BCAT Flashcards
Autism Spectrum Disorder (rate 1/88)
definition
deficits in social-emotional reciprocity: ranging from abnormal social back and forth conversation through reduced sharing of interests to total lack of initiation of social interaction
ASD
Abnormal social appriach
- unusual social initiations (eg. intrusive toughing or licking others)
- use of others as tools
ASD
Failure of normal back and forth converstations
- poor pragmatic/social use of language (e.g. does not clarify if not understood; does not proivde backgound info)
- failure to respond when name called or when spoken to directly
- does not initaite conversations
- one sided conversation/monolugues/ tangential speech; train of though wanders/ lack of focus
ASD
reduced sharing of interests
- doesn’t share
- lack of showing, brining, or pointing out objects of interest to other people
ASD
reduced sharing of emotions/affect
- lack of responsive social smile (response to others’ smile)
- failure to share enjoyment, excitement or achievement with others
- faiure to respond to praise
- doesn’t show pleasure in social interactions
- failure to offer comfort to others
- indifference/ aversion to physical contact/ affection
ASD
lack of initiaton of social interaction
- only initiates to get help/ limited social initiations
ASD
poor social imitations
failure to engage in simple social games
ASD defition 2
Deficits in nonverbal communicative behaviors used for social interaction: ranging from pooryly integrated verb al and nonverbal commmunication through abnormalities in eye contact and body language, or deficits in understanding a nd use of nonverbal communication to totoal lack of facial expressions or gestures
- impairments insocial use of eye contact
- impaireement in the use and unerstanding of body bosture ( eg facing away from listener)
- impairment in the use and understa nding of gesture (e.g. pointing waving nodding and shaking head
- abnormal volume, pitch intonation,, rate, rhythm, stres or prosody in speech
- lack of coordinated verbal and nonverbal communication (e.g. inability to coordinate eye contact or body language with words)
- lack of coordinated non verbal communicagtino (e.g. inability to coordinate eye contact with gestures)
ASD abnomalitie s in use and understanding of affect
- impairment in use of facial expresion (may be limited or exaggerated)
- lack of warm, joyful expressions directed at others
- limited communication of own affect (inability to convey a range of emotions, via words, expressions, tone of voice, gestures
- inability to recognize or interpret others’ nonverbal expressions
ASD defition 3
Deficits in developing and maintaining relationships appropriate to developmental leel (beyond those with caregivers) ranging from difficulties adjusting behaviors to suit different soical contexts through difficulties in sharing imaginative play and in making freinds to an apprents absence of interest in people
ASD
deficits in developing and maintaining relationships appropreiate to developmental lev;el
- lack of “theory of mind” inablity to take anothers perspective
ASD
difficulties adjusting behavior to suit socal context
- doesn’t notice anoth pe3rson’s lack of interest in an activyt or their distress/disinterest
- lack of response to contextual cues (eg. social cues from other indicating a change in behavior is implicity requested
- inappropriate expressions of emotions (laughing or smiling out of context)
- unaware of social conventions/appropriate social behavior; asks socially inappropriate questions or makes socially inappropriate statements (e.g. “oh great you’re here)
- doesn’t recognize when not welcome in play or conversational seting
- limitied recognition of soical emotions (e.g. doesn’t notice when being teased; doesn’t notice his/ her bx battern impacts others emotionally)
ASD
difficulties in imagitative play
lack of imaginative play with peers, inclduin social role playing
Difficulties in making friends
- doesn’t try to establish friendships
- doesn’t have prefferred friends
- lack of cooperative play, parallel play only (e.g. play next to each other but not interested in what other is doing)
- unaware of being teased/ridiculed by other children
- doesn’t play with children his/her age or developmental level
- has an interet in frienship but lack understanding of the conentions of social interactions (eg. extreemly directive or rigid; overly pasive)
- doesn’t respond to the social approaches of other children
ASD
absence of interest in others
- lack of interest in peers
- withdrawn/ aloof in own world
- doesn’t try to attract attn of others
- limited interest in others
- unaware or oblivious to children or adults
- limited interactions with others
- prefers solitary activiites
ASD 4 definition
stereotyped or repetitive speech, motor movoement, or use of objects (such as simple motor stereotypies, echoalia, repetitive use of objects, or idiosyncractic phrase
ASD
stereoytped or repetitive speech
- pedantic speech or unusually formal language (eg speaks like little adlt or “little profesor”
- echoalia (immediate or delayed ); may inclue repition of words, phrases, or more extensive songs/ dialogue
- “jargon” or gibberish (mature jargoning after develpmental age of 24 months)
- use of “rote language” from ememory, without thought of the meaning
- idiosyncratic or metaphorical languae (language that only has meaning to those familiar with the indivudals communicatio style;
ASD
stereotyped or repetitive motor movements
- repetitive hand movements (eg. clapping, finger, flapping, or twisting)
- stereotyped or complex whole body movements (e.g foot to foot rocking, dipping spinning)
- abnormailites of posture (e.g. toe waking); full body posturing
- intense body tensing.
- unusual facial griamcing
- excessive teeth grinding
- repetitively puts hands over ears, not in response to loud sounds
- perserverative or repetitive action/ play/ bx (if 2 or more components than considered a routine)
- repetitive picking
ASD
stereotyped or repetitive use of objects
- nonfunction play with objects (eg. waving sticks, dropping items)
- lining up toys or items
- repetitively opens/ closes doors or turns ligths on/off
ASD
definition 5
Excessive adherence to routines, ritualized paterns of verbal or nonverbal bx, or excesive resistance to change; such as motoric rituals, insistence on samw routine or food, repetitive questioning, or extreme distress at small changes)
ASD
Adherence to routine
- routines: specific, unusual multiple step sequences of behavior (2+ components)
- insistence on rigity following specific routine
ASD
Ritualized patterns of verbal and nonverbal behavior
- repeptitive questioning about a particular topic
- veral rituals: has to say one or more things in a specific way or requires other to say things or answer questions in a specific way
- compulsions (e.g. insistence on turning in a circle 3 times before entering a room)
ASD
Excessive resistance to change
- difficulty with transitions
- overreaction to trivial changes (e.g. moving items at diner table or driving alternate route)
ASD
rigid thinking
- inability to understand humor
- inability to understand nonliteral aspects of speech such as irony or implied meaning
- excessivily rigid, or rule bound in bx or thought
ASD definition 6
Highly restricted, fixated interests that are abnormal in intensity or focus; ( such as strong attachment to or a preocupation with unusual objects, excessively circumscribed or perserverative interests)
ASD
Highly restricted fixated interests that are abnormal in intensity or focus
- preoccupations/ obsessions
- interests that are abnormal in intensity
- narrow range of interests
- focused on same few objects, topics, or activities
- preoccupation with numbers, letters, and symbol
- being overly perfectionistic
- interests that are abnormal in focus
- excessive focus on nonrelelvant or non fucntional parts of objects
- attachment to unusual inanimate object (e.g. piece of rubber band)
- Having to carry around or hold specific or unusual objects (not common attachment objects such as blankets or stuffed animals)
- unusual fears (e.g. afraid of people wearing earrings or lion in the MGM ads)
ASD definition 7
hyper or hypo-reactivity to sensor input or unusual interest in sensory aspects of environement; ( such as apparent indifference to pain/heat/cold, adverse reponse to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects
ASD
hyper or hypo-reactivity to sensor input or unusual interest in sensory aspects of environement; ( such as apparent indifference to pain/heat/cold, adverse reponse to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects
- high tolerance for pain
- poking own eyes
- preoccupation with texture or touch ( includes attraction/ aversion to texture)
- – tactile defensiveness: doesn’t like to be touched by specific objects/ textures
- – significant aversion to having their hair/nails cut teeth or brushed
ASD
unusual visual exploration/activity
- close visual inspection of objects or self for no clear purpose (e.g. holding things at unusal angles with no vision impairment)
- looks at objects/ peole out of corner eye
- unusual squinting of eyes
- extreme fascination with watching movoement of other things (e.g. the spinning wheels of toys, the opening/ closing of doors or an electric fan)
ASD
In all domains of sensory stimuli (sound, smell taste, vestibular, visual) consider:
- odd response to sensory input (e.g. becoming extremely distressed by the atypical sound)
- atypical and/or persistent focus on sensory input
ASD
Unusual sensory exploration with objects ( sound, smell, taste, vestibular)
licking or sniffiing objects
Severity Level for ASD
Level 1 Requiring Support
Social Communication
Without supports in place, deficits in social communication cause noticeable impairments. Has difficulty initiating social interactions and demonstrates clear examples of atypical or unsuccesful responses to social overtures of others. May appear to have decreased interest in social interactions
Severity Level for ASD
Level 1 Requiring Support
Restricted Interests and Repetitive Behaviors
Rituals and repetitive behaviors (RRBS) cause significant interference with functioning in one or more contexts. Resists attempts by others to interrupt RRB’s or to be redirected from fixated interest.
Severity Level for ASD
Level 2 Requiring substantial support
Social Communication
Marked deficity in verbal and nonverbal social communcation skills; social impairments apparent even with supports in place; limited initiation of csocial interactions reduced or abnormal response to social overtures from others
Severity Level for ASD
Level 2 Requiring substantial support
Restricted Interests and Repetitive Behaviors
RRBs and/or preoccupations or fixated interests appear frequently enough to be obvious to casual observer and interfere with functioning in a variety of contexts. Distress or frusturation is apparent when RRb’s are interrupted; difficulty to redirect from fixated interest.
Severity Level for ASD
Level 3 Requiring very substantial support
Social Communcation
Severe deficits in verbal and nonverbal social communication skills cause severe impairments in functioning; very limited initiation of social interatctions and minimal response to social overtures from others
Severity Level for ASD
Level 3 Requiring very substantial support
Restricted Interests & Repetitive Behaviors
Preoccupations, fixated rituals and/or repetitve behaviors markedly interfere with functioning in all spheres. Marked distress when rituals or routines are interrupted, very difficult to redirect from fixated interes or returns to it quicly
BX/ symptoms that may not be captures by DSM-5 ASD
Problems with Play/imagination
-problems with play/ imagination
–impairments in imaginaive/ symbolic lay
– lack of functional play skills
– difficulty distinguishing fantasy from reality
Shyness/ social anxiety
language and developmental delays
- milestone delays/ developmental delays
- speech delays (expressive or receptive)
- language disorder
behavioral difficulties/ temper tantrums
- poor imitation skills (poor SOCIAL imitation skills ARE captured)
Knowledge of research regarding treatment intensity
- one on one treatment : 30-40 hrs/week most intensive; 2 or more years is necessary optimal outcomes
- – most recieve at least 3 years, some require longer others finish early
knowlege of early intensive behavioral intervention research
- 1970’s Ivar Lovaas- treatment can be maximized if intervention is:
- initiated early in child’s life
- -intensive, encompassing most of child’s waking hours
- comprehensive
- addressing all child’s skill deficits and behavioral excesses
DSM 4 Criteria
Total of 6 criteria from three domains, minimum of:
2 criteria w/ social interaction
– Failure to develop peer relationships - isolates self in group seting; when in proximithy of peers may not interact with others
– impairment in use of non-verbal behavior - eye to eye gaze; facilal expressions; gestures
– lack of seeking to share enjoyment interest or achievement with other people - not showing or pinting out objects of interest
- 1 criteria w/i communication
– delay in total lack in development in spoken language, not accompanied by an attempt to compensate throguh alternative modes of communication (gesture or mime)
– if individuals have language, deficient conversation skills (ex. doesn’t initiate ‘hello” when someone enters room)
– repetitive use of language (ex. repeats sounds, phrases out of context)
– impaired make- believe play (ex not engage in make beleive play, or only engage in make beleive play with a tea set where rep repeats same actions over and over
- 1 criteria for restrictive, repetitive and stereotypic bx patterns
– inflexible adherence to routine or rituals (ex. take same route to park each day)
– repetitve motor mannerisms (hand or finger flapping, or rocking back and forth)
– persistent preoccupation with parts of objects (ex. toy car, only interest in the wheels)
1/88 children are affected
4-5 times higher in males than female
onset of symptoms must occur prior to age 3
Distinguishing between evidence based intervention svs. non evidence based interventions
- Ivar lovaas First EIBI effectiveness study
- 1987 experimental group
- 19 kids recieving 40hrs/ week for 2+ years
- control 1 ( young autism project) & control 2 (different provider) recieved 10hrs/ week for 2+ years
- -Results
- – experimental group - 47% Normal function in general ed clas, 40% aphasia class, 10% special ed cls
- – Control groups - 2% in general ed class, 40% in aphasia class, and 53% I special ed class
- 1993 follow up with experimental group:
- 8/9 kids in the general ed and score in normal range in IQ
- 1 participant had moved to general education placement
Principles of ABA
- Positive reinforcement
- Negative reinforcement
- Positive punishment
- Negative punishment
- reinforcer
- punisher
- conditioned reinforcer
- unconditioned reinforcer
- extinction
- deprivation
- satiation
positive reinforcement
when a behavior is strenghtened by the reciept, addition, presentaiton or increased intensity of any stimulus, following an occurence of the behavior* can be socially mediated and automatic: someone delives reinforcer vs. person doesn’t present reinofrcer, problem bx produce preferred sensory stimuli
ex: social positive reinforceemtn = access to tangible
automatic positive reinforcement = sensory stimuli such as look finger waving
negative reinforcement
when a behavior is strengthened due to removal, termination, or avoidance of an aversive stimulus, following an occurence of bx * can be socialy mediated and automatic: problem bx is strenghtheded when someone removes following occurence of problem bx vs. problem snesory stimuli -
ex: social negative reinforcement = escaping from demands
automatic negative reinforcement = escape from sight ( pull jacket over head)
positive punsishment
a stimulus in which its presentation reduces the the likelihood of response that produce- ex: phone rings in class and you are reprimanded for not turning off phone
Negative punishment
stimulus in which its removal reduces the likelihood of responses that terminate it
ex: child yells at mom. gets allowance taken away
reinforcer
a stimulus that isprovided as a consequnce for a behavior that increases or maintains the strength of that behaivor - a preferred stimulus that immediately presented folllowing a response the - elimination of unwanted stumuls follow response
punisher
aversiv e stumulus or negative reinforcer that has the effect of decreasing the strenght (e.g of a behavior when it is presented as a conseuquence of (is contingent on ) that bheavior - a stimuls that the individual will actively work to avoid
Conditioned reinforcer
stimulus that acquired its reinforcing value by being paired with other reinforcers (ex praise or money)
unconditioned reinforcer
simulus whose reinforcing value is rooted bioligcall (natually food)
extinction
focus on eliminating mantaining reinforcer - processs in which previously reinforced behavior no longer result in reinforcing consequence and therefore stops occurin - terminatio of ccess to a function in order to extinguish the behavior - exc: when we use escape extinction = no longer letting client escame from task
deprivation
hunger, thirst, or zero attention - increases effectiveness of reinforcers
satiation
being too full, too much attn, and wants to be left alone, wanting something to cease - reduces effectiveness of reinforcers ex when acleint becomes satiated by music video that used to be an reinforcer
Contingency
What is used to determine the consequence of a particular behavior
contingent vs non- contingent reinforcement
Contingent– a consequence that is contingent based on appropriate/correct responding
Non-contingent: delivering reinforcement regardless of action (without providing reinforcement to extraneous behaviors)
3 term contingency
example: folliwng through with ABC during down time
Antecedent SD = “play with these cars”
Behavior : child plays with cars
Consequence: TX provides verbal praise. The verbal praise is given contingent upon the correct bx in response to the SD
Motivating operation (MO)
Antecedent stimuli that may temporarily increase or decrease value of a reinforcer and evoke a response
Establishing Operatioion
MO that establishes effectiveness of some stimulus, object or event as a consequence
Abolshing Operation
MO that decreases effectiveness of a stimulus , object or event as a consequence (reinforce or punisher)
Evocative Effect:
increase in the momentary frequency of bx
Abative Effect
decrease in the momentary frequency of behavior
Both evocative and abative effects….
influence BEHAVIOR
Conditioned Motivating Operation
MO whose value-altering effect depends on a learning history
Antecedent
An environmental event (stimulus) that precedes a response
ex. the light changes (antecedent) you press on the brake (response)
- a response that comes before a response is not considered n antecedent
Behavior
anything an organism doesn
Critical Attributes of Behavior
- Bx is biological
- involves movement (actions)
- can only be done by a living organism
- observable
- measureable
- involves interaction with the environment
EIBI focuses on function of behavior
refers to circumstanes under which a behavior occurs
Dead man test
anything that a dead persona can do is not considered a behavior
Function of behavior
increases the possibility that a behavior will be used in all or most appropriate situatios and whetehr or not that behavior is likey to be evoked or abated in the future
Receptive Behavior
responding non-vocally to a given instruction, child doesn’t have to say anything
– eg. matching objects, identifying objects
Expressive Behavior
a vocal response, child responds by saying something
- vocally identifying object in response to a question
Receptive/ expressive behavior topographies
description of what language behavior looks like
- doesn’t mean he/she can use it functionally
verbal behavior
any behavior for which consequences is mediated by the behavior of another person (bx reinforced by other person) includes gestruing and sign language)
vocal behavior
behavior that involves vocal output or speech (one speaks or produces souds with voice, can be type of verbal bx)
Other vocal vs verbal
behavior doesn’t have to be vocal to be considered verbal bx
Consequence (AKA postcedent)
a stimulus that occurs after a response
- ex i put on my hat (respone) the sun is no longer in my eyes (consequence
3 term contingency : Antecedent - Behavior Consequence importancee
consistency within consequnce is crucial for treatment with children with autism. It is used to increase appropirat behavior and decrease inappropriate behavior. We manipulate atecedents and consequences to increase appropriate behaviors (skill repetoier building) language skill - increase frequency and variety
ex- followign through with ABC during down time. Antecedent SD - “play with these cars”
Behavior: child plays with cars
Consequence: Tx provides verbal praise, “good playing with cars!” result child continues to play with cars. The verbal praise is gien contingent upuon the correct behaivior in response to the SD
Stimulus
- a change in the environment which can effect behavior
- includes environmental events outside of the observed individual
- involves an energy change
- two general types of stimuli (antecedent, consequence)
Examples: light turns on, music volume increases, a bug bites arm, an onset of a headache
non example - object is not a stimuli, PRESENTATION of object is stimulus
S-R
refers to the Stimulus and Response relationship in which a stimulus is presented and a response occurs
Discriminative stimulus (SD)
- an antecedent that evokes discriminative control of a response
- the sd that has been continually reinforced in the past as a pairning with a particular response
- SD has discriminative conrol (stimulus control) over the behavior of interes
Stimulus control(AKA discriminative control)
- when a bheviaor is more likely to occur in the presnece of a partiuclar simulus because in the past, that behavior has been reinforced in the presence of that stimulus
- Antecedent stimulus EVOKES a response
- Established through differential reinforcement which leads to DISCRIMINATION
ENVIRONMENT and discriminative control
ENV exerts discriminative control, organism does not exert discriminative control
Respone
- a SPECIFIC INSTANCE of a behavior
Response vs. behavior
- typing is the behavior, pressing a key is a response
- in a task analysis the bheaivor is tying shoes each step from beginning to end is a response.
Response Cycle
the beginning, middle and end of a response. It may be used to identify specific responses, but not all responses have clear responses cycles nor do they need to be clarified.
Discrete trial
- discriminative stimulus and stimulus control training
- pairing SD’s with responses in order to create Stimulus Control (discriminative control) which will ultimately allow for discrimination by an organism
eg. discrete trial training, running bak to back trials in a controlled setting
Treatment Skill Acquisition
- Discrimination training: teaching child to respond to/tell difference between 2 (or more) SDs.
two types of discrimination training
Simultaneous and successive
Simultaneous discrmination training (7-step) ( T1 and T2)
MT t1 alone MT t1 w/ unknown distractors MT t2 alone MT t2 w/ unknown distractors MT t1 w/ t2 present MT t2 with T2 present RR T1 and T2
Simultaneous discrmintaion training
4 steps (T3 - T#)
MT T# alone
MT T# w/ unknown distractors
MT T# w/ known distractors
RR T# w/ previously mastered Ts
Simultaneous discrimination training
field of stimuli (target and disctractors items) presented at same time. Requires “pointing to, touching, or picking up item”
Successive
stimuli presented one at a time. requires verbal response
Successive
3 step (intro T1 and T2)
MT T1 alone
MT T2 alone
RR T1 and T2
Succesive
2 step : (T3 - T#)
MT T#
RR T# w/ previously mastered Ts
Discrete trial training
Teaching technique method for skill acquisition
- defninite beginning and end
3 compondents of discrete trial training
1) Antecedent
- - EO - establishing operation; internal
- - SD - discrimintation stimulus ; external
2) response
3) consequence
WHY 3 components?
- ASD kids don’t learn by watching other kids
- allows multiple opportunities to be set up
- Lets kids know how they are expected to respond
- immediate consequence given
- assits tx with consistency
- decrease undesired bx, increase desired bx
- easy to take data and assess progress
Natural Environment training
- is child directed
- uses intrinsically motivating material and considers child’s current interests
- is performed in natural settings
ex: tx joins child, initiated by child’s expression of interest in item or topic. tx helps child engage in expanded resonse. Tx provides related consequence - demos to successfully build wde variety of skill
- often use for teaching: initiation sills, skills that are intrinsically motivating
4 main characteristics of Naturalistic Teaching Strategies:
1) focus on use of learner’s current motivation/MO
- child directed – therapist follows learner’s lead
- if learner’s motivation charges, activites follow
- activites may be embedded within regular daily activities
2) Functional relationship between task and reinforcer
- reinforcers given are directly related to activity, not arbitrary
- natural consequences provided for responses
3) taught in child’s environment in playful manner
- use of functional stimulus items
- more naturalistic transitions
- to untrained individual many appears as if the tx and learner are just playing
4) focus on reinforcing any appropriate attempt to respond
- shaping procedures lead learner to correct response
- less focus on “correct” versus “incorrect” responding
Fluency based training
- child is provided with several brief, times opportunities to practice the skill target
- timed training is continued until child can respond quickly and correctly
- targets taught in sequence: basic skills before complex skills
- useful when teaching skills in which speed of responding is just as important as accuracy
- easier to learn related more difficult skills later on
- children who perform fluently are able to stay on task and retain info longer
- tasks that can be performed well are less aversive and less likely to occasion problem bx
