Positive Behavior Interventions
Volume 3, Number 4, Fall 2001
TABLE OF CONTENTS AND ABSTRACTS
Robert L. Koegel and Glen Dunlap
Treating Sleep Terrors in Children with Autism
V. Mark Durand
Sleep terrors manifest themselves as a sudden arousal from slow wave sleep accompanied by screaming, crying, and other signs of intense fear. Children with autism spectrum disorders may be more likely to display problems with sleep, and a few experience sleep difficulties such as sleep terrors on a chronic basis. This nighttime disruption can lead to a great deal of concern as well as disruption in sleep for other family members. In this first study of the treatment of sleep terrors among children with autism, the effectiveness of one behavioral intervention (scheduled awakenings) was evaluated. Scheduled awakenings involved arousing the child from sleep approximately 30 minutes before expected sleep terror episodes. Results through a 12-month follow-up using a multiple baseline across three children indicated that this intervention quickly and durably reduced the frequency of their nighttime difficulties. Scheduled awakenings is a potentially useful non-medical intervention for chronic sleep terrors among children with autism.
Functional Assessment and Treatment of Mealtime Behavior Problems
Tami L. Galensky, Raymond G. Miltenberger, Jason M. Stricker, and Matthew A. Garlinghouse
This study utilized descriptive assessment methods to develop hypotheses regarding the function of mealtime behavior problems for three typically developed children. Functional treatment was evaluated in the natural setting with the caregivers as the change agents. Overall, results of the descriptive assessment suggested that each child's problem behavior was maintained by escape and, to a lesser extent, attention. In addition, this study suggested that direct observation was more reliable than a behavioral interview or questionnaire in acquiring the information necessary to develop hypotheses on factors maintaining a child's mealtime behavior problems. Finally, a functional treatment package, comprised of extinction, stimulus fading, and reinforcement of appropriate eating behaviors, implemented by the caregivers, was effective in decreasing the mealtime behavior problems for two of the children who continued in the study, thus providing support for the hypotheses developed from the assessment.
A Demonstration of the Effects of Augmentative Communication on the Extreme Aggressive Behavior of a Child with Autism within an Integrated Preschool Setting
William D. Frea, Cynthia L. Arnold, and Glenda L. Vittimberga
Research in the area of behavior support has repeatedly demonstrated the positive effects of learning more effective and efficient communication on the challenging behaviors of individuals with developmental disabilities. More recently, augmentative and alternative communication strategies have been receiving increased attention as primary teaching goals for young children with autism. Use of picture exchange and choice making opportunities has been reported to facilitate speech acquisition and/or result in increased communicative attempts across daily routines. The following case study examines the effects of picture exchange on the severe aggressive behavior of a preschooler with autism, at risk of losing his integrated school placement. Picture exchange was introduced within two play routines in the classroom. The effects of picture exchange on the student's aggression were evaluated within a multiple baseline design. Results indicated that the student's aggressive behavior was eliminated in a brief amount of time once picture exchanges were in place. These finding are discussed in terms of integrating augmentative communication into behavioral support planning, and future research in this area.
Long-Term Multicomponent Intervention to Reduce Severe Problem Behavior:
A 63-Month Evaluation
Craig C. Jensen, Gene McConnachie, and Todd Pierson
In this case study, a nonexperimental description is provided of the effects of access to community activities, functional communication training, and living situations on severe self-injury, assault, and property destruction by a 35 year-old man diagnosed with autism and moderate mental retardation. Functional assessments were conducted on an ongoing basis. Based on these assessments, hypothesis-driven intervention decisions made it possible to convert the use of restraint as a crisis management strategy into an intervention strategy. Problem behaviors decreased rapidly following the introduction of a communication strategy and this reduction was maintained after he moved to his own home for the remaining 35 months of the study. Significant improvements in his quality of life were apparent following the move to his own home. The development and implementation of the man's intervention plan was consistent with the recommendations of Carr et al. (1999a) regarding best practices in the area of community-based positive behavioral support and illustrates an approach to making complex intervention decisions through ongoing functional assessment, hypothesis generation, and analysis of behavioral data.
Programming Common Stimuli to Promote Generalized Question-asking: A Case Demonstration in a Child with Autism
Prudence H. Esbenshade and Jess Rosales-Ruiz
This research is a case demonstration of programming generalized question-asking. A 5-year-old child with autism was taught to: a) ask "What is that?" in the presence of unknown objects and b) name the objects he did know. In the training task, the experimenter held each item in front of the child and asked, "What is this?" Generalization in the presence of the experimenter was probed across four new tasks: a) with 4 items on the table, the experimenter instructed the child, "Tell me what you see on the table;" b) the experimenter held 10 cards face down and fanned out in front of the child and instructed the child, "Pick one;" c) while pointing to the location of an item, the experimenter said, "Look, [name of participant]" and d) the experimenter handed the child an item and instructed the child to either give an object to another person or to place an object in another location (i.e., "Give this to [name of third person]" or "Put this on the table/ counter/ bed."). The child's performance generalized to the first 3 tasks without additional training. The fourth task required programming of common stimuli before generalization occurred. Generalization was also assessed with the caregiver across these same four tasks. Results for the generalization probes involving the caregiver were similar except for the fourth task.