Abstract. Effectiveness of a behaviorally based day treatment program for young children diagnosed with Pediatric Bipolar Disorder (PBD) was evaluated using pre and post treatment mean scores from the Child Behavior Checklist (CBCL). Data were evaluated in aggregate and using the clinically significant change method for children diagnosed with PBD, Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), Adjustment Disorder, and no diagnosis/clinical and sub-clinical groups. We found significant treatment effects for all groups except the no diagnosis/sub-clinical group on the internalizing scale and for all groups on the externalizing scale. In addition to statistically significant improvements on both the internalizing and externalizing scales of the CBCL, clinically significant change was also supported for the PBD group as well as for the ADHD, ODD, and Adjustment Disorder groups. The limitations of the study and implications surrounding the behavioral treatment of pediatric bipolar disorder are discussed.
Abstract. Treatment integrity is an important concern in treatment centers but is often overlooked. Performance feedback is a well-established approach to improving treatment integrity, but is underused and undervalued. One way to increase its value may be to expose unrealized benefits to the observer who collects the performance feedback data. This "observer effect" could increase the value of performance feedback and promote more consistent evaluation of treatment integrity. The purpose of this investigation was to evaluate the observer effect on treatment integrity. Five supervisors who worked in a day treatment center were asked to collect performance feedback data on staff members' integrity with following a standard treatment protocol that supervisors were also expected to follow. Results showed an immediate and marked improvement in treatment integrity in three supervisors who collected but never received performance feedback. For two supervisors, this effect was reversed and replicated. Implications are discussed.
Abstract. The current study involved a preliminary job-site testing of computer software, i.e., VideoTote, delivered via a computer tablet and designed to provide users with video modeling and prompting for use by young adults with an autism spectrum disorder (ASD) across a range of employment settings. A multiple baseline design was used to assess changes in rates of completion with a complex, 104-step shipping task by four participants diagnosed with ASD. Baseline data were collected on accuracy of task completion after exposure to typical job-training involving instruction, modeling, and practice. The intervention involved video modeling and prompting with a 13 min video depicting an individual completing job responsibilities that entailed checking to make sure materials were in working order, replacing defective items, packing materials in a container, entering information into a computer, and attaching a label to a container. Results suggested that video modeling and prompting were effective in helping individuals with autism complete a multi-step shipping task. Participants and their parents gave the device and software high ratings as an acceptable treatment for adults with autism to use in the workplace and intervention that complies with universal design principles. Implications for competitive job opportunities for individuals with autism are discussed.
Abstract. This study used a multiple baseline with reversal design to assess whether visual performance feedback (VPF) influenced targeted and nontargeted staffs' use of behavior-specific praise (BSP) in a day-treatment program. This study expands on the typical VPF audience and assesses whether VPF can be effective with noncertified staff in a day-treatment program for young children with behavior disorders, an environment in which it is difficult to maintain high rates of BSP. In previous school-based studies, VPF has been collected by researchers and provided to targeted teaching staff. In the current study, rather than relying on researchers, the authors used staff instructors to collect VPF and assessed how that experience influenced the instructors' use of BSP. Results suggest that VPF provided, on average, a doubling in rates of BSP use by directly targeted staff and more than a 50% increase in rates of BSP in nontargeted instructors who collected BSP data. Furthermore, three of the four participants had substantially higher praise-to-correction ratios during the VPF intervention when compared with baseline and reversal conditions. Implications for improving treatment fidelity and reducing supervision time are discussed.
Abstract. We evaluated audio cuing to facilitate community employment of individuals with autism and intellectual disability. The job required promoting products in retail stores by wearing an air-inflated WalkAround® costume of a popular commercial character. Three adolescents, ages 16–18, were initially trained with video modeling. Audio cuing was then used by an attendant who delivered prompts regarding when to perform job skills. The two interventions were evaluated in an interrupted time series withdrawal design during training and then again in an actual job setting. Results show video modeling was not effective. However, the audio cuing produced job performances well above the designated criteria during training and when on the job. These changes were replicated with each participant, demonstrating clear experimental control. The changes proved statistically significant as well. Participants and parents reported high job satisfaction. The challenges of competitive employment for individuals with autism and intellectual disabilities are discussed.
Abstract. Students with persistent disruptive behavior problems lose valuable time in academic lessons, are a distraction for classmates, and cause stress for teachers. Recent meta-analyses indicate that 87% to 92% of published studies on school-based interventions targeting student problem behaviors report results from demonstration projects (involving highly trained staff under ideal circumstances) rather than routine practice programs. The present study investigates the routine use of a school-wide classroom management program and its relationship to elementary students' social and academic outcomes. Three years after training in the classroom management program, 56 second-, third-, and fourth-grade teachers in an urban school district were assessed for fidelity to the program. Program fidelity was determined via direct observation in the classroom and validated by teacher self-ratings of fidelity and administrator ratings of teacher fidelity. Dependent variables included student engagement during academic lessons, out-of-school suspension rates, and report card grades. Results indicated that high program fidelity was significantly related to greater academic engagement and fewer suspensions, but not higher report card grades. This study adds to the scant literature on implementation fidelity of routine programs with high-risk populations.
Abstract. We evaluated the efficacy of a vocational training program including behavioral skills training, and a "performance cue system" (i.e., a proprietary iPhone application adapted for the study) to teach targeted social-vocational skills to six young adults with an Autism Spectrum Disorder. In two separate studies, participants were employed to assist in the delivery of a fire safety education program. Participants were asked to wear an inflatable firefighter WalkAround® mascot costume and to perform 63 scripted behaviors in coordination with a fire prevention specialist who was the lead program presenter. In Study 1, three participants were initially exposed to established company training procedures comprised of behavioral skills training components to determine whether they met mastery of the skills. If necessary to reach criteria, participants were then exposed to a performance cue system. In Study 2, three additional participants were provided with the performance cue system alone, and then behavioral skills training if required. A single case, multiple-baseline design across subjects was used to evaluate efficacy of each intervention. Results indicate that 5 of 6 participants reached criterion only after introduction of the cue system while the sixth reached criterion with behavioral skills training alone. The program received high satisfaction ratings from participants, their parents, and consumers. Implications and potential use of the PCS in other employment settings are discussed.
Abstract. The authors examined the benefits of video modeling to teach a unique vocational skill set to an adolescent and two young adults with Autism Spectrum Disorders. Video modeling was used to teach skills necessary to entertain customers and promote products in a retail setting while wearing a WalkAround® costume. The three participants were observed before and after watching a video model perform the skills in the costume in scripted and naturalistic scenes. Data can be interpreted to conclude that all participants learned to use the skills in combination or sequence after watching the video model. The skills generalized to an actual job opportunity. The participants reported they enjoyed the work, and comments from supervisors were positive. Implications are discussed.
Abstract. As part of a collaborative project between a University Center for Excellence in Developmental Disabilities and a local private business, we examined the effects of video modeling to teach vocational skills to four adolescents and young adults with Autism Spectrum Disorders. Video modeling was used to teach the participants to wear a WalkAround® mascot and entertain customers in a retail setting. Observations were conducted before and after participants watched a video model of the skills performed in both scripted and naturalistic scenes. All participants learned to use the targeted skills after watching the video model and all reported that they enjoyed the work. Implications and vocational applications are discussed.
Abstract. Parents of young children with severe emotional and behavior problems have few services from which to choose if their child is expelled from preschool for aggressive and disruptive behavior. Two case studies provide an overview of a multicomponent, intensive, day-treatment program for children with moderate to severe behavior disorders. Proximal and distal program goals are to eliminate presenting problem behaviors and increase social competencies and to reintegrate children back to their school, preschool, or daycare, respectively. The cases presented in this study provide preliminary evidence that day treatment can be a viable option for young children with disruptive behavior disorders.
Abstract. This paper presents an overview of the transtheoretical model (TM) of change and use of the TM to explain an experienced, urban middle school teacher's resistance to implementing a classroom management program. The TM identifies six stages of change and nine change processes that serve as catalysts for movement through the stages (Prochaska, 2000). This instrumental case study describes a teacher who habitually raised her voice in response to student misbehavior. After assessing the frequency with which she raised her voice, she implemented classroom management strategies that led to an 82% baseline-to-intervention decrease in the use of a raised voice, another 14% decrease at 3-year follow-up, and increases in student on-task behavior. The teacher's progression from resistance to implementation was consistent with the TM's stages of change.
Abstract. Objective: To evaluate the efficacy and acceptability of a social story with tangible rewards to reduce children's disruptive bedtime behavior and frequent night waking. Method: Four children (ages 2 to 7), with clinically significant disruptive bedtime behavior, received the intervention, which consisted of a social story (The Sleep Fairy) that sets forth (a) parental expectations for appropriate bedtime behavior and (b) rewards for meeting those expectations. Results: Parent sleep diaries indicated that children had a 78% average decrease in frequency of disruptive bedtime behaviors from baseline to intervention, with another 7% decrease at 3-month follow-up. Night wakings, a problem for 2 children during baseline, were not a problem during intervention and follow-up. Parents reported improved daytime behavior for 3 of the 4 children. Parents gave the intervention high acceptability ratings and maintained a high level of treatment fidelity. Conclusions: Use of a social story helped parents implement a multicomponent intervention using a familiar bedtime routine, thereby increasing the likelihood that implementation and effects occurred. The book format makes this intervention widely available to parents and professionals, with minimal costs and inconvenience.
Abstract. Three hundred and seventy-nine parents at 25 Air Force bases participated in a collaborative child physical abuse prevention project designed by the United States Air Force Family Advocacy Program and Father Flanagan's Boys' Home (Boys Town). These participants were active duty or civilian employee parents and their spouses who completed the Boys Town Common Sense Parenting® program as part of a comprehensive prevention effort. We hypothesized that participants would report decreased child behavior problems, improved relationships with family members, and reduced risk for child physical abuse after attending parenting sessions. Results supported this hypothesis. The data were also analyzed to determine the frequencies of individual parents who made statistically reliable changes on the dependent measures using Jacobson's Reliable Change Index. Nineteen to 30% of the participants reported significant improvement in the areas assessed. Parents who improved in abuse risk were at a higher level of risk and were less satisfied with family relationships prior to their participation than those who did not change. Implications for prevention of child physical abuse and future directions for research are discussed.
Abstract. Used archival data from 206 mothers (of 2–16 yr olds) who attended group parent training to test for age effects on statistical and clinical significance of improvements in child behavior problems following program participation. The Total Problem T score from the Child Behavior Checklist served as the dependent measure for all analyses. Results indicate that, for the whole sample, the severity of problem behaviors before treatment was the best predictor of treatment outcomes. When the sample was divided into age groups, older children had more severe behavior problems before treatment, but all groups improved. When outcomes were examined for improvement, adolescents had the lowest rate of clinical recovery, but the only significant predictor of treatment effects was again the severity of behavior problems. The data supported the null hypothesis that group parent training is effective for children from early childhood through adolescence.
Abstract. Compared outcomes from parenting program (PP) that was modified to reduce costs and a wait-list control (WLC) condition. 39 parents (mean age of 35.78 yrs) who completed a PP were compared with 27 parents (mean age 32.44 yrs) in the WLC condition based on their responses in the Child Behavior Checklist, Parent Sense of Competence Scale, and Family Satisfaction Scale. Parents were asked to identify a target child (aged 2–17 yrs), who was living at home and had the most severe behavior problems, for behavior assessment. The PP reduced costs by over 50%. Statistical analyses showed that treatment parents had significantly greater improvements in child behavior problems, parent attitudes, and satisfaction with family relationships than did controls. These effects were maintained at 3-mo follow-up. The difference between clinical recovery rates for control and treatment children was not statistically significant.
Abstract. In the current study a practical parenting program was tested with both middle- and low income parents. 34 parents who completed an 8-wk parenting program completed outcome measures before, immediately after, and at 3 month following the completion of training. These dependent measured included a self-report inventory of the number and frequency of child behavior problems and an inventory of parent attitudes toward their home and their child. Results indicate significant improvements for families of both income groups. These effects were maintained at a 3 month follow-up. Implications for parenting programs' and further research are discussed.
Cohrs, C.M., Allen, K.D., and Burke, R. V. (2014, May). Functional Analysis and Treatment of Rumination in a Child with Autism Using DRI and NCR. Paper presented at the annual convention of the Assotiation of Behavior Analysis International, Chicago.
Allen, K.D., Vatland, C.H., Bowen, S.L., and Burke, R.V. (2014, May). An Evaluation of the Efficacy of Caregiver-Produced Video Self-Modeling to Improve Independence in an Adolescent with an Autism Spectrum Disorder. Paper presented at the annual convention of the Association of Behavior Analysis International, Chicago.
Burke, R., Schlueter, C., Authier, K. (2014, March). From finalization to forever: Supporting adoptive families beyond case closure. Invited presentation of the Wicked Problems Institute of Child Welfare and Their Incomplete Solutions, Washington, DC.
Allen, K. D., Burke, R. B., Bowen, S. L., & Vatland, C. (2013, August). iPad-based video modeling across settings for employment-age individuals with autism. Symposium presented at the American Psychological Association annual convention, Honolulu.
Burke, R. V., Howard, M. R., & Allen, K. D. (2013, May). Using visual performance feedback to improve treatment fidelity in the classroom: Benefits and limitations. Paper presented the annual convention of the Association of Behavior Analysis International, Minneapolis.
Guck, T. P., Rainville, C., Hill-Taylor, D. S., Burke, R. V. (2013, March). A brief primary care intervention to reduce fear of movement in chronic back pain patients. Paper presented at the Society for Behavioral Medicine annual conference, San Francisco.
Authier, K., & Burke, R. (2013, February). Right Turn: Help for post-adoptive parents and guardians. Invited presentation at the Wicked Problems Institute of Child Welfare and Their Incomplete Solutions, Washington, DC.
McTate, E., Handal, P. J., Badura Brack, A., Burke, R. V. (2012, August). A program intervention for pediatric bipolar disorder: Preliminary results. Paper presented at the American Psychological Association annual convention, Orlando.
Burke, R. V., Allen, K. D., Bowen, S. L., Howard, M. R., Downey, D., Flegle, J. K., & Matz, M. (2012, May). From fun to factories: Bootstrapping our way to tablet-based assistive technology for the workplace. Paper presented at the annual convention of the Association of Behavior Analysis International, Seattle.
Howard, M. R., Burke, R. V., Peterson, J. L., Peterson, R. W., Wachtler, J., & Allen, K. A. (2012, May). The impact of collecting performance feedback data on the treatment integrity of the data collector. Paper presented at the annual convention of the Association of Behavior Analysis International, Seattle.
Burke, R. V., Bowen, S. L., Allen, K. D., Wallace, D. P., Howard, M. R., Downey, D., Andersen, M., & Matz, M. (2011, November). Getting to work: Technology-based solutions for increasing employment opportunities for individuals with Autism. Paper presented at the annual convention of the Association of Behavior Analysis International, Granada, Spain.
Allen, K. D., Burke, R. V., Bowen, S. L., & Howard, M. R. (2011, November). PDA-based training and support for the workplace. Paper presented at the Autism Action Partnership's Annual Autism Summit, Omaha, NE.
Burke, R. V. (2011, October). From fun to factories: Developing assistive technologies for young adults with autism. Paper presented at the annual WINAhead Conference, Omaha, NE.
Howard, M. R., Burke, R. V., Peterson, J. L., Peterson, R. W., & Allen, K. A. (2011, May). Improving day treatment staff use of behavior-specific praise with visual performance feedback. Paper presented at the annual convention of the Association of Behavior Analysis International, Denver.
Allen, K. D., Wallace, D. P., Bowen, S. L., Burke, R. V., & Wilczynski, S. (2011, May). Evaluation of vocational training approaches for increasing access to employment for young adults with autism. Symposium presented at the annual convention of the Association of Behavior Analysis International, Denver.
Burke, R. V., Oats, R. G., Ringle, J. L., O'Neill Fichtner, L., DelGaudio, M. B., & Gross, J. (2011, March). School-wide classroom management fidelity and outcomes with students in elementary school. Paper presented at the Annual Conference on Positive Behavior Support, Denver.
Burke, R., Allen, K., Bowen, S., Bell, R., Bell, P., Egger, D., & Egger, P. (2010, November). Manufacturing mascots and mirth: "Inflating" employment opportunities for individuals with ASD. Paper presented at the Autism Action Partnership's Annual Autism Summit, Omaha, NE.
Bowen, S., & Burke, R. (2009, April). Effective education: Learning from the NBA and PhDs to keep kids alive. Paper presented at the Fire and Life Safety Conference of the Rockies, Winter Park, CO.
Griffith, A., Barnes, B., Ingram, S., Burke, R. V., Thompson, R. W., & Epstein, M. H. (2008, November). Conducting an Evaluation of a Behavioral Parent Training Program as a Dissertation Study. Paper presented at the American Evaluation Association conference, Denver, CO.
Allen, K. D., Wallace, D. P., Renes, D., & Burke, R. (2008, May). Use of video modeling to teach vocational skills to adolescents and young adults with autism spectrum disorders. Presented at the annual convention of the Association of Behavior Analysis, Chicago.
Bailey, B. I., D'Alessandro, M., Bye, K. A., Thompson, J. A., & Burke, R. V. (2008, April). STARplus: Using school-wide analyses of student work to focus instruction. Paper presented at the 87th National Association of Elementary School Principals Annual Convention, Nashville, TN.
Fernandes, M., & Burke, R. (2008, February). The well managed classroom: The portal to better teaching. Paper presented at the Joint National Conference on Alternatives to Expulsion, Suspension, and Dropping Out of School, Orlando, FL.
Burke, R., DelGaudio, M., Brayton, G., Lopez, A., Chawner, T., Hartman, S., & O'Neill Fichtner, L. (2007, October). Targeted intervention programs for k-8 at-risk students: A case study. Paper presented at the 12th Annual Conference on Advancing School Mental Health, University of Maryland School of Medicine, Orlando, FL.
Coker, B. I., Schroeder, A., Burke, R. V. Johnson, S., O'Neill Fichtner, L., Hensley, M., & Bolton, J. (2007, October). Reducing seclusion and increasing academic engagement in alternative education. Paper presented at the 12th Annual Conference on Advancing School Mental Health, University of Maryland School of Medicine, Orlando, FL.
DelGaudio, M., Burke, R., Brayton, G., Lopez, A., Hartman, S., O'Neill Fichtner, L. & Oats, R. (2007, March). A preliminary comparison of high- and low-functioning intervention programs for at-risk students. Paper presented at the Fourth International Conference on Positive Behavior Support, Boston, MA.
Ogden, G., Oats, R., Wilkin, D., Lamke, S., Bolton, J., & Burke, R. (2007, March). Data-sharing and goal-setting to improve staff consistency, student behavior, and academic performance. Paper presented at the Fourth International Conference on Positive Behavior Support, Boston, MA.