Behavioral Treatment of Problem Behavior for an Adult with Autism Spectrum Disorder and Misophonia

Abstract Elevated salivary cortisol levels have been documented in individuals who engage in self-injurious behavior (SIB), indicating acute physiological stress. Less is known about the chronicity of stress and SIB. We analyzed the relationship between parent ratings of problem behavior and hair cortisol concentrations (an index of chronic adrenocortical activity) in 23 children with autism spectrum disorder (ASD). Parent ratings of problem behavior were not significantly correlated with hair cortisol concentrations. When children were categorized into groups based on the frequency and severity of SIB, participants with the greatest frequency and severity of SIB had higher hair cortisol concentrations compared to children without SIB. Frequent and severe SIB may be associated with altered hypothalamic-pituitary-adrenal (HPA) axis activity in children with ASD.

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Evaluation of Free-operant Preference Assessment: Outcomes of Varying Session Duration and Problem Behavior

Behavior Modification ◽

10.1177/0145445520925429 ◽

2020 ◽

pp. 014544552092542

Author(s):

Casey J. Clay ◽

Brittany A. Schmitz ◽

Anne M. Clohisy ◽

Aqdas F. Haider ◽

SungWoo Kahng

Keyword(s):

Autism Spectrum Disorder ◽

Problem Behavior ◽

Preference Assessment ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Preference Assessments ◽

Reinforcing Efficacy ◽

Session Duration ◽

Free Operant ◽

Preferred Stimulus

Previous researchers have found brief versions of preference assessments correspond to outcomes of longer preference assessments, and that varying levels of problem behavior occur in different preference assessments. Researchers conducted two studies to examine 1-, 2-, and 5-min duration outcomes of the free-operant preference assessment and evaluated the correspondence between the shorter and longer session durations and to identify frequency of problem behavior at each duration. Researchers also assessed relative reinforcing efficacy of the highest preferred stimulus from the shortest duration sessions. Moderate to high correlations were found between the 1- and 2-min sessions and 1- and 5-min sessions across six of eight participants diagnosed with autism spectrum disorder in Study 1 and two of three participants in Study 2. Furthermore, all highest preference stimuli identified in the shortest duration assessment served as reinforcers. Researchers found problem behavior generally occurred more in longer duration sessions.

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A pilot investigation of an iOS-based app for toilet training children with autism spectrum disorder

Autism ◽

10.1177/1362361317741741 ◽

2017 ◽

Vol 23 (2) ◽

pp. 359-370 ◽

Cited By ~ 2

Author(s):

Daniel W Mruzek ◽

Stephen McAleavey ◽

Whitney A Loring ◽

Eric Butter ◽

Tristram Smith ◽

...

Keyword(s):

Autism Spectrum Disorder ◽

Skill Acquisition ◽

Behavioral Treatment ◽

Retention Rate ◽

Controlled Trial ◽

Children With Autism ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Toilet Training ◽

Significant Group

We developed an iOS-based app with a transmitter/disposable sensor and corresponding manualized intervention for children with autism spectrum disorder. The app signaled the onset of urination, time-stamped accidents for analysis, reminded parents to reinforce intervals of continence, provided a visual outlet for parents to communicate reinforcement, and afforded opportunity for timely feedback from clinicians. We compared this intervention with an intervention that uses standard behavioral treatment in a pilot randomized controlled trial of 33 children with autism spectrum disorder aged 3–6 years with urinary incontinence. Parents in both groups received initial training and four booster consultations over 3 months. Results support the feasibility of parent-mediated toilet training studies (e.g., 84% retention rate, 92% fidelity of parent-implemented intervention). Parents used the app and related technology with few difficulties or malfunctions. There were no statistically significant group differences for rate of urine accidents, toilet usage, or satisfaction at close of intervention or 3-month follow-up; however, the alarm group trended toward greater rate of skill acquisition with significantly less day-to-day intervention. Further development of alarm and related technology and future comparative studies with a greater number of participants are warranted.

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