Iterative redesign of a caregiver-mediated intervention for use in educational settings

Teachers endorse disruptive behavior as a considerable concern for autistic students, which is compounded by the lack of adequate resources for behavioral intervention planning in the classroom. The RUBI program is an evidence-based, low-intensity manualized intervention, initially developed for parents of autistic children ages 3–14 and co-occurring disruptive behavior. Utilizing the Discover, Design/Build, Test (DDBT) framework, which combines user-centered design and implementation science, RUBI intervention content was collaboratively and iteratively redesigned with elementary school stakeholders (40 school staff from 28 schools) to ensure the feasibility, acceptability, and appropriateness of the redesigned intervention, RUBI in Educational Settings (RUBIES). Iterative quantitative and qualitative methods were conducted with stakeholders to identify targets for RUBI redesign. Conventional content analysis was used to code qualitative data and identify usability issues. Recommendations were provided for modifications to RUBI sessions to address the needs of the school context and end-users to develop RUBIES. Feasibility scores improved following the redesign. The use of the DDBT framework to redesign the RUBI intervention may promote greater usefulness and usability in school contexts. Lay abstract Teachers often report concerns about behavior challenges in their students with autism spectrum disorder (ASD) in the school setting. Furthermore, teachers often report that they do not have adequate training in how to manage these challenging behaviors effectively. The RUBI program is an intervention initially developed for parents of children with ASD and co-occurring challenging behavior in clinic settings. The present project used school staff input to systematically redesign RUBI to be used with educators in schools. School staff gave input at multiple stages of development to ensure the adapted intervention was appropriate to use in a school setting. Responses were coded and analyzed to identify strengths and weaknesses of the RUBI manual in schools and adaptations were made accordingly. Scores of how appropriate, possible, likable, and usable RUBI would be in schools rose after the intervention was redesigned. The redesigned RUBIES manual may give school staff the tools they need to manage disruptive behaviors. In addition, collaborating with providers over multiple stages to redesign established interventions for new contexts may be a promising way to help bring research tools to practice in the future.

Technological Solutions for Helping Adaptive Responding of Children with Severe to Profound Developmental Disabilities

This article provides the reader with a literature overview of the newest empirical evidences available on the use of assistive technology-based programs for teaching and improving adaptive responding of children with severe to profound developmental disabilities. Four main categories of studies were selected, regarding (a) the technology for promoting independent access to positive stimulation, (b) the combination between microswitch and VOCA aimed at asking for social contact with a caregiver, (c) the cluster technology for increasing an adaptive response, and simultaneously reducing a challenging behavior, (d) the technology for requesting and choosing desired item or the access to the literacy. Overall, 26 studies were reviewed, and 75 participants were involved. The outcomes were largely positive, although few failures occurred. Psychological and Rehabilitative implications of the findings for both research and clinical practices were critically discussed

Enhancing Life Skills of Children and Adolescents With Autism Spectrum Disorder and Intellectual Disabilities Through Technological Supports

This chapter provides the reader with the newest empirical contributions available on the use of assistive technology-based interventions aimed at enhancing life skills of children and adolescents with autism spectrum disorders and developmental or intellectual disabilities. A selective overview along the last decade was carried out. Eighteen studies were reviewed, and 155 participants were involved. Five main categories of studies were identified, namely (1) emotional regulation, (2) communication skills, (3) academic performance, (4) social inclusion, and (5) challenging behavior. Results were fairly positive, although occasional failures occurred. Clinical, educational, psychological, and rehabilitative implications of the findings were critically discussed. Some useful guidelines for future research and practice were highlighted.

Technology-Aided Interventions to Reduce Challenging Behaviors for Individuals With Autism Spectrum Disorder

Individuals with autism spectrum disorder (ASD) display a variety of challenging behaviors, such as tantrums, aggression, stereotypy, and disruption. Challenging behaviors can have a serious negative impact on the development of social relations, in the learning process, and education. To this aim, there is a need for appropriate interventions in order to improve the quality of life of individuals with ASD. This chapter aims to provide data with regard to different types of interventions and technological tools used for the reduction of challenging behaviors of students with ASD. Functional communication training with the use of speech-generating devices, video self-modeling, self-monitoring with the use of technological devices, and social stories presented in electronic form reflect types of interventions used for challenging behavior reduction. Research data indicate that technology-aided interventions are generally effective in reducing challenging behaviors of students with ASD.

Analyzing the Role of Implicit Bias From a DisCrit Perspective

Using a disability studies/critical race theory (Discrit) lens, the authors reviewed and analyzed specific literature within the pyramid model (PM) framework—a three-tier hierarchical framework for promoting social-emotional competence and reducing challenging behavior among young children—to understand the model's framing of implicit bias and the specific strategies noted in the literature that help teachers to recognize and counteract implicit bias and subsequently reduce disciplinary inequities among Black preschool children. Findings revealed that although the PM literature discussed, defined, and emphasized the importance of cultural responsivity, it did not engage critically with the construct of implicit bias (i.e., racism and ableism), specifically as it relates to the experiences of children most vulnerable to disciplinary sanction. This chapter ends with suggestions to help readers rethink the PM framework as a way to shift practice toward more equitable experiences for Black children in their earliest years of schooling.

A functional communication training for developing verbal behavior and treatment of challenging behavior in individuals with autism spectrum disorders

Communication problems are one of the symptoms of autism spectrum disorders. Challenging behaviors may be a form of communication with the environment, and when other forms of communication are not available, they may be the only way to meet their needs. The purpose of this article is to demonstrate the potential use of functional communication training in reducing problem behaviors of individuals with ASD, as well as developing acceptable ways of communication. In a research process based on behavior analysis, the method of single-subject experiment with multiple-baseline design was used. The results of the study show that the research participants developed communication skills on the basic level, and the frequency of their challenging behaviors has significantly decreased.

Contingency-based delay to reinforcement following functional communication training for autistic individuals: A multilevel meta-analysis

Functional communication training, an intervention for challenging behavior rooted in principles of applied behavior analysis, has copious empirical support dating back to the mid-1980s for autistic individuals. Recently, there has been a concerted effort to thin reinforcement delivery during functional communication training using contingency-based delays that, in turn, are designed to enhance practicality and feasibility while not compromising on efficacy. In this synthesis, we meta-analyzed the literature using log response ratio effect sizes to investigate (a) combined and across type effectiveness of contingency-based delays and (b) moderating variables that might impact intervention outcomes. Findings showed that contingency-based delays were effective for autistic individuals (log response ratio = −2.17; 95% CI = (−2.76, −1.58)) and most effective when the contingency incorporated positive reinforcement (log response ratio = −2.30; 95% CI = (−2.83, −1.78)). In addition, delay procedures that included differential reinforcement of alternative behavior were overall more effective (log response ratio = −2.13; 95% CI = (−2.72, −1.55)) than those that involved differential reinforcement of other behavior (log response ratio = −1.24; 95% CI = (−3.84, 1.37)). Noteworthy moderating variables found to impact contingency-based delay efficacy included the intervention dosage and the topography of behavior. We discuss these findings and highlight directions where additional empirical research is warranted to improve our understanding about contingency-based delays for autistic individuals. Lay abstract Functional communication training, an intervention for challenging behavior rooted in principles of applied behavior analysis, has copious empirical support dating back to the mid-1980s for autistic individuals. Recently, there has been a concerted effort to thin reinforcement delivery during functional communication training using contingency-based delays that, in turn, are designed to enhance practicality and feasibility while not compromising efficacy. In this synthesis, we meta-analyzed the literature base with the goal of investigating both combined and across type effectiveness of contingency-based delays. We also aimed to investigate moderating variables that might impact intervention outcomes. Findings showed that contingency-based delays were effective for individuals with an autism spectrum disorder diagnosis and most effective when the delay incorporated some form of positive reinforcement. In addition, differential reinforcement of alternative-based delays was overall more effective when compared to differential reinforcement of other behavior-based delays. Noteworthy moderating variables found to impact contingency-based delay efficacy included the intervention dosage and the topography of behavior. We discuss these findings and highlight directions where additional empirical research is warranted to improve our understanding about contingency-based delays for individuals diagnosed with autism spectrum disorder.

A Case for Increased Rigor in AAC Research: A Methodological Quality Review

This comprehensive review reports on methodological quality of 162 single-case studies on augmentative and alternative communication for communication and challenging behavior in individuals diagnosed with autism or intellectual disabilities and with complex communication needs. Following review for inclusion criteria, documents were excluded if they failed to meet basic methodological standards. Each remaining study was evaluated for 10 detailed quality criteria. No studies met all standards without reservations. Only three of the included studies met all of the standards with reservations and the remainder met some but not all standards, with or without reservations. The included studies reported adequate detail for half of the quality indicators, but insufficient details for participant, setting, maintenance, and generalization, and social validity descriptions. An increased quantity and quality of research were found in over four decades. More recent studies have adequately reported half of the criteria investigated, including describing the materials, defining the outcome variables, describing baseline and intervention procedures, and evaluating procedural integrity. After identifying quality features, the authors report in more detail on low rated quality indicators particularly relevant to studies addressing social-communication interventions. The literature infrequently reported race, ethnicity, or home language. Future research should report characteristics of participants to ensure that research becomes representative of the population.