Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.


34th Annual Convention; Chicago, IL; 2008

Event Details

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Poster Session #204
#206 Poster Session (AUT)
Sunday, May 25, 2008
12:00 PM–1:30 PM
South Exhibit Hall
1. Social Competency in Preschool Learners with Autism: Comparing a Norm-Referenced Measure and Direct Observation.
Area: AUT; Domain: Applied Research
ELIZABETH DELPIZZO-CHENG (For OC Kids Neurodevelopmental Center), Kathleen Murphy (Newport-Mesa Unified School District)
Abstract: An important component of the well-being of our young learners with autism spectrum disorders is the ability to perform social tasks adequately. This ability allows for statements concerning the social competency of a learner. One aspect of socially competent behavior is the development and maintenance of appropriate social skills. In general, social skills are learned behaviors that increase the probability that important social outcomes will occur. The purpose of this poster presentation is to compare direct observational data of social skills (e.g., follows teacher directions, joins group activity) in the naturalistic setting (e.g., classroom, playground) of preschool learners with autism with the teacher and parent version of the Social Skills Rating System (SSRS), a norm- referenced rating scale used to access social competency, which has some documented use with learners with autism. Participants of this poster session will view (a) comparison results between direct observational data of individual social skills and the SSRS, and (b) a discussion of the benefits and the limitations of the use of both measures.
2. Treatment Acceptability, Child Outcomes, and Treatment Continuation in a Parent-Training Program for Preschoolers with Autism.
Area: AUT; Domain: Applied Research
LORI J. WARNER (William Beaumont Hospital), Jamie E. McGillivary (William Beaumont Hospital), Kaitlyn T. Sadlier (William Beaumont Hospital), Ivy M. Chong Crane (William Beaumont Hospital)
Abstract: Clinical psychology recognizes clients’ treatment acceptability beliefs as highly influential on treatment continuation decisions (Kazdin, French & Sherick, 1981; Naber & Kasper, 2000). However, this is less well studied within applied behavior analysis literature. The current study examines the possible relation between parental ratings of the acceptability of an intensive behavioral parent-training program on their decisions regarding continuation of behavioral treatment at the program’s end. Additionally, we will evaluate potential effects of childrens’ skill gains on the relationship between acceptability and continuation decisions. We will enroll 30 parent/child dyads who are participating in a center-based, 12-week intensive behavioral parent training program. Using the Treatment Evaluation Inventory-Short Form (TEI-SF; Kelley, Heffer, Gresham & Elliot, 1989), parents will rate progra acceptability; upon program completion, they will report their plans regarding continuation of treatment. We will assess child developmental functioning using the Mullen Scales of Early Learning (Mullen, 1995) and the Vineland Adaptive Behavior Scales—Second Edition (Vineland-II; Sparrow, Cicchetti, & Balla, 2005). It is expected that treatment acceptability will be positively related to treatment continuation, and that child gains during the program will moderate this relationship.
3. Assessing the Predictive Validity of the Assessment of Basic Learning Abilities Test for Children with a Pervasive Developmental Disorder.
Area: AUT; Domain: Applied Research
LINDSAY CAMPBELL (Brock University), Lisa J. V. Schwartzman (St. Amant Research Centre/University of Manitoba), Matthew Danbrook (Brock University), Tricia Corinne Vause (Brock University), Garry L. Martin (University of Manitoba), Dickie C. T. Yu (St. Amant Research Centre/University of Manitoba), Maurice Feldman (Brock University)
Abstract: The ABLA test is a criterion-referenced test that assesses that ease or difficulty with which an individual is able to learn six diagnostic tasks. These tasks include a simple imitation task, and five 2-choice motor, visual, and auditory discriminations of increasing difficulty, referred to as ABLA levels 1-6. Previous studies have shown that the ABLA test is a useful tool for selecting and sequencing educational and vocational tasks within individual curriculums for individuals with moderate to severe intellectual disabilities. The present study assessed the predictive validity of 16 children with PDDs, 8 who performed at ABLA Level 4 and 8 who performed at ABLA Level 6, for performing 20 educational and everyday tasks. Further, we compared the ABLA test predictions to parent predictions of performance on the predictive tasks. 94% of predictions based on ABLA performance were confirmed, and the ABLA was significantly more accurate for predicting a child's performance than were parents. Although further research is needed, this study shows that the ABLA test may be a valuable tool to guide in curriculum design concerning skill maintenance, and, further, may be useful in identifying skills that are missing from a child's repertoire.
4. On the Relation Between Severity of Autism and Resistance-to-Extinction.
Area: AUT; Domain: Basic Research
LISA M. TOOLE (The Kennedy Krieger Institute), Eric Boelter (The Kennedy Krieger Institute), Heather Jennett (The Kennedy Krieger Institute), Mandy M. Triggs (The Kennedy Krieger Institute), Gregory A. Lieving (West Virginia Institute of Technology), Louis P. Hagopian (The Johns Hopkins University School of Medicine)
Abstract: Individuals with autism are characterized by restricted, repetitive, and stereotyped patterns of behavior (DSM-IV, 1994) that may continue even when environmental conditions change. Thus, individuals with autism may display greater resistance to extinction and decreased behavioral variation when compared to other individuals without autism. The current study employs operant procedures traditionally used in basic research to examine this hypothesis experimentally. In this study, participants earned brief access to reinforcement for responding on a touch-screen monitor. In the response acquisition phase, 6 stimuli were present on the screen and reinforcement was available contingent on any 3-touch sequence. Once stability was established, extinction was implemented. In the extinction phase, no reinforcement was provided for responding, and sessions were conducted until responding was at a rate of less than 1 response per minute or until 12 sessions had been conducted. We hypothesized that the participants with autism would show greater resistance to extinction. Resistance-to-extinction was measured by calculating the log proportion of baseline rates of responding across sessions of extinction. The results to date suggest a positive relation between the level of severity of autism and resistance-to-extinction as indexed by the slope of proportional response rates across sessions.
5. Applying a "Usablity" Outcome Measure for Students with Autism in an Inclusive Elementary Program.
Area: AUT; Domain: Service Delivery
LOVELLE T. SUAREZ (Academy for Precision Learning), Alison L. Moors (Academy for Precision Learning), Nora Armstrong (Academy for Precision Learning)
Abstract: Implementing Fluency Based Instruction in center-based programs is sometimes a challenging task when it comes to managing outcomes checks (Retention, Endurance, Stability, and Application ) for all skills taught. This poster will focus on a "usability check"; whereas some skills are taught in isolation but measured in a generalized environment in order to ascertain whether or not a skill is ready for the remaining outcomes checks, student data on the Standard Celeration Chart will be presented which highlight the “usability” check.
6. Through the Eyes of Asperger's Syndrome: Assessing Children's Ability to Identify Relevant Social Stimuli.
Area: AUT; Domain: Service Delivery
KATHERINE GIOIA (Illinois State University ), Ashley Whittington (Illinois State University ), Anna M. Hickey (Illinois State University), Lewis Mazzone (Illinois State University), Marjorie Heitz (Illinois State University), Karla J. Doepke (Illinois State University), Kathryn Hoff (Illinois State University)
Abstract: Asperger’s Syndrome (AS) is primarily a social disorder characterized by qualitative, pervasive impairments in social interactions and narrow, repetitive patterns of interests and activities. While academically similar to peers, children with AS can easily be distinguished in social situations as “different” from their peers. Children with AS have been described as having difficulties understanding the social rules of peer interaction, and though they may desire social interactions with others, variables interfere with the successful negotiation of peer relationships. There is a growing body of evidence that many children with AS become adults with extreme social skills deficits, and concomitant problems with sustained employment and psychiatric difficulties (Gustein & Whitney, 2002). The purpose of this project was to further examine the social abilities of school-aged children diagnosed with AS. In this project, children with AS were presented with a series of video-taped ambiguous social situations at a university clinic. Children’s responses were examined to provide information about the types of discriminative stimuli they attended to and number of solutions they generated. Preliminary evidence suggests that children with AS had difficulties generating prosocial solutions and attending to relevant social stimuli. Implications of this research and directions for future research are discussed.
7. Assessment of Discrimination Performances in 100 Students with Autism Spectrum Disorders.
Area: AUT; Domain: Applied Research
CAMMARIE JOHNSON (The New England Center for Children), Maria Andrade (The New England Center for Children), Theresa Cerrone (The New England Center for Children), Laura M. Hutt (The New England Center for Children), Susan N. Langer (The New England Center for Children), Meghan Reilly (The New England Center for Children)
Abstract: A direct assessment of discrimination performances was conducted with 100 students with Autism Spectrum Disorders in preparation for developing their Individual Educational Programs. The following discrimination performances were tested in a match-to-sample format: session behavior, simple discrimination, conditional identity matching; arbitrary visual-visual matching of objects to pictures (and pictures to objects); arbitrary auditory-visual matching of spoken object names to objects (and pictures); and oral naming of objects (and pictures). For all conditional discriminations, 5 standardized sets of 3 stimuli each were used (e.g., Set 1 was chip, candy and cracker and assessment materials included these objects, pictures, and spoken words). Assessment results are evaluated within and across students, discrimination performances, and stimulus sets to answer 3 main questions: (1) how many of our students demonstrate each of these performances? (2) to what extent is individual student performance consistent with the discrimination performance hierarchy (e.g., session behavior as a prerequisite for simple discrimination performances, which is a prerequisite for conditional identity matching, which, in turn, is a prerequisite for arbitrary matching)? and (3) when some, but not all, arbitrary relations are demonstrated, are there some relations or stimulus sets that are more likely?
8. Can We Replicate Behavioral Treatments in Autism? A Review of Treatment Integrity Across Five Journals.
Area: AUT; Domain: Applied Research
SANDRA BLACK (May South, Inc.), April S. Worsdell (May South, Inc.), Jennifer A. Benne (Behavior Analysis, Inc.)
Abstract: Replicating behavioral treatments in autism may be compromised when experimenters do not adequately define independent variables. The purpose of the current study was to evaluate the degree to which behavioral treatments in autism assess or monitor treatment integrity. Five journals that publish behavioral research in the area of autism were reviewed, and studies were selected for inclusion if they were conducted between the years of 1997 and 2007, and if they included at least one participant diagnosed with an autism spectrum disorder. The primary questions of interest were whether the studies included treatment integrity data, a precise operational definition of the intervention, and an indication that the therapist was trained to implement the intervention. Preliminary results revealed that a small percentage of behavioral treatments in autism regularly assessed and reported data on the accuracy of independent variable implementation. The relationship between treatment integrity and robustness of treatment outcome will be discussed.
9. Norming and Use of the Social Interaction Inventory-Revised for Children with Autism Spectrum Disorders.
Area: AUT; Domain: Basic Research
EMILY HUBER CALLAHAN (Institute for Child Development), Jennifer M. Gillis Mattson (Auburn University), Raymond G. Romanczyk (Institute for Child Development)
Abstract: Autism spectrum disorders (ASD) are characterized by the presence of social deficits, namely in social interactions and skills. Currently there are no assessment instruments that specifically examine social interaction behavior (both responses and initiations) in children with ASD. The authors developed the Social Interaction Inventory-Revised (SII-R) to fill this need and to construct an instrument that might be sensitive to treatment progress. The purpose of this study was to establish norms for a group of typically developing children and a group of children with ASD. Participants were 30 typically developing children, and 41 children with ASD. Scores for social initiation and social responsivity were highly correlated for the typically developing preschoolers, indicating coordinated development of these 2 skill types. Thus, social interaction, described as a skill, includes the presence of both initiations and responses to social stimuli. The data from the ASD group suggest that the social behavior of initiating and responding independent rather than coordinated. The results suggest that typical children develop this integration very quickly and stably, but children with ASD acquire individual specific behaviors, and specific intervention may be needed to attempt skill integration.
10. What Variables Impact a Child with Autism’s Communication Success?
Area: AUT; Domain: Applied Research
CHRISTINE M. ACCARDO (The Shafer Center), Janet Preis (Loyola University in Maryland)
Abstract: Although similarities exist across children with autism, differences in specific and individual patterns of communication, emotional regulation, and learning style are often observed (Prizant & Wetherby, 2005). These differences typically require individualized, although not necessarily individual, intervention. Professionals and parents agree that such intervention is critical, although they do not necessarily agree on the specifics of such intervention. Intervention approaches and contexts vary greatly for children on the autism spectrum, often creating confusion or frustration for families as well as service providers on how to choose what’s “best” for a particular child. The purpose of this study is to determine what variables impact a child with autism’s communication success, including specific teaching practices (e.g., directive vs. facilitative teaching style), individual developmental profiles, and learning context (i.e., “naturalness”; group size). This study consists of participants ranging in age from two to seven years. All of the participants are currently enrolled in a small, private school for children on the autism spectrum. The participants’ learning profiles will be established through the presentation and analysis of their baseline assessments, including evaluations of (a) autism (i.e., CARS and/or GARS), (b) cognitive functioning (i.e., Mullen or WIPPSI), (c) language performance (i.e., CELF-4 or PLS-4; Assessment of Social Communication Skills), (d) play skills (i.e., informal play protocol), and (e) motor imitation (i.e., informal protocol). The outcomes for ongoing measures of social communication will then be presented, including spontaneous language initiation, play skills, and positive social behavior.
11. Teaching Elementary School Children with Autism to Compliment Others on Their Clothes in a Small Group Social Skills Training.
Area: AUT; Domain: Applied Research
MARI KASHIO (Nakayoshi Kids Station), Yoshiaki Nakano (Nakayoshi Kids Station)
Abstract: We taught three elementary school children with autism to compliment others on their clothes in a small group social skills training. Participants were second and third graders included in regular classrooms. Training consisted of two hours’ activities once a week for 10 months at our clinic. Two to five therapists participated in the training playing the role of instructor, prompter, or peers. We taught them how to compliment others on their clothing because two out of three mothers selected “complimenting others” as an important target for their children from the list of our social skiquestionnaire. We used a script board on which four narrative elements were written as prompts consisting of (1) someone’s name (peers or therapists), (2) a list of clothes (e.g. sweater, pants) or hairstyle, (3) attractive dimensions of clothes or hairstyle (e.g. color, design), and (4) wording of compliments (e.g. good, nice, cute). Their compliment responses were assessed by our rating scale and analyzed employing an ABA design. All of the children acquired how-to-compliment skills and generalized them to other persons (father or mother) and other situations within the training.
12. Assessment: What and How Much.
Area: AUT; Domain: Applied Research
ELIZABETH A. SWATSKY (Stanislaus County Office of Education)
Abstract: For an autism specialist for inclusion students, it is important to be efficient and effective in delivering assessments to intake for, update in, and exit out of the program. In order to do this a matrix was developed to determine how to select assessments in order to give the least amount of assessment with the most amount of treatment and service recommendations. Data will be shared on minutes assessed and number of interventions recommended along with the matrix of the decision making process.
13. Behavioral Subgroups in Autism Spectrum Disorders.
Area: AUT; Domain: Theory
ROSE F. EAGLE (Institute for Child Development, State University of New York, Binghamton), Raymond G. Romanczyk (Institute for Child Development, State University of New York, Binghamton)
Abstract: The heterogeneity found in autism and related disorders (i.e. “autism spectrum disorders” or ASD) is notorious. Even within a given ASD, such as Autistic Disorder, the range in abilities and clinical presentation is great. The degree of heterogeneity seen in the population of individuals with autism spectrum disorders has prompted many researchers to propose subgroups beyond the current commonly used DSM-IV-TR diagnostic categories of Autistic Disorder, Aspergers Disorder and Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) (APA, 2000). It seems likely that subgroups of children with ASD respond differently to treatment, particularly when outcome variability is considered (e.g. Sherer & Schriebman, 2005; Lovaas, 1987; Weiss, 1999). Many researchers have begun to advocate for an increased level of individualization in the treatment of autism spectrum disorders (Anderson & Romanczyk, 1999; Pelios & Lund, 2001), and the identification of subgroups may aid in this process. The current poster briefly reviews existing models of subgroups, and presents findings related to an on-going study of subtypes in ASD.
14. Increasing Joint Attention in Children with Autism and the Relationship to Outcomes in Inclusive Settings.
Area: AUT; Domain: Service Delivery
RYAN T. BOCKMANN (Rowan University), Crystal A. Harms (Behavior Counts Therapy, LLC), Rebecca Johnson (Rowan University), Karen Meredith (Behavior Counts Therapy, LLC), Joann Masterson (Behavior Counts Therapy, LLC)
Abstract: Joint attention continues to be a strong research focus in children with autism by both behavior analysts and developmental psychologists. The inability to engage in joint attention with an adult or peer is seen as one of the core social deficits of children with autism. Students not demonstrating joint attention may seek interaction with objects in isolation. The child’s ability to engage in joint attention often contributes to educational decision making regarding the inclusion of these students with neurotypical peers. This is due to the impact on perceived social participation of the student with his or her peers by the staff. These students are seen as needing more intense support in order to benefit from participation in general curriculum. In addition, some students with autism have benefited from increased opportunities for engaging in reciprocal social behaviors like joint attention when placed in a general education setting with same-age peers who are demonstrating this skill. In this study, the researchers utilize a rating system to operationally define joint attention in order to analyze its relationship with the outcomes of including students with autism in general education settings. Specifically, high levels of joint attention should produce more successful inclusion in the classroom.
15. Mand Training Versus Tact Training: Teaching Noun Labels to a Child with Autism.
Area: AUT; Domain: Applied Research
MICHAEL NEAL SAUNDERS (Westfield State College), Shannon Kay (The May Institute), Roger M. Tudor (Westfield State University)
Abstract: An alternating treatments design was used to assess the efficacy and efficiency of mand versus tact training procedures for teaching noun labels to an 8-year-old child with autism. During the study, the child learned ten new noun labels that were randomly assigned to either mand or tact training. Fewer learning trials were required to achieve mastery using the mand training procedure on four of the five sets of target items. The mean number of trials to criterion for the mand and tact training conditions were 26 and 40, respectively. The child did commit fewer errors during the tact training procedure. Directions for future research are discussed.
16. Derived Transfer of Mand Function: Establishing Novel Mands in Young Children with Autism without Direct Training.
Area: AUT; Domain: Applied Research
DANIELLE LYNN COTTERILL (Mercyhurst College), Robert Gulick (The Achievement Center), Ruth G. Auld (Mercyhurst College)
Abstract: Three children diagnosed with autism were trained to ask a question to obtain information within the context of a guessing game. The game required the children to systematically guess the identity of an unknown object depicted on a card held by the investigator. This study explored whether the establishment of an equivalence class of category-questions could evoke novel question-asking during the guessing game. This was tested by first directly training a single category-question. This specific question was then incorporated into conditional discriminations with five novel category-questions. Probes were then conducted for the derived transfer of mand response function from the initial category question to the five untrained questions. Participants #2 and #3 demonstrated derived transfer of mand function to the novel questions within five and eight days, respectively, of the onset of the conditional discrimination phase. Following 14 days of conditional discrimination training, Participant #1 failed to consistently demonstrate derived transfer during probes. An alteration in the schedule of reinforcement during probes was made and, subsequently, Participant #1 began consistently demonstrating derived transfer of mand function.
17. The Effect of Reinforcing Communicative Attempts on Acquisition of Incidental Language Instruction.
Area: AUT; Domain: Service Delivery
MIRANDA SIM (The Behaviour Institute), Nicholas Charlton (McMaster University), Johanna Lake (McMaster University)
Abstract: Incidental language instruction has been successfully used to increase the communicative responding of children with autism and also has been found to promote generalization of effects across natural environments. Incidental language instruction consists of using naturally occurring situations to elicit communicative attempts and then shaping the communicative response. In other words, there are two general goals of incidental language instruction: (a) to increase the frequency of communicative attempts; and, (b) to improve the quality of the speech production. One approach to language instruction may be to initially reinforce communicative attempts regardless of their quality, and then shape speech production. This poster will present the results of a study comparing the effects of pre-teaching communicative attempts on the acquisition of incidental language instruction and the reduction of disruptive behavior for two children with autism. Using a multielement design, communicative attempts were reinforced prior to the introduction of incidental language instruction. The number of training sessions were equated between incidental language instruction alone and incidental language instruction plus pre-reinforcement of communicative responses. The results indicated that reinforcing communicative responses prior to the introduction of incidental language instruction increased the acquisition rate of targeted language responses and produced greater reduction in disruptive behaviors.
18. Teaching Children with Autism to Answer Inferential "Why" Questions: Generalization Across Question Formats.
Area: AUT; Domain: Service Delivery
JANE LEE (Behaviour Institute), Joel P. Hundert (Behaviour Institute), Laura Henderson (McMaster University)
Abstract: High functioning children with autism may be expected in school and in everyday conversation to be able to answer “why” questions that require the child to make inferences. In contrast to factually based “why” questions in which the answer is specifically contained in the information provided, in inferential “why” questions the child is presented with incomplete information and must answer the “why” question by drawing upon general knowledge. There have been few studies examining whether children with autism can learn to answer inferential “why” questions and generalize this knowledge to untrained questions. The purpose of this poster is to present the results of a study in which two children with autism, aged six and seven years, were trained to answer inferential questions and the generalization of that skill to untrained questions was probed. The children with autism learned to answer inferential “why” questions and generalized their skills to untrained inferential questions presented in a naturalistic environment.
19. The Home-Based Intraverbal Training with an Autistic Child.
Area: AUT; Domain: Applied Research
SHINJI TANI (University of Osaka Human Sciences)
Abstract: Study objective: This study has two objectives. The one is to train students as home-based trainers, the other is to show the effectiveness of Intraverbal Training with an autistic boy. The intraverbal responses targeted were answers to general knowledge questions, such as “When it rains, what do you do?” Design: multiple baseline design across behaviors was used. Setting: Student trainers trained an autistic boy in his home. Participants: 5-year-old autistic boy was participant. Two students were trained as trainer. Students had a basic Behavior Analysis class in their university and achieved enough performance in The Basic ABA Knowledge Test (Kishisita & Tani, 2006). Independent variables: Training procedures were demonstrated to the student trainers. The supervisor observed student trainer training with the child and provided advices (On the Job Training). In order to transfer stimulus control of receptive responses to intraverbal responses, both visual prompts (picture cards) and echoic prompts were used. Measure: Rate of correct intraverbal responses was recorded as a dependent variable. Results: Correct intraverbal response rate to training tasks increased. This result showed student training and this intraverbal training procedure were effective for this child.
20. An Evaluation of the Independent Effects of Modeling in Teaching Mands to Children with Autism.
Area: AUT; Domain: Applied Research
SAMANTHA HARDESTY (Kennedy Krieger Institute), David E. Kuhn (Kennedy Krieger Institute), Nicole Lynn Hausman (Kennedy Krieger Institute)
Abstract: Children with autism often exhibit communication deficits which may increase the probability of maladaptive behavio emerging. Teaching appropriate communication (e.g., mand training) may decrease the likelihood of problem behaviors emerging or persisting. A variety of behavioral techniques (e.g., prompting, time delay, modeling) have been employed to increase communication skills when deficits are evident (MacDuff et al., 2000). However, few studies have compared multiple methods of training to determine the most appropriate means to effectively and efficiently achieve this goal. The current study evaluated two different methods of teaching mands, least-to-most training, and modeling plus least-to-most training, for three children diagnosed with autism. For each participant, preference assessments identified two moderately preferred stimuli, and reinforcer assessments were conducted to demonstrate the relative reinforcing value of stimuli prior to mand training. Results were mixed but suggest that modeling plus least-to-most prompting may be a more efficient approach to teach individuals diagnosed with autism to gain access to preferred stimuli. Data were collected on communication and total training duration. Reliability data were collected for at least one third of sessions and averaged above 80%.
21. An Evaluation of Intraverbal Training to Establish Question-Answering Skills in Children with Autism-Spectrum Disorders.
Area: AUT; Domain: Applied Research
EINAR T. INGVARSSON (Youngstown State University), Jacob Gailey (Youngstown State University), Bernadette Treece (Youngstown State University), Tatia Hollobaugh (Youngstown State University)
Abstract: A recent study by Ingvarsson, Tiger, Hanley, and Stephenson (2007) showed the effectiveness of teaching children with language delays to ask for the correct answers to unknown questions using the phrase “I don’t know, please tell me.” In that study, generalization of the targeted skill across teachers and questions was found, but acquisition of correct idiosyncratic answers did not occur until arbitrary reinforcement was added. The current study was designed to extend the Ingvarsson et al. (2007) study by (a) implementing the intervention with an alternative population (a sample of children with autism-spectrum disorders), (b) measuring setting generalization to the children’s classroom, and (c) evaluating the effects of thinning arbitrary reinforcement schedules designed to increase the number of correct answers. The results are discussed as a step toward the goal of developing a comprehensive, effective, and user-friendly teaching program targeting generalized question-answering skills. Inter-observer agreement data were collected during at least 25% of observations in all conditions and averaged above 90% for all measures.
22. The Role of Generative Responding on the Acquisition of Novel Language Exemplars.
Area: AUT; Domain: Applied Research
MELISSA J. GARD (The Lovaas Institute Midwest), Courtney Whitcraft (The Lovaas Institute Midwest), Eric V. Larsson (The Lovaas Institute Midwest)
Abstract: The treatment of children with autism often is comprised of highly structured and individualized teaching techniques. Effective teaching often depends upon repetition of teaching trials to result in independent responding. While repetition in teaching is often necessary for effective learning, it is often not sufficient for the child to be able to start successfully learning in a typical context. In fact, repetitive trials put the child at risk of stereotyped responding, which in turn prevents generalization to novel stimuli, if not managed carefully. However, an effective technology of generative programming, through the teaching of sufficient exemplars, has been developed to meet these needs. To develop generative responding, each child’s clinical needs are task analyzed on an individualized basis, and the total number of necessary teaching trials varies across children and skill areas as a function of generative programming. The goal of the current study was to more closely examine the process of teaching to achieve generative responding and to measure the effect of this generative responding on the acquisition of novel and natural language exemplars. The outcomes of the current study provide further information on the development and implementation of treatment procedures for language acquisition in children with autism.
23. Further Behavior Analytic Explanations of Joint Attention.
Area: AUT; Domain: Applied Research
BETSY WURSTNER (Temple University), Kelly Kates-McElrath (Temple University and Bucks County Intermed. Unit ), Erin Louise Robinson (Temple University)
Abstract: This poster explores behavior-analytic perspectives of joint attention. The tacting repertoire and its relation to joint attention are discussed in an effort to account for the occurrence of joint attention initiation and responding, as well as the details required to generate and maintain these behaviors. The importance of these data in guiding intervention is discussed.
24. Using the WebABLLS to Collect Data on the Development of the Basic Language and Learning Skills of Typically Developing Children.
Area: AUT; Domain: Theory
JAMES W. PARTINGTON (Behavior Analysts, Inc.), Autumn Bailey (Behavior Analysts, Inc.)
Abstract: Practitioners who work with children diagnosed with Autism Spectrum Disorder (ASD) are often asked to compare the developmental levels of a child with ASD to those of typically developing children. Data will be presented on the patterns of acquisition of basic language and learning skills of typically developing children ranging in age from six months to five years of age. These data will provide criterion-based measures that can be used to help identify specific skill differences between children with ASD and typically developing children.
25. Using Multiple Exemplars to Increase Generalization in Language Training with Children with Pervasive Developmental Disorder.
Area: AUT; Domain: Basic Research
KAREN NAULT (BEACON Services), Joseph M. Vedora (BEACON Services), Robert K. Ross (BEACON Services)
Abstract: Generalization problems, especially in language, are common in individuals with autism. Research conducted with individuals with severe mental retardation indicates that the use of multiple exemplars is an effective approach to ensure generalization across stimuli. The present study attempts to replicate the findings that training with multiple “good exemplars” will increase generalization (Hupp & Mervis, 1982) and extend these findings specifically to children with pervasive developmental disorder (PDD). The number of good exemplars required to produce both narrow and broad generalization across stimuli is examined using a multiple probes design across stimuli. Two 4–5 yr-old students, diagnosed with PDD participated in this study. Training materials consisted of photos of objects, rated as good exemplars, with additional moderate and poor exemplars used in generalization probes. Participants were trained on first a single and then multiple exemplars using a delayed-prompt technique. Generalization probes occurred at the completion of training of each set of exemplars. As expected, generalization to untrained stimuli did not occur until training with multiple exemplars had been conducted. The number of exemplars required varied. Generalization to good exemplars consistently occurred first, with generalized responding to exemplars rated as moderate and poor requiring additional training.
26. Can I Play? Teaching Spontaneous Question-Asking and Speech Variability to Children with Autism.
Area: AUT; Domain: Applied Research
RACHEL TRAVOLTA (Scripps College), Debra Berry Malmberg (Claremont McKenna College)
Abstract: Question-asking is a versatile social skill because it facilitates conversation and is a tool for acquiring new information. Children with autism are known to have difficulties with this skill given their deficits in communication and social initiations (Charlop & Milstein, 1989). Previous literature has focused on teaching children with autism to spontaneously ask, “What’s that?” in the presence of unknown stimuli (e.g., Le , 2000; Taylor & Harris, 1995). However, this skill has limited utility because it specifically targets one piece of information—the label of an object. The current study advanced existing research by teaching variability in spontaneous question-asking through the use of multiple exemplar training and a time-delay procedure. Four children were taught questions that represented common ways to gain access to a desired object or a social situation (e.g., "Can I play?"). A multiple baseline across participants design was used to assess the effectiveness of the intervention on the acquisition and generalization of spontaneous question-asking. Results indicated an increase of spontaneous use of the targeted questions and generalization across settings and people. Interobserver reliability and procedural integrity were greater than 80%. The findings of this study are discussed in terms of the social implications of learning spontaneous question-asking.
27. An Evaluation of the Effects of Token Economies on Mand Training In Public School Settings.
Area: AUT; Domain: Applied Research
DAVID ROBERT DILLEY (BEACON Services), Robert K. Ross (BEACON Services)
Abstract: Many in the field of Applied Behavior Analysis have identified Mand Training as a means for increasing generalized language in children with autism. However, Bourret et al. (2004) suggested that reinforcement schedules in the natural environment might be insufficient for the acquisition of appropriate manding behavior. In addition, there may be fewer opportunities for a student to mand for high potency reinforcers in a public school setting. The current study assessed the use of differential reinforcement with tokens for manding in natural school-based situations and the effect it had on overall manding rates. Specifically, we provided tokens when the student manded for instructional items (pencils, paper, chair, etc) that were necessary to complete a task but were not preferred items or reinforcers. Results indicated that differential reinforcement increased rates of manding in the school-based environment.
28. Increasing Vocalizations Through the Use of Differential Reinforcement in the Context of the PECS Procedure.
Area: AUT; Domain: Applied Research
SUSAN A. RAPOZA-HOULE (BEACON Services), Robert K. Ross (BEACON Services)
Abstract: One of the diagnostic symptoms of Autism is a significant delay in or total lack of spoken language (American Psychiatric Association, 2000). While vocal imitation training has been demonstrated to increase speech there are some learners who do not learn to reliably imitate simple sounds even with intensive training (Lovaas, 1987). For those non-vocal students, augmentative and alternative communication modalities such as sign language and picture-based communication systems are widely used to increase functional communication skills. The Picture Exchange Communication System (PECS) has previously been demonstrated to increase vocalizations in learners who utilize the system (Carr & Felce, 2006; Bondy & Frost, 2001). The current study investigated whether procedural modifications to the system might further enhance speech development without hindering functional communication (Tincani, 2004). This study investigated whether the PECS system, combined with a prompt delay procedure and vocal prompting with differential reinforcement for sound production (Attansio, 2007), could increase the frequency and variety of vocalizations in three young children with autism.
29. The Emission of Verbal Operants as a Function of Textual Prompts.
Area: AUT; Domain: Applied Research
ANNE MARIE MAZZA (Mercy College), Lina Slim-Topdjian (A Step Ahead Program, LLC)
Abstract: This study tested the effects of textual prompts on the emission of verbal operants. The participant was a 5-year-old male who attended a clinic for children with autism which implemented an applied behavior analytic approach to teaching. The dependent variable was the number of verbal operants emitted by the student and the independent variable was textual prompting. The results show a functional relationship across three different verbal operants. The dependent variable consisted of textual prompts in the form of textual stimuli presented on index cards. The experimenter created establishing operations for the emission of the verbal operants and subsequently presented textual prompts to evoke correct responding.
30. The Relevance of Preference Assessment for Transfer of Stimulus Control from Tacts to Mands.
Area: AUT; Domain: Applied Research
AURELIA POWER (University of Wales, Bangor), J. Carl Hughes (University of Wales, Bangor)
Abstract: The purpose of the present study was to investigate the role of reinforcer strength and extinction in transfer of stimulus control from tacts to mands. Thus three participants diagnosed with autism were initially taught to tact most and least preferred abstract stimulus properties of preferred items, identified in two preference assessments. Subsequently, they were probed to see if they exhibit those responses that had been taught as tacts under mand conditions; previous mand responses that did not include abstract stimulus properties were placed on extinction. The results indicate that tact responses may emerge as mands for those abstract stimulus properties identified as most preferred, thus suggesting that reinforcer strength and extinction may play an important role in facilitating such generalisation.
31. Teaching Mand for Activities Using Matrix Strategies with Pictures in Children with Autistic Disorders.
Area: AUT; Domain: Applied Research
HITOMI KUMA (Keio University), Nozomi Naoi (Keio University), Hiroshi Sugasawara (Keio University), Jun'ichi Yamamoto (Keio University)
Abstract: The present study aimed to teach mands for activities by teaching picture combinations to children with autistic disorders. Three children with autistic disorders participated. We used a multiple baseline design across target behaviors in this study. In Procedure 1, we did activity-mand training by using a visual prompt that was pictures of an adult doing some activities . Three target behaviors were selected from speaking “take,” “open,” “give,” “look,” or “teach” without a prompt. In Procedure 2, we aimed to teach a mand consisting of verb and object by using matrix strategies. We taught this mand by teaching how to combine the object-picture and the activity-picture as the prompt. Target behaviors were, for example, “give cookie,” “take ball,” “Daddy, teach,” or “Mam, look”. We taught only 4 picture combinations to the participants. We used matrix strategies for transferring to an untrained activity-object combination. As result of Procedure 1, two out of three participants acquired 3 target behaviors and demonstrated generalization across scenes and trainers.
32. Using Discrete Trial to Teach Adults with Autism to Mand Using Picture Exchange.
Area: AUT; Domain: Applied Research
STACEY A. TRAPANI-BARBER (Anderson Center for Autism), Amanda B. Coons (Anderson Center for Autism)
Abstract: This study was designed to teach adults with Autism a functional approach to communication using picture exchange. Participants included 3 non-verbal males between 26–28 years of age attending a day habilitation program. Paired stimulus preference assessments were conducted for all participants to determine highly desired items (Pace, Ivancic, Edwards, Iwata & Page, 1985). Baseline data indicated requests using picture exchange did not occur for all participants; however one participant was able to request items using sign. Mand training was implemented using a discrete trial format (10 trials per session) which included both an instructor (receiver) and shadow. This procedure was effective in producing independent mands across all participants.
33. The Effects of Extinction and Motivating Variables on the Transfer from Tacts to Mands.
Area: AUT; Domain: Applied Research
KELLY PAULSON (University of Wisconsin, Eau Claire), Elizabeth Kooistra (University of Wisconsin, Eau Claire), Kevin P. Klatt (University of Wisconsin, Eau Claire)
Abstract: In Experiment I of this study, we used a multiple baseline across participants design to assess the effects of mand extinction following tact training. Two children diagnosed with autism, ages two and four, were taught to tact a high- and low-preferred item. Following tact training, mand tests were run under extinction. Results suggested that the transfer of stimulus control from a tact to a mand was demonstrated. In Experiment II, motivating operations were manipulated to investigate whether deprivation and satiation would have an effect on the acquisition of mands. The participants manded more under the deprivation than the satiation condition. Implications of the results will be discussed.
34. Emergent Verbal Relations Based on Opposite Concepts.
Area: AUT; Domain: Basic Research
LUIS ANTONIO PEREZ-GONZALEZ (Universidad de Oviedo), Lorena Garcia-Asenjo Asenjo (Universidad de Oviedo)
Abstract: Several children participated in an experiment to explore the conditions for the emergence of novel verbal behaviors related to concepts of opposites. They learned relations between visual stimuli and words related to a property of the stimuli (e.g., “big” and “little” in the presence of pictures of a big or a little object). Then they learned pairs of related intraverbals referred to these concepts under the contextual cue “opposite” (e.g., “Name the opposite of big”). Initially, the children showed the emergence of several relations but they did not show the emergence of the intraverbals. After additional experiences with novel sets of stimuli, the intraverbals emerged directly in most children. These data show that verbal relations based on opposite concepts may emerge given certain conditions of learning.
35. Manding for Missing Items.
Area: AUT; Domain: Applied Research
DOROTHY SCATTONE (University of Mississippi Medical Center), Jenny Koskovitch (University of Mississippi Medical Center), Belmont C. Billhofer (University of Mississippi Medical Center), Ray Meeks (University of Mississippi Medical Center)
Abstract: We taught two 5-year-old students with autism to tact each component of two component activities (e.g., juice and cup, track and train, car and ramp, etc.). Using a multiple baseline design across activities, we then presented one component of the two component activities (e.g., track without train) to determine if the students could then mand for the item that was missing. Transfer of stimulus control from the tact to the mand did not occur and a prompt and prompt fade procedure was then used to teach the student to mand for the missing items.
36. Prerequisite Skills for the Emergence of Object Description.
Area: AUT; Domain: Applied Research
ANNA BEATRIZ QUEIROZ (Pontifícia Universidade Católica de São Paulo), Gladys Williams (Centro de Investigacion y Ensenanza del Lenguaje), Monica Rodriguez Mori (Centro de Investigacion y Ensenanza del Lenguaje ), Kimberly Vogt (Columbia University Teachers College), Daniel Carvalho de Matos (Pontifícia Universidade Católica de São Paulo), Manuela Fernandez Vuelta (Centro de Investigacion y Ensenanza del Lenguaje), Gina Elizabeth Vinueza (Applied Behavioral Consultant Services, NY)
Abstract: The purpose of this investigation was to determine the effectiveness of a procedure based on a combination of speaker and listener behavior using multiple exemplars to teach children with autism to describe novel objects (tacting). The procedure consisted of selecting pairs of objects belonging to categories (i.e., animals, fruits), and running a series of steps simultaneously as separate programs: (1) identical matching (object to object—object to picture—picture to picture) of the pairs in the category (e.g.., dog—bird and apple—strawberry), (2) object selection, (3) naming (tact) (speaker repertoire), (4) answering intraverbals and probing symmetry (e.g., Name an animal” and “what is a dog?”), (5) writing (filling blanks), reading and answering questions about the readings. If the post-test indicated that the behavior did not emerge, we repeated the same steps with new sets of objects using multiple exemplars. Preliminary results indicate that with some children the procedure can be effective in the production of novel language.
37. A Comparison of the Effects of Providing Choice-Making Opportunities Within and Between Activities to Children with ASD.
Area: AUT; Domain: Applied Research
BURCU ULKE KURKCUOGLU (Anadolu Üniversitesi), Gonul Kircaali-Iftar (Anadolu Üniversitesi)
Abstract: The present study compared the effects of providing choice making opportunities within and between activities during one-to-one teaching on on-task and self-stimulatory behaviors of children with ASD. Four male children with ASD participated in the study. An A-B-A-C-A-BC single-subject design was used to evaluate the effects of the choice opportunities provided within and between activities. During phase A (baseline), the teacher conducted various activities without providing any choice opportunities; during phase B, the teacher provided choice opportunities between activities; during phase C, the teacher provided choice opportunities within activities; and during phase BC, the teacher provided choice opportunities between activities as well as within activities. Results showed that all four participants were considerably more engaged during the phases where choice opportunities were provided, regardless of the type of the opportunity. Moreover, the participants performed slightly lower rates of self-stimulatory behaviors during the choice conditions. Based upon the evaluation of the findings and implications of the study, future research needs are discussed.
38. Choice-Making to Improve Maintenance and Transfer of Academic Abilities in Children with Autism.
Area: AUT; Domain: Applied Research
SHANE L. LYNCH (University of Alberta), Judy Cameron (University of Alberta), W. David Pierce (University of Alberta)
Abstract: Children with autism spectrum disorder (ASD) suffer from reduced intrinsic motivation (IM) for participation in academic activities. As well, maintenance and transfer of intervention gains continue to be problematic. It may be that difficulties with maintenance and transfer are the result of reduced motivation. It has been shown that IM can be increased when reinforcers are delivered in autonomous contexts (i.e., with choice). The present investigation (a repeated measures, alternating-treatment design), examines whether performance-based rewards, along with choice-making opportunities can increase children’s IM for academic activities, and improve maintenance and transfer. Preliminary data suggests that children prefer those activities that are associated with choice, and the results maintain across settings. The findings will be discussed from both behavioral and cognitive perspectives.
39. Training and Testing Theoretical Music Skills in a MTS Format with a 16-Year-Old Boy with Autism.
Area: AUT; Domain: Basic Research
LILL-BEATHE HALSTADTRØ (Trondsletten Habilitation Services, Norway), Eli Bjerke (Byasen College, Norway), Moncia Halstadtro (Byasen High School, Norway), Erik Arntzen (Akershus University College)
Abstract: A relatively small number of studies have demonstrated stimulus equivalence with individuals who have mental retardation. For example equivalence training has been used to train money skills (e.g., Trace et al., 1977), reading skills (e.g., Mackay, 1985), math skills (e.g., Maydak et al., 1995) and geography skills (e.g., LeBlanc et al., 2003). We wanted to expand the knowledge of equivalence training by establishing classes of theoretical music skills, and to also to study differences in equivalence responding following MTO and OTM training structures. The participant was a 16-year-old boy diagnosed with autism. He was in first grade at high school and very interested in music. We started to train three 3-member classes in an MTO training structure, where the A set (the node) was written X major chords, the B set was X major chord piano keys and C set was X major chord notes on scale (X indicates A, C, G, F etc.).
40. Assessing the Effectiveness of Social Attention as a Reinforcer for a Student with Autism.
Area: AUT; Domain: Applied Research
TODD FRISCHMANN (Rutgers University, Douglass Developmental Disabilities Center), Meredith Bamond (Rutgers University, Douglass Developmental Disabilities Center), Robert LaRue (Rutgers University, Douglass Developmental Disabilities Center)
Abstract: Prompt dependence is a significant concern for learners with autism. Although prompt dependence is a pervasive problem with this population, the function is often poorly understood. To address the prompt dependence for an adolescent male with autism, we evaluated the effect of an instructor’s social attention on the rate of initiation and off-task behavior during an independent task. The student was given a mastered task (putting inserts into envelopes) in three different conditions involving social attention in a multielement design. In the No social attention condition, the instructor did not provide social attention to the student after presenting the task. For the Noncontingent social attention condition, the instructor provided continuous social attention (i.e., dialogue, but not praise) throughout the duration of the task. During the Contingent social attention condition, the instructor provided social attention (praise) for actions initiated and task items completed independently but not for off-task or stereotypical behaviors. Rates of task initiation and item completion were highest in the contingent attention condition relative to the other conditions. Similarly, the duration of off-task behavior during the 15-minute sessions was lowest in the contingent attention condition relative to the other conditions.
41. Teaching Verbal Behaviors of Emotion to Children with Mild Developmental Disabilities using a Stimulus-Equivalence Training Procedure.
Area: AUT; Domain: Applied Research
SATORU SHIMAMUNE (Hosei University), Miyako Hosohata (Naruto-City Kurosaki Elementary School)
Abstract: We evaluated the effect of a stimulus-equivalence training procedure in teaching verbal behaviors of five emotional status(“happy,” “cheerful,” “sad,” “angry,” and “afraid”) to children with mild developmental disabilities. A multiple probe design between the stimulus-class sets was used, the first set being “angry” and “afraid,” and the second set “happy,” “cheerful,” and “sad.” Training sessions were conducted in the classrooms of the participants’ affiliated schools. The participants were two 9-year-old male students with mild developmental disabilities showing autistic characteristics. We trained the participants to state the appropriate emotional word given a situational sentence using a verbal praise, with a prompt and withdrawal of sight-word cards. The percentage of correct responses to each situational sentence was measured. Also, test scores in stimulus-equivalence relationships were evaluated. After the training was completed, both participants’ percentage of correct responses in the generalization and equivalence tests increased. The results suggested the effectiveness and efficacy of the stimulus-equivalence training in teaching verbal behaviors of emotion to children with mild developmental disabilities.
42. Multicomponent Fear Extinction of Needle Phobia in an Adult with Autism.
Area: AUT; Domain: Applied Research
JASON J. WOLFF (University of Minnesota), Frank J. Symons (University of Minnesota)
Abstract: Stimulus fading is frequently employed in treatment of various phobias, and may be effectively paired with differential reinforcement. Using a changing criterion design, the present study sought to extend the work of Shabani and Fisher (2006) by examining the contribution of DRO to stimulus fading treatment of needle phobia in an adult with autism. To address noncompliance in an early phase, a safety signal component was added to the treatment package. The DRO and safety signal components were variously removed during middle phases of treatment to assess their contributions. Treatment consisting of stimulus fading plus DRO with a safety signal proved effective in decreasing fear response in the presence of a surgical needle. Results also suggest that the removal of DRO and/or a safety signal from treatment is not necessarily associated with unsuccessful treatment trials. Overall, it appears that the stimulus fading procedure is flexible enough to accommodate component change and leaner schedules of associated reinforcement. Future studies may wish to explore the effect of stimulus fading alone prior to implementation of DRO to better control for sequence effects.
43. Treating Obsessive-Compulsive Disorder in Children with High Functioning Autism (HFA) and Asperger’s Syndrome (AS): Cognitive-Behavioral Treatment (CBT) with Function-Based Intervention.
Area: AUT; Domain: Service Delivery
TRICIA CORINNE VAUSE (Brock University), Sarah E. Grubb (Brock University), Shauna McCambridge (Brock University), Maurice Feldman (Brock University)
Abstract: Recent research suggests that children with Pervasive Developmental Disorders (PDDs) have increased risk for developing obsessive-compulsive disorder (OCD); one study found ~1 in 68 persons have PDD and OCD. Despite these findings, few published studies exist concerning empirically-based treatment for anxiety disorders including OCD in persons with PDD. Using a multiple baseline design across OCD behaviors (N = 4), treatment is ongoing for children ranging from 9 to 16 years of age, with a dual diagnosis of OCD and Asperger’s Syndrome (AS) or High Functioning Autism (HFA). The treatment consists of a synthesis of cognitive-behavioral treatment and applied behavioral analytic methods including function-based intervention to treat OC behaviors such as needing reassurance following bothersome thoughts, handwashing, counting, and checking. The treatment package includes 12 to 20 one-hour sessions, occurring one to two times per week. Using a variety of data collection methods (e.g., tracking of OCD behaviors and antecedents/consequences; using self-report measures), we are attempting to reduce OCD behaviors to manageable levels, and, in turn, improve quality of life.
44. “I Like Basketball but Not Cheering:” Use of a Desensitization Program to Address Loud Noises.
Area: AUT; Domain: Applied Research
JANET A. BUTZ (Collaborative Autism Resources & Education), Craig W. Butz (Odyssey Charter School), Sue Mirman (Collaborative Autism Resources & Education)
Abstract: The authors will present how a desensitization program was used by a family who has a young son diagnosed with autism that engaged in hitting behavior to get others to stop making noise during family celebrations and outings. The family identified the types of noises that triggered the aggressive behavior in their son using a stress hierarchy. The focus of this presentation is to share how the noise that produced the highest level of stress for their child was effectively addressed. The father who is a sports agent identified the most intolerable noise for his son was the constant cheering produced by the fans at a basketball game. He would engage in hitting behavior like he used in the home setting to attempt to get strangers to quit cheering. The plan implemented by the family involved reading a social story to the child prior to going to the game that addressed how he could effectively cope with the cheering behavior of the fans. A desensitization program was also employed that allowed him to use noise canceling headphones and then later wear an MP3 player during the game that he could activate to counteract the noise produced by the cheering fans.
45. Advanced Autism Practicum.
Area: AUT; Domain: Applied Research
ABBY FERREE (Western Michigan University), Nicole Hoffmeister (Western Michigan University), Richard W. Malott (Western Michigan University)
Abstract: The Advanced Autism Practicum is the last in a set of three practica with the goal of training undergraduate student technicians to administer Discrete-Trial Therapy to preschool-aged children with autism. Students who show exemplary skills after completing the Basic and Intermediate Autism Practica are considered for the Advanced Autism Practicum. Our practicum site is an Early Childhood Developmental Delay preschool classroom. In addition to gaining experience with this population, the Advanced Autism Practicum students write an original procedure to be implemented with the children they work with. These student technicians must detect specific skill deficits, write a procedure to address the problem, interpret the data, and write any recycle phases to make the procedure as effective as possible. The student technician is also in charge of writing sub-phases to aid in a procedure for which the child is having trouble meeting criteria for mastery of a certain phase. Additionally, the student technician gives feedback to Intermediate practicum students to assist in these students’ development as technicians. Lastly, as a part of the Advanced Autism Practicum, student technicians are trained in the analysis of the children’s self-injurious or problem behavior. This includes introductions to functional assessments and taking observational data.



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