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Retention (i.e., response maintenance) is rarely the primary variable of interest when examining skill acquisition procedures. Trial presentation type (i.e., acquisition targets only vs. interspersal of previously acquired targets) within discrete-trial training is one procedural component that researchers have hypothesized may affect performance on follow-up retention probes. The present study compared single-task presentation (varied instruction) and task interspersal procedures with regard to retention of a mastered task. We taught four children two skills so that retention of the mastered skill (Skill 1) could be assessed during ongoing instruction of a new skill (Skill 2) using varied instruction versus task interspersal. Findings demonstrated equivalency of varied instruction and task interspersal. Results support that frequent rehearsal of a skill acquisition program without consequences is equivalent to ongoing instruction with consequences. Findings suggest instructors should program follow-up probes of previously mastered content into or between sessions, especially when utilizing single-task trial arrangements that do not incorporate such. [ABSTRACT FROM AUTHOR]

Missed appointments are detrimental to the healthcare system and to the clients themselves. Autistic youth may be particularly impacted due to unique service needs and limited services available within the system. To date, there is limited literature specific to treatment attendance in autistic populations receiving behavioral services. This study examines prevalence, predictors of, and reasons for missed appointments in an outpatient clinic specializing in addressing behavioral concerns. This retrospective case review examines missed appointments in a sample of 306 autistic youths from an outpatient clinic from 2019 to 2022. An average of 5.2 appointments were cancelled and 9.0 were completed, resulting in an average individual cancellation rate of 38%. Statistically significant predictors of no shows and patient cancellations were younger age and a post-COVID appointment. The most common reasons for missed appointments was sickness, scheduling conflict, insurance authorization issues, and family emergency. Missed appointments may be common in outpatient behavioral settings for autistic youth. Resolving issues related to cancellations (e.g., sleep concerns), identifying families in need of targeted support strategies (e.g., assistance and flexibility with scheduling, transportation support), and advocating for systemic change may help meet the multifaceted needs of this population. [ABSTRACT FROM AUTHOR]

The present evaluation aimed to begin development of a survey tool for measuring workplace stressors specific to behavioral health providers in clinical settings for autism and related developmental disabilities: the Burnout Assessment for Developmental Disability Settings (BADDS). BADDS development was guided by Patient-Reported Outcomes Measurement Information System (PROMIS®; Cella et al., (Journal of Clinical Epidemiology, 63(11), 1179–1194, 2010) procedures. We used a qualitative analysis to define the target conceptual model (Phase 1). Using the analysis and reported lived experiences, we generated individual items for the BADDS. We then piloted these items in an online survey study to examine correlations with established measures of burnout (Phase 2). Finally, we used a modified Delphi approach to refine items with an expert panel, resulting in a preliminary item pool for the BADDS (Phase 3). Qualitative interviews produced a framework of four themes and nine sub-themes for analysis. Initial items were written across each theme and sub-theme. Findings from preliminary psychometric evaluation in Phase 2 demonstrated promising internal consistency, score stability, and positive associations with validated measures of burnout level. Finally in Phase 3, an expert panel edited items for relevance and clarity across three iterations of feedback. Though further analysis is needed, the BADDS tool has the potential to provide a conceptual analysis of burnout by identifying workplace stressors impacting behavioral health providers in autism service settings. This is in contrast to existing measures that solely inquire burnout level, but do not identify causes of job stress. Organizations may develop more effective strategies for mitigating burnout within their specific setting by incorporating assessments such as the BADDS into burnout interventions for providers. [ABSTRACT FROM AUTHOR]

Identification of reinforcers is critical to the effectiveness of behavioral interventions. Stimulus preference assessments (SPA) are a frequently used method to identify putative reinforcers. Given the fluctuating nature of individual preferences, there is need for efficient training of providers that may regularly implement SPAs. The present study evaluated the utility of a web-delivered training with virtual role play to train SPA implementation. This study builds upon previous literature by utilizing a larger sample and incorporating role-play, a component often omitted from other efficient methods of training. Study 1 trained 40 undergraduate students to implement an SPA via web or in vivo. Results suggest both trainings were equivalently effective, and the web-delivered training reduced trainer time by approximately 25 min. Live role-play and feedback was still necessary with web-delivered training, consistent with suggestions that rehearsal and feedback is a vital component of training. Results also suggest web-delivered training may identify areas of weakness following training. A follow-up clinical pilot showed that the web-delivered training was also effective at training eight novice providers to competently implement the SPA with children with ASD in a special education school. This study demonstrates that web-delivered training with virtual role-play is likely another efficient training method for implementation of behavioral procedures. [ABSTRACT FROM AUTHOR]

Bullying is problematic for school-age children and especially for children with autism spectrum disorder (ASD). It is commonly defined in research using three themes: intent to harm, repetition, and a power imbalance. Despite encompassing a wide range of behaviors, these themes may not fully align with day-to-day layperson experiences. They also may not account for the cognitive biases within respondent groups that impact bullying perception. This study used a mixed-methods approach to understand how laypersons determine the presence and type of bullying behavior. The impact of an ASD relationship (i.e., ASD parents and teachers) on perceptions of bullying was also examined. Participants (N = 184 adults) categorized brief, written vignettes describing child dyadic interactions as a type of bullying behavior (i.e., physical, verbal, interpersonal, cyber), non-bullying behavior, or provided an "other" response. Thematic analysis of the qualitative, "other" explanations for bullying ambiguity revealed three themes: a need for more contextual information, the presence of other types of bullying (outside the options provided), and other non-bullying behaviors (e.g., crime, peer pressure). Comparing the probability of use across and within themes revealed statistically significant differences such that layperson views of bullying did not fully align with research definitions. Additionally, perceptions of bullying differed among individuals with and without ASD relationships (i.e., parents, teachers) and undergraduate students. Existing research definitions for bullying do not fully encompass the breadth of daily-lived and cultural experiences of laypersons. We propose an expanded "working definition" of bullying that may be useful to more accurately identify children in need of intervention and generate more reliable estimates of bullying across studies. [ABSTRACT FROM AUTHOR]

Autistic people, by definition, differ in social behavior from non-autistic individuals. One characteristic common to many autistic people is a special interest in a particular topic—something spoken about with such frequency and intensity that it may be stigmatized by non-autistic peers. We investigated college students' interest in interacting with peers described as behaving in ways characteristic of autism (or not), and additionally described as having a special interest (or not). As expected, autistic characters were more stigmatized, but autistic characters with a special interest were not more stigmatized than those without. Only among non-autistic characters was having a special interest associated with greater stigmatization. Findings give further insight into factors influencing the stigmatization of autistic college students. [ABSTRACT FROM AUTHOR]

Differential reinforcement of alternative behavior (DRA) is a common strategy for escape-maintained behaviors targeted for reduction (i.e., targeted behavior) exhibited by youth with intellectual and developmental disabilities. DRA often involves various methods of prompting to ensure the instruction or task remains in place until contingencies for the DRA are met. Currently, there is little research on client preference for these different prompting strategies in the context of DRA treatments. The current study includes four participants diagnosed with autism spectrum disorder (ASD) who exhibited targeted behavior maintained by escape from instructional tasks. We evaluated efficacy and preference for three prompting strategies (three-step least-to-most, repeated vocal prompt, or a single initial prompt) embedded in a DRA treatment aimed at reducing targeted behavior (e.g., aggression) and improving task completion. For all participants, more than one prompting strategy was effective when positive was combined with negative reinforcement in the DRA. We then implemented a concurrent-chains assessment to determine client preference, a rank-order task for caregiver preference, and an acceptability questionnaire for therapists. Two participants demonstrated a clear preference, and preference was obtained from a total of two caregivers and seven therapists. The initial and repeated verbal prompts were most preferred. Results are discussed in the context of client autonomy and incorporating choice in treatment planning. [ABSTRACT FROM AUTHOR]