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| #395 Poster Session (CBM) |
| Monday, May 26, 2008 |
| 12:00 PM–1:30 PM |
| South Exhibit Hall |
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| 47. Treating Qatari Children with Traumatic Brain Injury for Verbal. |
| Area: CBM; Domain: Applied Research |
| HAKAM M. KAIR (Shafallah Center for Children with Special Needs), Tarek Abdullah Masood (Shafallah Center for Children with Special Needs), Bilal Ahmad Al-Shallakh (Shafallah Center for Children with Special Needs) |
| Abstract: We used a self-regulation Program in conjunction with a token economy in addition to extinction to treat verbal aggression and sexually inappropriate behavior in a Qatari teenager with a recent onset of traumatic brain injury. |
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| 48. Exploring the Impact of Reinforced Suppression on the Temporal Distribution of Tics. |
| Area: CBM; Domain: Applied Research |
| CHRISTINE A. CONELEA (University of Wisconsin, Milwaukee), Christopher C. Bauer (University of Wisconsin, Milwaukee), Douglas W. Woods (University of Wisconsin, Milwaukee), Joshua James Kemp (University of Wisconsin, Milwaukee) |
| Abstract: Tourette Syndrome (TS) is a neurological disorder characterized by motor and vocal tics. Research has shown that reinforcement for tic-free periods can impact tic frequencies (Woods & Himle, 2004). The current study explored whether the temporal distribution of tics during conditions of reinforced suppression (DRO) differed from baseline (BL) tic levels. Nine children with TS participated in a study comparing conditions of BL and DRO using an alternating treatments design. During DRO, children were given tokens contingent on every 10 second tic free interval. During BL, children were told to tic as much or little as needed. DRO conditions were included in the current analyses if at least 1 tic/minute occurred and if tokens were delivered with at least 75% accuracy. For each child, DRO conditions meeting these criteria were compared to BL conditions. Cumulative tic frequency graphs were visually inspected for differences in patterns of responding. Results indicated that tics during BL generally occurred at steady rates, whereas tics during DRO generally occurred in bouts. Results suggest that children who are unable to fully suppress their tics during a DRO schedule tend to redistribute the occurrence of tics into bouts. Implications and future directions will be discussed. |
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| 49. A Preference Assessment of Qualities of Attention Delivered from Care Providers to Children: An Analysis of “Saying versus Doing”. |
| Area: CBM; Domain: Applied Research |
| REBECCA A. CRAWFORD (Northern Arizona University), Micael E. Burnett (Northern Arizona University), Audra F. Gentz (Northern Arizona University), Andrew W. Gardner (Northern Arizona University) |
| Abstract: Idiosyncratic qualities of attention have been shown to influence behavior (Kodak, Northup & Kelley, 2007). However, few studies have systematically identified individual qualities of attention desired by typically developing children. Preference assessments have typically been used to identify preferences for tangible items and edibles (Fisher et al., 1992) and are typically completed in vivo (versus verbal report). The current study used a preference assessment to identify and compare verbal and actual preferences for specific qualities of attention through a two-phase study with three typically developing children. In Phase 1, verbal choices for qualities of attention were recorded. In Phase 2, each child was presented with the same choices (via concurrent operants) in vivo with a parent in a clinic setting. Time allocation was the dependent variable and 30% of all sessions included IOA. Some of the qualities of attention presented to each child included: proximity, physical contact, vocal intonation, reprimands versus positive vocalizations, type of physical contact, and schedules of reinforcement for their choices. The results are discussed in terms of differences in what children may say and what they might choose in vivo, as well as a methodology to accurately identify children’s preferences for specific qualities of attention. |
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| 50. Analysis of an Attention Deficit-Hyperactivity Disorder (ADHD) Assessment with the use of Antecedent Manipulation. |
| Area: CBM; Domain: Service Delivery |
| JENNIFER S. KAZMERSKI (Mississippi State University), Kristin N. Johnson-Gros (Mississippi State University), Keever Gartman (Mississippi State University) |
| Abstract: Current practice for Attention Deficit-Hyperactivity Disorder (ADHD) assessments utilizes behavior rating scales, interviews and observations. Ideally, these assessments should occur across settings and rule out a differential diagnosis. Unsuccessful students may not only have academic deficits but possibly behavioral excesses in the instructional environment that may present similar to ADHD. To gain an accurate picture of behavior it is necessary to manipulate the tasks within the environment to show consistency regardless of the task. The present study utilized ADHD assessment reports with and without additional behavioral assessment. The reports were presented to school psychologists, clinical psychologists and pediatricians through an electronic internet survey system to determine if a diagnosis was given with or without the additional behavioral assessments. A discussion, potential limitations, and future research will be provided. |
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| 51. An Evaluation of a Concurrent Schedule to Increase Self-Feeding in Children Diagnosed with Feeding Disorders. |
| Area: CBM; Domain: Applied Research |
| VICTORIA STEWART (University of Nebraska Medical Center), Cathleen C. Piazza (University of Nebraska Medical Center, Munroe-Meyer Institute), Kristi D. Murphy (University of Nebraska Medical Center, Munroe-Meyer Institute), Heather J. Kadey (Marcus Autism Center) |
| Abstract: A child is diagnosed with a feeding disorder when he or she consumes an insufficient amount of food or liquid to gain weight and grow. Data from a number of research studies conducted with children diagnosed with feeding disorders has shown that negative reinforcement in the form of escape from eating maintains the inappropriate mealtime behaviors of these children. Specifically, the results of functional analyses conducted with 15 children in one study indicated that escape from eating was the maintaining variable for inappropriate mealtime behavior of 90% of the children whose functional analyses were differentiated. Furthermore, the motivation to escape eating may increase as a function of alterations in the response effort associated with eating. Therefore, the purpose of this study was to examine the effects of manipulation of response effort to increase the self-feeding of 2 children diagnosed with a feeding disorder. |
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| 52. Clicking to Decrease Behavior: A Pilot Study on Habit Reduction in Adults. |
| Area: CBM; Domain: Applied Research |
| DIANA J. WALKER (The Chicago School of Professional Psychology), Vinh Dang (The Chicago School of Professional Psychology) |
| Abstract: “Clicker training” has been used to establish or refine behavior in humans. Clicker training appears to be effective because it provides immediate feedback for correct behavior and functions as a positive reinforcer. The present study seeks to examine whether “clicking” can be used to decrease habits, such as nail biting, hair pulling/twisting, and swearing, in adults. If clicking is effective in decreasing behavior, it may be preferable over other habit-reduction techniques, which can be time-consuming, overly aversive, or stigmatizing. In this ongoing study, adults who report that they want to reduce a habitual behavior are observed in a classroom or other naturalistic setting, or in a contrived social situation. After baseline observations, a fixed-ratio 1 schedule of clicking begins, in which clicks are contingent on each instance of the target behavior. At least one reversal to baseline is conducted, and a transfer to “self-clicking” is attempted. The data from this study will show whether clicking is effective under these circumstances and may suggest future research that can examine generalization and maintenance effects, as well as generality across populations and responses. |
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| 53. Effects of Behavioral Treatments to Children with Intestinal Failure. |
| Area: CBM; Domain: Applied Research |
| LARA BARNETT (University of Nebraska Medical Center, Munroe-Meyer Institute), Cathleen C. Piazza (University of Nebraska Medical Center, Munroe-Meyer Institute), Kristi D. Murphy (University of Nebraska Medical Center, Munroe-Meyer Institute), Heather J. Kadey (Marcus Autism Center) |
| Abstract: Intestinal failure (IF) is defined as reduced absorption of nutrients from the gastrointestinal tract, resulting in the need for parenteral nutrition (PN) for survival. We hypothesize that behavioral feeding problems (e.g., aversions to eating) develop in many children with IF as a result of their inexperience with eating, the pairing of unpleasant experiences with eating (e.g., diarrhea), and/or their experiences with painful and/or unpleasant medical procedures, particularly those involving the face and the mouth (e.g., laryngoscopy). Prior studies have suggested that behavioral treatments are effective for increasing acceptance of food and decreasing inappropriate mealtime behavior in children with feeding disorders. However, there is limited research applying these procedures to children with IF. Therefore, the purpose of the current investigation is to apply behavioral treatments to children with IF and food refusal to demonstrate that children with IF and food refusal can transition to oral feeding following treatment; and to treat a small group of children with IF and feeding refusal to demonstrate that transition to oral feeding is possible even in children with significant avoidance behavior. Results indicated that over 87% of the goals set for children with IF were met by the time of discharge through use of behavioral treatments that included extinction and reinforcement components. |
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| 54. Effects of Self-Monitoring on Mealtime Behaviors of a 9-Year-Old Boy with Food Refusal. |
| Area: CBM; Domain: Applied Research |
| PING WANG (Kennedy Krieger Institute), Emily Sangkavasi (Kennedy Krieger Institute), Peter Girolami (Kennedy Krieger Institute) |
| Abstract: Swallowing food in a timely manner is one of the ultimate goals when treating food refusal. However, packing (i.e., holding or pocketing food) often interferes with meeting the goal. Previous studies used treatment procedures including both antecedent manipulations of variables such as texture, spoon size, preference/food groups as well as reinforcement-based strategies. The current study examined the effects of self-monitoring procedures on the latency to swallow, percentage of mouth cleans and percentage of independent bites of a 9-year-old boy diagnosed with feeding disorders. Results demonstrated that latency to swallow was decreased during the self-monitoring condition compared to the baseline condition, and percentage of mouth cleans was greater during the self-monitoring condition than the baseline. The effectiveness of self-monitoring was also demonstrated on other target mealtime behaviors. |
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| 55. Effect of a Paired Choice Stimulus Preference Assessment on Decreasing Food Neophobia. |
| Area: CBM; Domain: Applied Research |
| ADRIANNA M. AMARI (Kennedy Krieger Institute), Bridget G. Gibbons (Kennedy Krieger Institute), Keith J. Slifer (Kennedy Krieger Institute/Johns Hopkins University) |
| Abstract: Food neophobia in young children is well-documented. Systematic research with children indicates that a minimum of 8-10 exposures may be needed to increase initial acceptance of new foods, with clear increases in acceptance after 12-15 exposures. In this study, parents of children with and without medical diagnoses (N=29) completed a Food Experience Inventory to rate the frequency of the each child’s previous exposure to 14 food items. The children then participated in an in vivo paired choice food preference assessment, in which each item was paired with every other item. Children were asked to choose and allowed to consume small amounts of the selected item from each random pair. Items that had been rated on the inventory as having never been tried were compared with results of the preference assessment for each child. Surprisingly, many previously unexposed food items were not only accepted, but were chosen by children at a frequency indicating moderate to high preference; unexposed foods were rarely avoided. Data will be presented, and these findings, which suggest a potential treatment effect of the paired choice procedure methodology on food neophobia, will be discussed. |
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| 56. A Comparison of Molar vs. Spoon Placement to Increase Mouth Cleans. |
| Area: CBM; Domain: Applied Research |
| JOHN P. ROCK (Kennedy Krieger Institute), Danielle N. Dolezal (Kennedy Krieger Institute), Regina Meredith Elkins (Kennedy Krieger Institute) |
| Abstract: We compared the effects of bite placement, with and without contingent positive reinforcement, on a child’s mouth cleans across three different food categories. Escape extinction was in place throughout the evaluation of bite placement and positive reinforcement conditions. The participant was a 2-year-old boy diagnosed with gastroesophageal reflux, failure to thrive, oral-motor skill deficits and feeding difficulties. Bite placement consisted of the following two conditions (a) traditional spoon placement: a ½” x ½” piece of food placed in the mouth by a spoon or (b) molar placement: a ½” x ½” piece of food placed in the mouth by the feeders hand directly to the child’s lower molar teeth. Two different positive reinforcement conditions consisted of either noncontingent access to toys or contingent access to toys for mouth cleans. We examined the effects of bite placement across three food categories (fruits, vegetables, and starches). A multielement design was embedded within a multiple baseline across food categories to evaluate the effects of bite placement. Results showed that molar placement facilitated shorter latencies to swallow the food across all food categories when combined with DRA for mouth cleans. |
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| 57. Using a Treatment Package to Decrease Expulsion in Children with Feeding Problems. |
| Area: CBM; Domain: Applied Research |
| JENNIFER LEIGH KING (Clinic 4 Kidz), Meeta R. Patel (Clinic 4 Kidz), Angela Pruett (Clinic 4 Kidz) |
| Abstract: Children with pediatric feeding disorders may display a variety of inappropriate behaviors (e.g., pushing the spoon away, head turning) to avoid eating and in some cases other problem behaviors such as expulsion may emerge. However, it is unclear whether expulsion, like other inappropriate behaviors is maintained by negative reinforcement in the form of escape from eating. In some cases expulsion occurs due to a skill deficit (i.e., limited oral motor skills) and in those cases an alternative treatment to escape extinction would be warranted. The purpose of this study was to evaluate a treatment approach to decrease expulsion by using escape extinction and bolus (size of the bite on the spoon) fading. A multiple probe design was used to evaluate the treatment package. Data showed that in baseline mouth cleans (i.e., swallowing) were low and expulsion was high. However, as the bolus was faded in small increments, mouth cleans increased and expulsion decreased. In addition, another procedure (keeping the spoon in the mouth) was necessary to further decrease expulsion. Responding (high mouth cleans and low expulsion) also generalized to a variety of foods and maintained in follow-up. These data are discussed in relation to negative reinforcement, escape extinction, and skills training. |
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| 58. Using an Antecedent Assessment to Treat Feeding Problems in Children. |
| Area: CBM; Domain: Applied Research |
| ANGELA PRUETT (Clinic 4 Kidz), Meeta R. Patel (Clinic 4 Kidz), Jennifer Leigh King (Clinic 4 Kidz) |
| Abstract: Children with pediatric feeding disorders may display a variety of inappropriate behaviors (e.g., pushing the spoon away, head turning) to avoid eating. It is unclear what properties of eating are aversive to children. Previous research has indicated the utility of escape extinction as an effective treatment to increase oral consumption in children with feeding problems. However, escape extinction has also been shown to produce some negative side effects such as extinction bursts and/or emotional responding. As a result of these side effects, escape extinction may not be considered an acceptable treatment approach to some consumers. More research evaluating alternative approaches to escape extinction is necessary. Therefore, the purpose of this study was to evaluate the effects of various antecedent manipulations for two children who were 100% gastrostomy (G-) tube dependent prior to treatment. Three different conditions (i.e., empty spoon, spoon with water, spoon with yogurt) were evaluated based on the child’s history with eating. The results showed an increase in acceptance and a decrease in inappropriate behaviors under baseline conditions as the child contacted reinforcement for a response that possibly required less response effort. Overtime responding transferred from a response that may have required less effort (acceptance of an empty spoon) to a response that required more response effort (acceptance of yogurt). In addition, generalization occurred with a variety of foods. These data are discussed in relation to reinforcement, transfer of control, and response effort. |
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