Contingency-based delay to reinforcement following functional communication training for autistic individuals: A multilevel meta-analysis

Functional communication training, an intervention for challenging behavior rooted in principles of applied behavior analysis, has copious empirical support dating back to the mid-1980s for autistic individuals. Recently, there has been a concerted effort to thin reinforcement delivery during functional communication training using contingency-based delays that, in turn, are designed to enhance practicality and feasibility while not compromising on efficacy. In this synthesis, we meta-analyzed the literature using log response ratio effect sizes to investigate (a) combined and across type effectiveness of contingency-based delays and (b) moderating variables that might impact intervention outcomes. Findings showed that contingency-based delays were effective for autistic individuals (log response ratio = −2.17; 95% CI = (−2.76, −1.58)) and most effective when the contingency incorporated positive reinforcement (log response ratio = −2.30; 95% CI = (−2.83, −1.78)). In addition, delay procedures that included differential reinforcement of alternative behavior were overall more effective (log response ratio = −2.13; 95% CI = (−2.72, −1.55)) than those that involved differential reinforcement of other behavior (log response ratio = −1.24; 95% CI = (−3.84, 1.37)). Noteworthy moderating variables found to impact contingency-based delay efficacy included the intervention dosage and the topography of behavior. We discuss these findings and highlight directions where additional empirical research is warranted to improve our understanding about contingency-based delays for autistic individuals. Lay abstract Functional communication training, an intervention for challenging behavior rooted in principles of applied behavior analysis, has copious empirical support dating back to the mid-1980s for autistic individuals. Recently, there has been a concerted effort to thin reinforcement delivery during functional communication training using contingency-based delays that, in turn, are designed to enhance practicality and feasibility while not compromising efficacy. In this synthesis, we meta-analyzed the literature base with the goal of investigating both combined and across type effectiveness of contingency-based delays. We also aimed to investigate moderating variables that might impact intervention outcomes. Findings showed that contingency-based delays were effective for individuals with an autism spectrum disorder diagnosis and most effective when the delay incorporated some form of positive reinforcement. In addition, differential reinforcement of alternative-based delays was overall more effective when compared to differential reinforcement of other behavior-based delays. Noteworthy moderating variables found to impact contingency-based delay efficacy included the intervention dosage and the topography of behavior. We discuss these findings and highlight directions where additional empirical research is warranted to improve our understanding about contingency-based delays for individuals diagnosed with autism spectrum disorder.

Selecting Communicative Interventions Targets for School-Aged participants with ASD and ID: A Single-Case Experimental Design Meta-analysis

Objective: This meta-analysis reviews the literature on communication modes, communicative functions, and types of augmentative and alternative communication (AAC) interventions for school-age participants with autism spectrum disorders and/or intellectual disabilities who experience complex communication needs. Considering potential differences related to outcomes that were targeted for intervention could help identify the most effective means of individualizing AAC interventions. Methods: We performed a systematic literature search using Academic Search Ultimate, ERIC, PsycINFO, Web of Science, and Proquest Dissertations & Theses Global to retrieve research conducted between 1978 and the beginning of 2020. Studies included in the synthesis are (a) in English; (b) has one or more participants with an intellectual delay, developmental disability(ies); (c) reported the results of an augmentative and alternative communication (AAC) intervention to supplement or replace conventional speech for people with complex communication needs; (d) was a SCED; (e) measured social-communicative outcomes. We synthesized results across studies using multi-level meta-analyses of two case-level effect size metrics, Tau and log response ratio. We conducted moderator analyses using meta-regression with robust variance estimation.Results: Across 114 included studies with 330 participants and 767 effect size, overall Tau effects were moderate, Tau = 0.72, 95% CI [0.67, 0.77], and heterogeneous. For the subset of data series where log response ratio could be estimated, the overall average effect was LRR = 1.86, 95% CI [1.58, 2.13], and effects were highly heterogeneous. There were few statistically significant differences found between moderator categories, which included communication mode, communicative function, and type of AAC implemented.Conclusions: This meta-analysis highlights the potential differences related to outcomes that were targeted for AAC interventions for individuals with ASD and IDD. AAC intervention has been shown to improve communication outcomes in this population. However, there was a lack of sufficient data to analyze for some potential moderators such as insufficient descriptive information on participant characteristics. This is likely due to the heterogeneity of the participants and implementation factors; however, these factors were frequently underreported by original study authors which disallowed systematic analysis. That said, there is a need for more detailed participant characteristic descriptions in original research reports to support future aggregation across the literature. Sponsorship: We received funding for the review from the Institute of Education Sciences.Protocol: The review protocol was registered in the PROSPERO system (CRD42018112428).

Participant Characteristics Predicting Communication Outcomes in AAC Implementation for Individuals with ASD and IDD: A Systematic Review and Meta-analysis

This meta-analysis examined social communication outcomes in augmentative and alternative communication (AAC) interventions, or those that involved aided (e.g., speech generating devices, picture point systems) or unaided AAC (e.g., gestures, manual sign language) as a component of intervention, and the extent to which communication outcomes were predicted by participant characteristics. Variables of interest included chronological age, communication mode used prior to intervention, number of words produced and imitation skills of participants prior to intervention. Investigators identified 117 primary studies that implemented AAC interventions with school-aged individuals (up to 22 years) with autism spectrum disorder and/or intellectual disability associated with complex communication needs and assessed social-communication outcomes. All included studies involved single-case experimental designs and met basic study design quality standards. We synthesized findings across studies using two complementary effect size indices, Tau(AB) and the log response ratio, and multi-level meta-analysis with robust variance estimation. With Tau(AB), the overall average effect across 338 participants was 0.72, 95% CI [0.67, 0.76], with a high degree of heterogeneity across studies. With the log response ratio, the overall average effect corresponded to a 538% increase from baseline levels of responding, 95% CI [388%, 733%], with a high degree of heterogeneity across studies and contrasts. Moderator analyses detected few differences in effectiveness when comparing across diagnoses, ages, the number and type of communication modes the participants used prior to intervention, the number of words used by the participants prior to intervention, and imitation use prior to intervention.

LEARNING NEW INNOVATIVE METHODOLOGIES USED IN COVID-19 TIMES

Currently, online or hybrid teaching are increasingly in demand and have been driven by social, demographic and health factors such as that experienced during the global COVID-19 pandemic. The traditional classroom as originally was conceived has expanded both its temporal and physical limitations. This text shows how new innovative methodologies have been developed through different applications such as Wooclap or Gamification works, with the main objective of checking the perception, motivation and satisfaction of students. These are useful tools for teachers to get an easy and fast feedback from students. Two hypotheses are also presented, which will be contrasted with the analysis of the grades of the final tests of the 2019/2020 academic year and several questionnaires, with a high response ratio (88.33%), but with a small sample (60 subjects), where it has been found that the students adapt to the methods previously exposed. The main conclusion is the following: students adapt to remote teaching, they get involved in the subject and spend time learning, they are motivated to use innovative techniques, they show interest and participation in them. Resumen En la actualidad la docencia online o híbrida están cada vez más solicitadas y se han visto impulsadas por factores sociales, demográficos y sanitarios como el vivido durante la pandemia mundial por el COVID-19. El aula tradicional como se concebía en origen ha expandido sus limitaciones tanto temporales como físicas. En este texto se expone cómo se han desarrollado nuevas metodologías innovadoras a través de diferentes aplicaciones como Wooclap o trabajos con Gamificación, con el objetivo fundamental de comprobar la percepción, motivación y satisfacción del alumnado. Herramientas útiles para los docentes por conseguir en el alumnado una retroalimentación fácil y rápida. Se exponen, además, dos hipótesis que serán contrastadas con el análisis de las calificaciones de las pruebas finales del curso académico 2019/2020 y varios cuestionarios, con una ratio de respuesta alto (88,33%), pero con una muestra pequeña (60 sujetos), donde se ha comprobado que el alumnado se adapta a los métodos expuestos previamente. La conclusión principal es la siguiente: los alumnos se adaptan a la docencia en remoto, se involucran en la asignatura y emplean tiempo en el aprendizaje, les motiva emplear técnicas innovadoras, muestran interés y participación en las mismas.

Approaches to assessing the effectiveness of earthquake predictions using the LURR (load-unload response ratio) method on Sakhalin

A retrospective analysis of the seismicity of Sakhalin from 1997 to 2019 was performed to demonstrate the possibilities of the LURR technique recently in previous our work. The following results were obtained: 84 % of earthquakes (16 out of 19, with M ≥ 5) are predicted, 25% alarms (4 out of 15 predicted areas) were false. This paper proposes an analytical dependence to describe the forecast effectiveness (Ke) for this research. The extremes of Ke were found at the value of the alarm period of 12 and 24 months. At the same time, Ke is significantly higher for the alarm period of 24 months and decreases after a two-year alarm period. Another way to prove the results obtained is the random spatio-temporal distributions of the predicted objects (19 earthquakes with M ≥ 5). 10 such random sets have been assigned to 15 predicted areas, the result shows a significant advantage of a real sample over random ones, and also practically confirms the reliability of the algorithm for using the LURR technique. The methodology and results of this work can serve as practical recommendations for working with the LURR method for seismologists.

Analyses of the Mode of Action of an Alpha-Adrenoceptor Blocker in Substantia Gelatinosa Neurons in Rats

To elucidate why naftopidil increases the frequency of spontaneous synaptic currents in only some substantia gelatinosa (SG) neurons, post-hoc analyses were performed. Blind patch-clamp recording was performed using slice preparations of SG neurons from the spinal cords of adult rats. Spontaneous inhibitory and excitatory postsynaptic currents (sIPSCs and sEPSCs, respectively) were recorded. The ratios of the frequency and amplitude of the sIPSCs and sEPSCs following the introduction of naftopidil compared with baseline, and after the application of naftopidil, serotonin (5-HT), and prazosin, compared with noradrenaline (NA) were evaluated. First, the sIPSC analysis indicated that SG neurons reached their full response ratio for NA at 50 μM. Second, they responded to 5-HT (50 μM) with a response ratio similar to that for NA, but prazosin (10 μM) did not change the sEPSCs and sIPSCs. Third, the highest concentration of naftopidil (100 μM) led to two types of response in the SG neurons, which corresponded with the reactions to 5-HT and prazosin. These results indicate that not all neurons were necessarily activated by naftopidil, and that the micturition reflex may be regulated in a sophisticated manner by inhibitory mechanisms in these interneurons.

Long-term Fertilization Enhances Soil Carbon Stability by Increase the Ratio of Passive Carbon: Evidence From Four Typical Croplands

Aims Soil organic carbon (SOC) plays an important role in improving soil quality, however how long-term fertilization influences SOC and contrasting active carbon (AC) and passive C (PC) pools at large scale remains unclear. The aim of this study was to examine the effect of long-term fertilization on SOC, including AC and PC, across four typical croplands in China and to explore the potential relationships and mechanism. Methods We assessed the effect of different fertilization (standard and 1.5 × standard of inorganic fertilizer (NPK) with or without manure (M), with a control for comparison) at soil depths (0-20 cm, 20-40 cm, 40-60 cm) on SOC, AC and PC. Results We found that SOC, AC and PC increased in the order Control < NPK < NPKM < 1.5NPKM. 1.5NPKM resulted in a significant increase in SOC, AC and PC, of 76.3%, 53.0% and 108.5% respectively across the soil profile (0-60 cm) compared with Control. The response ratio of PC to long-term fertilization was 2.1 times greater than that of AC across four sites on average. In addition, Clay was identified as the most important factor in explaining the response of AC and PC to different fertilization application, respectively. Conclusions Long-term fertilization enhanced both AC and PC, but the greater response of PC suggests that fertilization application could enhance the stability of carbon and thus the potential of cropland for soil carbon accumulation.

Correcting Coagulopathy With Fresh Frozen Plasma in the Surgical Intensive Care Unit: How Much Do We Need to Transfuse?

Introduction Thromboelastography (TEG) is an assay that assesses the coagulation status. Patients with prolonged reaction time (R) require fresh frozen plasma (FFP); however, the volume required to correct the R time is unknown. We sought to quantify the volume required to correct the R time and calculate the response ratio in our surgical intensive care unit (SICU) to allow for targeted resuscitation Methods Surgical intensive care unit patients between Aug 2017 and July 2019 with a prolonged initial R time and at least two TEG tests performed within 24 hours were included. The response ratio was defined as the change in the R time divided by the number of FFP units. High responders (response ratio >5 minutes/unit) were compared to low responders (response ratio ≤5 minutes/unit). Results Forty-six patients were included. While the mean response ratio was 5 minutes/unit, there was significant variation among patients. There were 28.0 (60.9%) low responders and 18.0 (39.1%) high responders. Low responders were more likely male (64.0% vs. 33.0%, P = .04), had a higher Acute Physiology and Chronic Health Evaluation (APACHE) IV score (42.0 vs. 27.0, P = .03), and a higher mortality rate (54.0% vs. 22.0%, P = .04). Conclusions On average, one unit of FFP corrects the R time by 5 minutes; however, there was significant variation between high and low responders. Male patients with higher APACHE IV score are expected to be low responders with a higher mortality rate. These findings can guide FFP transfusion and provide additional prognostication.

Neurons in the Nonhuman Primate Amygdala and Dorsal Anterior Cingulate Cortex Signal Aversive Memory Formation under Sedation

Background Anesthetics aim to prevent memory of unpleasant experiences. The amygdala and dorsal anterior cingulate cortex participate in forging emotional and valence-driven memory formation. It was hypothesized that this circuitry maintains its role under sedation. Methods Two nonhuman primates underwent aversive tone–odor conditioning under sedative states induced by ketamine or midazolam (1 to 8 and 0.1 to 0.8 mg/kg, respectively). The primary outcome was behavioral and neural evidence suggesting memory formation. This study simultaneously measured conditioned inspiratory changes and changes in firing rate of single neurons in the amygdala and the dorsal anterior cingulate cortex in response to an expected aversive olfactory stimulus appearing during acquisition and tested their retention after recovery. Results Aversive memory formation occurred in 26 of 59 sessions under anesthetics (16 of 29 and 10 of 30, 5 of 30 and 21 of 29 for midazolam and ketamine at low and high doses, respectively). Single-neuron responses in the amygdala and dorsal anterior cingulate cortex were positively correlated between acquisition and retention (amygdala, n = 101, r = 0.51, P &lt; 0.001; dorsal anterior cingulate cortex, n = 121, r = 0.32, P &lt; 0.001). Neural responses during acquisition under anesthetics were stronger in sessions exhibiting memory formation than those that did not (amygdala median response ratio, 0.52 versus 0.33, n = 101, P = 0.021; dorsal anterior cingulate cortex median response ratio, 0.48 versus 0.32, n = 121, P = 0.012). The change in firing rate of amygdala neurons during acquisition was correlated with the size of stimuli-conditioned inspiratory response during retention (n = 101, r = 0.22 P = 0.026). Thus, amygdala and dorsal anterior cingulate cortex responses during acquisition under anesthetics predicted retention. Respiratory unconditioned responses to the aversive odor anesthetics did not differ from saline controls. Conclusions These results suggest that the amygdala–dorsal anterior cingulate cortex circuit maintains its role in acquisition and maintenance of aversive memories in nonhuman primates under sedation with ketamine and midazolam and that the stimulus valence is sufficient to drive memory formation. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New