Toe walking, which is defined as walking with a bilateral toe-to-toe gait, is common among children with intellectual and developmental disabilities and can result in a number of medical problems. Both medical and behavioral treatments for toe walking have been evaluated. In the current study, we surveyed caregivers of individuals who engage in toe walking about their use of various medical and behavioral treatments. Results suggest that the use of medical treatments is more common, and most respondents reported that they were unaware that behavioral treatment of toe walking is an option. Most respondents reported that the hypothesized function of toe walking by their child is automatic positive reinforcement, although more than half attributed toe-walking to a disorder (e.g., autism spectrum disorder), a physical cause (e.g., tight muscles), or reported they did not know why their child engaged in toe walking. Surgery and increased response effort via weighted boots were the medical and behavioral treatments, respectively, perceived to be most effective in treating toe walking. To assist the behavior analytic community in managing toe-walking cases, we also provide some specific recommendations for practitioners, including a description of the advantages and disadvantages of behavioral treatments for toe walking and a decision tree for behavior analysts unfamiliar with the literature on this topic.

Graphing is an important skill that is used across various career fields. Behavior analysts have examined various methods for training individuals to use various graphing software packages (e.g., GraphPad Prism, Microsoft Excel) to manually create graphs. Behavior-analytic techniques, however, have been underused in fields outside of behavior analysis. Therefore, the purpose of the current study was to use the graphing tools developed by Lehardy et al. (2021) to create a treatment package featuring the graphing workbook, video tutorials, an itemized graphing checklist, and corrective feedback to train college students to create AB graphs in Microsoft Excel. The current study addressed some of the limitations and comments in the social validity survey of Lehardy et al. by providing the itemized checklist concurrently with the video tutorials. Graphing behavior increased to near 100% levels for all participants with an average session time of 43.58 min. Therefore, the results indicate that this procedure may be effective in increasing graphing skills in less than an hour with students across fields and levels. This study provides further evidence that behavior-analytic techniques are useful in a plethora of scenarios, and we should aim to disseminate these techniques within these various areas.

Parents of children diagnosed with autism face enormous stressors, which may interfere with achieving personal and family goals. The typical approach for reducing stress is often pathological; the individual attempts to directly eliminate the stress through counseling, behavioral therapy, or medication. As an alternative, the constructional approach builds repertoires for accessing important reinforcers. In this study, a mentoring program based on the constructional approach was used to teach three parents of children diagnosed with autism how to analyze their lives, formulate goals, and implement programs to reach these goals. A mentor's support was gradually reduced until each participant could implement these steps independently. After the implementation of this program, events that each participant wanted to keep as part of their life encompassed a larger proportion of their total weekly events, as compared to before the program. In addition, time spent working on chosen goals increased as each goal was targeted for intervention. This mentoring program offers a promising approach for teaching people to manage their own lives by cultivating skills that help them get what they want, without dwelling on the problems interfering with their happiness.

Strategic incremental rehearsal (SIR) involves the systematic introduction of targets during instruction. Specifically, SIR includes an incrementing set size such that correct responding to a subset of targets is required before additional targets are included during instructional sessions. Prior research has arranged SIR using flashcards, although the features of SIR that are likely responsible for its efficacy may not be restricted to flashcards. In the current study, we arranged SIR in a word list (SIR-WL), which includes the presentation of target words on a single page. Instruction using SIR-WL was effective across all evaluations during sight word instruction for children exhibiting reading deficits and resulted in durable responding during maintenance and generalization probes for most targets.Several trial interspersal methods have been described in the extant literature and may confer unique benefits for skill acquisition interventions in applied practice.SIR has been shown to be effective, likely due to the arrangement of an incrementing target set size and within-session prompt delay fading.These features of SIR might also result in fewer errors than static set sizes and across-session prompt delay fading procedures.Presentation modalities, such as word lists rather than flashcards, might improve the feasibility of effective instructional methods by reducing material management.

The current study evaluated the effectiveness of relational training on the establishment of three deictic framing repertoires (I/You, Now/Then, Here/There) in an eight-year-old autistic boy using a multiple baseline across behaviors design. Relational training was effective in establishing all three directly trained and mutually entailed deictic relations, while differences were observed in transformation of stimulus function. Results support previous findings with the systematic development of multiple types of perspective taking repertoires with the same participant.

[This corrects the article DOI: 10.1007/s40617-023-00905-x.].

In the U.S., approximately 13 million individuals identify as part of a sexual and gender minority (SGM). This broad spectrum includes sexual orientation identities such as , , , , , and , as well as gender identities such as , , , and . As behavior analysts heed the call to engage in culturally competent practices that address diverse sexual orientation and gender identities (SOGI), they will likely consider collecting SOGI data as part of their practice. The benefits of SOGI data collection certainly exist. However, the historical oppression and increased vulnerability of SGM populations require a careful and thorough evaluation of ethical data collection practices to avoid harm and to ensure respectful and inclusive practices. The present tutorial aims to begin the discussion of ethical and effective SOGI data collection practices within behavior analysis by offering initial guidelines and considerations. We highlight methods that improve cultural sensitivity, and caution against traditional methods that could harm respondents or contribute to a non-inclusive environment.

Effective intervention for children on the autism spectrum who engage in challenging behavior is critical. To ensure meaningful behavior change, caregiver training to support intervention implementation in the natural environment is often required. It is fortunate that both behavioral interventions and caregiver training are considered evidence-based for the reduction of challenging behavior. However, behavioral interventions may be comprised of an idiosyncratic combination of behavior-change strategies that require caregivers to accurately implement several strategies simultaneously or sequentially. The complexity of these interventions may affect parents' ability to implement interventions accurately and consistently in the natural environment, which may in turn affect child outcomes. However, no review has synthesized the evidence from single-case design studies that evaluate the effects of caregiver training on a variety of caregiver-mediated interventions for autistic children who engage in challenging behavior. Given the complexity of caregiver training and caregiver-mediated interventions, and their increasing popularity, a greater understanding of the related evidence is warranted. We identified trends in participant demographics, caregiver training approaches implemented, child challenging behavior addressed, and behavioral intervention approaches employed. We propose recommendations for interpreting and applying results in practice, and avenues for future research directions.

The Behavior Analyst Certification Board (BACB) (2020) guides our practice and our professional responsibilities, and some certificants of the BACB may experience possible conflict between engaging in ethical practice and organizational policies at their place of employment (Greeny et al. , (4), 368-381, 2022). An ethics coordinator (Brodhead & Higbee, , (2), 82-88, 2012), ethics committee (Cox, , (4), 939-949, 2020), or ethics network (LeBlanc et al., , (4), 905-913, 2020) could help mitigate such conflict. In this article, we described the formation of our organizational ethics network, based on the network developed by LeBlanc et al. (, (4), 905-913, 2020). We also reported on the use of our ethics hotline during the first year of the network, showcasing the possible cross-level and cross-departmental collaboration with occasional organizational change that occurred related to situations submitted to the ethics hotline. We concluded with our reflections and considerations for other practitioners or organizations who want to establish an ethics network.

There is a concerning lack of published smoking cessation research on people with intellectual and developmental disabilities (IDD). A Functional Assessment for Smoking Treatment Recommendations (FASTR) was recently developed to help personalize patients' tobacco treatment. Adapting this tool to effectively identify putative environmental variables that maintain smoking for people with IDD is predicted to improve current treatments. The purpose of this study was to pilot the FASTR with people with IDD to understand modifications necessary to implement it in this population. During 1-hour interviews participants ( = 8) described the extent they agreed with each FASTR statement using a Likert scale, corresponding to one of five potential functions of smoking (i.e., Automatic Positive, Automatic Negative, Social Positive, Social Negative, and Antecedent). Participants gave input on potential modifications to make the assessment more inclusive for people with IDD. A quantitative approach was used to pilot the FASTR and participant narratives were used to understand difficulties and potential modifications. For each participant a function was endorsed if the average response to questions corresponding to that function was greater than 3 (neutral) or over 50% "yes" responses. The two most frequently endorsed functions were Automatic Negative (87.5% participants) and Social Negative (75% of participants). Participants recommended making the focus of each statement larger and in bold so respondents can understand the most important part of the statement. The FASTR was modified based on their feedback and will be distributed to a larger sample of people with IDD for further validation.

We conducted an online survey of board certified behavior analysts ( = 67) at a human services organization to assess their attitudes and opinions about trauma-informed care (TIC) of persons with intellectual and developmental disabilities (IDD) and compatibility with behavior analytic practice. Survey respondents indicated they had no to minimal college level/graduate school coursework, training, supervision, and implementation experience in TIC. They largely agreed that TIC should be considered for persons with IDD, provides knowledge that can improve behavior analytic services, should be emphasized in training, and is within the scope of behavior analyst practice. However, there was strong agreement that TIC is not defined or practiced consistently and is not well-researched by behavior analysts. We discuss the implications of these findings and present survey informed recommendations for advancing TIC within the behavior analytic professional community.

Board certified behavior analysts (BCBAs) are often called upon to recommend treatments while working with autistic individuals. As practitioners of the science of human behavior, behavior analysts must make recommendations supported by scientific evidence. However, at times, individual practitioners may inadvertently recommend interventions that are not evidence-based. This study sought to examine if the severity level of the present symptoms of autism impacted the recommendations made by behavior analysts. A survey of 122 BCBAs gathered information about how they allocated resources toward interventions across three categories: evidence-based, emergent, and nonevidence-based. The results indicate that up to 62% of BCBAs allocated resources toward nonevidence-based or emergent practices and that these resource allocations were affected by the autism severity of hypothetical client presentations. There were statistically significant differences between allocations to resources between individuals with the lowest symptom severity and those maximally affected for both evidence-based practice ( < 0.0009) and nonevidence practice ( < 0.0011).

Excessive collecting is frequently reported in children with autism spectrum disorder, but few studies have used behavior analytic interventions based on functional analysis to treat it. In the current study, functional analysis results informed the creation of a multicomponent treatment package involving parent training for a 12-year-old girl with autism spectrum disorder who engaged in interfering hoarding that was significantly limiting quality of life for both her and her family. Based on the results of the functional analysis, which suggested automatic and potential attention functions, we evaluated differential reinforcement, rules, and acceptability criteria across the two hoarding topographies. Using a multiple baseline across behaviors design, results showed that the multicomponent treatment package successfully reduced hoarding. Social validity measures indicated a reduction in symptom severity, improvements in family quality of life, and high consumer satisfaction. In addition, outcomes were maintained over 2 months. This study shows the utility of functional analysis-based treatments for hoarding in children with autism spectrum disorder.

The present article details the data collection behavior of residential staff employed in community-based settings for adults with intellectual disabilities and significant behavioral challenges. The staff members who participated in the study were responsible for collecting behavioral data related to episodes of aggressive behavior that were observed in their residential settings. A descriptive analysis data collection system was in place for each of the residences in the study. Individualized preference assessments were performed with a representative staff member from each of the homes. Once a highly preferred item was identified by the staff person, they were able to earn the item that had been identified contingent upon data collection in the house meeting or exceeding 80% completion of their daily data expectations. The assessment and intervention were examined across all three of the residences in the study via a multiple baseline design with a reversal design embedded within one of the legs of the design. The results demonstrated increases in data collection across each of the residences in the study as the intervention was introduced at each of the sites.

Variable-ratio (VR) schedules of reinforcement can lead to steady response rates and make behavior less resistant to extinction but can be difficult to implement with fidelity. Utilizing a concurrent multiple baseline design across participants, we sought to determine how classroom assistant (CA) delivery of VR schedules followed mean and variability requirements and evaluated the effects of programmed schedules of reinforcement on the implementation of VR schedules. Results suggest that the use of programmed schedules of reinforcement led CAs to increase the variability of reinforcer delivery and remain closer to the desired mean. Programmed schedules of reinforcement increase the variability in classroom assistant-implemented VR schedules. Programmed schedules of reinforcement assist classroom assistants in remaining close to the intended mean of the VR schedule. Programmed schedules of reinforcement are cost-effective and easy to provide for classroom assistants in the classroom. The descriptive statistic range can be used to characterize the variability of reinforcement schedules.

Severe challenging behaviors, such as aggression and self-injurious behavior, have a high comorbidity with autism spectrum disorder (ASD; Hill et al., 2014; Soke et al., 2016). Although we have effective assessment and treatment procedures for severe challenging behavior, the relapse of severe challenging behavior following effective treatment is highly prevalent (Briggs et al., 2018; Falligant et al., 2022; Haney et al., 2022; Muething et al., 2021). Effective in 2025, the Board Certified Behavior Analyst (BACB) Test Content Outline (TCO; 6th ed.) includes a task-item requirement for Board Certified Behavior Analysts to plan for and attempt to mitigate possible relapse (BACB, 2022). Thus, it is important for practitioners to understand the variables that impact relapse of severe challenging behavior, and it is critical that they have access to tools to help them in preparing for and reacting to relapse in practice. The purpose of the current paper is to provide (a) a consumable framework on relapse for practitioners and (b) considerations for practitioners on managing relapse when it occurs.

Children diagnosed with autism spectrum disorder (ASD) are likely to experience sleep disturbance. Evidence supports the effectiveness of functional analysis and behavioral sleep interventions to address sleep problems. However, these approaches are resource intensive in terms of assessment and measurement of target sleep behaviors, intervention implementation, and progress monitoring. Recent advances in the use of technology and telehealth in behavioral services may improve the efficiency and effectiveness of behavioral intervention. We evaluated the effectiveness of a hybrid (face-to-face and telehealth) model of behavioral sleep assessment and intervention as implemented by community-based behavior analysts. We used motion/sound detection cameras and various "apps," for remote viewing, caregiver coaching, data collection, and treatment decision making. We explored the agreement between various data sources. Three autistic children, who engaged in caregiver reported unwanted co-sleeping or behavioral sleep challenges, participated in the study along with their caregivers. A nonconcurrent multiple baseline design across participants was used to evaluate the effects of the intervention on sleep onset delay, sleep interfering behavior, and total sleep duration. For two participants, caregiver co-sleeping was eliminated, target bedtimes were achieved, and child participants regularly achieved an age-appropriate amount of sleep. Caregivers rated the intervention and child outcomes positively. The results provide preliminary evidence for the use of telehealth technology to provide caregiver coaching, monitor child progress, and make timely data-based treatment decisions. Results of this study may be used to increase the efficiency of--and access to--behavioral sleep assessment and intervention.

This study evaluates the effects of a treatment package to reduce toe-walking (TW) in four male children with autism spectrum disorder, aged between three and six years, with persistent TW. The treatment package involved a combination of motor exercises, positive reinforcement, corrective feedback, and precision teaching. We used concurrent multiple probes across participants design, with RESA checks, to evaluate the effectiveness of the intervention. We measured the correct steps during probe sessions, the rate per minute of correct steps during the training, the ankle joint's passive range of motion, and social validity, measured through caregiver questionnaires before and after the intervention. The results indicated a decrease in TW across all participants, with a beneficial effect on the participants' gait patterns and overall physical mobility. It also underscored the potential for applying such an intervention to improve the daily lives of children with ASD. However, the study has several limitations, including not directly measuring generalization, the brief follow-up period post-intervention, and the absence of a component analysis to determine the differential effects of the intervention components.

Individuals with autism spectrum disorder (ASD) can struggle to acquire social, communication, and safety skills. Many of these skills can be targeted in individualized behavior analytic instruction. However, some skills can be challenging to teach given the difficulties associated with reconstructing a real-world scenario within a learning session. Virtual reality (VR) has emerged as a promising technology that can help people with ASD practice these types of skills in an immersive environment. VR is an emerging technology, and more research is needed to determine its efficacy as well as its impact on variables such as client indices of happiness and social validity. In this study, we successfully taught three children with ASD three different skills using a VR treatment package that consisted of VR, prompts, and reinforcement. Prior to teaching these skills, we included a cooperation phase with the intent to increase acceptance of VR equipment as needed. We found that each of the three participants accepted the equipment and VR sessions without the need for additional training. In all cases, the skills the participants acquired in the VR platform were maintained and generalized to the natural environment. Participants demonstrated indices of happiness when engaged with the VR software and parents and clinical staff ranked the VR software positively. Results are discussed in terms of the use of the VR treatment package in intervention and future research for similar technologies.

Many adolescents, particularly those diagnosed with autism spectrum disorders (ASD), fail to get ≥ 60 min/day of moderate- to vigorous-intensity physical activity (MVPA), in line with the World Health Organization's guidelines. Whole-day interventions (i.e., interventions implemented throughout the day) can increase physical activity (PA) levels throughout the day to meet these guidelines. However, there are no known behavior-analytic studies examining the effectiveness of whole-day interventions for increasing PA levels in adolescents diagnosed with ASD in both the short- and long-term. Two adolescent boys diagnosed with ASD and their mother tested the effectiveness of a parent-implemented multicomponent intervention package comprising progressive goal setting, feedback, reinforcement, and self-monitoring to increase whole-day step count. The participants increased their daily step counts to 14,000 steps (which translates to ≥ 60 min/day of MVPA) by the conclusion of the intervention, thus meeting or exceeding PA guidelines. The family then adjusted the procedure to better meet their lifestyle needs, resulting in long-term maintenance of PA above baseline levels at 6- and 11-months post-intervention for one participant, and 11-months post-intervention for the other participant. This study therefore shows the importance of tracking long-term changes in outcomes and understanding factors influencing the sustainability of these outcomes.

The use of single-subject research designs is common among behavior analysts, as well as among other professionals interested in the study of behavior. Although there are clear guidelines for creating graphs to represent data collected with these designs, the type of tools used to produce them requires considerable time and effort to cover the specific criteria to plot data for each type of design and always involves the purchase of a software's license. This manuscript describes four functions created in R language to automatically produce plots with specific characteristics for data collected using single-subject experimental designs. These functions were included in a package created in R to facilitate their sharing, installation, and use (R package for data analysis and representation in behavior science, https://github.com/ruizvja/RDARBS). The application of these functions is exemplified for the cases of reversal design, multi-element design, changing criteria, and multiple baseline. The relevance and convenience of functions is illustrated and discussed in the context of other proposals that have been made for the specialized production of plots for single-subject research designs.

The use of compound stimuli in match-to-sample training arrangements can potentially increase the efficiency of target acquisition in some circumstances as a result of the development of emergent relations. However, utilizing compound stimuli in training arrangements comes with the risk that responding could come under the restrictive control of one of the individual components of the compound stimulus. The purpose of this case study was to demonstrate an evaluation process for determining the impact of compound stimuli on stimulus control within a match-to-sample arrangement.

Play is critical to child development. In early childhood, object play evolves from exploratory behavior to complex symbolic play. Engagement during play, particularly joint engagement, is essential for learning and social interaction. Board Certified Behavior Analysts® (BCBAs) who provide early intervention services to young autistic children may experience barriers when designing programming and data collection systems for play and engagement. In this paper, we compare Naturalistic Developmental Behavioral Intervention (NDBI) and Natural Environment Teaching (NET) approaches. Considerations for measuring object play and engagement during naturalistic play routines are presented. We encourage BCBAs to consider simple frequency counts when measuring object play actions and interval recording or rating scales for tracking engagement states. These methods may better accommodate the variability in play and engagement behavior, allow for more flexible play routines, and support a more nuanced analysis of child progress.

This Multiperspectival Interpretative Phenomenological Analysis (MIPA) delves into the nuanced experiences of 20 special education teachers across severe, mild to moderate, and early childhood backgrounds collaborating with Board Certified Behavior Analysts (BCBAs) in school settings. While identifying facilitators and barriers to this collaboration, the study sheds light on factors that contribute to a breakdown in rapport between teachers and BCBAs. Notable challenges include perceived condescension, feelings of blame for intervention shortcomings, and receiving recommendations deemed non-feasible or impractical. Despite these hurdles, special education teachers acknowledge the expertise of BCBAs and value their contributions. The study underscores the imperative for enhanced collaboration, communication, and mutual understanding between BCBAs and special education teachers to effectively support students exhibiting challenging behaviors in diverse school settings. Recommendations include BCBAs incorporating teacher-focused measures of social validity to foster a more collaborative and supportive partnership and tailoring BCBA training to address specific challenges encountered within educational settings.

Culturally and linguistically diverse (CLD) families of autistic children face unique challenges in accessing services that are appropriate for their cultures and languages. The purpose of the current study was to evaluate the impact of training language on caregiver skill acquisition. Using behavioral skills training (BST) through telehealth, three Latino caregivers whose first language is Spanish were taught to implement two different behavioral protocols with their autistic children. For one protocol, BST was done in Spanish; for the other, BST was done in English. Overall, the training in each family's first language was (1) more efficient at promoting the skill acquisition of both caregivers and children; (2) rated by caregivers as more socially valid, and (3) associated with higher levels of caregivers' indices of , involvement, and happiness. Findings suggest that cultural adaptations may be necessary to provide more effective and enjoyable training for CLD families.

Naturalistic observation of verbal behavior on social media is a method of gathering data on the acceptability of topics of social interest. In other words, online social opinion may be a modern-day measure of social validity. We sought to gain an objective understanding of online discourse related to the field of applied behavior analysis (ABA). We analyzed Twitter posts related to ABA (e.g., #ABA, #BehaviorAnalysis, #appliedbehavioranalysis). Our initial sample consisted of 119,911 tweets from 2012 to 2022. We selected a random subset ( = 11,000) for further analysis using a stratified sampling procedure to ensure that tweets across years were adequately represented. Two observers were trained to code tweets for relevance and sentiment toward the field. A total of 5,408 relevant tweets were identified and analyzed, with an arithmetic mean of 492 tweets per year. Tweets were categorized as having neutral (51.41%), positive (43.81%), or negative (4.79%) sentiment. Negative sentiment tweets received approximately three times higher engagement scores compared to positive and neutral tweets. Positive sentiment tweets commonly used hashtags related to special education, therapy, behavior analysis, autism, and specific individuals. Negative sentiment tweets focused on the harmful effects of ABA, disability, variations of ABA, and promoting alternatives to ABA. Our results suggest that there is a small but vocal minority that has the potential to shape the narrative on ABA. We suggest a path forward for behavior analysts in the study of the online discourse on ABA.

One of the most critical intervention strategies when working with individuals with significant language delays associated with autism spectrum disorder and related developmental delays is teaching mands. For mand training to be effective, an establishing operation (EO) must be in effect, yet EOs are often difficult to observe. Before learning to mand, an individual may point to or approach a reinforcer, which likely indicates an EO related to that reinforcer, and may be considered an indicating response (IR). Observing an IR before prompting a mand increases the likelihood that the prompt is delivered when an EO is in effect and that the response is truly a mand. Missing from the literature is a consistent definition of IRs and a robust set of guidelines for using them in practice. In this tutorial, we review the terms and topographies of IRs in the literature to arrive at a definition of IRs. We then provide practical, research-based recommendations for using IRs during mand training, as well as assessing, selecting, teaching, and replacing IRs. Last, we provide tools and resources related to decision making and data collection with respect to IRs.

Employment offers many important benefits yet the majority of adults with disabilities are not represented in the workforce suggesting more research is needed on evidence-based vocational training for adults with disabilities (U.S. Bureau of Labor Statistics, 2024). The evidence base for improving current vocational training practices can be expanded through more research on fluency-based instruction and precision teaching. Precision teaching has been demonstrated to improve skill repertoires in a number of academic settings but its application for vocational skill acquisition is still emerging. The present study evaluated precision teaching as a tool to teach employment skills and extended Cohen (2005). Thus, the purpose of this study was to determine the effects of precision teaching with frequency building on the acquisition of job skills for adults with disabilities and examine the effects of training component skills using frequency building at a simulated training site on composite skill performance at the job site requiring the vocational skill. The results suggest frequency building was successful at improving vocational component repertoires. Evaluations of fluency outcomes after aims were met found degradations in participants' component performances. Finally, maximizing the effects component skill fluency has on related composite repertoires may require composite skills to be explicitly trained.