2005 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced or distributed without the

Transcription

1 2005 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced or distributed without the express written permission of NECC.

2 What is autistic behavior? Restricted and Repetitive Interests Social Communication

3 What s wrong?: Responsiveness to social stimuli Jones, Carr, & Klin (2008)

4 Autism: Is the product of A motivational distinctiveness Attention to sensory relative to social stimulation Develops across time Social learning off track 70 Relative Duration CWA TDC year-olds 3-year-olds 4-year-olds

5 During typical development Children Adults (e.g., Rojahn et al., 2000) Sensory impairment Blind (e.g., Fazzi et al., 1999) IDD/MR (Berkson et al., 1999) ASD (Lewis & Bodfish, 1998) (Cuccaro et al., 2003)

6 Occurs in typical development Skill acquisition (e.g., Dunlap et al., 1983) Socially unacceptable (e.g., Wolery et al., 1985) (e.g., Jones et al., 1990)

7 Stereotypic behavior circa 2000 Status as functional operant class Manualized recommendations Status of evidence poor RB for Auto SIB (N=1-2) NCR (Piazza et al., 2000) (BMOM!) DRO (but neither fosters Appropriate Behavior; oh and BMOM!) DRA?

8 5-minute sessions No interaction baseline Reinforce requesting/app speech Contingent upon vocal stereotypy Establish attention (eye contact) Ask social questions (hi-p compliance) Reinforce requesting/app speech

9 Percentage of intervals - Vocal Stereotypy BL RI+RD BL Session Response interrupt + redirect (RI+RD) Stereotypy Cal

10 BL RI+RD BL Response interrupt + redirect (RI+RD) Session Percentage of intervals - Vocal Stereotypy Frequency appropriate speech appropriate VS Cal

11 Interruption - quick decrease in VS Appropriate speech more probable Adding materials may be necessary to increase requesting Intervention requires 1:1 staffing Requires high integrity (Maybe not!) Effortful (Sometimes not necessary)

12 Spurred a flurry of SS studies on this technique Martinez & Betz (2013) Several variants of RIRD effective TX comparisons have favored RIRD (however!) Added components that target supporting adaptive skills likely superior to RIRD alone Colon, Ahearn et al. (2012) Vanderkerken et al. (2013) Meta-analysis of SCE for VCB (N=74) Large TX effect (e.g., RIRD VS+)

13 One of 27 Evidence-Based focused intervention practices for ASD treatment National Professional Development Center on Autism Spectrum Disorders Module: Response Interruption/Redirection (RIR) Evidence-Based Practice Brief: Response Interruption/Redirection (RIR)

14 Clip 4 - BL Clip 5 RIRD 1 st session

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17 Variation may be crucial to success with RIRD/RB Ahrens, Lerman, Kodak, Worsdell, & Keegan (2011) RIRD-v may not be a possible treatment option for students that are noncompliant or have a limited vocal verbal repertoire RIRD-v vs. RIRD-m Prompting for compliance w/ demands

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19 Without Prompting/Cesana, Ahearn (in prep)

20 Ahrens et al. (2011) Parametric analysis (see also Lerman & Iwata, 1996; Smith, Russo, & Le 1999)

21 Colon & Ahearn (in press)

22 Clip 6 Teaching social reciprocity Clip 7 Generalization

23 Social interaction (via prompting) (e.g., Odom & Strain, 1986; MacDonald et al., 2009) Play skills (via prompting & whatever) (e.g., Libby et al., 2009; Tereshko et al., 2011) Collateral effects Less stereotypy

24 Produce decreased levels of vocal stereotypy and increased levels of appropriate vocalizations Evaluate effect of tact training on occurrence of appropriate vocalizations & vocal stereotypy Evaluate effect of a response interruption/redirection procedure on vocal stereotypy

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26 4 stimuli trained (2 high preference items from preference assessment & 2 contextually relevant items) Progressive prompt delay w/ echoic prompt Response modeled, I see chip Appropriate student response social praise & tokens exchanged for edible Tact training until 90% accuracy

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28 Frequency of Appropriate Vocals BL Post Tact Training (PTT) Unspecified RIRD removed primer PTT Sessions Response Interruption & Redirection (RIRD) with in vivo tact training Post Mand Training Mands Tacts RIRD PTT with in vivo tact training RIRD Anna Jeff Parker

29 VOT effective in increasing VB, decreasing vocal stereotypy RIRD decreased vocal stereotypy further Some mands seen in Post-tact Training and RIRD sessions

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31 Reinforcer Assessment of Socially Mediated Stimuli Responses per Minute

32 Social Side of Room Non-Social Side of Room

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34 Pre-Training Post-Training Owen Social Side of Room Evan Non-Social Side of Room Harry Andrew Sessions Unengaged Attention Bid Supported Joint Coordinated Joint Figure 2. The proportion of each session Owen, Evan, Harry, and Andrew spent in each state of engagement. Bars above the line show proportion of session allocated to the social side of the room. Bars below the line show proportion of session allocated to the non-social side of the room. Seventeen sessions were conducted with Owen, 12 with Evan, 18 with Harry, and 19 with Andrew.

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36 Assessment to test for OL; Multi-probe design 5 tasks with 3 variations of each task 1) Hidden Item (Miller & Dollard, 1941) 2) Computer Game (MacDonald et al., 2015) 3) Academic (Orelove, 1982) 4) Broken Construction Toy (Varni et al., 1979) 5) Building (Werts, Caldwell, & Wolery, 1996)

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41 When setting our goals as clinicians Research can help set our agenda For ASDs, the goals are clear But, how to get there not always clear Research in treatment settings The best way to identify effective Tx These effective teaching tools can be bettered Best practices can be revealed

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43 Controversial topic Not requiring mediation by another person Crucial concept!

44 There are occasions upon which we say that the speaker needs a verbal response. The circumstances may be incomplete, as when variables which strengthen behavior without respect to form need supplementary sources of strength. Thus we cast about for a stimulus and respond to it. -Skinner (1957; p. 403)

45 Skinner (e.g., 1957) Not a technical term Verbal and non verbal behavior Vaughan & Michael (1982) Perceiving Producing Problem solving

46 Stimuli Sensory apparatus Reflexive Conditioned seeing A man may see or hear "stimuli which are not present" on the pattern of the conditioned reflex: he may see X, not only when X is present, but when any stimulus which has frequently accompanied X is present. Skinner (1953/2005; p. 266)

47 Emitted behavior Sensory consequences Operant Active seeing

48 we have to ask how contingencies of reinforcement are arranged. When is a numerical operation reinforced as right? Eventually, of course, the pupil may be able to check his own answers and achieve some sort of automatic reinforcement, but in the early stages the reinforcement of being right is usually accorded by the teacher. -Skinner (1954/1999; p. 184)

49 Historied behavior Stimulus control The discriminative stimulus Operant & respondent Complex behavior

50 Thinking is more productive when verbal responses lead to specific consequences and are reinforced because they do so The verbal fantasy, whether over or covert, is automatically reinforcing to the speaker as listener. Just as the musician plays or composes what he is reinforced by hearing, or as the artist paints what reinforces him visually, so the speaker engaged in verbal fantasy says what he is reinforced by hearing or writes what he is reinforced by reading. -Skinner (1957; p. 438)

51 Because BFS says so? Implications for acquisition and maintenance of behavior Behavior no obvious consequence An explanatory fiction Or a pragmatic

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