studies that have 'tested' the outcomes of treatment models for children with autism. The first large-scale and most well documented outcome study of ABA as a treatment for autism was published by Lovaas (1987). Out of 19 children given 40 hours of one-on-one treatment for two years, almost half were able to complete a typical first grade class without special supports or accommodations. These nine children achieved IQ scores in the normal range (94-120). They had achieved typical or average functioning both developmentally and educationally. In a follow-up study aimed at investigating the long-term outcomes of these same children, McEachin, Smith, and Lovaas (1993) found that IQ and behavioral gains were maintained over about a ten-year period. Using double blind clinical assessments, eight of the nine children with the best outcomes were indistinguishable from normal controls based both on clinical evaluation as well as standard clinical assessment measures. Results indicated that these children continued to function normally into adolescence (McEachin et. al., 1993). A study conducted by Anderson, Avery, DiPietro, Edwards, and Christian (1987) produced results similar to Lovaas', but did not include a control group. Three additional studies have in part replicated Lovaas' original findings and demonstrated results in significant gains intellectually or in precise skills for participants (Birnbrauer & Leach, 1993; Sheinkopf & Siegel, 1998; Smith, Eikseth, Klevstrand, and Lovaas, 1997). All three of these studies demonstrated IQ improvements and other gains in children receiving ABA, although not to the same degree demonstrated by Lovaas (1987). However, the intensity of treatment differed somewhat from that in the Lovaas study with fewer hours of ABA intervention per week, so it is difficult to draw comparisons. Like Lovaas (1987), Sallows & Graupner (2001) demonstrated that 45% of those receiving ABA treatment in their study (these children were considered to show the best outcomes) achieved average levels of intellectual functioning. While earlier research investigated the different effects of varying the intensity of treatment, more recently, research has focused on comparison of treatment types. For example, recent studies have indicated important outcomes by providing a comparison between the use of an applied behavior analysis approach and 'eclectic' mixtures of procedures. Such studies presented one group of children with an applied behavior analysis program that emphasized the use of empirically supported techniques, such as reinforcement strategies, shaping, prompting, functional communication training etc. …
HISTORICAL CONTEXT AND CURRENT CONCERNS The need for states to regulate the practice of behavior analysis and for behavior analysis in turn to become a recognized applied discipline is a growing issue (see Cautilli & Dziewolska, 2008). While behavior analysis is an independent academic discipline having its own training programs, offering degrees at the master's and doctoral levels, these programs are often not tailored to prepare the graduate for licensure in existing mental and behavioral health professions, such as counseling, marriage and family therapy, or clinical psychology. There are manifold reasons for this. One of the major historical reasons is that the behavioral model of human development originated outside of the field of psychology at the University of Kansas in the Family Life Department located in the department of home economics (Baer, 1993), which placed it outside of psychology and opened its training programs to greater focus on behavioral intervention, while focusing less on other aspects of psychological knowledge. Another historical factor that remains powerfully influential is that behaviorism was and still is viewed as a dead area by many in both academic and clinical psychology. The cognitive revolution in academia (1) (see Robinson-Riegler & Robinson-Riegler, 2003) and the prevalence of psychoanalytic and humanistic models--as well as the incorporation of some New Age ideas--in the clinical realm can be viewed as contributing factors (see Dawes, 1994; Lilienfeld, Lynn, & Lohr, 2003). Indeed, some academic institutions effectively expelled behaviorists from psychology departments (for one battle see Wyatt, 1991). In spite of psychology's relative neglect of behavior analysis, the field of behavior analysis has made significant contributions to many areas of human treatment, including neurological rehabilitation (Wood, 1987), developmental disorders such as autism (Mental Health: A Report of the Surgeon General, 1999), and behavioral elements of psychiatric disorders (Salzinger, 1998). A burgeoning area of interest in which applied behavior analysis has shown success is crime reduction, which places behavior analysis as a sought after service in the now growing field of community re-entry. Overall, behavioral programs based on the operant and respondent conditioning procedures of behavior analysis have been shown to lead to a 13-20% reduction in criminal recidivism (Redondo-Illescas, Sanchez-Meca, & Garrido-Genoves, 2001). While this is modest by intervention standards in other areas, these numbers taken across the entire prison population represent a substantial reduction in criminal activity and a substantial reduction in the pain brought by crime to victims and their family members, as well as the family members of offenders. Studies have shown that behavior modification/analysis procedures can reduce criminal activity of those with ADHD by as much as 50% (see Satterfield & Schell, 1997; Satterfield, Satterfield, & Schell, 1987). In addition, parenting models based on operant conditioning procedures have been shown consistently to reduce conduct disorders in children and adolescents, prevent delinquency, and have sustained long term effects (Cautilli & Tillman, 2004; McMahon & Wells, 1998). With sex offenders, behavioral programs are a promising practice for reducing socially inappropriate sexual desires and behavior (Marshall, Jones, Ward, Johnston, & Barbaree, 1991). It is our belief that in a free market society the public should have access to choose this type of professional--yet current insurance laws block such access. These laws suggest that only licensed professionals can receive reimbursement in essence locking behavior analysts out of this market. Since behavior analysis is not yet a licensed profession, ready access to these effective interventions may be limited. Given the historical context mentioned above, most programs in clinical psychology or counseling do not provide more than a cursory glance at the theory, techniques, or clinical evidence that undergird applied behaviorism (Dorsey & Mikolsky, in preparation). …
Parents of young infants are faced with a number of adjustments and challenges. In particular, during the first few weeks or months following birth, infants require feeding at regular intervals throughout the day and night. Infants signal their need to be fed by crying, and thus the nighttime of parents is frequently disrupted by the cry signal and the need to awaken to feed the infant, change the infant's diaper, and soothe the infant back to sleep. Most parents know to expect these interruptions to their during early infancy, and many mothers and some fathers are able to devote full time to the many demands of caring for a young infant by foregoing employment or taking maternity or paternity leave from their jobs. By 3-4 months, however, most infants no longer physiologically require feedings, and most infants have adapted to a daily rhythm in which they more at than during the day. Although essentially all infants continue to awaken at at 3 months, about half of them are able to return to without signaling and without parental intervention (Karraker & Cottrell, 2000). The other half signal to their parents when they awaken, and often require feeding, rocking, and other parental assistance to return to sleep. These signaled awakenings continue throughout the first year and beyond for a significant proportion of infants, and some infants who begin to sleep through the (meaning that they do not signal to their parents following an awakening) at some point in early infancy return to a pattern of signaled waking around 9 months. These signaled waking behaviors (henceforth referred to simply as night waking) beyond the first few months of infancy are the focus of the present discussion. They are of concern to parents and practitioners primarily because of their impact on parents. Parents whose is frequently shortened and fragmented experience substantial deprivation, which can cause daytime fatigue, irritability, motor and cognitive deficits, impaired decision making, and lack of motivation (Dement, 1999; Pilcher & Huffcutt, 1996). It has been estimated that parents of infants lose an average of 2 hours of per from birth to 5 months, and 1 hour of per from 6 to 24 months (Dement, 1999). Sadeh and Anders (1993) also report that infant difficulties are the most common concern parents report to pediatricians at well-baby visits. The present paper addresses what is known about infants' waking, with a focus on the role of environmental causes and correlates of individual differences in this behavior. To provide context, the discussion begins with a review of the normative developmental course of infant waking, followed by a description of the effects of deprivation on adults. Then, factors associated with individual differences in the frequency of waking are described. Both intrinsic factors (characteristics of infants) and extrinsic factors (parent behaviors, family environment, etc.) are addressed. Then, the types of interventions commonly used to reduce infant waking are summarized. Finally, a behavioral and developmental model of the causes and effects of infant waking is described and illustrated. Normative Developmental Changes in Night Waking During Infancy Information about infant behavior is based primarily on maternal reports, video recordings, and actigraph recordings. An actigraph is a wristwatch-like device that is typically attached to the infant's leg and that records movements for later analysis. Hayes (2002) discussed the relative value of these different methods. Although video and actigraph recordings are more objective and detailed than maternal reports, they can be costly, intrusive, and difficult to use. Further, the sole use of actigraph recordings makes it difficult to discriminate signaled and unsignaled waking events. …
The past two decades have seen a rise in use of term practice' and a simultaneous increase in variations in its definition and evaluation. Some of variability may be attributed to differing, but related, conceptualizations of what constitutes an evidence-based practice across disciplines. Review of literature reveals that a wide variety of professions and professional organizations are wrestling with this topic area. Such disciplines include, but are not limited to, medicine, clinical psychology, school psychology, counseling, behavior analysis, education, and nursing (Kazdin, 2006). Using our backgrounds as an example, it is clear that we--like many of readers of Journal of Early Intensive Behavior Intervention--have training and experience that involves numerous disciplines. Specifically, we both received training in experimental psychology before entering a school psychology doctoral program where we were intertwined in both regular and special education. We were fortunate to receive additional training in a clinical psychology internship and have worked in early intervention settings, school-aged programs, and with adults receiving residential services. In addition, we are also Board Certified Behavior Analysts. Thus, for demonstration purposes, we focused our attention to our governing organizations for insight and clarification regarding evidence-based practices. The National Association of School Psychologists' (NASP) Professional Conduct Manual states that school psychologists are expected to engage in services which are delivered following completion of a strategic planning process based on needs of consumers and an empirically supported program evaluation model (NASP, 2000, pg. 51). Moreover, federal regulations now mandate use of based in selection and design of instructional strategies (Individuals with Disabilities Education Improvement Act of 2004; No Child Left Behind Act of 2001). The American Psychological Association (APA) Presidential Task Force on Evidence-Based Practice--which evolved from an APA Division 12 (Clinical Psychology) Task Force--defines evidence-based practice in its position paper as the integration of best available research with clinical expertise in context of patient characteristics, culture, and preferences (APA, 2006, p. 273). Finally, as Board Certified Behavior Analysts, we operate under Behavior Analyst Certification Board Guidelines for Responsible Conduct for Behavior Analysts which explicitly states that a behavior analyst responsibility to recommend scientifically supported most effective treatment procedures. Effective treatment procedures have been validated as having both long-term and short-term benefits to clients and society (BACB, 2004, Section 2.09a). Although these guidelines may imply a united front across disciplines with regards to an interest in utilizing treatments that work, implementation is a challenge since these terms are too vague to actually prescribe criteria to one's practice. Within broader scope of psychology and education, various other groups are attempting to delineate evidence-based practices further. For instance, both Divisions 17 (Society of Counseling Psychology) and 29 (Psychotherapy) of APA have established task forces to arrive at standards of evidence-based practice (APA, 2006). The Society for Behavioral Medicine has also established similar criteria (Davidson, Trudeau, Ockene, Orleans, & Kaplan, 2003). In addition, Council for Exceptional Children (CEC) called upon its Professional Standards & Practice Committee, as well as its Division for Research, to make proposals for evidence-based practice criteria (CEC, 2006). Finally, Association for Behavior Analysis International recently launched Evidence-Based Practices Special Interest Group (EBP SIG) aimed at translating behavioral research to practice in an effort to provide evidence-based practices to general public. …
Although there has been a corresponding explosion of literature regarding the treatment of the social deficits in autism, the establishment of more complex social behaviors still remains a challenge. Video modeling appears as one approach to have the potential to successfully address this challenge. Following an introduction to modeling that constitutes the basis of this procedure, the current paper explores those video modeling studies that have targeted the promotion of complex social skills. It is suggested that this approach could be an effective addition to peer-mediated treatment procedures, especially for children with autism who cannot always be in environments where peers are present. Further, the likely success of video modeling seems to be dependent upon the prior elimination of behaviors that interfere with the development of imitation skills.
What and students do can be understood. By analyzing the classroom, can make themselves more organized and more responsible so that they can encounter fewer disappointments (Heward & Wood, 2003). This available method by which the environment can be analyzed to understand behavior is called Applied Behavior Analysis (ABA). ABA is a scientific approach for discovering environmental variables that reliably influence socially significant behaviors and developing technology of behavior change that takes practical advantage of those discoveries (Cooper, Heron, & Heward, 2007). Practitioners of ABA are guided by five documents regarding ethical behavior: Ethical Principles of Psychologists and Code of Conduct (American Psychological Association, 2002), The Right to Effective Behavioral Treatment (Association for Behavior Analysis, 1989), The Right to Effective Education (Association for Behavior Analysis, 1990), Guidelines for Responsible Conduct for Behavior Analysts (Behavior Analyst Certification Board, 2001), and the Behavior AnalystTask List (Behavior Analyst Certification Board, 2005). Referring to these documents for guidance, behavior analysts can best answer three questions related to their service (Cooper et al., 2007): What is the right thing to do, what is worth doing, and what does it mean to be a good practitioner? By adhering to these guidelines, practitioners will have a ready source of reliable, accurate, and valid data to inform educational decision making. The methods of ABA have successfully served the public in a wide variety of areas. These areas include education (Dardig et al., 2005), health and exercise (De Luca & Holborn, 1992), language acquisition (Barbera & Kubina, 2005), AIDS prevention (DeVries, Burnette, & Redmon, 1991), and parenting (Kuhn, Lerman, & Vorndran, 2003). Several successful and popular methods using ABA principles in the classroom are Direct Instruction (Adams & Englemann, 1997; Englemann & Carnine, 1991), school-wide positive behavioral support (Tobin, Lewis-Palmer, & Sugai, 2001), curriculum based measurement, and curriculum matching (Hale et al., 2007). While treatment for autism is currently a popular area of research (Borrero & Borrero, 2008; Jerome, Frantino, & Sturmey, 2007), ABA methods have been established as effective for reducing target behaviors displayed by individuals with disabilities as well as non-disabled individuals (Didden, Duker, & Korzilius, 1997; Weisz, Weiss, Han, Granger, & Morton, 1995). Despite over 40 years of data supporting the effectiveness of behavior analytic methods, misconceptions and opposition remain. Opponents of ABA often attack the use of sequenced, structured instruction as compromising the intellectual development of the learner (Kim & Axelrod, 2005). Contrasting existing views in education and psychology, ABA seeks to identify present environmental contingencies that determine behavior rather than conform to mentalistic explanations of behavior. Further opposition to ABA claims that its methods are insensitive to the interests and needs of the learner. In putting the resistance to using ABA methods in schools in a nutshell, Glass (1993) may have said it best, teachers do not need data-based findings of experiments to decide how best to teach children. This popular resistance to the scientific method has been a significant barrier to the dissemination of ABA teaching techniques. That ABA has the documented empirical ability to address behaviors affecting education is now exceptionally relevant. The field has the means to assist schools in the development of effective assessment and intervention procedures (Kates-McElrath, Agnew, Axelrod, & Bloh, 2007). Recent federal legislation now mandates that schools use behavioral methods that have been employed in ABA since its inception. …
There is something so universal about saying goodbye: Universal and sad. The minute after I uttered the words that I was leaving Journal of Early and Intensive Behavioral Intervention (JEIBI) at the last meeting of the Behavior Analyst Online Governing board Meeting in 2007, so that I could free up time for the two new journal assignments the words seemed to echo with me. For the rest of the meeting, much of my energy went into maintaining the appearance that this was an easy decision for me. It was not and the words stayed several days. My thoughts traveled back to a time when Craig Thomas was first proposing the journal. I actually opposed the initial proposal. Craig spent several persistent conversations talking me into it. We had the Behavior Analyst Today at that point, were their really enough articles to start a new journal? I spent almost a year gathering the editorial team and convincing authors to take a risk and send us their articles. I assured them that since the Behavior Analyst Today was a success this journal would be too and thus JEIBI was borne. At the time, we were concerned that the journal would become very limited in scope- early intervention for children with autism. These concerns were not unique to us and others have since echoed similar concerns about the field of behavior analysis. The three that most influence the development of Journal of Early and Intensive Behavioral Intervention were (1) Loss of mission for the field of behavior analysis (2) the field had become withdrawn and isolated (Critchfield, 2002) and (3) and timid in its application focusing mostly on the use of contingency management procedures and ignoring recent developments in the basic literature such as focus on the matching law, research on momentum, relational frames, and (O'Donohue & Fryling, 2007). One of the major concerns was loss of mission, simply stated was that behavior analysis was becoming a subfield of developmental disabilities (Hayes, 2001). With the above concerns, we began to invite authors for the first issue and if truth were known we caught a lucky break. The first few issues of a journal are often considered the defining issues. Readers look at those issues and decide if their work is suitable for the journal. Many of the early invites for people in developmental disabilities were returned as not having the time. This allowed our first issue to be focused mainly on a diverse array of issues including two excellent articles on typical children. So the first issue helped us define ourselves broadly and we were luck in avoiding most of the three criticisms about the field of behavior analysis as a whole. …
The ADA Undergoes Some Critical Fine-Tuning: Amendments effective in January 2009 Should Correct the Too-Narrow Interpretations the Courts I. The ADA's original purposes: The Americans With Disabilities Act (the ADA), enacted by Congress in 1990, was greeted with great celebration by persons with disabilities, their families and advocates. The idea was broadminded and straightforward: Congress intended that the ADA protect those with disabilities (including those who were simply perceived as having a disability) against discrimination because their disabilities in access to jobs, education, commerce, entertainment and other benefits public life. If a person was otherwise able to engage in the in question--with the help whatever reasonable accommodations were necessary--s/he could not legally be prevented from participating because his or her or perceived disability. Under a key provision the ADA, a person was deemed to be entitled to protection under the Act if s/he had a disability--an impairment that limits a life activity. II. Restrictive Interpretations by the Courts: Unfortunately, the initial celebration over the ADA's passage turned to disappointment and frustration in many quarters as courts began to interpret and apply its provisions as narrowly as possible. Courts needed to interpret the ADA's provisions defining what a covered disability is; the extent to which a disability must interfere with one's life to warrant protection; the definition life for these purposes, and so on. One by one, the courts' pronouncements reduced the scope protection afforded under the ADA and the categories people who could seek that protection. This judicial narrowing came to a head in two Supreme Court cases. In Sutton v. United Air Lines, Inc., 527 U.S. 471 (1999), the Court held that mitigating measures--such as medications or medical devices that ease the effects an impairment--must be taken into account in determining whether a person is limited in a major life activity. Under this interpretation, even if a person suffers discrimination because s/he has an impairment, the court would treat him or her as outside the ADA's protection because medications or other mitigating measures enable the person to function well despite the impairment. In another case, Toyota Motor Mfg. Kentucky v. Williams, 534 U.S. 184 (2002), the Supreme Court considered what a life activity is and narrowed that concept to include only those activities that are of central importance to most people's daily lives. Some federal courts have effectively required that more than one life activity be affected by an impairment before a person falls within the ADA's protection. (See, e.g., Stein v. Ashcroft, 284 F.3d 721 (7th Cir. 2002) where the court found that an inability to lift and to carry objects did not constitute a because those impaired activities were only part the tasks required by the person's employment and did not, therefore, impair the major life working.) Others have said that impairments whose effects are only episodic or intermittent, such as epilepsy or a peanut allergy, do not fall under the ADA because their effects are only temporary. (See, e.g., Land v. Baptist Medical Center, 164 F.3d 423 (8th Cir. 1999), finding that a child's peanut allergy did not substantially limit major life activities eating or breathing because the child's physical ability to eat was not restricted and his ability to breathe was unrestricted when he was not experiencing an allergic reaction). III. The ADA Amendments 2008: This year Congress rejected the courts' narrowing the ADA's scope protection and amended the Act to correct what it considered to be misinterpretations. …
The most recent report published by the Centers for Disease Control (CDC) note the prevalence of autism to be approximately 1 out of every 150 live births with a male to female ratio of 4 to 1 (CDC, 2007). Autism is a heterogeneous neurodevelopmental disorder characterized by a wide array of symptoms but with some commonalities (Volkmar & Klin, 2005). Symptoms are primarily noted in three domains; specifically impairments in social interaction and communication, and engagement in repetitive behaviors. Social interaction impairments may include the failure to develop appropriate peer relationships, lack of desire to share social enjoyments or interests, or lack of social reciprocity. Impairments in communication may include a delay in the development of spoken language, the ability to initiate or continue a conversation, stereotyped or repetitive use of language, or lack of spontaneous pretend play or social imitative play. Finally, those with autism may also engage in repetitive and stereotyped behavior such as abnormal preoccupation with one or more patterns of interest, the need for strict routines, preoccupation with parts of objects, repetitive motor mannerisms, and self-injurious behavior. Self-injurious behavior (SIB) is any harmful behavior that an individual inflicts upon himself/herself and is usually considered to be the most pressing issue facing individuals with developmental disorders or mental retardation, including autism (Barrera, Violo, & Graver, 2007; Dawson, Matson, & Cherry, 1998; Murphy, Hall, Oliver & Kissi-Debra, 1999; Newell, Sprague, Pain, Deutsch, & Meinhold, 1999). About 5 to 16 percent of individuals with mental retardation exhibit SIB (Richman & Lindauer, 2005) with the severity of the SIB correlated with the severity of the delay (Baghdadli, Pascal, Grisi & Aussilloux, 2003). The etiology of autism and SIB are still being researched and debated. To date, there have been many candidate genes identified (e.g., SERT, MAOA, FOXP2) as potential causes of autism (Wassink, Brzustowicz, Bartlett, & Szatmari, 2004). Given the multitude of genes and the diversity of phenotypic expression, there is suggestion that the underlying cause of autism may vary across children. Similarly there are multiple behavioral and biological correlates that influence the onset of SIB. This paper specifically addresses the treatment of SIB focusing on behavioral and pharmacological methods. Within each of these methods there is a wide array of options that will be assessed. By reviewing all of these options we hope to provide an awareness of the treatment options available and provide a prompt for further research on effective treatments for SIB in individuals with autism. Treatment of Self-injury in Autism It is difficult to find one comprehensive course of treatment for autism as it is generally considered to be a heterogeneous disorder. Attempting to find comprehensive treatment for SIB is equally challenging as there may be multiple variables maintaining SIB--environmental and/or physiological Since is it hypothesized that in some cases, SIB may be the result of many interacting effects of genetics, biochemistry, and environment, understanding the behavioral and biological function of SIB may aid in the development of a treatment regimen, especially in those cases where SIB is treatment resistant, a common feature of SIB (Sandman, 1988). Behavioral Treatment of Self-injurious Behavior The foremost approach for the treatment of SIB in individuals with autism is behaviorally based. Research has demonstrated that for many individuals SIB is socially mediated warranting environmental modifications (Iwata, Pace, et al., 1994). Determining the function of SIB and selecting treatments based on these functions is paramount for successful treatment. Functional assessments allow for the identification of the relations between SIB and relevant antecedents and consequences on an individual basis (Iwata, Dorsey, Slifer, Bauman, & Richman 1982/1994; Iwata et al. …
Recently, early childhood educators and policy makers have placed an increased emphasis on assessing emotional development in young children who are considered educationally at-risk. (Department of Health and Human Services Administration on Children, Youth, and Families/Head Start Bureau, 2000). The desire to assess emotional development is not surprising given that children's skill in understanding others' emotions appears closely tied to their ability to establish and maintain positive social relationships with others in the school years and throughout life. Specifically, researchers have found that young children who have better developed emotion recognition and emotional perspective-taking abilities demonstrate higher levels of prosocial behavior and are more popular with their peers (Denham, 1986; Denham, McKinley, Couchoud, & Holt, 1990; Leppanen & Hietanen, 2001). Other research has linked emotion recognition and understanding with high levels of pretend play and behavioral and emotional competence with peers (Carlo, Knight, Eisenberg, & Rotenberg, 1991; Lindsey & Colwell, 2003). In contrast, children who are poor at emotion recognition and emotional perspective-taking are at increased risk of being disliked by their peers (Denham et al.; Leppanen & Hietanen, 2001), are rated by teachers as being more socially withdrawn (Strand, Cerna, & Downs, in press), and are at risk for the numerous negative educational and psychosocial outcomes long known to be associated with peer rejection (Asher & Wheeler, 1985; Asher & Coie, 1990; Ladd, 1990). Although results such as these have suggested that emotion understanding in general, and emotion recognition in particular, are important developmental variables, there is limited information available regarding the effectiveness of attempts to manipulate emotion recognition skill in individuals who have disabilities. Research with adults has generally indicated that interventions can successfully improve the emotion recognition ability of those who have learning disabilities, (McKenzie, Matheson, McKaskie, Hamilton, & Murray, 2000), intellectual disabilities (McAlpine, Singh, Ellis, & Kendall, 1992; Rydin-Owen, Drake, & Bratt, 1999), high-functioning autism (Bolte, Hubl, Feineis-Matthews, Dierks, & Poutska, 2006), or acquired brain injury (Guercio, Podolska-Schroeder, & Rehfeldt, 2004). However, studies focused on children have been less consistent. For example, Dyck and Denver (2003) reported no improvements in emotion recognition skill for deaf children exposed to an 11-lesson psychoeducational program. In contrast, Stewart and Singh (1995) found that teaching via directed rehearsal led to significant gains in basic emotion recognition skill in a study of boys with mental retardation. Emotion recognition has long been thought to be impaired in children with autism spectrum disorders (ASD; Hobson, Ouston, & Lee, 1989), so it is not surprising that some researchers have examined the effectiveness of emotion recognition training with this population. As has been the case in children with other disabilities, the results have been equivocal. Using a computer training program, LaCava, Golan, Baron-Cohen, and Myles (2007) found significant gains in emotion recognition skill in children with ASD. However, Silver and Oakes (2001) reported that computer training did not lead to significant emotion recognition gains in adolescents with ASD compared to controls. Other research has shown that children with autism exposed to behavioral interventions may develop advanced emotion understanding abilities (e.g., the understanding of desire-based emotions in others) but may still have difficulties with basic emotion recognition (Downs & Smith, 2004). It is interesting to note that none of the studies cited above attempted to teach emotion recognition skills to preschoolers, even though the developmental literature suggests that the preschool years are typically a time of significant growth in this ability (Denham, 1998). …
Humans can learn in one of two ways; through direct instruction, or through the observation of others (Greer, Singer-Dudek, & Gautreaux, 2006). Observational learning is the process in which an individual learns a new response/environment relation (one that was not previously in his repertoire) as a result of the observation of another individual receiving contact with the contingencies of reinforcement, punishment, and corrections of incorrect responses (Catania, 2007; Gautreaux, 2005). Greer et al. (2006) state that there are three different functions of observational learning, including 1) the emission of previously acquired operants, 2) the acquisition of new operants through observation, and 3) the acquisition of conditioned reinforcers through observation. Although observational effects on learning new operants has a growing literature (Brody, Lahey, & Combs, 1979; Egel, Richman, & Koegel, 1981; Griffen, Wolery, & Schuster, 1992; Goldstein & Mousetis, 1989; Greer, et. al, 2006; McDonald, Dixon, & Leblanc, 1986; Werts, Caldwell, & Wolery, 1996) and the effects of observation on performance has been studied extensively (Bandura, 1986; Bandura, Adams, & Beyer, 1977; Kazdin, 1973; Ollendick, Dailey, & Shapiro, 1983), the acquisition of conditioned reinforcers through observation appears to be a new type of observational learning that has only very recently been identified (Greer & Singer-Dudek, 2008; Greer, Singer-Dudek, Delgado, & Oblak, 2007; Greer, Singer-Dudek, Longano, & Zrinzo, in press; O'Rourke, 2006). This new type of learning, identified as the acquisition of conditioned reinforcers by observation, can be defined as the acquisition of reinforcing properties of previously neutral stimuli as a function of observation (Greer et al., 2006; Greer & Singer-Dudek, 2008). Conditioned reinforcement, which typically results from the stimulus-stimulus pairings of unconditioned or conditioned reinforcers with initially neutral stimuli that lead to the acquisition of reinforcing properties for the previously neutral stimuli (Catania, 2007; Donahoe & Palmer, 2004; Dinsmoor, 2004; Kelleher & Gollub, 1962) has been identified in the literature as important for increasing students' communities of reinforcers while decreasing stereotypy (Greer, Becker, Saxe, & Mirabella, 1985; Nuzzolo-Gomez, Leonard, Ortiz, Rivera, & Greer, 2002) and increasing the rate of learning for textual responding (Tsai & Greer, 2006). However, stimulus-stimulus pairings can often be time consuming and, even then, are not always effective in conditioning new stimuli as reinforcers. The use of peers has often been employed in conditioning new reinforcers for getting children to try new foods (Greer, McCorkle, & Sales, 1998; Greer & Sales, 1997) and inducing swallowing (Greer, Dorow, Williams, McCorkle, & Asnes, 1991). Greer and Singer-Dudek (2008) reported an observational procedure that was effective in converting small plastic discs for five participants or pieces of string for one participant from non-reinforcers to reinforcers for both learning and performance tasks. The present study was conducted in order to determine whether the results of this observational procedure (Greer & Singer-Dudek, 2008) would replicate when the neutral stimuli used were strings, since there was only one participant in the Greer and Singer-Dudek study for whom strings were used. Could small pieces of string, which hold neither inherent value nor generalized reinforcement application, be conditioned as reinforcers using this procedure with other participants? In other words, would the results replicate? If so, what would that mean for developing stimuli that require no back up reinforcement or satiation potential for educational applications? Specifically, we wanted to further examine the role of the experimenter in the present study. …
A World Health Organization report (e.g., Richter, 2004) on importance of caregiver-child relationships as a context for growth and development of young children throughout world noted that: Sensitive and responsive caregiving is a requirement for healthy neurophysiological, physical and psychological development of a child. Sensitivity and responsiveness have been identified as key features of caregiving behavior related to later positive health and development outcomes in young children. (p. 1) One of developmental consequences of sensitive and responsive caregiving is secure infant/adult attachment (Bowlby, 1988). Secure attachment is generally understood to be an affectional bond between an infant and an adult caregiver (1) that has two elements: (1) infant seeking out attachment figure in times of distress and need and (2) infant having ability and confidence to engage in activities separate from attachment figure (Ainsworth, 1989). The development of attachment relationship is recognized as one of most important aspects of human social and emotional development (e.g., Lamb, Ketterlinus, & Fracasso, 1992). This is case, in part, because secure attachment has been found to be related to enhanced cognitive, social, and emotional development throughout childhood and early adolescence (Bukatko & Daehler, 2001; Fagot & Kavanagh, 1993; Hazen & Durrett, 1982; Matas, Arend, & Sroufe, 1978; Sroufe, Egeland, & Kreutzer, 1990). Many theories as well as variations of theories have been posited for explaining sources and consequences of secure infant attachment (see e.g., Cassidy & Shaver, 1999; Egeland & Erickson, 1993). John Bowlby (1969) is credited with original formulation of attachment theory, and Mary Ainsworth (Ainsworth & Wittig, 1969) is credited with highlighting importance of caregiver sensitivity as a determinant of secure attachment. Gewirtz and his colleagues proposed a behavioral, or operant learning analysis, perspective of secure infant attachment that considers caregiver sensitivity and responsiveness as having reinforcement properties and infants' responses to caregivers' behavior as having differential consequences on caregivers' reactions (e.g., Gewirtz, 1972a, 1991; Gewirtz & Boyd, 1977; Gewirtz & Pelaez-Nogueras, 1991). According to Gewirtz, attachment is parsimoniously explained by fact that child behavior is cued and reinforced by caregiver responses and may have either positive or negative effects on child behavior that in turn is directed toward caregiver (e.g., type of attachment). In Gewirtz's (1991) own words, the dyadic functional relations between cue and reinforcing stimuli from attachment figure/object person and child's responses they control that connote attachment of child to attachment figure may occur in any segment of life from infancy onward (p. 250). The purposes of this article are to summarize findings from: (a) two practice-based research syntheses of relationships between caregiver sensitivity and secure infant attachment (Kassow & Dunst, 2004, 2005) and (b) one practice-based research synthesis of interventions for strengthening caregiver sensitivity to child behavior (Dunst & Kassow, 2004). A practice-based research synthesis involves review and integration of research evidence where focus of investigation is same or similar environmental (intervention) characteristics and how variations in characteristics are related to variations in consequences of different events or experiences. These kinds of research syntheses differ from more traditional research reviews and syntheses by disentangling and unpacking what matters most in terms of explaining relationship(s) between different environmental experiences and their consequences (Dunst, 2007; Dunst, Trivette, & Cutspec, 2002). …
A primary task of schools is to teach young children to read. Teaching reading is a complex task, further complicated by the fact that this intricate skill is more difficult for some participants to learn than others (Bursuck & Damar, 2007; Moats, 2000). In addition, children enter schools with varying levels of pre-reading skills, thus requiring different levels of instruction. The challenge for teachers of reading is to meet the diverse instructional needs of all children in their classrooms. Once children fall behind in reading, a challenging instructional task becomes even more difficult. Children who are behind in reading at the end of the first grade usually continue to be behind at the fourth grade and throughout their schooling (Francis, Shaywitz, Stuebing, Fletcher, & Shaywitz, 1996; Hall & Moats, 1999; Juel, 1988; McGuinness, 2004, 2005; Stanovich & Siegel, 1994). Consequences for participants who do not learn to read proficiently are often dire. Children who are poor readers are at increased risk for having behavior problems (Walker, Colvin, & Ramsey, 1995; Walker & Severson, 2002), special education placement (Snow, Burns, & Griffin, 1998), and low paying jobs as adults (Chhabra & McCardle, 2004). On the other hand, proficient reading remains the most essential skill required for academic success (Chhabra & McCardle, 2004). The ability to identify those children who need extra assistance can allow teachers to target their instruction to benefit all children. The last decade has seen an intensive effort to identify participants that are at risk or high risk for reading failure and to intervene before they experience failure (Kame'enui et al., 2006). For example, the Dynamic Indicators of Basic Early Literacy Skills (DIBELS) (Good, Kaminski, Smith, & Laimon, 2001) has proven to be an effective assessment and predictive tool for early reading success/failure. The DIBELS is an assessment tool that allows teachers to determine if a participant is demonstrating the appropriate level of pre-reading and reading skills for his or her grade level and age. In other words, it answers the question of whether the participant is on target (at benchmark) in prerequisite skills to be a proficient reader at the end of third grade. If the participant is on target then the current instruction should be continued. However, if the participant is not on target that participant should receive additional explicit instruction with the intensity of the intervention based on the degree to which the participant is below benchmark standards. Unfortunately, many teachers do not know what to do with the results of the DIBELS assessment, particularly how to modify instruction or provide more intensive instruction in problem areas. Curriculum-based measures (CBM) are an assessment tool that can be used to supplement DIBELS. CBMs are generally probes of particular performances on skills related to the on-going classroom instruction. We discuss one effective modification for teaching kindergarten children letter/sound relationships using the DIBELS and CBMs as the dependent variables. Important indicators of future reading difficulties in young children are deficits in phonemic awareness skills (Ehri, 2004; McGuinness, 2004, 2005). That is, young children who are at risk for reading failure have difficulty discriminating between the sounds in English words and consequently they have difficulty associating the sounds with the appropriate letters. Letter sound relations require a child to perceive individual sounds and associate the sounds with letters. This two-fold task encompasses both phonemic awareness and beginning phonics instruction, crucial prerequisites for mastering the alphabetic code. Bowey and Francis (1991) found that kindergarten participants who were nonreaders did not have adequate phonological awareness skills. …
As organisms living in a complex environment we are affected by multiple stimuli from moment-to-moment. As a result we have developed a singularly efficient method of selecting and attending to stimuli so that we can affect some kind of control over the environment in which we live. For some of us, is the foundation of our entire system of scientific inquiry (Haury, 2002). For most of us, connects the physical world, the sensory information we receive from it, and the uniting of those discriminations as we interpret that information. Observing responses are operant responses that are selected out by their consequences. These responses can be measured in terms of their sensory modalities. When a child looks at a person calling his name, listens to someone giving a direction, tastes foods, smells a flower, or touches items across a variety of textures, the child is responding as an observer of the environment. The various stimuli that reinforce those responses provide a conditioning process for (Keohane, Delgado & Greer, in press). Importantly, responses and the reinforcers that support them are basic to the emergence of increasingly more complex behaviors (Donahoe & Palmer, 2004; Greer & Ross, 2008). As part of our search for more effective ways to provide instruction to children with disabilities so that they would have increased access to the social community, we became increasingly aware of the role of responses and their controlling stimuli. Observing has been a topic of interest to many fields of inquiry. Psychology in particular has attempted to understand behavior. Over time, psychology has branched into a myriad of sub disciplines, each providing explanations of a variety of interests from divergent perspectives. With the specialization of sub disciplines, individuals have found it necessary to define the terms they use to talk about phenomena. How we define terms has far reaching effects for their application in research. As each sub discipline separated from the others, they often distinguished themselves by insisting on their own definitions and terms. Behaviorism did just that. Skinner proposed distinct vocabulary for use in talking about language and differentiated it from the terminology used by other types of psychologists (Skinner, 1957). From a behavioral perspective, language and the study of language, has been greatly influenced by Skinner's proposition of a functional account of language. Observing is a critical element of language function and is treated in Skinner's account of language. Skinner referred to observing and suggested that there may be some automatically reinforcing properties of behavior, when it functions to intensify or bring into focus the stimulus discriminative (p. 416). Donahoe and Palmer (2004) defined responses as: acquired environment-behavior relations whose primary function is to affect the sensing of stimuli (p. 156). Essentially, our ability to have salient environmental stimuli select our responses is adaptive and provides us with the controls of what we experience in our world. We believe that responses represent the first instances of the joining of the listener and speaker repertoires, as defined by Skinner. As such, the joining provides an intersection of what are at first two distinct repertoires. We argue that joint control provides the first evidence of truly complex operant responding, particularly as it relates to the development of language. Observing appears to be critical to the foundation of the acquisition of language (Greer & Keohane, 2005; Keohane, Pereira Delgado, & Greer, in press) and as such, represents a valuable focus for research and inquiry. Conceptually, responses, as we have defined them, can be compared to establishing operations or, perhaps even more so, to a setting factor in the physical sense (Bijou, 1996). …
Families are a critical source of support for children with disabilities. Family members absorb the added demands on time, emotional resources, and financial resources (Baker-Ericzen, Brookman-Frazee, & Stahmer, 2005) that are associated with having a child with a disability. Yet, rewards from having a family member with a disability, such as personal and spiritual growth, have also been noted (Scorgie & Sobsey, 2002). The literature on disability in early childhood encompasses studies of a broad array of diagnoses. While a few diagnosis-specific differences exist, Stein and Jessop (1989) found that caregivers of children with all chronic conditions experience similar impacts, concerns, and needs for support. Thus, this paper will examine family impacts and approaches to intervention across a broad range of disabilities and developmental delays building on the assumption that these diagnoses affect families in similar ways. An extensive amount of research has been conducted on the impact of childhood disability on parents, particularly mothers. The findings of this research have important implications for practitioners who are working with young children and will be discussed below. While parents are the most common type of caregivers for young children with disabilities, there are a growing number of grandparents who are providing custodial care. The literature on custodial grand parenting is not as extensive, yet this population has some unique needs and it is important for practitioners to be aware of these. In addition, there is a growing recognition that families who care for children with disabilities differ cross-culturally. As our society is becoming increasingly diverse, it is important for practitioners to be aware that culture impacts the ways in which families perceive childhood disability. Although much has been written on issues affecting family caregivers, we know of no other paper that has attempted to synthesize this literature and speak to the implications for clinicians working in early intervention. This paper begins with a review of the literature on parents; proceeds to a discussion of issues affecting custodial grandparents; gives special emphasis to the ways in which families differ across culture; and finally, discusses the emerging ideas in intervention that are relevant for these varied types of family caregivers. PARENTS The view that having a child with an intellectual or developmental disability creates negative family outcomes including added stress and parental depression has underpinned much of the research of the past three decades (see Baxter, Cummins, & Yiolitis, 2000; Hayden & Goldman, 1996 for a review). Yet, research on this subject has suggested varying outcomes for families. In support of the view that disability leads to negative outcomes, a couple of comparative studies have noted greater stress in parents of children with disabilities than parents of children without disabilities (Baker-Ericzen, Brookman-Frazee, & Stahmer, 2005; Dyson, 1997). Likewise, two studies, focusing specifically on mothers, have found that mothers of children with mental retardation experience more depression than those of typically developing children when compared using the Beck Depression Inventory (Olsson & Hwang, 2001) and the Center for Epidemiologic Studies Depression Scales (Blacher, Shapiro, & Fusco, 1997). Although these studies suggest a relationship between childhood disability and parent stress or depression, it is important to note that they did not control for variations related to the diagnosis or care demands associated with the disability. When the parental experience has been examined across diagnoses, some differences have been noted. Parents of children with Down syndrome have been found to experience less stress (Ricci & Hodapp, 2003), depression (Abbeduto, Seltzer, Shattuck, Krauss, Orsmond, & Murphy, 2004), and pessimism (Lewis, Abbeduto, Murphy, Richmond, Giles, Bruno, et. …
