|Strength or Challenge: Intervention Studies on Obsessive-Compulsive Behavior in Children With Autism Spectrum Disorders|
|Sunday, May 27, 2012|
|10:30 AM–11:50 AM |
|Area: AUT; Domain: Applied Research|
|Chair: Nicole Neil (The Graduate Center of the City University of New York)|
|Discussant: W. Larry Williams (University of Nevada,Reno)|
|CE Instructor: Lauren Kryzak, M.A.|
Obsessional, ritualistic, stereotyped, and repetitive behaviours are a core feature of autism spectrum disorders (ASD), and researchers have conceptualized these behaviours in individuals with ASD on a continuum ranging from lower-level, motoric, repetitive behaviours to higher-order, obsessive-compulsive like, repetitive behaviours, which may include circumscribed interests, inflexible routines, and insistence on sameness (Hollander, Wang, Braun, & Marsh, 2009). This symposium will describe research findings from three intervention studies, which involve higher-order repetitive behaviour in children with ASD. The first study investigated the use of a group function-based cognitive behavioural treatment (GFb-CBT) package to reduce obsessive-compulsive behaviour (OCB) in7 children with high functioning autism (HFA). The second is an in-depth case study of an additional participant (young girl with HFA) who received the GFb-CBT package described in Study 1, with a focus on parental OCD tendencies and other variables that impact assessment/treatment. The third study will present an investigation using circumscribed interests, with prompting and reinforcement, to teach responding to joint attention directives in 3 children with ASD.
|Keyword(s): Group Treatment, Joint Attention, Obsessive Compulsive, Repetitive Behavior|
Using Group Function-Based CBT to Reduce Obsessive Compulsive Phenomena in Seven Children With High Functioning Autism
|NICOLE NEIL (The Graduate Center of the City University of New York), Heather Yates (Brock University), Debbie Finkelstein (Brock University), Melissa Fleishman (Brock University), Lisa Lam (Brock University), Tricia Corinne Vause (Brock University), Maurice Feldman (Centre for Applied Disability Studies, Brock University)|
Individuals with ASD frequently experience obsessions and compulsions that meet the DSM-IV-TR criteria (APA, 2000) for Obsessive-Compulsive Disorder (OCD). Given the acknowledged difficulty in differentiating between OCD and Autism-related OC phenomena, the present study will use the term Obsessive Compulsive Behaviour (OCB). This study examined Group Function-based CBT (GFb-CBT) to reduce OCB in children with High Functioning Autism (HFA). A multiple baseline design across parent reports of OCB was used to examine effects of this package for seven children (7-11 years of age). For three participants, probe data was also collected. The GFb-CBT protocol I Believe in Me, not OCD! (Vause et al., 2010) consisted of an indirect functional assessment, awareness training, cognitive-behavioral skills training, and graded exposure plus response prevention. Across seven participants, a total of 37 behaviors were treated; visual inspection indicated that 26 behaviors improved with treatment and11 stayed the same. Complementing time series data, standardized assessments showed decreases in symptom severity, and increases in quality of life. Correspondence between parent report and probe data was 82.6% (range = 62% 94%). Treatment integrity was collected for four of seven participants on 67% of sessions; TI was 100%.
Addressing Obsessive-Compulsive Behavior in a Young Female: Impact of Parental Obsessive-Compulsive Tendencies on Treatment
|HEATHER YATES (Brock University), Nicole Neil (The Graduate Center of the City University of New York), Keeley White (Brock University), Tricia Corinne Vause (Brock University), Maurice Feldman (Centre for Applied Disability Studies, Brock University)|
Research has found that approximately 37 percent of individuals with Autism Spectrum Disorder (ASD) meet diagnostic criteria for Obsessive Compulsive Disorder (OCD) (Leyfer et al., 2006). The present case involved an 11-year-old female with High Functioning Autism who displayed Obsessive-Compulsive Behavior (OCB), and had a family history of obsessive-compulsive tendencies. Targeted behaviors included: seeking reassurance related to contamination and harm to self/others, excessive toothbrushing, and a strong need to complete activities. Eight behaviors were targeted in a 9-week manualized Group Function-based Cognitive-Behavioral Therapy (Fb-CBT) (Vause et al., 2010), with individual support provided to the parents in between sessions. The treatment consists of an indirect functional assessment, awareness training, cognitive-behavioral skills training, and graded exposure plus response prevention. A multiple-baseline design across parent report data (OCBs) was used to evaluate the effects of treatment for this child. Visual inspection indicated that six of the eight behaviors immediately improved when the treatment package was administered. All sessions were taped, and treatment integrity data is currently being collected. In addition to demonstrating the success of this treatment in reducing OCB, this presentation will focus on parental OCB tendencies, and how they present various challenges but also aid in the treatment of pediatric OCB.
The Effect of Using Circumscribed Interests on Joint Attention Intervention
|LAUREN KRYZAK (The Graduate Center of the City University of New York), Sara Bauer (The Graduate Center of the City University of New York), Emily A. Jones (Queens College, The City University of New York), Peter Sturmey (Queens College, The City Unversity of New York)|
Children with autism often exhibit restricted interests in specific topics which many believe preclude social engagement with others or become more intense if included in intervention. However, studies have demonstrated that integrating topics of restricted interests into intervention materials has benefits on social-communicative interactions between children with autism and their siblings, peers, and caregivers. Studies by the applicant, which integrated topics of restricted interests into joint attention intervention materials, have demonstrated improvements, such as increased joint attention and decreased restricted interest intensity. Joint attention occurs when two people engage in verbalizations, gestures and/or eye contact between each other and a common object. It is a characteristic deficit specific to autism and its presence has been directly related to the success of other intervention measures, including language growth. As such, it is important to empirically demonstrate efficient intervention procedures, which using restricted interests may represent. The proposed paper will discuss results from two studies targeting joint attention, limitations and prospective future research directions.