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Bullying Among Adolescents With Autism Spectrum Disorders: Prevalence and Perception

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This study examined: (a) the prevalence of bullying and victimization among adolescents with ASD, (b) whether they correctly perceived bullying and victimization, and (c) whether Theory of Mind (ToM) and bullying involvement were related to this perception. Data were collected among 230 adolescents with ASD attending special education schools. We found prevalence rates of bullying and victimization between 6 and 46%, with teachers reporting significantly higher rates than peers. Furthermore, adolescents who scored high on teacher- and self-reported victimization were more likely to misinterpret non-bullying situations as bullying. The more often adolescents bullied, according to teachers and peers, and the less developed their ToM, the more they misinterpreted bullying situations as non-bullying. Implications for clinical practice are discussed.


Educational Priorities for Children with Cri-Du-Chat Syndrome

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There are few data on the educational needs of children with cri-du-chat syndrome: a neurodevelopmental disorder that affects learning and development. We therefore designed an Internet survey to identify parents’ educational priorities in relation to children’s level of need/ability. The survey listed 54 skills/behaviors (e.g., toileting, expresses wants and needs, and tantrums) representing 10 adaptive behavior domains (e.g., self-care, communication, and problem behavior). Parents rated their child’s current level of ability/performance with respect to each skill/behavior and indicated the extent to which training/treatment was a priority. Fifty-four surveys were completed during the 3-month data collection period. Parents identified nine high priority skills/behaviors. Results supported the view that parent priorities are often based on the child’s deficits and emergent skills, rather than on child strengths. Implications for educational practice include the need for competence to develop high priority skills/behaviors and the value of assessing children’s deficits and emergent skills to inform the content of individualized education plans.

Communication in Individuals with Rett Syndrome: an Assessment of Forms and Functions

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In the present study we assessed the forms and functions of prelinguistic communicative behaviors for 120 children and adults with Rett syndrome using the Inventory of Potential Communicative Acts (IPCA) (Sigafoos et al. Communication Disorders Quarterly 21:77–86, 2000a). Informants completed the IPCA and the results were analysed to provide a systematic inventory and objective description of the communicative forms and functions present in each individual’s repertoire. Results show that respondents reported a wide variety of communicative forms and functions. By far most girls used prelinguistic communicative behaviors of which eye contact/gazing was the most common form. The most often endorsed communicative functions were social convention, commenting, answering, requesting and choice-making. Problematic topographies (e.g., self-injury, screaming, non-compliance) were being used for communicative purposes in 10 to 41% of the sample. Exploratory analyses revealed that several communicative forms and functions were related to living environment, presence/absence of epilepsy, and age. That is, higher percentages of girls who showed some forms/functions were found in those who lived at home, who had no epilepsy and who were relatively young.

Use of Computer-Based Interventions to Teach Communication Skills to Children with Autism Spectrum Disorders: A Systematic Review

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The purpose of this review is to provide a systematic analysis of studies involving the use of computer-based interventions (CBI) to teach communication skills to children with autism spectrum disorders (ASD). This review evaluates intervention outcomes, appraises the certainty of evidence, and describes software and system requirements for each included study. This review has three main aims: (a) to evaluate the evidence-base regarding CBI, (b) to inform and guide practitioners interested in using CBI, and (c) to stimulate and guide future research aimed at improving the efficiency and effectiveness of CBI in communication for individuals with ASD. Results suggest that CBI should not yet be considered a researched-based approach to teaching communication skills to individuals with ASD. However, CBI does seem a promising practice that warrants future research.

Camera-Based Microswitch Technology to Monitor Mouth, Eyebrow, and Eyelid Responses of Children with Profound Multiple Disabilities

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A camera-based microswitch technology was recently used to successfully monitor small eyelid and mouth responses of two adults with profound multiple disabilities (Lancioni et al., Res Dev Disab 31:1509–1514, 2010a). This technology, in contrast with the traditional optic microswitches used for those responses, did not require support frames on the participants’ face but only small color marks. The present study was aimed at extending the research evidence available on the aforementioned technology with the involvement of new participants and responses. The participants were three children with profound multiple disabilities. The responses selected for them consisted of mouth closing, eyebrow lifting, and repeated eyelid closures. The results showed that the new technology could be satisfactorily applied with all three children, across the three different responses. All children had large increases in responding during the intervention periods (i.e., when their responses were followed by preferred stimulation). The findings are discussed in relation to the possible impact of the new technology on programs for persons with multiple disabilities and minimal motor behavior.

Nature, Prevalence, and Characteristics of Challenging Behavior

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Challenging behaviors are among the most serious and studied problems in the field of developmental disabilities (Matson et al. 2011). An increasing number of studies are being published that have provided more insight into the nature, prevalence, and characteristics of challenging behaviors in this target group. Results of these studies have shown that challenging behaviors are common in children and adults with autism spectrum disorders (ASD) and/or intellectual disabilities (ID). Population studies have shown that between 5 and 15% of individuals with ID show some type of challenging behavior, like self-injury, aggression, stereotypic behavior, and other problem behaviors. Studies also show that rates of challenging behaviors are increased if individuals also have ASD. For example, Holden and Gitlesen (2006) found that among over 900 individuals with ID, 11% showed one or more types of challenging behavior. Of the study sample, 6% had been diagnosed with autism, and 36% of this subgroup showed challenging behavior. Rojahn, Matson, Lott, Esbensen, and Smalls (2011) employed the Behavior Problem Inventory-01 (BPI-01) in a sample of individuals with ID (n = 432) who lived in a residential facility and who were between 14 and 19 years old. Results showed that individuals with ASD had higher rates of aggression, self-injury and stereotypy than those with ID without ASD. These findings were corroborated by results from a meta-analysis by McClintock, Hall, and Oliver (2003) who have explored risk factors for challenging behaviors in individuals with developmental disabilities. They have published a meta-analysis of 22 studies conducted over 30 years, and the results showed that children and adults with ASD were more likely than other individuals with ID to exhibit challenging behaviors such as self-injury and aggression. These results indicate that ASD itself may be a risk factor for challenging behavior in individuals with ID. However, other researchers failed to find an association between challenging behavior and ASD. For example, Tyrer et al. (2006) investigated prevalence rate of physical aggression in over 3,000 adults with profound to mild ID, and they failed to find a relationship between challenging behavior and the presence of autism.

Function of Challenging Behaviors

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This chapter presents a selection of studies on functional analysis of challenging behaviors to illustrate the procedural conditions involved in the analysis and the possible results of it (i.e., the possible functions identified at the basis of the challenging behaviors). The studies are divided into five groups, which differ with regard to the behavioral functions identified. Those functions concern attention, access to tangible items, escape from demands, automatic reinforcement, and idiosyncratic events for the five groups, respectively. The chapter also discusses possible adaptations of the functional analysis procedure aimed at allowing the procedure to cover a wider range of situations and making its application practically feasible in daily contexts.

Use of Computer-Based Interventions to Promote Daily Living Skills in Individuals with Intellectual Disabilities: A Systematic Review

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We provide a systematic analysis of studies investigating the effectiveness of computer-based interventions (CBI) to promote daily living skills (e.g., navigating public transit, shopping, and food preparation) in individuals with intellectual disability. This review synthesizes intervention outcomes and describes software features and system requirements for each CBI. This review has three aims: (a) to evaluate the evidence-base regarding CBI, (b) to inform and guide practitioners interested in using CBI and, (c) to stimulate and guide future research aimed at promoting daily living skills in individuals with intellectual disability. The majority of the participants in the reviewed studies were identified as having moderate intellectual disability. The results of this review suggest that CBI is a promising approach for promoting daily living skills in individuals with intellectual disability. Additional research is needed before CBI could be considered a well-established intervention.


Incontinence in Individuals with Rett Syndrome: A Comparative Study

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Frequency and type of incontinence and its association with other variables were assessed in females with Rett Syndrome (RS) (n = 63), using an adapted Dutch version of the ‘Parental Questionnaire: Enuresis/Urinary Incontinence’ (Beetz et al. 1994). Also, incontinence in RS was compared to a control group consisting of females with non-specific (mixed) intellectual disability (n = 26). Urinary incontinence (UI) (i.e., daytime incontinence and nocturnal enuresis) and faecal incontinence (FI) were found to be common problems among females with RS that occur in a high frequency of days/nights. UI and FI were mostly primary in nature and occur independent of participants’ age and level of adaptive functioning. Solid stool, lower urinary tract symptoms and urinary tract infections (UTI’s) were also common problems in females with RS. No differences in incontinence between RS and the control group were found, except for solid stool that was more common in RS than in the control group. It is concluded that incontinence is not part of the behavioural phenotype of RS, but that there is an increased risk for solid stool in females with RS.

Comparing Three Augmentative and Alternative Communication Modes for Children with Developmental Disabilities

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We compared acquisition, maintenance, and preference for three AAC modes in four children with developmental disabilities (DD). Children were taught to make general requests for preferred items (snacks or play) using a speech-generating device (SGD), picture-exchange (PE), and manual signs (MS). The effects of intervention were evaluated in a multiple-probe across participants and alternating-treatments design. Preference probes were also conducted to determine if children would choose one AAC mode more frequently than the others. During intervention, all four children learned to request using PE and the SGD, but only two also reached criteria with MS. For the AAC preference assessments, three participants chose the SGD most frequently, while the other participant chose PE most frequently. The results suggest that children’s preference for different AAC modes can be assessed during the early stages of intervention and that their preferences may influence acquisition and maintenance of AAC-based requesting responses.

Technology-Based Programs to Support Adaptive Responding and Reduce Hand Mouthing in Two Persons with Multiple Disabilities

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These two single-case studies assessed the use of microswitch clusters to support adaptive responses and reduce problem behavior with two adults with multiple disabilities. Study I involved a man whose adaptive responses consisted of touching color shapes appearing on a computer screen in front of him and the problem behavior was hand mouthing. Study II involved a woman whose adaptive response consisted of using a napkin to wipe her mouth to reduce drooling effects. Her problem behavior, like for the man, was hand mouthing. Initially, the intervention focused on the adaptive responses, which were followed by preferred stimulation. Then the intervention was extended so that the stimulation for the adaptive responses would be interrupted if the problem behavior appeared during its occurrence. The data of the two studies suggest that the intervention was effective in helping the participants engage in consistent rates of adaptive responses and curb their problem behavior. These findings were analyzed in relation to the characteristics of the intervention approach and its practical implications.

Functional Analysis and Functional Communication Training in the Classroom for Three Children with Angelman Syndrome

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Effectiveness of functional analysis (FA) and functional communication training (FCT) on challenging behavior was assessed in three children with Angelman syndrome (AS). Analogue FA conditions were used to assess the behavioral function of the challenging behavior. FA and FCT protocols were administered in the children’s classroom and were performed by their teachers. Replacement behavior was prompted upon the onset of precursor behavior. One or more function(s) of their challenging behavior were identified and challenging behavior appeared to be escape or tangibly motivated. Making physical contact with the teacher was found to be a precursor of challenging behavior in one child. In all children, challenging behavior decreased as a function of FCT. Functional equivalence of both challenging and replacement behavior was evinced. Clinical and research implications are discussed.

Erratum to: Comparing Three Augmentative and Alternative Communication Modes for Children with Developmental Disabilities

A Video-Based Package to Teach a Child with Autism Spectrum Disorder to Write Her Name

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The purpose of this study was to trial a procedure involving point-of-view video modeling, backward chaining and reinforcement to teach a child with ASD to write her name. Video modeling and reinforcement were used to teach letter writing, and backward chaining to produce the complete name. A multiple baseline across behaviors design treating each letter as a different behavior established the effectiveness of the procedure for teaching letter writing and generalization data suggest the efficacy of backward chaining in teaching production of her name. Treatment integrity was satisfactory and a post-intervention questionnaire indicated the intervention was acceptable to the participant’s mother. These findings suggest that point-of-view video modeling in combination with backward chaining and reinforcement may be an effective tool for teaching new academic skills.

Increasing On-Task Behavior in Students in a Regular Classroom: Effectiveness of a Self-Management Procedure Using a Tactile Prompt

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Self-management strategies have been shown to be widely effective. However, limited classroom-based research exists involving low performing but developmentally normal high school-aged participants. This study examined the effectiveness of a self-management strategy aimed at increasing on-task behavior in general education classrooms with students without a diagnosed disability, behavior disorder, or exceptionality. The self-management package included provision of a tactile prompt, training in self-monitoring and data recording, self-monitoring, and the plotting of the results on a cumulative graph. A multiple baseline design across three participants was used to evaluate the effects of the intervention. An increase in on-task behavior was observed with all participants on implementation of the self-management package, and questionnaire-based social validity findings suggest this was an acceptable and effective procedure for the classroom context. Limitations, implications, and future directions of these findings are discussed.


Assistive Technology for People with Autism Spectrum Disorders

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This chapter reviews research involving the use of assistive technology in the education and treatment of people with autism spectrum disorders (ASD). The chapter is organized in three sections corresponding to the most common uses of assistive technology for this population; specifically, to support or improve (a) communication skills, (b) social and emotional skills, and (c) daily living and other adaptive skills. Three tables summarize intervention research involving AT in terms of participant characteristics, dependent variables, intervention procedures, and outcomes. The most common forms of assistive technology are discussed within each intervention category including: (a) speech-generating devices, (b) computer-based intervention, (c) the Picture Exchange Communication System, (d) video modeling, and (e) audio-script training. The chapter concludes that a variety of high-tech (e.g., speech-generating devices) and low-tech (e.g., picture cards) systems have been used to teach new skills, promote independent functioning, and improve the quality of life of people with ASD. However, additional research in which a person’s individual preferences, existing abilities, goals, and natural environment are better incorporated within assistive technology planning and intervention is warranted. Considerations for researchers and practitioners working with people with ASD are discussed.

Families of Children with Autism Spectrum Disorders: Intervention and Family Supports

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Autism spectrum disorders (ASD) are characterized by communication and social impairments, and restricted and repetitive behaviors and interests (American Psychiatric Association, Diagnostic and statistical manual of mental disorders. Washington, DC: American Psychiatric Association, 2000). Children with autism also often engage in challenging behaviors such as tantrumming, elopement (e.g., leaving a designated area without adult supervision), aggression, and self-injury (Baghdadli et al., Journal of Intellectual Disability Research 47:622–627; Conroy et al., Topics in Early Childhood Special Education, 25:157–166; Horner et al., Journal of Autism and Developmental Disorders, 32:423–446). These core deficits represent a significant disability affecting child development, but also present unique and persistent challenges to the child’s parents and other family members.

Pivotal Response Treatment for Children with Autism Spectrum Disorders: A Systematic Review

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Intervention studies evaluating pivotal response treatment (PRT) were systematically identified and analyzed. Forty-three studies were summarized in terms of (a) participant characteristics, (b) dependent variables, (c) intervention procedures, (d) intervention outcomes, and (e) certainty of evidence. The majority of the reviewed studies (56.4 %) had serious methodological limitations. However, the reviewed studies that provided conclusive or preponderant evidence (43.6 %) indicated that PRT results in increases in self-initiations and collateral improvements in communication and language, play skills, affect and reductions in maladaptive behavior for a number of children. Furthermore, the reviewed studies suggested that the majority of caregivers and staff members were able to implement PRT techniques, but evidence for collateral improvements in caregivers' and staff members' behaviors remains sparse. Implications for future research are discussed.

Educational Priorities for Individuals with Angelman Syndrome: A Study of Parents’ Perspectives

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The priorities of parents of children with intellectual disability should be considered when selecting educational goals. To this end, 77 parents of children with Angelman syndrome (AS) completed a questionnaire that involved rating their child’s abilities and prioritizing educational goals across a range of adaptive and maladaptive domains. A factor analysis was used to determine if parents prioritized the training of skills in which their child showed a major, moderate or minor deficit. Results suggest that skills related to communication, recreation, self-care, motor and academic domains are high priorities. Further, parents of children under the age of 18 indicated that communication skills were a high priority, whereas parents of adults also prioritized daytime activity skills (e.g., swimming and cycling). Training for communication, recreational and ingestion skills was prioritized when children showed emerging skills; training for motor skills was prioritized when children were highly dependent; and training for self-care skills was prioritized when children were more independent in the self-care domain. In terms of behavioral problems, sleep and eating problems were prioritized.

An iPad-Based Intervention for Teaching Picture and Word Matching to a Student with ASD and Severe Communication Impairment

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iPads® have been successfully used as speech-generating devices (SGD) for children with ASD and limited speech, but little research has investigated the use of iPads to enhance academic skills, such as picture/word matching. In the present study, a student with ASD received intervention to teach picture and word matching using an iPad-based SGD as the response mode. A multiple baseline across matching tasks design was used to evaluate the effects of a graduated guidance prompting procedure and differential reinforcement on correct matching across four matching tasks (i.e., picture to picture, word to picture, picture to word, and word to word). With intervention, the student showed increased correct matching across all four combinations, suggesting that picture and word matching with an iPad-based SGD can be successfully taught using graduated guidance and differential reinforcement. This approach might have relevance for teaching a range of academic/literacy skills to students with ASD who present with limited or no speech.

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