Behavior Modification : Communication Intervention for Individuals with Complex Communication Needs (Novembre 2019)

samedi 2 novembre 2019

Le numéro de novembre 2019 de la revue Behavior Modification est consacré aux interventions sur la communication qui peuvent notamment concerner des personnes avec TSA.

1. Sigafoos J, Gevarter C. Introduction to the Special Issue : Communication Intervention for Individuals with Complex Communication Needs. Behavior Modification ;2019 (2019/11/01) ;43(6):767-773.

Individuals with complex communication needs are likely to experience considerable difficulties and challenges with everyday communication interactions due to limited use and understanding of natural speech. In this editorial, we review the nature of complex communication needs, describe the wide range of individuals who may experience such needs, and provide a brief history of behavioral approaches to addressing these needs. We also highlight the six papers in this special issue that contribute to the further understanding of the use of behavioral intervention approaches for addressing complex communication needs. These papers include one conceptual overview of aided augmentative and alternative communication (AAC) interventions for individuals with complex communication needs, four intervention studies addressing a range of communicative topographies (i.e., vocal speech, AAC, and a social messaging app), and one systematic review examining interventions that promote communicative response variability. These six papers highlight the diversity of complex communication needs and emphasize the importance of examining the efficacy of a wide range of individualized behavioral approaches that are matched to specific needs and goals.

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2. Ferguson RH, Falcomata TS, Ramirez-Cristoforo A, Vargas Londono F. An Evaluation of the Effects of Varying Magnitudes of Reinforcement on Variable Responding Exhibited by Individuals With Autism. Behav Modif ;2019 (Nov) ;43(6):774-789.

Interventions aimed at increasing communicative response variability hold particular importance for individuals with autism spectrum disorders (ASD). Several procedures have been demonstrated in the applied and translational literature to increase response variability. However, little is known about the relationship between reinforcer magnitude and response variability. In the basic literature, Doughty, Giorno, and Miller evaluated the effects of reinforcer magnitude on behavioral variability by manipulating reinforcer magnitude across alternating relative frequency threshold contingencies, with results suggesting that larger reinforcers induced repetitive responding. The purpose of this study was to translate Doughty et al.’s findings to evaluate the relative effects of different magnitudes of reinforcement on communicative response variability in children with ASD. A Lag 1 schedule of reinforcement was in place during each condition within an alternating treatments design. Magnitudes of reinforcement contingent on variable communicative responding were manipulated across the two conditions. Inconsistent with basic findings, the results showed higher levels of variable communicative responding associated with the larger magnitude of reinforcement. These outcomes may have potential implications for interventions aimed at increasing response variability in individuals with ASD, as well as future research in this area.

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3. Wolfe K, Pound S, McCammon MN, Chezan LC, Drasgow E. A Systematic Review of Interventions to Promote Varied Social-Communication Behavior in Individuals With Autism Spectrum Disorder. Behav Modif ;2019 (Nov) ;43(6):790-818.

Individuals with autism spectrum disorder (ASD) may engage in repetitive social-communication behaviors that can limit their skill acquisition, access to reinforcement, and access to less restrictive settings. Basic and applied research indicates that variability, or the extent to which responses are topographically different from one another, is influenced by antecedent and consequence interventions. Our purpose in this study is to systematically review the literature on interventions to increase variable social-communication behaviors in individuals with ASD. We identified 32 studies through a database search and screened them using the What Works Clearinghouse (WWC) Single-Case Design Standards. Eighteen studies containing 55 cases met WWC Design Standards. We coded the descriptive characteristics and strength of evidence based on visual analysis from each of these 18 studies and calculated effect sizes using Tau-U. Our results indicate that most cases (65%) provide strong evidence of a functional relation between the interventions and varied social-communication behaviors, and the median Tau-U was .82. We discuss the implications of our results for practice and for future research on interventions designed to increase variability with this population.

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4. Roche L, Carnett A, Sigafoos J, Stevens M, O’Reilly MF, Lancioni GE, Marschik PB. Using a Textual Prompt to Teach Multiword Requesting to Two Children With Autism Spectrum Disorder. Behav Modif ;2019 (Nov) ;43(6):819-840.

Autism spectrum disorder is characterized by social and communication impairment, but some children appear to have relative strength in areas such as reading printed words. The present study involved two children with limited expressive communication skills, but relatively stronger reading ability. Based on this existing strength, we evaluated a textual prompting procedure for teaching the children to produce multiword spoken requests. The effect of providing textual prompts on production of multiword requests was evaluated in an ABAB design. The results showed that multiword requests increased when textual prompts were provided and decreased when the prompts were removed. In subsequent phases, the textual prompts were successfully faded by gradually making the printed text lighter and lighter until eventually the prompts were eliminated altogether. We conclude that identification of children’s strengths may assist in identifying effective prompting procedures that could then be used in teaching functional communication skills.

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5. Reichle J, Simacek J, Wattanawongwan S, Ganz J. Implementing Aided Augmentative Communication Systems With Persons Having Complex Communicative Needs. Behavior Modification ;2019 (2019/11/01) ;43(6):841-878.

Augmentative and alternative communication (AAC) systems can support communication skills for people with significant developmental disabilities who experience complex communication needs (CCNs). There is a need to tailor best practices in AAC assessment and intervention to create individualized communication systems with this population. In this article, we outline the important components of AAC systems that can be implemented in authentic settings. However, given the limited evidence on AAC interventions specific to people with CCNs, we also identify some priority areas for future inquiry. Among these involve strategies to enhance decision making regarding (a) matching communication mode(s) to learner skills and contextual demands, (b) identifying communicative opportunities and obligations, (c) individualizing aided communication display features, (d) selection of vocabulary specificity, and (e) considering dosage parameters needed to acquire and maintain a communicative repertoire. In addition, we briefly discuss the use of telehealth to enhance intervention capability.

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6. Lancioni GE, Singh NN, O’Reilly MF, Alberti G, Chiariello V, Campanella C, Grillo G, Tagliente V. A Program Based on Common Technology to Support Communication Exchanges and Leisure in People With Intellectual and Other Disabilities. Behavior Modification ;2019 (2019/11/01) ;43(6):879-897.

The aim of this study was to assess a new smartphone-based program version to allow seven participants with intellectual plus visual and/or motor disabilities and hesitant speech to send out and receive WhatsApp messages, make telephone calls, and access leisure activities. This program version relied on a Samsung A3 smartphone, which was automated through the MacroDroid application and responded to the input of specific cards and miniature objects. During the baseline (i.e., without the program), the participants ? performance was zero or close to zero on communication and leisure. During the use of the program, the participants increased their frequency of WhatsApp messages sent out and received/listened to, and of leisure activities accessed. Their frequency of telephone calls averaged between virtually zero and slightly above one. The implications of the findings are discussed in relation to the technology used for the program and the applicability of the program in daily contexts.

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7. Wendt O, Hsu N, Simon K, Dienhart A, Cain L. Effects of an iPad-based Speech-Generating Device Infused into Instruction with the Picture Exchange Communication System for Adolescents and Young Adults with Severe Autism Spectrum Disorder. Behav Modif ;2019 (Nov) ;43(6):898-932.

This study used a multiple baseline, single-subject research design to investigate the efficacy of an iPad((R))-based speech-generating device (SGD). The iPad was equipped with the SPEAKall !((R)) application to function as a SGD. SGDs are a form of aided augmentative and alternative communication (AAC) allowing a user to communicate using digitized and/or synthesized speech. Instruction followed a modified version of the intervention phases from the Picture Exchange Communication System (PECS). This modified PECS protocol was implemented with two adolescents and one young adult between the ages of 14 and 23. All three participants were diagnosed with severe autism spectrum disorder and little to no functional speech. Dependent measures included the ability to request for edible and tangible items as the primary measure, and the ability to engage in natural speech production as an ancillary measure to determine simultaneous, additive effects on speech acquisition. Results indicated increases in requesting behaviors for all three participants across intervention and maintenance phases. Once participants mastered requesting of edible items, they were able to generalize the skill to tangible items. However, mixed results were found when targeting natural speech production. Based on the current findings, the infusion of an iPad-based SGD into PECS instruction may be effective in increasing initial requesting skills ; however, a facilitative effect on increasing speech acquisition cannot necessarily be expected for every participant.

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