Handbook of Autism and Pervasive Developmental Disorder: Assessment, Diagnosis, and Treatment

Contents
Part I: An Introduction and Overview to Autism and Pervasive Developmental Disabilities
Autism across the Ages: An Abbreviated History
ERA 1: Earliest Accounts (Pre-Twentieth Century)
Era 2: Institutionalization and the Initial Naming & Framing of ‘Autism’
Era 3: Psychogenic and Psychiatric Viewpoints
Era 4: Burgeoning of Research and Nature Vs Nurture
Era 5: The Brain and Autism
Era 6: Awareness, Advocacy, and Advancement
Era 7: Future Directions
References
Psychopathologies Associated with ASD: Anxiety, OCD, Depression, and ADHD
General Overview of co-Occurring Psychiatric Disorders in ASD
Attention-Deficit/Hyperactivity Disorder (ADHD)
Anxiety
Obsessive-Compulsive Disorder (OCD)
Depression
Conclusion
References
Challenging Behaviors Associated with Autism and Pervasive Developmental Disabilities
Introduction
Implications for the Individual and the Family
Theories on the Etiology of Challenging Behavior
Environmental Influences
Biomedical Models
Mixed Model Considerations
Treatment for Challenging Behavior
Antecedent Interventions
Consequence-Based Interventions
Punishment-Based Strategies
Extinction-Based Strategies
Reinforcement-Based Strategies
Extensions of Function-Based Treatment: Cognitive-Behavioral Therapy
Psychopharmacological Treatments
Conclusion
References
Sensory Processing and Motor Issues in Autism Spectrum Disorders
Introduction
Sensory Processing
Sensory Systems in ASD
Sensory Subtypes
Sensory Processing Disorder
Functional Implications
Motor Performance in ASD
Neurological Explanation for Motor Impairment
Motor Impairment
Motor Patterns across Childhood
Functional Implication of Motor Impairment
Treatment Approaches
Conclusion
References
Emotional Cognition, Theory of Mind, and Face Recognition in Individuals with Autism and PDDs
Emotional Cognition in ASD
Hypotheses of Emotion Processing Deficits in ASD
Neurobiology of Emotion Processing in ASD
Theory of Mind (ToM) and ASD
Neural Correlates of ToM in Autism
Critique of ToM Account of ASD
Face Processing in ASD
Neurobiology of Face Processing
Implications
References
Epidemiological Surveys of ASD: Current Findings and New Directions
Introduction
Part I. Review of Prevalence Surveys
Part II. Advances and Remaining Challenges
Case Definition and Case Status Determination
The Problems of Parental Reports
Novel Approaches to Case Finding/Ascertainment
The Male Preponderance in Autism
Age Considerations
Social Class, Race and Ethnic Minority Status
Socioeconomic Status
Race and Ethnicity
Implications and Unmet Research Needs
Part III. The Development of World Studies of ASD and Population Surveillance
Worldwide Studies and Cultural Issues
Databases, Ad Hoc Surveys and Surveillance
Conclusions
References
Quality of Life for Individuals with Autism and Pervasive Developmental Disabilities
Introduction
Autism Spectrum Disorder
Measuring QOL in People with ASD
Normative and Subjective Outcomes for People with ASD
Choice/Self-Determination
Self-Advocacy
Employment
Independent Living
Support Services for People with ASD
Concluding Remarks
References
Parental Stress and Effective Parent Training for Parents of Individuals Diagnosed with ASD
Overview of Parental Stress
Stress Commonalities across Mothers and Fathers
Differences between Mothers’ and Fathers’ Stress
Potential Causes of Parental Stress
Child Characteristics
Child Interventions
Financial Burden
Outcomes of Parental Stress
Depression
Divorce
Mediating Factors to Stress, Depression, and Divorce
ABA and Parent Training
Early and Seminal Research
Various Approaches to Train Parents
Behavioral Skills Training and Teaching Interaction Procedure
Active Coaching
Parent Training Manuals
Telehealth
A Progressive Approach
Child Targets in Parent Training
Aberrant Behavior
Social and Communication Skills
Mealtime Challenges
Conclusion
References
Part II: General Assessment Issues in Autism and Pervasive Developmental Disabilities
Psychometric Principles and Standards for Assessing Autism and Pervasive Developmental Disabilities
ASD Characteristics
Psychometrics and Measure Selection
Testing Theories, Development, and Analysis
ASD and Psychometric Challenges
ASD Assessment
Anxiety Assessment
Behavioral Assessment
IQ Assessment
Adaptive Assessment
Accommodation and Modification for Testing Individuals with ASD
Conclusion
References
Diagnostic Systems for Autism and Pervasive Developmental Disabilities
Purposes of Classification Systems
Challenges Associated with Classification Systems
Etiology
Thresholds
Comorbidity
Current Classification Systems
History
DSM
ICD
RDoC
Aim
DSM
ICD
RDoC
Similarities and Differences
DSM and ICD
RDoC
Strengths
DSM and ICD
RDoC
Weaknesses
DSM and ICD
RDoC
Challenges Associated with the DSM, ICD, and RDoC
Etiology
Thresholds
Comorbidity
References
Purposes of Assessment in Autism and Pervasive Developmental Disorders
Introduction
Overview of Assessment
Purposes of Autism Assessment by Context
Clinical Contexts
Academic Contexts
Criminal, Civil, and Administrative Contexts
Conclusions
References
Effects of Cognition and Age on Assessment of Autism and Pervasive Developmental Disabilities
Introduction
Cognition and ASD Assessment
Effects of Cognition on Assessment of ASD
Does the Level of Cognitive Impairment Preclude a Diagnostic Assessment for ASD?
How Should Cognitive Impairment Be Taken into Account during an ASD Assessment?
How Should Cognitive Functioning Be Taken into Account in an ASD Assessment in the Absence of Cognitive Impairment?
Age and ASD Diagnosis
Effects of Age on Assessment Procedures for ASD
What Methods Are Appropriate for Assessing ASD during a Specific Age Period?
Toddler Stage
Preschool Stage
School-age Stage
Adolescence/Adult Stage
How Does the Age of the Examinee Affect Evaluation of the Diagnostic Criteria for ASD?
Conclusion
References
Methods of Screening for Core Symptoms of Autism and Pervasive Developmental Disabilities
Level 1 Screeners
Ages and Stages Questionnaire
BITSEA
M-CHAT
PEDS
Level 2 Screeners
BISCUIT
FYI
GARS
SCQ
SRS-2
STAT
Parent’s Role in Screening
Pediatrician’s Role in Screening
Universal Screeners
Conclusion
References
Methods for Diagnosing ASD in Young Children
Current Problem: Late Diagnoses Leads to Later Interventions and Worse Outcomes
Barriers to Early Diagnoses
What Are We Looking For?
Communication/Social
Restricted and Repetitive Behaviors (RRBs)
Regression
Diagnostic Process
Accuracy/Stability of Early Assessment
Measures
Autism Diagnostic Measures
The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2)
Autism Diagnostic Interview—Revised (ADI-R)
The Autism Spectrum Quotient (AQ)
The Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT)
The Childhood Autism Rating Scale, Second Edition (CARS-2)
Gilliam Autism Rating Scale, Third Edition (GARS-3)
The Modified Checklist for Autism in Toddlers (MCHAT)
Conclusion
References
Monitoring Progress in Core Symptoms of Autism Spectrum Disorder
Self-Monitoring
Technology and Self-management
Pharmaceuticals
Challenges to Monitoring Symptoms
Measurement Tools
Autism Impact Measure
Autism Diagnostic Interview—Revised
Autism Treatment Evaluation Checklist
Baby and Infant Screen for Children with aUtIsm
Childhood Autism Rating Scale
Social Responsiveness Scale
Psychoeducational Profile
Behavioral and Adaptive Measures
Aberrant Behavior Checklist
Behavior Assessment System for Children
Behavior Problems Inventory
Childhood Behavior Checklist
Vineland Adaptive Behavior Scale
Parent and Teachers
Conclusion
References
Part III: Assessment Issues Related to Core Symptoms of Autism and PDDs
Educational Assessment
Introduction
Educational Assessment
Formal Assessments
Informal Assessments
Adaptations
Conclusion
References
Monitoring Educational Progress
Introduction and Legal Requirements for Progress Monitoring
Defining Student Progress Monitoring
Monitoring Student Progress Using a Curriculum-Based Measurement Model
Procedures for Using CBM to Monitor IEP Progress
Step 1: Identify Target Behavior
Step 2: Set Target Goals
Step 3: Select Appropriate Measures
Step 4: Determine Administration and Scoring Procedures
Step 5: Graph Data and Plot Student Performance
Step 6: Instructional Decision-Making
Step 7: Communicating Educational Progress
Conclusions
References
Measuring Comorbid Psychopathology
Introduction
Instruments for the Assessment of Mental Health in Toddlers, Children and Youth
Instruments for the Assessment of Mental Health in Adults
Use of Conventional Assessment Tools
Assessment Tools Developed for People with Intellectual Disabilities
Clinical Implications and Concluding Remarks
References
Measuring Challenging Behaviors
Behavior Assessment Methods
Interviews
Behavior Rating Scales
Direct Observation
Direct Behavior Ratings
Permanent Products
Functional Behavioral Assessment
Indirect FBA
Direct Descriptive
Functional Analysis
FBA Evidence Base
Conclusion
Purpose
Cultural Considerations
Feasibility
References
Measuring Social Skills
Importance of Social Skills
Norm-Referenced Measures of Social Skills
Sociometric Ratings
Summary
References
Measuring Feeding Disorders in Individuals with Autism and Pervasive Developmental Disorders
Picky Eating Versus Problematic Eating
Changes in Diagnostic Criteria
A Multidisciplinary Approach in the Assessment of Feeding Problems
Assessment of Medical-Related Feeding Problems
Pediatrician or Primary Care Physician
Physical Exam
Failure to Thrive
Gastroenterologist
Gastrointestinal Problems
Gastroesophageal Reflux (GERD)
Eosinophilic Esophagitis/Upper Endoscopy
Nutritionist or Dietician
Restricted Eating and Nutritional Deficiency
Obesity
Speech-Language Pathology and Occupational Therapy
Oral Motor Dysfunction/Dysphagia
Videofluoroscopic Swallow Study
Fiberoptic Endoscopic Evaluation of Swallow
The Family
Social Work
Psychology/Board Certified Behavior Analyst (BCBA)
Indirect Questionnaires and Caregiver Interview
Direct Observation
Functional Analysis
Finals Thoughts
References
Measuring Psychotropic Drug Effects and Side Effects
Introduction
Overview of the Measurement of Psychotropic Medication Effects and Side Effects
Monitoring Instruments
The Measurement of Psychotropic Medication Effects and Side Effects
General Instruments for Measuring Effects of Psychotropic Medication
General Instruments for Monitoring Medication Side Effects
Monitoring Stimulant and Non-Stimulant Medications Prescribed to Treat ADHD
Instruments to Measure the Effects of Stimulants and Nonstimulants Prescribed for ADHD
Instruments to Measure the Side Effects of Stimulant
Monitoring Antidepressant Medications Prescribed to Treat Depression or Anxiety
Instruments to Measure Effects of Antidepressants
Instruments to Measure the Side Effects of Antidepressants
Monitoring Mood Stabilizers Prescribed to Treat Bipolar Disorders
Instruments to Measure Effects of Mood Stabilizers
Instruments to Measure Side Effects of Mood Stabilizers
Monitoring Antipsychotic Medications Prescribed to Treat Psychotic Disorders
Instruments to Measure Antipsychotic Effects
Instruments to Measure Antipsychotic Side Effects
Future Directions
References
Assessing Effects of Early Intervention
History of Early Intervention
Assessment in EI
Intervention Strategies
Addressing Comorbidities
Monitoring and Evaluating Progress
Transitioning Out of Early Intervention
Effects of Early Intervention
Conclusion
References
Assessing Transitions During School or Workday and Across the Life Span
Activities Most Commonly Effected
Transition Assessment Cycle
Identifying Transition Issues
Assessing the Environment
Gathering and Organizing Data
Analyzing Data
Creating a Transition Focused Plan of Action
Transition-Based Interventions
Verbal and Auditory Supports
Visual Supports
Tactile Supports
Combining Supports
Additional Transition Supports
Selecting the Intervention
Transition Plan Implementation
Progress Monitoring
Teaching the Intervention
Completing the Assessment Cycle
Conclusion
Scenario 1: Transition Assessment Cycle for 5th Grade Student with ASD, Carlos
Step 1: Identify Transition Issues—Gather and Analyze Data
Interviews
Direct Observation Data
Step 2: Create an Action Plan—Set Goals and Identify Instructional Strategies
Ecological Inventory
Step 3: Implement Plan—Teach and Monitor Progress
Repeat
Scenario 2: Transition Assessment Cycle for Adult with ASD, Emma
Step 1: Identify Transition Issues—Gather and Analyze Data
Interviews
Direct Observation Data
Step 2: Create an Action Plan—Set Goals and Identify Instructional Strategies
Ecological Inventory
Step 3: Implement Plan—Teach and Monitor Progress
Repeat
References
Part IV: Ethics and Methods of Evidence-Based Practices in the Treatment of ASD
The Importance of Evidence Based Practices and Autism
Evidence Based Practice
Classifying Autism Practices
Use of Unsupported Practices
What’s the Harm?
Evidence-Based Practice Is the Ethical Approach and Supports Human Rights
Challenges to Implementation of EBP in Practice
Conclusion
References
Applying Dissemination and Implementation Science to Facilitate Community Implementation of Evidence-Based Interventions
Community Services Across the Lifespan
Improving Community Services Through Dissemination and Implementation Science
Applying D & I Science Concepts to ASD Services
Early Intervention Services: Project ImPACT for Toddlers
Community Identified Need and Implementation Gaps
Early Behavioral Intervention: Project ImPACT
Adapting Project ImPACT for Delivery in Community Early Intervention Services
Implementation Strategies and Community Partners
Clinical and Implementation Outcomes
Education Services: Classroom Pivotal Response Teaching (CPRT)
Community Identified Need and Implementation Gaps
Intervention: Classroom Pivotal Response Teaching
Adapting PRT/CPRT for Community Implementation
Implementation Strategies
Role of Community Partners
Clinical and Implementation Outcomes
Mental Health Services: An Individualized Mental Health Intervention for ASD
Community Identified Need and Implementation Gaps
Evidence-Based Intervention: An Individualized Mental Health Intervention for ASD
Adapting AIM HI for Latinx Families
Implementation Strategies
Role of Community Partners
Clinical and Implementation Outcomes
Mental Health Services: Adapted Unstuck and On Target
Implementation Gaps
Evidence-Based Intervention: Unstuck and On Target (UOT)
Adapting UOT for Mental Health Services
Implementation Strategies
Role of Community Partners
Clinical and Implementation Outcomes
Secondary Education and Transition Vocational Rehabilitation Services: Transition Age Youth Supported, Comprehensive Cognitive Enhancement and Social Skills
Community Identified Need and Implementation Gaps
Evidence-Based Intervention: Transition Age Youth Supported, Comprehensive Cognitive Enhancement and Social Skills
Adapting SUCCESS for Transition Age Youth
Implementation Strategies and Community Partners
Clinical and Implementation Outcomes
Multiple Service Systems: Parent And Caregiver Active Participation Toolkit
Community Identified Need and Implementation Gaps
Evidence-Based Intervention: Parent And Caregiver Active Participation Toolkit
Adapting Parent And Caregiver Active Participation Toolkit for Multiple ASD Services
Implementation Strategies and Role of Community Partners
Implementation Outcomes
Multiple Service Systems: California Autism Professional Training and Information Network (CAPTAIN)
Community Identified Need and Implementation Gaps
Multiple Evidence-Based Interventions for ASD
Implementation Strategies
Role of Community Partners
Implementation Outcomes
Multiple Service Systems: Access to Tailored Autism Integrated Care (ATTAIN)
Community Identified Need and Implementation Gaps
Evidence-Based Intervention: Access to Tailored Autism Integrated Care
Adapting Integrated Care Models for ASD
Role of Community Partners
Access to Tailored Autism Integrated Care Implementation Strategies
Summary and Conclusions
References
Part V: Early Intervention in the Treatment of Autism and Pervasive Developmental Disabilities
Evidence-Based Applied Behavior Analysis (ABA) Autism Treatments: An Overview of Comprehensive and Focused Meta-Analyses
Some Reactions to the Term “Evidence-Based”
The Perception of Evidence
Comprehensive ABA-Based Intervention: Meta-Analytical Evidence
An Empirical Analysis of Bias in EIBI Studies
Focused ABA-Based Interventions: Meta-Analytical Evidence
Concluding Remarks
References
What Do Staff Working in Care and Criminal Justice Settings Know About Autism and How Does This Affect Their Practice?
Introduction
Autism in the Context of Care and Criminal Justice Settings
Search Strategy
Data Extraction
What Do Staff Working in Criminal Justice Settings Know About Identifying Individuals with Autism and What Does This Mean for Their Practice?
What Are the Main Features of the Literature Reviewed?
How Was Professionals’ Awareness of ASD Assessed?
What Do Staff Working in CJS Settings Know About ASD?
What Are the ASD Specific Training Needs for Professionals Working in a CJS Setting?
What Do Staff Working in Care Settings Know About Identifying Individuals with Autism What Does This Mean for Their Practice?
What Are the Main Features of the Literature Reviewed?
What Are the Characteristics of the Surveys Used to Assess Care Professionals’ Awareness of ASD?
What Do Staff Working in Care Settings Know About ASD?
What Are the ASD Specific Training Needs for Care Professionals?
How Important Are ASD Specific Resources and Services for Care Professionals?
Conclusions
Main Findings
Limitations
Clinical Implications and Recommendations
References
Economic Evaluations of Early Intensive Behavioral Interventions for Autism
Introduction
Defining Economic Evaluation
The Research Question
Costing
Cost Item Identification
Cost Item Measurement
Cost Valuation
Study Perspective
Outcome Measurement
Time Horizon
Cost-Effectiveness Analysis
Uncertainty
Synthesis, Reporting and Knowledge Translation
Economic Evaluations of Early Intensive Behavioural Intervention
Methodologic Challenges
Conclusions
References
The Early Start Denver Model
Theoretical Basis of ESDM
The Denver Model
Pivotal Response Treatment (PRT)
Rogers and Pennington’s Model of Interpersonal Development
The Social Motivation Hypothesis
Core Features of the ESDM
Joint Activity Routines
Teaching Fidelity Rating System
Curriculum Checklist
Setting Objectives
Progress Monitoring
Review of the Literature
Therapist-Implemented 1:1 Intervention
Intensive/Moderate 1:1 ESDM Therapy
Low-Intensity 1:1 ESDM Therapy
Parent-Implemented Intervention
Parent Coaching Procedures
Studies Evaluating P-ESDM
Group-Based Intervention (G-ESDM)
Structure
Studies Evaluating G-ESDM
Moderators of Treatment Outcome
Future Directions
Conclusion
References
Early Intervention for Children At-Risk for Autism Spectrum Disorder
Risk for ASD
Early Signs of ASD
Early Screeners
Intervention for At-Risk Young Children
Systematic Reviews and Meta-Analyses of Intervention Literature
Quasi-Experimental Studies
Single-Case Experimental Design Studies
Randomized Control Trials
Putting It All Together
Participants
Early Screening
Measures
Child Target Behaviors
Intervention Packages
Parent Training
Treatment Efficacy
Future Research
Clinical Implications
References
Part VI: Applied Behavior Analysis for Autism and PDDs
A Brief History of Contributions of Applied Behaviour Analysis to Autism Treatment
1910–1930: A Paradigm Shift
1930–1950: Operant Behaviour in the Lab
1950–1970: Operant Behaviour in the Field
1960–1980: Behaviour Analysis Burgeons
1980–2000: Applied Behaviour Analysis as an Evidence-Based Intervention for ASD
Lovaas’s UCLA Young Autism Program (1987)
Early Intensive Behavioral Intervention
2000–Present: Applied Behaviour Analysis—A Diverse and Progressive Science/Discipline
Summary
References
Foundational Principles of ABA
Introduction
Behavioral Assessment
Indirect Assessment
Direct Observation Assessment
Basic Behavioral Principles: Consequences
Reinforcement
Extinction
Punishment
Basic Behavioral Principles: Antecedents
Stimulus Control
Motivating Operations
Behavioral Acquisition Strategies
Preference Assessments
Prompting
Response Prompts
Stimulus Prompts
Prompt Fading and Prompt Delay
Shaping
Chaining
Behavioral Skills Training
Behavioral Reduction Strategies
Functional Assessment
Indirect Assessment
Direct Assessment
Functional Analysis
Extinction
Differential Reinforcement
Antecedent Control
Punishment Procedures
Time Out
Response Cost
Promoting Generalization
Summary
References
Programming for Generalization and Maintenance
Types of Generalization and Maintenance
The Importance of Promoting Generalization and Maintenance
Reasons for Generalization and Maintenance Difficulties
Strategies to Promote Generalization and Maintenance
Train and Hope
Sequential Modification
Teach in the Natural Environment
Introduce Naturally Maintaining Contingencies
Teach Sufficient Exemplars
Train Loosely
Use Indiscriminable Contingencies
Program Common Stimuli
Mediated Generalization
Recommendations for Practice
Summary and Conclusion
References
Generalized Imitation and Applied Behavior Analysis
Generalized Imitation and ABA
Higher Order Imitative Repertoires
Generalized Imitation
Atomic Repertoires
Observational Learning
Assessing Imitation Skills in Children with an ASD
Approaches for Teaching Imitation to Children with ASD/Teaching Approaches
Discrete Trial Training
Naturalistic Teaching
Reciprocal Imitation Training
Research on Teaching Strategies and Procedures
Antecedent Presentation
Target Selection
Conclusions
References
Using Applied Behavior Analysis to Teach Adaptive Skills
Using Applied Behavior Analysis to Teach Adaptive Skills
Adaptive Skills
Importance of Adaptive Skills
Previous Literature on Adaptive Skills
Literature Review Method
Important Skills Excluded from the Current Review
Toileting Skills
Feeding Skills
Staff and Personnel Training
Communication
Challenging Behavior Interventions
Sleep and Sleep Hygiene
Choice Making
Data Extraction
Results
Summary of Intervention Domains
Safety Skills
Technology and Recreation Skills
Food Access and Preparation
Employment Skills
Housekeeping
Dressing and Hygiene Skills
Community Access Skills
Teaching Strategies
Video Modeling and Video Self-modeling
Chaining and Task Analysis
Audio Cueing and Audio Prompting
Self-Monitoring
Visual Schedules
Game-Based/Virtual Reality
Behavior Skills Training
Literature Review Discussion
Recommendations for Research
Putting It Into Practice
Start Early
Make the Most of Technology
Train the Trainer
Be Flexible
Conclusion
References
Social Behavior and Interventions for Individuals Diagnosed with Autism Spectrum Disorder
Social Behavior and Interventions for Individuals Diagnosed with Autism Spectrum Disorder
Deficits Observed
Joint Attention
Social Language and Communication
Play Skills
Emotional Recognition and Theory of Mind
Friendship
Adolescence and Dating
ABA-Based Procedures
Discrete Trial Teaching (DTT)
Video Based Instruction (VBI)
Script-Fading
Peer Mediation Intervention (PMI)
The Teaching Interaction Procedure (TIP)
Behavioral Skills Training (BST)
Cool Versus Not Cool
Social Skills Groups
Conclusion
References
Verbal Behavior and Applied Behavior Analysis
Skinner’s Analysis of Verbal Behavior
Multiple Control
Behavioral Language Assessment
Teaching Strategies for Elementary Verbal Operants
Mands
Natural Environment Training
Transfer of Stimulus Control
Multiple Exemplar Training
Tacts
Massed- and Interspersed-Trials
Error Correction and Reinforcement Parameters
Tacts for all Sensory Modalities
Echoics
Stimulus Pairing
ODT and NET
Intraverbals
Transfer of Stimulus Control
MET and Instructive Feedback
Summary
References
Equivalence-Based Instruction for People with Autism Spectrum Disorder
Equivalence-Based Instruction for People with Autism Spectrum Disorder
Theoretical Underpinnings
Delineation Between Equivalence Formation and Generalization
Teaching Procedures
Current Research
Inclusion Criteria
Language Skills
Academic Skills
Life and/or Leisure Skills
Experimental
Discussion
Limitations and Future Directions for Research
Skills Taught and Contexts
Efficiency
Structured Curricula
Conclusion
References
Academic Skills and ABA
Academic Skills and ABA
Applied Behavior Analysis Instructional Strategies
Literacy Skills
Behavioral Strategies to Teach Reading Skills
Behavioral Strategies to Teach Writing Skills
Mathematics and Science Skills of Individuals with ASD
Behavioral Strategies to Teach Mathematics Skills
Behavioral Strategies to Teach Science Skills
Using Technology in Behavioral Interventions to Teach Academic Skills
Summary and Recommendations for Practice
References
Self-Management Skills and Applied Behavior Analysis
Self-Management Skills and Applied Behavior Analysis
Components of Self-Management
Historical Background
Evidence-Based Status
Treatment Populations
Areas of Intervention
Supplemental Teaching Strategies
Conclusion
References
Problem Behavior and Applied Behavior Analysis
Problem Behavior in Individuals with Autism Spectrum Disorder
Indirect Assessment
Descriptive Assessment
Experimental Functional Analysis
Summary
References
ABA Treatment Approaches to Problem Behavior
Categories of Problem Behavior
Functional Assessment
Indirect Assessments
Descriptive Assessments
Functional Analysis
Treatment of Problem Behavior
Function-Based Treatment Strategies
A Comprehensive ABA Approach to Treating Problem Behavior
Functional Communication and Complexity Training (FCCT)
Denial and Delay Tolerance Training
Conclusion
References
Food-Related Disorders and Applied Behavior Analysis
Children with Autism and Feeding Difficulties
Etiology
Undesirable Side Effects
Interdisciplinary Approach
Intensive Services for Children with ARFID
Starting Early with Eating and Developmental Skills
Inclusion and Exclusion Criteria
Setting
Materials
Therapists
Response Measurement and Dependent Variables
Goals
Oral Hygiene
Toilet Training
Pre-academic Skills and School Readiness
Social Communication and Language Skills
Assessment
Intervention for ARFID
Discussion
Considerations for Developing Hybrid Programs
Benefits of Hybrid Programs
References
Applied Behavior Analysis Training for Parents and Caregivers
Dissemination and Implementation Science
Needs Assessment
EBP Guidelines
Broad Based Guidelines
System-Wide Training Needs
Staff Training Needs
Family Training Needs
Summary
Skills Training
Criteria for Best Practice Training
Behavioral Skills Training
Making Skills Training More Efficient
Programming Generalization
Programming Maintenance
Systems Issues
Pyramidal Training
Training Systems
Recommendations for Practitioners and Researchers
Recommendations for Practitioners
Recommendations for Researchers
Summary
References
Organizational Behavior Management in Autism
History of OBM
History of OBM in Autism
Common OBM Interventions in Settings Serving Individuals with ASD
Sub-Disciplines of OBM
Recent Research on OBM Sub-Disciplines in ASD
Performance Management
Behavioral Safety
Behavioral Systems Analysis (BSA)
Conclusion
References
Restrictive Behavior Management Practices
Introduction
Types of Restrictive Behavior Management Practices
Restraint and Restriction of Movement
Psychotropic Medication
Seclusion and Isolation
Implications for Using Restrictive Behavior Management Practices
Considerations for Using Restrictive Behavior Management Practices
Alternatives to Restrictive Behavior Management Practices
Organizational Policy and Practices
Staff Training
Assessing Challenging Behaviour
Treatment Alternatives
Focused Restraint Reduction Procedures
Conclusion
References
Part VII: Psychopharmacology for ASD and Pervasive Developmental Disabilities
Evaluating the Effectiveness of Psychotropic Medications: Principles, Experimental Designs, and Outcome Measures
Ethical Principles
Phases of Clinical Trials
Principles of Study Design
Study Population
Inclusion and Exclusion Criteria
Comparison Group
Outcome
CGeneral Psychometric Principles
Issues in ASD Clinical Trials
Timeframe
Structural Design
Statistical Issues in Clinical Trials
Statistical Power and Sample Size
Analytic Models
Estimates of Drug Effect
Baseline Covariates
Subgroup Analysis
Missing Data
Statistical Significance
Summary and Conclusions
References
Rational Prescription of Psychotropic Medications
Excessive Use of Psychoactive Medications
Lack of Research and High Quality Evidence
Indications for Psychotropic Medications
Diagnostic Difficulties and the Phenomenology of Psychiatric Disorders
Prevalence of Psychiatric Disorders
Problem Behaviors
Off-Label Prescribing
As Required Medication
Safety and Tolerability
Outcome Measures
Ethical Aspects
References
Antidepressants
Antidepressants
Cochrane Review of Tricyclic Antidepressants
Cochrane Review of SSRIs
Fluvoxamine
Fluoxetine
Sertraline
Paroxetine
Citalopram
Escitalopram
Mirtazapine
Venlafaxine
Duloxetine
Vortioxetine
Agomelatine
Conclusion
References
Anti-Anxiety Medications and Novel Treatments for Autism
Anti-Anxiety Medication
Buspirone
Beta-Blockers
Effect of a Single Dose of Propranolol on ASD Symptoms
Effect of Long-Term Administration of Propranolol on Challenging Behavior in ASD
Benzodiazepines
Antianxiety Medication: Summary of Evidence
Novel Pharmacological Treatments
Conclusion
References
Antipsychotic Medications
Antipsychotic Medications
Antipsychotic Medications
Use and Prescribing Issues for Children with ASD
Side Effects
Issues in Prescribing and Managing Atypical Antipsychotics
Conclusions
References
Psychotropic Medications for Sleep Disorders in Autism Spectrum Disorders
Methods
Search Strategy
Study Selection
Level of Evidence Ratings
Results
Nutritional Supplements for Sleep Problems in ASD
Melatonin (GOR A)
Effects of Exogenous Melatonin Treatment on Daytime Behavior in ASD
Adverse Effects of Melatonin in ASD
Ubiquinol (GOR B)
Carnosine (GOR B)
Cannabidiol (CBD) (GOR B)
Multivitamin (GOR C)
Iron (GOR D)
Medications for Sleep Problems in ASD
Quetiapine (GOR B)
Agomelatine (GOR C)
Clonazepam (GOR C)
Clonidine (GOR C)
Donepezil (GOR C)
Niaprazine (GOR C)
Nicotine (GOR C)
Ramelteon (GOR C)
Fluvoxamine (GOR D)
Guanfacine (GOR D)
Discussion
References
Integration of Psychopharmacology and Behavior Analysis for Autism Spectrum Disorder
Measuring the Efficacy of Treatments
Using a Functional Analysis Paradigm to Evaluate Medication Effects
Using Functional Analysis to Evaluate Medication Side Effects
Integration of Pharmacotherapy and Behavior Intervention
Effectiveness of Risperidone as Monotherapy
Combination of Risperidone and Behavior Intervention
D-Cycloserine for Anxiety and Social Communication
Other combination treatment studies
Medical Versus Non-Medical Models
Conclusion and Recommendations
References
Caregiver Education and Treatment Adherence
Correlates of Psychotropic Medication Use
Age
Demographic Variables
Comorbid Conditions
Type of Insurance Plan
Medication Adherence
Prevalence of Non-Adherence
Factors Contributing to Poor Medication Adherence
Factors Related to Non-Adherence
Child Related
Caregiver and Family Related
Physician Related
Attitudes Toward Psychotropic Medication
Caregiver Treatment Preferences
Improving Medication Adherence
Caregiver Education
Identifying Barriers to Medication Adherence
Improving Relationships between Families and Providers
Involving Educators
State Initiatives
References
Medication Reduction Programs
Background
Surveys of Psychotropic Medication Use
Factors Associated with the Prescribing of Psychotropic Medication
Medication Review Programs
Legal and National Requirements
Psychotropic Medication Scrutiny as a Part of Inspections
National Guidance
A Social Movement: STOMP
Mental Health and Autism Diagnoses as an Exclusion
Financial Incentives
Multidisciplinary Team Reviews
Knowledge and Participation in Decision Making
Behaviour and Other Monitoring Tools
Availability of Alternatives
Alternative Psychotropics
Alternative Non-Medication Approaches
Withdrawal Regimens
Withdrawal Problems and Relapse
References
Part VIII: Psychosocial Treatments for Autism and PDDs
Mindfulness: Therapeutic Applications for Individuals with Autism Spectrum Disorder
Mindfulness
Qualities of Mindfulness
Process of Mindfulness
Mindfulness-Based Programs
Mindfulness-Based Stress Reduction
Mindfulness-Based Cognitive Therapy
MYmind
Cultivating Mind
Be Mindful
Mindfulness-Based Practices
Soles of the Feet
Surfing the Urge
SOBER Breathing Space
Conclusions
References
Cognitive Behavior Therapy for People with Autism Spectrum Disorder
Modifications to Cognitive Behavioral Therapy for Autism Spectrum Disorder
Research on Cognitive Behavioral Therapy for Autism Spectrum Disorder
Comorbid Mental Health Symptoms
Anxiety
Obsessive Compulsive Disorder/Behavior
Post-Traumatic Stress Disorder and Trauma
Depression
Comorbid Behavior Problems
Sleep
Emotion Regulation and Anger
Core Symptoms of Autism Spectrum Disorder
Affection
Conclusion
References
Sensory Interventions
Sensory Processing Disorder: Disputation and Consensus
Sensory Interventions
Sensory Integration: Theory and Description
Sensory Integration: Evidence-Base
Sensory Based Interventions: Theory and Description
Auditory Integration Therapies: Theory and Description
Auditory Integration Therapies: Evidence-Base
Comparing Sensory Interventions to Other Interventions
Conclusions
References
Special Education
Special and Inclusive Education
The Role of the Teacher
Disability Rights
Policy and Legal Context
Individual Educational Plans
Educational Technology
Inclusive Educational Practice
Case Study 1
Case Study 2
Comment
Conclusion
References
Interventions for Family Members
Interventions for Family Members
Overview of Theoretical Orientations of Interventions for Family Members
Interventions to Increase Parent Knowledge
Behavioral Parent Training and Coaching to Address Autism Symptoms
Mental Health Intervention for Parents
Behavioral Skills Training and Coaching of Siblings
Discussion
Concluding Remarks
References
Animal-Assisted Therapy
Human–Animal Interaction Effects
Reduction of Stress and Anxiety
Improved Health and Rehabilitation
General Well-being
Animal-Assisted Intervention
Multidisciplinary Practice
Lack of Standardized Approach
Animal-assisted Therapy
Animal-assisted Activities
Animal-assisted Education
Animal-assisted Intervention for Individuals with Autism Spectrum Disorder
Horse-Assisted Intervention
Canine-Assisted Intervention
Guinea Pig-Assisted Intervention
Dolphin-Assisted Intervention
Additional Animals
Scientific Investigation
Conclusions
References
Music Therapy and Other Music-Based Interventions
Historical Perspectives
Music Therapy and Music Practitioners
Theoretical Accounts
Why Music-Based Interventions May Work for Autistic People
Sensorimotor Integration Processes
Attentional Processes and Rhythmic Entrainment
Emotional Processes
Social Processes
Therapeutic Goals and Research Findings
Musical Giftedness
Conclusions
References
Part IX: Other Biological Treatments for ASD and Pervasive Developmental Disabilities
Complementary and Alternative Therapies
Complementary and Alternative Medicine
Definitions
Classification of Complementary and Alternative Therapies
Relevance of Complementary and Alternative Medicine
Patterns of Use in Children with Autism
Natural Product-Based Therapies
Biomedical Foundations
Evidence on Nutritional Therapies
Acupuncture
Principles of Traditional Chinese Medicine
Acupuncture in Autism Spectrum Disorder
Physiological Correlates of Acupuncture in Western Medicine
Massage Therapy
Sensory Processing in Autism Spectrum Disorders
Efficacy of Massage Therapy
Qigong Massage for Autism Spectrum Disorders
Music therapy
Mind-Body Therapies
Conclusions
References
Part X: Special Populations and Problems in Individuals with Autism and PDDs
Gay, Lesbian, and Gender Nonconforming Individuals with Autism
Language Considerations
Sexuality in Autistic Boys and Men
Sexual and Romantic Interest
Sexual Attraction
Solo- and Partnered Experiences
Online Experiences
Paraphilias
Inappropriate Behaviors and Reasons for Concern
Victimization and Offending
Support Needs and Questions for Future Research
Sexuality in Autistic Girls and Women
Sexual and Romantic Interest
Diversity in Gender and Sexual Attraction
Solo and Partnered Experiences
Online Experiences
Paraphilias
Inappropriate Behaviors and Reasons for Concern
Victimization
Support Needs and Questions for Future Research
Gender Diversity and Autism
Prevalence Rates of Co-occurring Autism and Gender Diversity
Differences Between Transgender Males and Females
Potential Underlying Explanations or Hypotheses
Clinical Implications
Gender Identity and Sexual Identity
Support and Interventions
Interventions Targeting Psycho-sexual Development
Interventions Targeting Social Skills and Romantic Relationships
Interventions to Support Gender Identity
Conclusion
References
Offenders with Autism Spectrum Disorders
Autism and Offending: Who, Where and How Many?
Autism Diagnosis
Autistic Offenders in the Criminal Justice System: Characteristics, Types of Crime and Vulnerabilities
Current Research on Interventions for Autistic Offenders
Cognitive Behavioral Programmes
Other Treatments
Evidence on Interventions Overall
Future of Research and Practice for Autistic Offenders
Useful Resources
References
Neurodiversity, Advocacy, Anti-Therapy
The Medical and Social Models
Autism Knowledge Production
Opposition to Therapy: ABA Case Study
Evidence and Efficacy
Normalization
Trauma and Wellbeing
Autonomy and Identity
Can ABA be Reformed?
Implications for All Autism Therapies
References
Sleep Problems in Young People with Autism: Applied Behavior Analysis Approaches
Sleep in Young People with ASD
Etiology of Sleep Problems
Biological and Medical Factors
Psychological Factors
Core Features of ASD
A Behavioral Model of Sleep Disturbance
Age-Related Change in Sleep
Assessment of Sleep Problems
Functional Behavioral Assessment (FBA) of Sleep Problems
Treatment of Sleep Problems in Young People with ASD
Sleep Scheduling and Antecedent Modifications
Modification of Sleep/Wake Schedules
Faded Bedtime
Faded Bedtime with Response-Cost
Sleep Restriction
Sleep Hygiene
Visual Supports
Consequence-Based Modifications
Extinction
Modified Extinction
Reinforcement
Parent Education Programs
Teaching Replacement Skills
Self-Monitoring
Relaxation Strategies
Bedtime Pass
Young Person Psychoeducation
Conclusions
References
Teaching Employment Skills to People with Intellectual and Developmental Disability
What Are Employment Skills?
How Do We Teach Employment Skills?
Recommendations for Practitioners
Step 1: Identify the Skills that Fit in the Employment Context
Step 2: Determine the Most Important Skills for the Student
Step 3: Explore the Best Intervention Approach
Step 4: Test the Intervention Approach for the Target Skills
Step 5: Assess Student Progress and Modify as Necessary
Future Directions and Summary
Summary
References
Index