Assessment and Treatment of Problem Behavior Maintained by Termination of Interruptions

Purpose: Previous research has identified termination of interruptions to repetitive behaviour as a reinforcer capable of maintaining problem behaviour. Effective treatments have included functional communication training and multiple schedules of reinforcement.

Methods: In the present study, a functional analysis determined that the aggression of an eight-year-old boy with autism spectrum disorder was maintained by termination of interruptions of repetitive behaviour. An intervention was implemented consisting of differential reinforcement of other behaviour and response cost.

Results: The intervention produced and maintained a reduction in aggression and increased tolerance for interruptions of systematically increasing durations.

Conclusions: This case study demonstrates an alternative approach to the treatment of problem behaviours such as aggression maintained by termination of repetitive behaviour that includes teaching the individual to tolerate interruption of repetitive behavior.

Keywords: Avoidance; differential reinforcement of other behaviour; interruption; repetitive behaviour.

We report the feasibility and preliminary efficacy of a structured behavioral intervention with a sample of minimally verbal girls with autism spectrum disorder between the ages of 2 and 6 years old. Ten participants with no functional vocal behavior were randomized to a 4-week behavioral intervention or waitlist control group. Caregivers reported child communicative repertoires at pre- and post-randomization assessments. Social communication was also assessed at these time points using the Early Social Communication Scales. All feasibility benchmarks were met and findings of preliminary efficacy showed large effect sizes within groups. The current findings suggest the feasibility of recruiting and retaining samples of young, minimally verbal girls with autism spectrum disorder in randomized clinical trials.

Keywords: Feasibility; Female; Intervention; Minimally verbal; Sex differences.

Computational linguistics holds promise for improving scientific integrity in clinical psychology, and for reducing longstanding inequities in healthcare access and quality. This paper describes how computational linguistics approaches could address the “reproducibility crisis” facing social science, particularly with regards to reliable diagnosis of neurodevelopmental and psychiatric conditions including autism spectrum disorder (ASD). It is argued that these improvements in scientific integrity are poised to naturally reduce persistent healthcare inequities in neglected subpopulations, such as verbally fluent girls and women with ASD, but that concerted attention to this issue is necessary to avoid reproducing biases built into training data. Finally, it is suggested that computational linguistics is just one component of an emergent digital phenotyping toolkit that could ultimately be used for clinical decision support, to improve clinical care via precision medicine (i.e., personalized intervention planning), granular treatment response monitoring (including remotely), and for gene-brain-behavior studies aiming to pinpoint the underlying biological etiology of otherwise behaviorally-defined conditions like ASD.

Autistic self-advocates, family members, and community organizations have called for greater emphasis on enhancing quality of life (QoL) for people with autism. Doing this is critical to understand how QoL unfolds across the life course and to clarify whether gender affects QoL, health, and functioning for people with autism. The purpose of this study was to curate and test a lifespan QoL measurement tool using freely available and well-constructed National Institutes of Health Parent-Reported Outcomes Measurement Information System (PROMIS). To develop the PROMIS Autism Battery-Lifespan (PAB-L), we identified PROMIS scales relevant for autism, reviewed each item, consulted with a panel of autism experts, and elicited feedback from autistic people and family members. This battery provides a comprehensive portrait of QoL for children ages 5-13 (through parent proxy), teens 14-17 (parent proxy and self-report), and adults 18-65 (self-report) with autism compared to the general population. Participants and parent informants (N = 912) recruited through a children’s hospital and nationwide U.S. autism research registry completed the PAB-L online. Results indicate that compared to general population norms, people with autism of all ages (or their proxies) reported less desirable outcomes and lower QoL across all domains. Women and girls experienced greater challenges in some areas compared to men and boys with autism. The PAB-L appears to be a feasible and acceptable method for assessing patient-reported outcomes and QoL for autistic people across the life course. Autism Res 2020, 13: 970-987. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: We developed a survey to measure the quality of life of children, teens, and adults with autism using free National Institutes of Health PROMIS questionnaires. People with autism and family members rated the PROMIS Autism Battery-Lifespan as useful and important. Some reported a good quality of life, while many reported that their lives were not going as well as they wanted. Women and girls reported more challenges in some areas of life than men and boys.

Keywords: adults; life course; life span/lifespan; patient-reported outcomes; quality of life; sex/gender; women with autism.

2020Alycia Halladay

2020Alycia Halladay

2020Alycia Halladay

2020Alycia Halladay

2020Alycia Halladay

2020Alycia Halladay