This research assessed whether an artificial intelligence (AI) program could support autistic adolescents and adults with question asking, and whether these gains would generalize to human conversation. Participants were asked to use the online AI program on weekdays for 20 trials per day, where they responded to each leading statement with a question, then received AI-written feedback. The results show that all participants, who used few to no questions at pre-intervention, improved their question asking following intervention. Importantly, all participants generalized their gains to appropriate question asking during human conversation, and these gains maintained over time. Regarding social validation, participants reported improved confidence levels during conversation following the program, and most reported being positive and satisfied with the program. Overall, this study supports AI-aided intervention as a viable and effective option for individuals who lack access to support or could benefit from further practice with specific areas of social communication.
Research has shown that removing bites is the primary motivator for children with feeding difficulties to engage in inappropriate mealtime behavior (IMB) and escape extinction (EE) is the most well-established treatment component. Escape extinction may result in temporary but negative side effects (e.g., increases in crying). Attention from the feeder is another common motivator but less is known regarding the impact or efficacy of different applications of feeder attention, including attention extinction, noncontingent attention, or differential reinforcement of alternative behavior with attention. The current study included six participants and is the first to directly compare the efficacy and caregiver acceptability of EE with different schedules of feeder attention in isolation. All treatment packages resulted in reductions in IMB and increased consumption of new foods. Overall, results indicated that different schedules of feeder attention may mitigate negative side effects of EE and that caregivers prefer a treatment that includes feeder attention.
Individuals diagnosed with psychotic disorders have reduced life expectancy, primarily attributed to cardiovascular diseases exacerbated by lifestyle habits and antipsychotic side effects. Poor diet quality, marked by low fruit and vegetable consumption and high discretionary food intake are also at play. Limited information exists on factors influencing healthy dietary habits in this population. This systematic review aims to analyze qualitative and quantitative data, from the past 20 years, on obstacles and facilitators to healthy dietary habits among individuals with psychotic disorders. PsycINFO, PubMed and Google scholar searches with these inclusion criteria were conducted: (a) peer-reviewed articles, (b) participants are adults, (c) at least 30% or more of the sample had a psychotic disorder, and (d) focus on obstacles, facilitators or interventions related to healthy dietary habits. Among 21 identified articles, 14 addressed obstacles 11 discussed facilitators and 12 proposed interventions. This review identified seven key obstacles (cost and accessibility, taste of healthy food, emotional role of food, social environment, cognitive challenges, symptoms, and medication) and four facilitators (social support, health-related motivation, improved self-perception and interventions). Notably, some factors, such as social support and neighborhood environment, emerged as both obstacles and facilitators depending on the context. Access to effective interventions, including educational resources, such as cooking and planning skills, and more research on group therapy and peer-based programs are discussed.
Although function-based interventions (FBIs) are effective for individuals with intellectual and developmental disabilities, less is known about FBIs for students with extensive support needs (ESN) and school personnel involvement in FBI development and implementation. As such, we conducted a systematic literature review of 14 single-case research studies involving FBI implementation in K-12 U.S. school settings to address challenging behavior among 18 students with ESN. To identify relevant peer-reviewed articles, dissertations, and theses published between 2006 and March 2025, we searched 10 online databases, reference lists of 10 published reviews, and 19 peer-reviewed journals. Descriptive analyses revealed school personnel involvement varied widely, with school personnel often assuming FBI implementer roles and researchers primarily leading functional behavior assessments. Findings may be limited due to the small number of studies and eligible students with ESN included in the analyses and the limited descriptions of student and study characteristics.
Time-out from positive reinforcement (TOPR) is an effective limit-setting strategy for decreasing disruptive behaviors in young children. However, most publicly available information on TOPR (e.g., social media and other internet outlets) is inaccurate, leading to misperceptions and ineffective implementation by caregivers. We evaluated a brief (2-minute) behavioral, psychoeducational video on the evidence-based use of TOPR to determine whether a low-dose, universal intervention would change caregivers’ attitudes, increase knowledge, and improve correct use of TOPR. The primary caregivers of 1,472 children 2 to 8 years old were randomly assigned to watch a video on TOPR (intervention) or a video on the stages of child play (control). Caregivers completed self-report measures assessing their knowledge of and attitudes toward TOPR, use of TOPR, and severity of their child’s behavior problems at baseline, immediate follow-up, and 1-month follow-up. Acceptability of the intervention was assessed at immediate and 1-month follow-up. Caregivers who watched a 2-minute video on TOPR showed significant improvements in their understanding of TOPR ( F (1, 703) = 6.56, p = .011, Cohen’s d = .20) and the correct use of time-out ( F (1, 703) = 4.36, p = .037, Cohen’s d = .16), but their attitudes toward time-out did not significantly change. Implications for the development and dissemination of universal, low-dose psychoeducation on TOPR are discussed.
Functional communication training (FCT) has emerged as the most often researched intervention to reduce challenging behavior exhibited by individuals with developmental disabilities. In recent years, there has been a shift toward evaluating FCT under conditions that approximate treatment challenges. In our research, we have noted that, during such challenges, variable responding sometimes emerges and this variability can include vocalizations. In the current study, we reported examples of this finding, as vocal behavior was not a dependent variable targeted by the larger study. The changes in vocal responding exhibited by three individuals receiving FCT that incorporated alternative and augmentative communication (AAC) strategies are discussed in the context of extinction-induced variability and the potential utility of AAC-based FCT interventions to bring about vocal responding.
Despite public health efforts and technological advancements, the global burden of lifestyle-related chronic diseases continues to grow. Lifestyle medicine, a discipline that leverages evidence-based behavioral interventions to prevent and manage chronic disease, presents a promising path to address this epidemic. Thus far, the lifestyle medicine field lacks comprehensive and validated tools to assess program effectiveness. This convergent mixed methods study fills a gap in research by examining the preliminary effectiveness of a promising lifestyle medicine program, the PAVING the Path to Wellness program. PAVING the Path to Wellness (PAVING program) is a group-based health promotion program centered on improving health behaviors, including physical activity, nutrition, sleep, substance use, stress management, and social connection. This pre-post evaluation aimed to assess (1) the preliminary effects of the PAVING program on the six lifestyle medicine health behaviors using the Lifestyle Medicine Health Behavior (LMHB) scale with 19 cohorts of PAVING groups ( n = 126) and (2) the impacts of the PAVING program on determinants of health behaviors (attitudes, perceived norms, and self-efficacy, etc.) through semi-structured interviews. The program positively influenced determinants of behavior and significantly improved self-reported nutrition, physical activity, sleep, social connection, stress, and avoidance of risky substances. This mixed methods pilot study captures the impact of a group-based lifestyle medicine program and provides an evaluation blueprint for other lifestyle medicine and health promotion programs to more effectively translate from research to practice.
Evaluating psychosocial outcomes in families of children with chronic health conditions is complicated by heterogeneity in impact across and within conditions. This study used goal attainment scaling to assess individual families' progress towards child behaviour goals following brief parenting support for families of children (2-11 years) with phenylketonuria (PKU). Twelve hospital-recruited families nominated up to two behaviour goals and completed baseline monitoring before attending two 2-hr Healthy Living Triple P group sessions. Monitoring was repeated at 4-weeks post-intervention and 4-month follow-up. Families reported partial or complete success on 20 of 23 goals by follow-up. Nine goals were PKU-related, focusing on formula intake for younger children and dietary independence for older children; 14 were general, targeting aggression/non-compliance in younger children, with older children's goals more varied. Goal attainment scaling is feasible and effective for monitoring progress towards individually tailored child behaviour goals, with potential applications in research and clinical care.
Emergency physical restraints may still be widely used, with prevalence rates ranging from 11% to 78% across different service sectors (Fitton & Jones, 2020). At times, behavior analysts may recommend restraint when severe challenging behavior poses significant safety risks (e.g., intense aggression causing severe tissue damage; Foxx & Meindl, 2007; Vollmer et al., 2011). Most existing physical restraint literature featuring child and adolescent participants focuses on variables that behavior-analytic interventions do not manipulate (e.g., sex, diagnosis). Additionally, this literature most often features inpatient clinical populations with psychiatric conditions as opposed to those with intellectual and developmental disabilities. The current study applied a multi-level analysis informed by retrospective outpatient data (N = 12) from children and adolescents with intellectual and developmental disability who required emergency physical restraints. The study aimed to (a) examine and report on participant and restraint application characteristics and trends, and (b) determine if challenging behavior severity at intake predicted latency to restraint-application. According to the descriptive analysis, most participants were experiencing polypharmacy (i.e., prescribed at least three concurrent psychotropic medications), had been assigned moderate to high scores on challenging behavior severity, and primarily exhibited behavior maintained by access to tangibles or multiple reinforcers. Regarding restraint characteristics, the average restraint rate was 9.11 per 100 service hours, with most participants described as calm during restraint application. Typically, more than two staff members applied the restraints. Regression results indicated that challenging behavior severity scores significantly predicted latency to the first restraint application. Clinical implications related to these outcomes are discussed.
Concurrent-chains arrangements are commonly used to assess preference for interventions. Typically, these assessments are used to identify the most-preferred intervention, which may result in the rejection of other acceptable interventions. Modifications to the chained schedule might allow for the quantification of the degree of relative preference. The current study served as an initial demonstration of a modified concurrent-chains arrangement that included a progressive-ratio schedule as the second link of a three-link chain. Two participants preferred a single condition, requiring removal of the most-preferred alternative to yield a preference hierarchy. For two additional participants, preference hierarchies were identified through break points, although both participants exhibited small differences in relative preference across conditions. The findings of the current study suggest that alternative measures of relative preference might provide additional information for behavior analysts tasked with identifying individualized interventions.
The Focus-Based Integrated Model (FBIM) tailors interventions based on a functional assessment of clients' needs, integrating psychotherapy with pharmacological or rehabilitative support when necessary and emphasizing a strong Working Alliance (WA). This study evaluated therapeutic progress in clients treated with FBIM at four time points: baseline (T0), 3 months (T1), 12 months (T2), and follow-ups at 3 months post-therapy (T3). From April 2022 to July 2024, this longitudinal study was conducted at a community-based psychotherapy centre in Italy, enrolling 154 participants (Mage = 32.8 years; 54.3% female) who completed baseline assessments, with sociodemographic and clinical data collected on symptom severity, WA, and client motivation. Symptom severity declined significantly from T0 to T2. Within the integrated approach employed, that combined psychodynamic and Cognitive Behavioural Therapy (CBT) components, CBT showed stronger Task subscale scores at T2. Resistance to change impacted WA at T1 but decreased by T2. Contextual differences in WA at T1 diminished over time. Client motivation had no effect on WA. Structured approaches like CBT foster early collaboration, while changes in the WA over time reflect the therapist's capacity to adapt to client needs and therapeutic challenges.
Transition-related challenging behavior is common among individuals with intellectual and developmental disabilities, particularly during changes between activities. Two hypothesized controlling variables—unpredictability and negative incentive shifts—may contribute to the occurrence of these behaviors. This targeted research synthesis and meta-analysis identified studies published in behavior-analytic journals examining interventions developed to decrease transition-related challenging behavior. Nineteen experiments across sixteen peer-reviewed articles were included in the targeted research synthesis, with interventions categorized as those incorporating a signaling stimulus (e.g., advance notice, visual schedules) or other procedures (e.g., differential reinforcement, extinction). A multilevel meta-analysis was conducted to estimate overall intervention effects and examine whether the intervention type moderated its effectiveness. Results indicated that, although overall effects were not statistically significant, consequence-based interventions without signaling stimuli were associated with greater reductions in challenging behavior. Implications for practice, including the integration of signaling stimulus and consequence-based procedures, are discussed, along with directions for future research on intervention efficiency, generalization, and long-term maintenance.
Feeding disorders in early childhood involve maladaptive mealtime behaviors, nutritional deficits, and strained parent-child interactions. Standardized tools for Persian-speaking populations are scarce. This study translated and adapted the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) into Persian and evaluated its psychometric properties. The process included translation/adaptation and psychometric testing. Content validity was reviewed by 14 experts, face validity by interviews with 25 mothers, and construct validity via factor analysis with 203 mothers. Reliability was assessed through internal consistency and test-retest stability. Interviews refined the questionnaire format. Factor analysis yielded five child subscales and three parent subscales, explaining 45.11% and 56.72% of variance. The scale demonstrated strong reliability (Cronbach's alpha = .94; ICC = 0.94). Findings confirm that the Persian BPFAS is a reliable and valid tool for assessing feeding disorders in children in Persian-speaking families. Its multidimensional factor structure highlights the complexity of feeding problems and supports its use for early identification and behavioral intervention planning in clinical and community settings.
There is little known about the behavior intervention plan (BIP) team composition for students with intellectual disability, developmental delay, and/or autism (i.e., IDD). We sought to understand whether students with IDD are included as part of the team to develop their BIPs and who is involved and the correlation with quality of the BIP. We reviewed and statistically analyzed records from 87 BIPs from one large school district. Of the records reviews, most BIP teams included a parent or guardian, administrator, general education teacher, and special education teacher. Less than 5% of BIPs included a student with IDD. Implications for policy and practice are provided. Specifically, federal and state policy guides are needed to ensure that BIP teams include both the individual with IDD and their parents or guardians, along with individuals with expertise in supporting students with IDD.
Conducting a functional analysis (FA) is considered the gold standard for assessing the function of disruptive behavior and informing function-based treatment plans for individuals with autism and developmental disabilities. However, data collected during FAs are subject to human error. Accelerometers are wearable sensors that capture an individual's movement and can be used to identify behavioral events. The purpose of this study was to pilot the use of accelerometers to identify the occurrence of self-injurious behavior events during a FA. Three participants with autism, who engaged in self-hitting behaviors, participated in this study. Researchers conducted a FA with the participants while they wore small accelerometer devices. Observational data were collected using (1) live observation ("clinical-grade"), (2) from frame-by-frame video analysis ("research-grade"), and (3) via accelerometers. Researchers calculated interobserver agreement across data sets. Discussion of results and recommendations for practice and future research are included.
Research has shown that instructive feedback (IF) facilitates the generalization of tacts in individuals with autism spectrum disorder (ASD). However, no study to date has examined the effects of IF on the emergence of tacts across primary and secondary languages with both trained and non-trained exemplars. This study evaluated the efficacy of IF in promoting the generalization of tacts across languages using a nonconcurrent multiple baseline design with four participants with ASD from Spanish-speaking families. The results demonstrated that IF was effective at producing generalization across novel stimuli exemplars in primary and secondary targets for two of the four participants. Additional training components (i.e., rehearsals and no-no prompts) were effective in producing the same generalization outcomes with the remaining two participants.
Research suggests that praise serves as a key component of behavioral interventions. However, residential facilities may lack systems to teach their staff members to provide praise to residents. As a structured approach to behavior management, an applied behavior analysis (ABA) team in a secure juvenile justice facility utilized group contingencies to increase written praise, termed "kudos," by staff members across five dormitories. While implementing the Kudos program, the ABA team measured the frequency of (a) verbal and gestural forms of praise to evaluate generalization from written Kudos and (b) residents' problem behavior. Results of statistical analyses indicated increased written praise by staff members was associated with decreased problem behavior by residents; however, the written behavior of staff did not generalize to verbal and gestural forms of praise toward residents. Practice implications, including strategies for implementing praise consistently in juvenile justice settings, are discussed.
Mobile health (mHealth) interventions offer scalable ways to deliver mental health support via smartphone technology. This updated meta-analysis builds on Lindhiem et al., synthesizing findings from 79 randomized controlled trials identified through PsycINFO. Eligible studies included clinical samples, randomized designs, and at least one mHealth intervention group. Three comparisons were examined: mHealth + treatment versus control treatment, mHealth versus control treatment, and mHealth versus no treatment. Results showed small to moderate effects, with the strongest outcomes when mHealth interventions supplemented traditional care. Moderator analyses revealed greater effects for studies targeting substance use and for interventions that included clinician guidance or text messaging as a supplement. Effects were stronger in this updated meta-analysis compared to the original. High heterogeneity and wide prediction intervals suggested variability across studies. Despite limitations, findings support mHealth interventions as effective tools to expand mental health care access, particularly when integrated with traditional treatment.
Interventions aimed at enhancing social cognition deficits in individuals with schizophrenia are globally supported by evidence demonstrating improvements in various functional outcomes. The Social Cognition and Interaction Training (SCIT) intervention was adapted for use in the Indian context for individuals with schizophrenia using the Reporting Cultural Adaptation in Psychological Trials (RECAPT) guidelines, informed by expert consultations. This included contextually relevant changes in the resource materials (print, photographs, and video) and the development of additional resources. Changes in the intervention delivery process included the use of individual sessions with adjunctive group sessions. Initial feasibility was assessed via a pilot tryout of the adapted SCIT on three persons diagnosed with schizophrenia. This informed additional changes for future applications of the adapted SCIT, such as structured involvement of family members as practice partners and modifications in the intervention delivery format. Content validation process for the final adapted intervention modules was carried out by four mental health practitioners. The experiences, challenges, and decision-making process involved in the adaptation are outlined, along with implications for future research and contextually tailored intervention strategies.
