autism exam 2 Flashcards
fad intervention
a “craze”; short-lived; widespread
autism treatment is largely considered a “fad magnet”
these interventions are not based on science and their effectiveness has not been researched
science, evidence-based treatment
-relies on experimental approach to show that an intervention works
-uses methods that can rule out alternative explanations: experimental design, not based on case studies, anecdotes, or correlation
-verifies findings by replication by other researchers
-objective data collection
-defined variables
-clearly explained treatments that connect what is known
-peer review
-self-correcting attitude
pseudoscience
-a method that seeks confirmation of an already accepted conclusion
-uses practices that are said to be based on scientific method and theory, but are often anecdotes, case studies, and research designs that do not rule out others
-described in a way that make them appear scientific: use jargon, endorsed by people with credentials
-purposeful misrepresentation of facts/evidence
scientific method
observation/question - research topic area - hypothesis - test with experiment - analyze data - report conclusions that either support or refute hypothesis
anti-science
-rejection of scientific method as a way of gaining knowledge
-failure to recognize the importance or existence of objective facts
self-correcting attitude
science has a self-correcting attitude, which means that it identifies where improvements can be made and corrections are made when needed
differences between pseudoscience, science-based, and anti-science with respect to autism interventions and a method of obtaining knowledge in general
-science/evidence-based treatments only make up 1% of treatments available, even though there are hundreds of treatments for autism that can be found online
-pseudoscience and fad therapies are not reliable for autism interventions
-science & evidence-based interventions are based on experiments that prove that interventions work & can rule out other possible explanations
why are pseudoscientific interventions a problem for autism
-pseudoscience interventions are problematic for autism treatment, because they are not helpful or accurate
-pseudoscience treatments claim to have high success rates, promise a quick fix, and have lots of other red flags
-such as: training is not needed, heavy use of jargon, often contradict science or common sense, need “faith” for intervention to work, critical of testing the intervention, ignore negative findings, hostile towards critics, and avoid peer review
reasons why parents might choose a non-evidence-based practice
parents choose fad therapies for multiple reasons, such as:
-lack of understanding about what science is
-lack of critical thinking skills
-pressure to act quickly & achieve the best results (science based interventions take years of work, involve parents and are costly)
how to identify science-based and pseudoscientific interventions
scientific:
-use evidence to inform belief, relies on entire body of evidence
-conservative claims that are tentative & change based on new evidence
-precise & measurable terminology conductive to understanding & replication
-knows, understands, & applies logic with body of evidence to defend position
-views critics as colleagues; seeks criticism & refutation
pseudoscience:
-forms beliefs first & selects evidence to confirm; disqualifies/rejects opposing evidence
-grandiose claims uncoupled from evidence; dogmatic & unchanging when provided new & conflicting evidence
-convoluted evidence w jargon to elude criticism; inhibit replication & defund outstanding findings
-relies on logical fallacy & selected evidence to advance a position
-views critics as enemies; avoids criticisms & condemns dissent; works alone
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augmentative and alternative communication (AAC)
-communication tools for for those with limited or no vocal speech
-2 types of AAC systems: topography based and selection based
topography based systems
one of the two AAC systems
-unaided/does not include external materials
-different form of a response for different meanings
includes:
-gestures
-manual signing (ASL)
advantages:
-may be easier for someone with intellectual disability to learn
-hands are always there
disadvantages
-requires fine motor skills
-not universally understood
-each sign needs to be taught
selection based system
one of two types of AAC system
-aided/involve use of a device or communication aid
-series of meaningful symbols
-learner responds to the symbol to communicate
includes:
-speech generating devices
-iPad systems
-PECS
advantages:
-easy to update/maintain
-portable
-pictures are understood by most
-can be used to teach sentence structure
-once the response it taught, new pictures can be introduced without additional response teaching
disadvantages:
-less efficient with longer utterances
-binders become cumbersome as vocabulary grows
-pictures can get lost
picture exchange communication systems (PECS)
-picture exchange communication system
-a selection based AAC system
-individual with autism learns to give picture of desired object to communication partner, who immediately honors the exchange as a request
-goal is to teach functional communication
echoics
one of the 4 verbal behavior vocabulary words
-repeating what was heard
reciprocal interactions
exchange in which individuals or objects exhibit similar behavior, either at the same time or in a back-and-forth manner
-part of typical development occurring at 6-12 months
tact
one of the 4 verbal behavior vocabulary words
-object/stimulus identification
semantics
a part of language that is concerned with the meaning of words
-study of meaning of words, sentences, and phrases
-what a speaker conventionally means (objective or general meaning) - not what he is trying to say
mands
one of the 4 verbal behavior vocabulary words
-asking for what you want
nonverbal communication
-ability to read and understand other’s facial expressions and gestures
broca’s area
-plays a critical role in language
-controls the ability to speak words
wernicke’s area
-plays a critical role in language
-controls the ability to understand the meaning of words
pivotal response training (PRT)
-play-based behavioral treatment
-target pivotal areas of development instead of working on one specific behavior
-this means that treatment spans & improves areas like communication, behavior and learning
-major component of ABA treatment
expressive verbal language
the ability to express a person’s wants and needs through verbal communication
-sentences make sense and are grammatically correct
-the “output” of language
response to joint attention (RJA)
JA: coordination of attention between 2 people and an object; active shared experience
responding to JA: ability to follow the direction of the gaze and gestures of others in order to share a common point of reference
language
one component of communication
-system of abstract symbols
-rule-governed
intraverbals
one of the 4 verbal behavior vocabulary words
-responding to someone else’s words
verbal behavior
-book by BF Skinner that discusses the verbal behavior vocabulary (echoic, mand, tact, intraverbal)
-ABA approach to expressive language skills
-verbal behavior language can be taught
-language assessment & teaching protocol based on BF Skinner’s verbal operants (VB-MAPP)
verbal behavior-milestones assessment and placement program
-used for really young learners
VB-MAPP
-language assessment & teaching protocol based on BF Skinner’s verbal operants
-verbal behavior-milestones assessment and placement program
-used for really young learners
a criterion-referenced communication assessment
communication
ability to use spoken words, gestures, facial expressions, and symbols to convey or receive information, like feelings and thoughts to and from another person
-communication allows a person to get their needs met and for relationships with others
discrete trial instruction
involves breaking skills down into smaller components and teaching those smaller sub-skills individually
-repeated practice of skills is conducted
-teachers may incorporate prompting procedures as necessary
receptive language
-how we interpret language and understand others
-can often be a challenge for kids who have been diagnosed with autism
-the “input” of language
-the ability to understand and comprehend spoken language that you hear or read
initiating joint attention (IJA)
involves use of gestures and eye contact to direct others’ attention to objects, to events, and to themselves
video modeling
-video demonstration of the behavior
-learner then practices the modeled behavior
syntax
the arrangement of words and phrases to create well-formed sentences in a language
typical early language development across different developmental stages
-3 months: will coo, smile and laugh, begin to play with sounds & communicate with gestures like waving and pointing.
-4-6 months: start babbling, make single-syllable sounds like ‘ba’, babbling is followed by the ‘jargon phase’ (‘speech’ won’t sound like recognisable words)
-10-11 months: baby might speak their first word and know what it means.
-12 months: baby should be using gestures
-12-18 months: say a few words and know what those words mean
communication differences in children with autism
impaired joint attention, language (verbal and nonverbal)
importance of communication
communication allows a person to get their needs met and for relationships with others to be created
foundational skills for typical language development
foundational skills:
-joint attention: coordination of attention between 2 people and an object; active shared experience
-communicative intent: speaker intends to convey something to another person
-symbol use: a word (spoken or written), gesture, picture used to convey meaning
list and describe the verbal operants
4 verbal operants
-mand: asking for what you want
-tact: object/stimulus identification
-echoic: repeating what was heard
-intraverbal: responding to someone else’s words
importance of language assessments
-critical when beginning intervention
-determine client’s developmental level
-determine what skills a client has
-on-going assessment: change intervention to meet needs
-point to areas that need intervention
considerations for language/communication assessment (10)
-frequency of social-communication interactions with others
-how interactions are initiated
-purpose of the interaction (request something, protest, shared experience)
-joint attention
-symbol use (eye gaze, gestures, facial expression)
-play skills (parallel play, pretend play)
-spoken language skills
-activities the client enjoys
-client strenghts
-preferred way to learn
distinguish between norm-referenced and criterion-referenced assessments
norm-referenced: compare the client’s language skills to a group of peers
-standardized assessments
-get a percentile score
-typically focus on 1 aspect of language (labeling)
-used in many states to determine eligibility for services
criterion-referenced: compare client’s language skills to a predetermined standard
-establish a baseline for each skill (what the client can and cannot do)
-point to specific areas for intervention
describe AAC interventions
-augmentative and alternative communication
-communication tools for those with limited or no vocal speech
-2 types: topography based and selection based
-topography: unaided, does not include external materials
-selection: aided, use device or communication aid
how did the schedule/routine for the parents and for tristan differ? how does this help tristan?
Tristan has a separate schedule made for himself that involves pictures of his daily activities
-this helps him understand that there is a schedule to every day & it is not fully random
-Tristan’s schedule did not include times on it like the family’s did, his was only very simple pictures and words
-His also had removable pictures that could be taken off once the activity is completed
what were the 3 steps used in the intervention to get tristan to speak?
- finding something Tristan likes enough that he’ll try to talk for it (in the video, this was swings)
-this gives him opportunity to speak - prompting him to talk (stopping activity & saying word to him hoping he’ll repeat word to continue activity)
- rewarding him for any attempt or any good word
when tristan needed to speak to get what he wanted, what did he do first? how did the mom and Dr. Koegel respond?
he started to throw tantrums/get upset and lash out when he was made to speak in order to get the preferred activity
-they did comfort him but had to continue stopping the activity in order to give him more opportunities to speak
-can’t give him the prefered activity even when he would cry because it’s not a good way to communicate - he must use communication and words
how does this intervention procedure differ from AAC systems and the interventions discussed in the chapter?
this intervention procedure is different from both types of AAC systems. Like topographical, it is unaided, but topographical systems use gestures or manual signing. Tristan’s intervention forced him to use words (or attempt to) without gestures or signing.
prompting
one of the 4 performance enhancement strategies for social communication
-cues and other support to guide the client to perform the behavior
-can be: vocal, gesture, physical, or model
common social skills performance deficits
impaired:
-nonverbal communication
-social reciprocity
-social initiation
-social cognition
those with ASD less likely to:
-respond to initiations from others
-approach & imitate peers
-share toys
-offer assistance to others
-seek or respond to adult attention
-interactions are often repetitive, one-sided or unusual
social reciprocity
poor “give-and-take” in the interaction; one-sided interactions
gesture
part of nonverbal communication
a movement of part of the body, especially a hand or the head, to express an idea or meaning.
-children with autism have impaired use and understanding of gestures
-this is an early sign of impaired social communication & skills
motivating operations (SEAT)
one of the principles of behavior
there are 4 functions of behavior:
-attention (provide access or awareness to/from people or interactions)
-escape (remove undesired activities, interactions or situations)
-tangible (provide preferred activities or items)
-sensory (provide stimulation to pleasure zone of brain)
social initiation
one of the common social skills deficits
those with ASD have trouble with initiation
-difficulty starting interactions with others OR frequent but inappropriate approaches
-trouble initiating interactions with peers and adults
-trouble initiating new tasks by themself
social scripting
-one of the skill acquisition strategies for social communication
-uses storytelling techniques to explain new experiences, environments, and interactions to Autistic people through simple language and images
-ex: someone is annoying me - 1) look at them 2) put my hand up in a ‘stop’ sign 3) say to the person “stop it, I don’t like it”
social problem solving
one of the skill acquisition strategies for social communication
-very advanced skill
-uses roleplaying and situations
-could include asking for help
social cognition
impaired understanding of other’s thoughts, intentions, motives and behaviors
peer-mediated intervention
one of the 4 performance enhancing strategies used in social communication
-used to teach typically developing peers ways to interact with and help learners with ASD acquire new social skills by increasing social opportunities within natural environments
self-monitoring
one of the 4 performance enhancing strategies used in social communication
-goal is for student to be able to record and track their own behavior
-act of assessing, recording and tracking own behavior can change the frequency of behaviour
-can increase/decrease frequency, intensity, and duration of existing behavior
social stories
one of the skill acquisition strategies for social communication
-presenting social concepts and rules to children in a brief story
-individualized and made based on the child’s need
-written at the child’s level
-written in a way pleasing to the child
-personalized
common social skills deficits in autism
-nonverbal communication: ability to read and understand other’s facial expression and gestures
-social reciprocity: poor “give-and-take” in the interaction; one-sided interactions
-social initiation: difficulty starting interactions with others OR frequent but inappropriate approaches
-social cognition: impaired indersanting of other’s thoughts, intentions, motives, and behaviors
assessment considerations related to social skills
-norms and conditions in the client’s home
-availability of natural reinforcers for the target
-behavior of typically developing peers
-current communication skills
-presence of competing behaviors or reinforcers
-relevance across multiple contexts
distinguish between acquisition vs performance deficits
-performance deficit: refers to a skill or behavior that is present, but not demonstrated or performed
-skill acquisition deficit: refers to the absence of a particular skill or behavior
3 common mistakes in teaching social skills
-not doing an assessment
-teaching at too high a level
-not using explicit teaching techniques
describe some social skill acquisition strategies
4:
-video modeling
-social problem solving
-social scripting
-social stories
describe some social skills performance enhancement strategies
4:
-prompting
-reinforcement
-self-monitoring
-peer-mediated intervention
lower-order RRB
repetitive sensory motor stereotypies
-body movements (hand flapping, body rocking)
-repetitive manipulation of objects
-speech: echolalia
-self-injurious behavior (head banging, eye poking)
higher-order RRB
cognitive behaviors
-compulsions
-insistence on sameness
-rituals and routines
-formulaic phrases
-circumscribed interests
shared characteristics for both categories of RRBs
-behavior involves repetition
-behavior is rigid
-behavior is invariant
functions of RRBs
to gain access to something
-increase arousal (physiological response)
-increase stimulation
-access items in the environment
-access social interaction
to escape from something
-decrease arousal from external stimuli
-reduce stress or anxiety
-block out unpleasant feelings
-get out of doing a task
-remove social interaction
functional analysis
manipulation of environmental variables to determine effect on behavior
-allows you to determine function
-involves: antecedent & consequence behaviors
antecedent
comes before the behavior
may trigger a behavior
ex: school bell rings indicating end of recess
behavior: Ethan pushes peer
consequence
after/follows the behavior
ex: Ethan given time out & consequently attention from peers & teachers
attention condition
one of the 5 functional analysis conditions
-therapist is in the room but does not interact with the client unless the RRB occurs
-therapist gives attention if target behavior occurs
play condition
one of the 5 functional analysis conditions
-client and therapist engage in a preferred task
-therapist gives regular attention
tangible condition
one of the 5 functional analysis conditions
-client has access to an item or activity for a brief period
-therapist then removes the activity
-if RRB occurs, then therapist returns the items/activity
escape condition
one of the 5 functional analysis conditions
-client is asked to complete a task
-if RRB occurs, then therapist removes the task demand for a short period
alone condition
one of the 5 functional analysis conditions
-client is alone in the treatment room
-if target behavior occurs, no consequence is delivered
visual schedule
an antecedent strategy
-images or words to indicate daily activities
non-contingent reinforcement
an antecedent strategy
-delivery of a reinforcement independent and regardless of the performance of a specific behavior
-rewards are not given based on behavior, instead on passage of time
response interruption and redirection
a consequence strategy
-physically or vocally stop the RRB right when it begins
-redirect the client to a more appropriate behavior
lag schedule
a consequent strategy
used to increase variability in behavior
used for people with ritualized behaviors
-only reinforce a behavior when it is different from a previous behavior
-LAG 2: every other response has to be different in order for reinforcement to occur
(can be any Lag #)
differential reinforcement
a consequent strategy
-DRO and DRA
-selectively reinforcing desired behaviors while withholding reinforcement for undesired behaviors
DRO
differential reinforcement of other behavior
DRA
differential reinforcement of alternative behavior
behavior skills training
a consequent strategy
-specifically teaching replacement behaviors
RRB (restrictive and repetitive behavior)
very broad category of behaviors that is divided into 2 categories:
-repetitive sensory motor stereotypies
-insistence on sameness
distinguish between the types of RRBs
lower vs higher order
-lower = sensory motor stereotypies
-higher = cognitive behaviors
discuss RRBs in and out of autism
RRBs are not limited to ASD
seen in those with:
-sensory impairments
-intellectual disability
-other diagnoses
-neurotypical people
seen as: foot tapping, nail biting, leg shaking, hair twirling, listening to same song, watching same TV/movie many times
discuss when intervention is required for RRBs
it is a problem when the behaviors are:
-socially stigmatizing
-causing family stress
-limiting interactions with peers/others (lost opportunities to learn via observation)
-interference with classroom engagement and learning
-is potentially harmful (self-injurious behaviors)
describe assessment considerations for RRBs
3 questions
1. what is the nature of the RRB?
2. does the RRB have negative impacts on the person? (if the answer to this is no, then leave the behavior alone)
3. why is the RRB occuring/what is its function?
describe specific intervention strategies
intervention strategies are determined based on assessment results
antecedent
-altering the environment & identifying triggers
-increase structure (unstructured time increased RRBs)
-visual schedules
-provide non-contingent access to preferred items
consequent
-changing the outcome of behavior
-response interruption & redirection
-lag schedules
-differential reinforcement
-behavior skills training
compare and contrast FC with AAC interventions
FC:
-depend on others to communicate
-disproven in numerous studies, anecdotal reports
-cites miraculous changes and major improvements very quickly
-counters well-established scientific theories and facts
-no systematic training needed to facilitate
-impossible to replicate
-allegedly instant results
AAC:
-goal is independence from others & functional communication
-many studies and results supporting method
-requires highly-trained personnel to implement practices
-progress is often slow and varies for each person
-results in functional communication
FC (aka S2C or rapid prompting method) and the problems with these interventions
facilitated communication and speech to communication
5 principles of behavior that interventions are based on
-reinforcement
-punishment
-extinction
-stimulus control
-motivating operations
7 principles of ABA
GETACAB
-generality
-effective
-technological
-analytic
-conceptually systematic
-applied
-behavioral
Applied
-Socially significant/meaningful to client and family
-Will improve way of life
Behavioral
-Observable and measurable
-What we SEE (different than mental health therapy)
-We avoid “I feel” (i.e., private events, thoughts, feelings)
Analytic
-The data
Technological
-Replicate it to ensure others can mimic our intervention
Generality
-Ensure behaviors can overlap in other settings, i.e., from home to school vice versa
Conceptually systematic
-Research based and emphasize principles of behavior
Effective
-Is it working?
what type of study was used to disprove the effects of FC
double blind study
-researcher and participants don’t know what stimulus each person received
-study proved that facilitator was playing unconscious role in affecting communication
