Using Functional Behavioral Assessment to Develop a Multicomponent Treatment for Sleep Problems in a 3-Year-Old Boy With Autism

2017 ◽  
Vol 16 (3) ◽  
pp. 254-270 ◽  
Author(s):  
Laurie McLay ◽  
Karyn France ◽  
Neville Blampied ◽  
Kate Danna ◽  
Jolene Hunter
Keyword(s):  
Sleep Disturbance ◽  
Sleep Problems ◽  
Behavioral Assessment ◽  
Autism Spectrum ◽  
Functional Behavioral Assessment ◽  
Negative Effects ◽  
Number Of Children ◽  
Assessment And Treatment ◽  
Function Of Sleep

A large number of children with autism spectrum disorder (ASD) and their families are affected by sleep disturbance. Given the concomitant negative effects of sleep problems, it is essential to identify effective treatments. This case study exemplifies the use of Functional Behavioral Assessment (FBA) to develop treatments for sleep problems in a 3-year old boy with ASD. A function-based, multicomponent intervention resulted in the elimination of nighttime breastfeeding, a reduction in the frequency of curtain calls, and the frequency and duration of nighttime awakenings, although not all gains were maintained at follow-up. This case study highlights the importance of FBA in the assessment of sleep problems for each individual, and the need to develop treatments that address the unique function of sleep disturbance for each individual. Further research into the assessment and treatment of sleep problems in children with ASD is required.

Assessment and Treatment of Selective Mutism in a Child With Autism Spectrum Disorder

2020 ◽  
pp. 153465012098345
Author(s):  
Mirela Cengher ◽  
Joy C. Clayborne ◽  
Adrianna E. Crouch ◽  
Julia T. O’Connor
Keyword(s):  
Autism Spectrum Disorder ◽  
Social Interaction ◽  
Environmental Variables ◽  
Behavioral Interventions ◽  
Selective Mutism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Future Research ◽  
Assessment And Treatment

Over 60% of children diagnosed with selective mutism are also diagnosed with Autism Spectrum Disorder. Previous research established that behavioral interventions are effective at increasing speech in children with both diagnoses. However, few studies conducted assessments to determine environmental variables that inhibit speech, and such assessments are necessary for the development of effective and efficient treatments. This case study describes an assessment that evaluated the function(s) of selective mutism. The results confirmed that the participant did not talk to avoid social interaction and that mutism occurred primarily in the presence of multiple, unfamiliar people. Our first treatment focused on increasing tolerance for social interaction, demonstrated by an increase in speech production in the presence of unfamiliar people. Our second treatment focused on increasing qualitative aspects of the participant’s speech (i.e., both responses and initiations). Finally, we taught the participant’s parents to implement the treatment in naturalistic settings, and the participant demonstrated generalization of treatment effects across people and settings. Implications for clinical practice and future research are discussed.

Attributions, causal beliefs, and help-seeking behavior of parents of children with autism spectrum disorder and sleep problems

Autism ◽  
2020 ◽  
Vol 24 (7) ◽  
pp. 1829-1840 ◽  
Author(s):  
Laurie McLay ◽  
Sarah G Hansen ◽  
Amarie Carnett ◽  
Karyn G France ◽  
Neville M Blampied
Keyword(s):  
Autism Spectrum Disorder ◽  
Sleep Disturbance ◽  
Help Seeking ◽  
Parental Education ◽  
Online Survey ◽  
Sleep Problems ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Sources Of Information

Sleep problems in children with autism spectrum disorder are prevalent and persistent but also treatable. Little is known about how and why parents of such children seek help for sleep disturbance. Via an online survey ( n = 244 respondents), we gathered information about parents’ attributions about children’s sleep problems and beliefs about causes and on sources of information about, and their decisions regarding, help-seeking. Eighty-two percent of parents reported seeking some kind of help for their child’s sleep disturbance, and the average parent had tried six different treatment strategies, most commonly medical. Alignment of parents’ treatment choices with empirical evidence about treatment efficacy was poor, but belief in effectiveness was closely related to frequency of use of a treatment. In a Principal Components Analysis, parental attributions loaded on two factors: one which suggests the sleep problems are viewed as intrinsic to autism and stable (factor one) and the other as located within the child, stable, and treatment resistant (factor two). These findings have important implications for parental education and clinical practice in the treatment of sleep problems in children with autism spectrum disorder. Lay abstract Sleep problems are commonly reported among parents of children with autism spectrum disorder (ASD). Without effective treatment, such problems are unlikely to resolve. To date, we know very little about how and why parents of children with ASD seek help for sleep disturbance. Via an online survey, we gathered information about how parents make sense of their children’s sleep problems, beliefs about their causes, sources of information, and help-seeking behavior. The analysis of responses from 244 parents revealed that parents commonly view sleep problems (a) as a consequence of their child’s ASD, and unlikely to change over time (stable), and (b) as located within the child (intrinsic), stable over time, and difficult to treat. Despite this, parents also rated sleep problems as being important to treat. Eighty-two percent of parents surveyed reported seeking some kind of help for their child’s sleep disturbance, and the average parent had tried six different treatment strategies, most commonly medical approaches (e.g. melatonin). The alignment between parents’ treatment choices and those strategies that are supported by research was poor, but belief in the effectiveness of treatments was closely related to how often the treatment was used. These findings have important implications for parental education and clinical practice in the treatment of sleep problems in children with ASD.

Behavioral Assessment and Treatment of Aerophagia

2021 ◽  
pp. 153465012110645
Author(s):  
Mirela Cengher ◽  
Craig W. Strohmeier
Keyword(s):  
Problem Behavior ◽  
Divided Attention ◽  
Differential Reinforcement ◽  
Behavioral Assessment ◽  
Social Consequences ◽  
Initial Assessment ◽  
Negative Effects ◽  
Assessment And Treatment ◽  
Clinically Significant ◽  
Graduated Exposure

Aerophagia is characterized by excessive air swallowing and can have serious negative effects on one’s health. We present the assessment and treatment of a 16-year-old girl, Khloe, with developmental disabilities and aerophagia. The initial assessment indicated that aerophagia occurred primarily to access attention in a divided attention context; however, our function-based treatment did not result in a clinically significant reduction in problem behavior. We then conducted a second assessment that indicated that Khloe’s aerophagia indeed occurred primarily in a divided attention context, but that it persisted independent of social consequences. We concluded that the divided attention context served as a motivating variable for aerophagia. Our second treatment consisted of differential reinforcement of other behavior, noncontingent access to competing stimuli, and graduated exposure to contextual variables (i.e., people and divided attention) that occasioned aerophagia. The treatment was successful in reducing rates of aerophagia. We discuss implications for assessment and treatment, as well as recommendations for clinicians and students.

Managing Challenging Behavior in Adolescents with Autism Spectrum Disorder

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.

Sleep and pain in children and adolescents

2013 ◽  
pp. 135-144
Author(s):  
Bruce D. Dick ◽  
Penny Corkum ◽  
Manisha Witmans ◽  
Christine T. Chambers
Keyword(s):  
Children And Adolescents ◽  
Sleep Problems ◽  
Psychological Treatment ◽  
Sleep Onset ◽  
Treatment Strategies ◽  
Chronic Illnesses ◽  
Recurrent Pain ◽  
Negative Effects ◽  
Number Of Children ◽  
Delayed Sleep

Ongoing pain is a problem that affects a large number of children and adolescents. It has been well documented that recurrent and chronic pain are associated with many difficulties related to both physical and psychological function. A major difficulty that many young people with chronic or recurrent pain experience is disrupted sleep. Sleep problems have been reported to exist in as many as 50% or more of children with chronic illnesses (Owens, 2007). In many cases, pain is reported by the sufferers to cause sleep fragmentation as well as significant difficulties with delayed sleep onset. As well, there is increasing evidence that disrupted sleep is associated with increased pain. Both pain and sleep disruption further complicate the patient’s overall clinical picture by making it more difficult for children and teens to cope with health problems and associated difficulties. Further, there is evidence that childhood sleep problems can have important negative effects on adult sleep patterns and, thereby, influence health status later in life (Fricke-Oerkermann et al., 2007; Sivertsen et al., 2009). This chapter will address the prevalence, importance, and consequences of sleep problems in children and adolescents with pain. First, the prevalence and possible relationship between pain and sleep will be discussed. Next, we will highlight the assessment of sleep with a specific focus on assessment of sleep in paediatric pain populations. We will then review established and emerging medical and psychological treatment strategies used to effectively treat these important difficulties. Practical suggestions will also be provided as a general and basic guide for treatment of children and teens with pain and sleep problems.

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