Iterative redesign of a caregiver-mediated intervention for use in educational settings

Teachers endorse disruptive behavior as a considerable concern for autistic students, which is compounded by the lack of adequate resources for behavioral intervention planning in the classroom. The RUBI program is an evidence-based, low-intensity manualized intervention, initially developed for parents of autistic children ages 3–14 and co-occurring disruptive behavior. Utilizing the Discover, Design/Build, Test (DDBT) framework, which combines user-centered design and implementation science, RUBI intervention content was collaboratively and iteratively redesigned with elementary school stakeholders (40 school staff from 28 schools) to ensure the feasibility, acceptability, and appropriateness of the redesigned intervention, RUBI in Educational Settings (RUBIES). Iterative quantitative and qualitative methods were conducted with stakeholders to identify targets for RUBI redesign. Conventional content analysis was used to code qualitative data and identify usability issues. Recommendations were provided for modifications to RUBI sessions to address the needs of the school context and end-users to develop RUBIES. Feasibility scores improved following the redesign. The use of the DDBT framework to redesign the RUBI intervention may promote greater usefulness and usability in school contexts. Lay abstract Teachers often report concerns about behavior challenges in their students with autism spectrum disorder (ASD) in the school setting. Furthermore, teachers often report that they do not have adequate training in how to manage these challenging behaviors effectively. The RUBI program is an intervention initially developed for parents of children with ASD and co-occurring challenging behavior in clinic settings. The present project used school staff input to systematically redesign RUBI to be used with educators in schools. School staff gave input at multiple stages of development to ensure the adapted intervention was appropriate to use in a school setting. Responses were coded and analyzed to identify strengths and weaknesses of the RUBI manual in schools and adaptations were made accordingly. Scores of how appropriate, possible, likable, and usable RUBI would be in schools rose after the intervention was redesigned. The redesigned RUBIES manual may give school staff the tools they need to manage disruptive behaviors. In addition, collaborating with providers over multiple stages to redesign established interventions for new contexts may be a promising way to help bring research tools to practice in the future.

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Teaching Menstrual Care to a Student With Autism Spectrum Disorder in a School Setting

10.4018/978-1-6684-3542-7.ch027 ◽

2022 ◽

pp. 541-555

Author(s):

Karly Cordova

Keyword(s):

Autism Spectrum Disorder ◽

Public School ◽

Intellectual Disabilities ◽

School Setting ◽

Self Care ◽

Autism Spectrum ◽

Spectrum Disorder ◽

School Staff ◽

Empirically Supported ◽

Residential Staff

There is a lack of training for parents, school staff, and residential staff aimed at helping persons with intellectual disabilities acquire menstrual self-care skills. This may be due in part to the sensitive nature of this topic, the aversion to performing menstrual care for individuals with a disability, and the lack of empirically supported training protocols. This chapter critically reviews behavior analytic research on menstrual care that has been published in peer reviewed journals. This is followed by a case illustration using behavior analytic methods to teach menstrual self-care skills for a student with autism spectrum disorder in a public school setting. Evaluated using a multiple baseline across behaviors design, it was shown that the student increased her independent performance of selected menstrual self-case skills.

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Comparing Autism Symptom Severity Between Children With a Medical Autism Diagnosis and an Autism Special Education Eligibility

Focus on Autism and Other Developmental Disabilities ◽

10.1177/1088357620922162 ◽

2020 ◽

Vol 35 (3) ◽

pp. 186-192 ◽

Cited By ~ 1

Author(s):

Jonathan Safer-Lichtenstein ◽

Laura Lee McIntyre

Keyword(s):

Special Education ◽

Symptom Severity ◽

Challenging Behavior ◽

Adaptive Functioning ◽

Challenging Behaviors ◽

The United States ◽

Autism Spectrum ◽

School Age Children ◽

Future Research ◽

Special Education Eligibility

Rates of children identified as having autism spectrum disorder (ASD) continue to increase in both medical and school settings. While procedures for providing a medical diagnosis are relatively consistent throughout the United States, the process for determining special education eligibility under an ASD classification varies by state, with many states adopting looser identification criteria than medical taxonomies. This study included a sample of 73 school-age children with ASD and sought to examine differences in ASD symptom severity, adaptive functioning, and challenging behaviors between those identified in the medical system versus those identified in schools. Results indicate that children identified as having ASD only by their school had less severe clinician-rated ASD symptomatology than children with a medical ASD diagnosis but that caregiver reports of adaptive functioning and challenging behavior did not differ between the two groups. These findings do not appear to have been influenced by demographic factors including caregiver education, household income, or health insurance status. Implications and directions for future research are discussed.

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A Escola Regular e o Aluno Autista: Desafios e Possibilidades

Revista de Ensino Educação e Ciências Humanas ◽

10.17921/2447-8733.2017v18n4p432-436 ◽

2018 ◽

Vol 18 (4) ◽

pp. 432

Author(s):

Lumiko Mori Tedesco ◽

Mário Molari

Keyword(s):

Inclusive Education ◽

Social Relationships ◽

Paradigm Shift ◽

School Context ◽

School Setting ◽

Autism Spectrum ◽

Learning Processes ◽

Citizenship Rights ◽

Content Learning ◽

Teaching Learning

O reconhecimento da diferença no contexto da escola é o resultado de lutas históricas dos movimentos sociais por direitos de cidadania e deigualdade para todos. Nesse cenário, a inclusão das pessoas com Transtorno do Espectro Autista vem ganhando espaço, em todo o território nacional, criando discussões acerca de estratégias, que garantam o ensino dessas crianças, no mesmo espaço de alunos com desenvolvimento típico. Sendo assim, o objetivo do artigo é refletir sobre ações voltadas às atitudes e desafios implícitos nos processos de ensino-aprendizagem daqueles alunos considerados diferentes, particularmente, daqueles com autismo, que apresentam atrasos no desenvolvimento e prejuízos no relacionamento social, em graus que requerem atendimento individualizado, tornando possível seu aprendizado e convivência na escola. O estudo foi feito a partir do levantamento de referências teóricas já analisadas e publicadas, com a finalidade de explicar as hipóteses e suposições formuladas pelo pesquisador a respeito das questões a serem investigadas em documentos de cunho científico. O que se percebeu, nesse estudo, é que no cenário escolar, quando é incluída uma criança com autismo, há uma dificuldade por parte dos professores em organizar ambientes, que possam oferecer uma aprendizagem de conteúdos significativos para todos os alunos da mesma turma, indiferentemente de suas diferenças cognitivas, sensoriais ou físicas. Porém, mesmo os desafios sendo grandes se observa uma mudança de paradigma, que tem como foco dar oportunidade para todas as crianças de estarem no mesmo ambiente. Além disso, persiste uma luta permanente dos pais, em prol de uma educação inclusiva, que vem superando cada vez mais as barreiras na sociedade em todos os aspectos.Palavras-chave: Autismo. Inclusão. Estratégias pedagógicas.AbstractThe recognition of difference in the school context is the result of historical struggles of social movements for citizenship rights and equality for all. In this scenario, the inclusion of people with Autism Spectrum Syndrome has been gaining space throughout the national territory, creating discussions about strategies that ensure the teaching of these children in the same space of students without any type of disability. Thus, the objective of the article is to reflect on actions aimed at the attitudes and challenges implicit in the teaching-learning processes of those students considered to be different, particularly those with autism who present delays in development and impairments in social relationships in degrees that require individualized attention, making it possible theue learning and coexistence in school. The method used in the study was based on the collection of theoretical references already analyzed and published, with the purpose of explaining the hypotheses and assumptions formulated by the researcher regarding the questions to be investigated in scientific documents. What was perceived in this study is that in the school setting when a child with autism is included there is a difficulty on the part of the teachers to organize environments that can offer meaningful content learning for all the students of the same class regardless of their cognitive, sensorial or physical differences. However, even the big challenges are a paradigm shift that focuses on giving all children the opportunity to be in the same environment. In addition, there is a continuing struggle for parents for inclusive education that has increasingly been overcoming barriers in society in all aspects.Keywords: Autism. Inclusion. Pedagogical Estrategies.

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Differential Reinforcement of Other Behaviors to Treat Challenging Behaviors Among Children With Autism: A Systematic and Quality Review

Behavior Modification ◽

10.1177/0145445517743487 ◽

2017 ◽

Vol 42 (4) ◽

pp. 584-609 ◽

Cited By ~ 11

Author(s):

Regan Weston ◽

Abby Hodges ◽

Tonya N. Davis

Keyword(s):

Challenging Behavior ◽

Differential Reinforcement ◽

Challenging Behaviors ◽

Children With Autism ◽

Autism Spectrum ◽

Future Research ◽

Exceptional Children ◽

Systematic Analysis ◽

Evidence Based Practices

This review summarizes the literature regarding differential reinforcement of other behaviors (DRO) to treat challenging behavior among children with autism spectrum disorder (ASD) and determines the quality of studies among the current literature according to the 2014 Council for Exceptional Children (CEC): Standards for Evidence-Based Practices in Special Education. Studies that focused on the use of DRO in the treatment of challenging behavior for individuals with ASD were included for systematic analysis. Forty-five studies were identified for inclusion in this review and were evaluated using the eight quality indicators described by the CEC. To the authors’ knowledge, this is the only systematic review of the literature that evaluates DRO as an intervention for individuals diagnosed with ASD. Principle findings, practical recommendations, and areas of future research are discussed.

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A Meta-Analysis of Paraprofessional-Delivered Interventions to Address Challenging Behavior Among Students With Disabilities

Journal of Positive Behavior Interventions ◽

10.1177/1098300720911147 ◽

2020 ◽

pp. 109830072091114

Author(s):

Virginia L. Walker ◽

Megan E. Carpenter ◽

Kristin J. Lyon ◽

Lindsey Button

Keyword(s):

Students With Disabilities ◽

Challenging Behavior ◽

Behavioral Interventions ◽

Single Case ◽

Meta Analysis ◽

Challenging Behaviors ◽

Autism Spectrum ◽

Future Research ◽

School Environments ◽

Wide Range

Paraprofessionals report spending a substantial amount of time addressing challenging behavior in a range of school environments, yet identify behavioral intervention as a high-priority training area. The purpose of this meta-analysis was to systematically review and summarize single-case intervention studies involving paraprofessional-delivered behavioral interventions for students with disabilities. Descriptive findings suggest that, among the reviewed studies, paraprofessionals primarily provided behavioral support to students with autism spectrum disorder, intellectual disability, and multiple disabilities who engage in a wide range of challenging behaviors in both inclusive and noninclusive school environments. Overall, training largely was delivered by researchers and resulted in positive paraprofessional implementation outcomes. Likewise, paraprofessional-implemented behavioral interventions contributed to desirable changes in student challenging and appropriate behavior, with effect size estimates significantly higher for interventions delivered to early childhood–age students and within inclusive school settings. Implications for practice, limitations, and future research directions are described.

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Enhancement of Social Communication Behaviors in Young Children With Autism Affects Maternal Stress

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.797148 ◽

2021 ◽

Vol 12 ◽

Author(s):

Dominik Laister ◽

Giacomo Vivanti ◽

Peter B. Marschik ◽

Johannes Fellinger ◽

Daniel Holzinger

Keyword(s):

Social Communication ◽

Challenging Behavior ◽

Mental Health Problems ◽

Maternal Stress ◽

Challenging Behaviors ◽

Children With Autism ◽

Well Being ◽

Autism Spectrum ◽

Communication Behaviors ◽

Children With Asd

Children with autism spectrum disorder (ASD) show difficulties in social communication behaviors, emotion regulation and daily living skills, and they frequently present with challenging behaviors. In parents of children with ASD, higher rates of stress and mental health problems have been reported than in parents of either typically developing children or children with other conditions. In this study, we tested whether maternal well-being changes with improved social communicative behaviors of children with ASD receiving early intervention. We examined developmental changes in 72 pre-schoolers and stress levels in their mothers (measured by the Parental Stress Inventory) before and after a 12-month community-based intervention program based on the Early Start Denver Model, a naturalistic developmental behavioral intervention targeting social communication. Multiple regression analyses showed that maternal child-related stress was predicted by changes in children's social communication behaviors (measured with the Pervasive Developmental Disorder Behavior Inventory). Gains in the early social communication behavior domain were the strongest predictor of post-intervention child-related maternal stress, surpassing adaptive behavior, language and non-verbal cognitive gains, and reduction in challenging behavior. These findings support the hypothesis that, in children with ASD, the acquisition of social communication behaviors contribute to improvements in maternal well-being.

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Technology-Aided Interventions to Reduce Challenging Behaviors for Individuals With Autism Spectrum Disorder

Advances in Early Childhood and K-12 Education - Interventions for Improving Adaptive Behaviors in Children With Autism Spectrum Disorders ◽

10.4018/978-1-7998-8217-6.ch007 ◽

2022 ◽

pp. 108-125

Author(s):

Maria Zygopoulou

Keyword(s):

Autism Spectrum Disorder ◽

Social Relations ◽

Challenging Behavior ◽

Negative Impact ◽

Challenging Behaviors ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Functional Communication ◽

Self Monitoring

Individuals with autism spectrum disorder (ASD) display a variety of challenging behaviors, such as tantrums, aggression, stereotypy, and disruption. Challenging behaviors can have a serious negative impact on the development of social relations, in the learning process, and education. To this aim, there is a need for appropriate interventions in order to improve the quality of life of individuals with ASD. This chapter aims to provide data with regard to different types of interventions and technological tools used for the reduction of challenging behaviors of students with ASD. Functional communication training with the use of speech-generating devices, video self-modeling, self-monitoring with the use of technological devices, and social stories presented in electronic form reflect types of interventions used for challenging behavior reduction. Research data indicate that technology-aided interventions are generally effective in reducing challenging behaviors of students with ASD.

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Managing Challenging Behavior in Adolescents with Autism Spectrum Disorder

Adolescents with Autism Spectrum Disorder ◽

10.1093/med-psych/9780190624828.003.0010 ◽

2017 ◽

pp. 242-272

Author(s):

Maya Matheis ◽

Jasper A. Estabillo ◽

Johnny L. Matson

Keyword(s):

Autism Spectrum Disorder ◽

Challenging Behavior ◽

Behavioral Treatment ◽

Behavioral Assessment ◽

Challenging Behaviors ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Behavior Interventions ◽

Treatment Methods ◽

Assessment And Treatment

The term “challenging behavior” describes a wide range of behaviors that may be harmful to an individual and that pose significant risks related to health, emotional distress, or exclusion from community settings. Challenging behaviors occur at high rates among individuals with autism spectrum disorder (ASD). Some forms of challenging behavior include: aggression, self-injurious behavior (SIB), stereotypical behavior, pica, and vomiting/rumination. Functional behavioral assessment (FBA) is the process of gathering and interpreting data related to the underlying function of a behavior. Interventions that target the function of a behavior are more effective and efficient. Behavioral treatment methods for challenging behavior are based on operant principles of reinforcement and punishment. Several common treatment methods are described. Suggestions for the assessment and treatment of challenging behaviors are outlined.

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My Student Cannot Wait! Teaching Tolerance Following Functional Communication Training

Beyond Behavior ◽

10.1177/1074295619852106 ◽

2019 ◽

Vol 28 (2) ◽

pp. 99-107 ◽

Cited By ~ 1

Author(s):

Reem Muharib ◽

Robert C. Pennington

Keyword(s):

Challenging Behavior ◽

Challenging Behaviors ◽

Functional Communication Training ◽

Communication Training ◽

Functional Communication ◽

Schedules Of Reinforcement ◽

Educational Settings ◽

Multiple Schedules ◽

Teaching Tolerance ◽

Alternative Responses

Functional communication training (FCT) involves the reinforcement of an appropriate communicative response as an alternative to challenging behavior. The intervention has been identified as an evidence-based practice across multiple populations. Despite its extensive research support, FCT may be impractical in some educational settings because it often requires educators to reinforce alternative responses at high rates. In this discussion article, we describe three procedures (delay to reinforcement, chained schedules of reinforcement, and multiple schedules of reinforcement) that can be used following FCT in educational settings to teach students who exhibit challenging behaviors to tolerate waiting for a reinforcer.

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