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Children with food selectivity often have a learning history of challenging behaviour around feeding time. The goal of intervention is often to increase food consumption while shifting the negative reinforcement contingency as demonstrated by parents or caregivers removing food or terminating the meal (Penrod, Gardella & Fernand, 2012; Najdowski, Wallace, Doney & Ghezzi, 2003). The purpose of this intervention is to increase protein and vegetable intake by a 5-year-old learner diagnosed with Autism Spectrum Disorder (ASD). Prior to intervention, the learner ate a variety of carbohydrates and fruits, but refused other food groups. Food selectivity has been conceptualized as noncompliance as opposed to complete food refusal (Penrod et al., 2012). The goal of phase one of intervention was to introduce a low response effort, high probability request sequence in order to develop a learning history of reinforcement. The learner is presented demands that involve successively higher degrees of contact with the target food, according to a pre-determined exposure hierarchy, similar to a shaping procedure. During phase two, the learner was required to consume one bite of the target food before accessing reinforcement. In subsequent phases, systematic demand fading is introduced, where the learner is required to consume progressively greater amounts of the target food before reinforcement is delivered. Progress to date indicates that the learner has mastered the first targeted item and is independently able to consume an entire meatball at mealtime in the absence of challenging behaviour.

References

Najdowski, A.C., Wallace, M.D., Doney, J.K., & Ghezzi, P.M. (2003). Parental assessment and treatment of food selectivity in natural settings. Journal of Applied Behavior Analysis, 36, 383-386.

A multi-component treatment approach was used to increase the frequency of approach responses to school while decreasing rates of problem behavior for an adolescent with ASD and comorbid anxiety. This treatment package approach combined graduated exposure with differential reinforcement of alternative behavior (DRA), psycho-education and functional communication training. During the intervention, the client showed substantial decreases in rates of problem behavior and significant increases in school attendance. This intervention was implemented in collaboration with psychiatric services through Dr. Dua, which include psychopharmacological intervention.

When a treatment is implemented in a clinical setting, it is often assumed that therapists will carry out the intervention with high treatment integrity. However, this assumption is not warranted as stability within the dependent variable does not suggest that the treatment is applied with accuracy (Gresham, Gansle & Noell, 1993). If it is determined that treatment integrity is found to be below acceptable levels, how does one teach those carrying out the intervention to achieve more accurate results? Behaviour skills training (BST) involves giving instruction, feedback, rehearsal and modeling. It has been shown to be effective in teaching a wide variety of behavioural skills (Sarokoff & Sturmey, 2004). This poster will review pre and post data on therapist treatment integrity when implementing a multi component behaviour reduction plan. BST was used to teach therapists to more accurately implement procedures. Overall, treatment integrity scores improved from pre-BST to post-BST training with specific feedback given.

Maladaptive behaviours are a common amongst individuals with autism spectrum disorder and/or intellectual disabilities and their families. Furthermore, these behaviours can be increased when individuals are in close proximity to them. Therefore, it can be difficult to increase skills through physical prompting as this could trigger the maladaptive behaviour. Therefore, differential reinforcement can be a useful tool when attempting to decrease behaviour. Mediator support is essential to teaching these skills. The current research demonstrates how differential reinforcement of alternative behaviour was utilized to increase independence with a morning routine and decrease aggression in the form of grabbing crying and hitting with a 17-year-old with autism spectrum disorder.

An important goal as children transition to adulthood is to improve independent living skills. These skills could include cooking, using appliances and following recipes. One may assume that reading is a pre-requisite skill for being able to follow a recipe, but that is not the case. With individuals with intellectual disabilities reading is not always an achievable goal. Therefore, using visuals and colour matching could be a solution to this barrier. The current research demonstrates the process in teaching a young adult with autism spectrum disorder with the skills of following a recipe and using kitchen appliances through a visual task analysis.

The purpose of this poster is to present on the implementation and skill acquisition within an Independent Activity Schedule for a client attending the Treatment Research and Education for Autism and Developmental Disorders (TRE-ADD) program at Surrey Place. This client was referred for high rates of self-injurious behaviour that historically impacted his safety and impeded his ability to learn and build skills. The client has been in service since October 2017, he began the Independent Activity Schedule program in February 2018. Included are both academic tasks and open-ended activities, currently the client can work independently and mainly unsupervised, minimal verbal or gestural reminders only, for up to 45 minutes while maintaining zero or near zero rates of maladaptive behaviour.

The purpose of this poster is to present on the reduction of maladaptive behaviour, specifically self-injurious behaviour, in a single subject within the Treatment Research and Education for Autism and Developmental Disorders (TRE-ADD) program at Surrey Place. The client is a 14-year-old male who is currently in service, he was admitted to the program in October 2017 and has a projected discharge date of June 2019. The procedure and results of both standard analogue and pairwise functional analyses will be discussed. Treatment protocols including Functional Communication Training (FCT), a Token Board Economy and the various problem-solving strategies within treatments, including individualized aspects, will be examined. At TRE-ADD the treatment approach is individualized, comprehensive and multidisciplinary. This involves the expertise and input of multiple disciplines working together to achieve an identified terminal goal, the reduction of maladaptive behaviour and successful transition to a less-intrusive setting. Due to the severity of self-injury of this client, he has been on medication for a protracted period of time. During his time at TRE-ADD there has been significant medical oversight, including tapering of long-standing medication and the introduction of additional medication trials. This aspect of his treatment will be discussed at length and in combination with his individualized behavioural treatment.  All of which has culminated in a significant reduction in his referring maladaptive behaviour, self-injury.

Background: Caregivers of children with Autism Spectrum Disorder (ASD) are faced with unique experiences that can be positive and/or negative. In Ontario, most children with ASD receive some form of intervention encompassing a wide range of skill domains and containing varying levels of caregiver involvement. Some evidence suggests that caregiver involvement in intervention can have benefits for both child and caregiver outcomes. The purpose of this study is to investigate caregiver wellbeing and quality of life and whether these factors change as a child with ASD completes a behavioural group intervention.

Research Questions: 1) Do caregivers report a change in wellbeing and/or quality of life after their child with ASD has completed the group? 2) Are changes maintained at a 2-month follow-up? 3) Do groups with a more intensive caregiver training component demonstrate better outcomes?

Method: Caregivers of children with ASD who were enrolled in applied behaviour analysis group intervention were recruited from Surrey Place. Questionnaires were completed by 178 caregivers (134 females, 40 males, 14 unknown) over three time points. One questionnaire was completed at the beginning of the group intervention, another was completed near the end of the group intervention, and a final questionnaire was completed at a two-month follow-up. The data collected through the questionnaires included: basic child information (date of birth, gender, brief adaptive skills), caregiver personal resources (positive gain, coping, self-efficacy), family system resources (marital satisfaction, impact of having a child with ASD, family hardiness, family quality of life), informal social support, formal supports and services (services accessed, satisfaction with services, fit of services with families’ needs), stressful live events, positive and negative caregiver outcomes (parenting stress, mental health, and personal wellbeing), and caregiver demographics. Data regarding the specific group intervention (skill domain, caregiver involvement level) were also collected.

Results: Data for this study have been collected and analyses are currently underway. Case-by-case change plots have been created for each participant to determine whether change patterns over time are visually apparent and inform the ensuing analyses. Multilevel modeling will be utilized, with variables entered into the model in an order based on conceptual and statistical considerations. Child and select environmental factors (e.g., socioeconomic status) will be used as control variables. The outcome variables will include both positive and negative factors.

Discussion: The results of this study will contribute to our knowledge of wellbeing and quality of life of caregivers of children with ASD, and specifically in the context of children’s intervention. It is important to understand the impact of these interventions on caregivers and to assess whether additional resources might be required, as caregivers play a vital role in children’s lives.

The quality of intensive behavioural intervention (IBI) is difficult to measure and literature is limited. To address this lack, the York Measure of Quality of IBI (YMQI) was developed, researched and revised through a series of studies. This study extended on previous findings and reported on the psychometric properties of the YMQI. The dataset consisted of 39 young children who were diagnosed with autism and receiving publicly-funded IBI. Two 5-minute segments from video recordings of the children in IBI sessions were scored using the YMQI. A previous study reported on results analysed from the first segments. This study analysed the second segments and compared the findings. The results showed that the YMQI is consistently reliable. A confirmatory factor analysis supported that the quality of IBI is multidimensional and can be measured via four aspects: Pace and Organization, Technical Correctness, Engagement and Motivation, and Generalization. The results enhance our understanding of the YMQI and have implications for improving IBI quality.

Decreasing self-injurious behaviours (SIB) can be a complicated process. This poster discusses the process of treating a child’s SIB (hand biting) through the implementation of differential reinforcement of other behaviours (DRO). This technique has been proven to be useful in decreasing frequent, severe, or repetitive behaviours. In this case a DRO procedure was implemented for a non-verbal client with Autism Spectrum Disorder (ASD) who engages in hand biting. A functional analysis was completed, and results showed that the client’s rates of hand biting were highest during alone conditions. The DRO was implemented by a behaviour intervention team, and includes two treatment conditions: one with moderately preferred activities and one with highly preferred activities. This intervention has led to a decrease in hand biting when the client is engaging with toys, in the absence of attention from the therapist. This poster will discuss the process and analyze the data so far.

High rates of hand stereotypy were observed in a child with autism. Treatment during table instruction included Response Interruption and Redirection (RIRD) and Response Blocking. RIRD consisted of an instructor delivering mastered imitation and one-step instructions until the learner complied with three consecutive demands in the absence of stereotypy. A back prompter was used to physically block stereotypy. After 2 weeks of in-centre treatment, hand stereotypy during table instruction decreased below baseline and maintained at a low frequency.

Teeth brushing is not only essential for cavity prevention, but poor oral care is linked to health issues such as cardiovascular disease and diabetes (Li et al., 2000). Several studies in the field of behaviour analysis have targeted this socially valid behaviour for increase.
A procedure involving task analyzing the skill of teeth brushing and prompting least-to-most via forward chaining was found effective to teach individuals with an intellectual disability to brush their teeth when teeth brushing was reinforced with conditioned reinforcers (Horner & Keilitz, 1975).
A procedure similar to that implemented by Horner and colleagues was implemented with the current participant prior to the study, however the participant did not respond to least-to-most prompting, and became resistant when most-to-least prompting was attempted. Therefore, shaping combined with the Teaching with Audible Guidance (TAG) procedure was implemented to increase the participant’s tolerance of teeth brushing (Cooper, Heron & Heward, 2007; TAGteach International, 2012).
The TAG procedure involves pairing several reinforcing stimuli with a neutral auditory stimulus so that the neutral auditory stimulus becomes a generalized conditioned reinforcer that can be used to increase socially significant behaviours (TAGteach International, 2012). Peer reviewed studies have provided support for the use of the TAG procedure to decrease toe-walking in a child with an Autism Spectrum Disorder (ASD) (Persicke, Jackson & Adams, 2014) as well as to teach self-care tasks to adolescents with an ASD (Wertalik & Kubina, 2018).
The purpose of the current study was to examine the use of shaping combined with the TAG procedure to increase tolerance of teeth brushing in a young man with an ASD.

Research supports the use of differential reinforcement of alternative behaviours (DRA) procedures to decrease maladaptive behaviours and increase socially appropriate behaviours in individuals with Autism Spectrum Disorder (ASD). A common criticism of differential reinforcement procedures is that they do not address the function of the problem behaviour (Kahng, Boscoe, & Byrne, 2003). The use of escape contingencies has been found to be an effective addition to DRA interventions for escape-maintained behaviours (Kahng et al., 2003; Piazza, Moes, & Fisher, 1996). This study evaluates the effects of a DRA plus extinction procedure on decreasing escape-maintained maladaptive behaviour and increasing appropriate sitting behavior exhibited by a 5.5 year old boy with ASD during circle time. The intervention employed a token economy and an escape contingency on a fixed interval reinforcement schedule to increase the duration of time spent in group and decrease instances of aggression and self-injury.

It is evident in both past and present research that having a child with ASD can and will have a significant impact on the family dynamic. Through my review of various journal articles, I have come to realize that the impact on siblings of children with ASD is an area of research that is quite underdeveloped. In terms of family dynamics, the majority of the research I have come across has discussed the impacts on parents of children with Autism, as well as the struggles the child with ASD experiences with a typically developing family. However, minimal focus has been dedicated to how having a child with ASD can impact their siblings. The purpose of this poster presentation will be to address how having a child with ASD can impact their typically developing sibling’s social, emotional and psychological development. Along with referencing journal articles and qualitative research studies, I plan to inquire with
some families here at Surrey Place (West site) to see if they would be interested in sharing with me some feedback regarding how their typical children have adapted to having a sibling with Autism. I am also hoping to interview some older siblings directly (if they are within an age range where it would be appropriate to do so and approved by the parents). My objective is to understand the impact that having a child with ASD can have on their sibling’s social, emotional and psychological development. I am also hopeful that this poster presentation will be a positive resource for families with children impacted by ASD. I hope that it will provide them with helpful feedback that could support them within their home, as they are parenting both typical and atypical children.

In matrix training system, the components of desired skill are arranged across horizontal and vertical axes in a two-dimensional matrix. Each cell in the matrix contains a combination of the two stimuli (e.g., verb-noun, adjective-noun etc.).  Previous studies suggest that after training the diagonal targets in the matrix, novel responses of the components may emerge within and across matrices. In this study, we examined the effectiveness of matrix training to teach generative expressive language to participants with autism spectrum disorder (ASD). A multiple baseline across subjects design was used. Following baseline of targeted combinations (noun-verb, adjective-noun etc.), desired stimuli were arranged on x-axis and y-axis in a 2-dimensional matrix. Diagonal training was provided at the Etobicoke Children’s Center to 3 participants with most-to-least prompting until correct responding was observed.  The intervention was conducted within a regional ABA group and individual Treatment Program. The group consisted of a 5-year-old boy with ASD and a 6-year-old girl and 2 ABA facilitators. The individual treatment setting consisted of a 9-year-old boy with ASD and 1 ABA facilitator. Results indicated that providing diagonal training of the components to participants with ASD and language delays promoted the emergence of novel combinations within and across the matrices.