Cognitive Behavior Therapy for Obsessive-Compulsive Behavior in Children with Autism Spectrum Disorder: A Comparison of Hierarchical Linear Modelling and Visual Analysis

Behavioral researchers commonly use single subject designs to evaluate the effects of a given treatment. Several different methods of data analysis are used, each with their own set of methodological strengths and limitations. Visual inspection is commonly used as a method of analyzing data which assesses the variability, level, and trend both within and between conditions (Cooper, Heron, & Heward, 2007). In an attempt to quantify treatment outcomes, researchers developed two methods for analysing data called Percentage of Non-overlapping Data Points (PND) and Percentage of Data Points Exceeding the Median (PEM). The purpose of the present study is to compare and contrast the use of Hierarchical Linear Modelling (HLM), PND and PEM in single subject research. The present study used 39 behaviours, across 17 participants to compare treatment outcomes of a group cognitive behavioural therapy program, using PND, PEM, and HLM on three response classes of Obsessive Compulsive Behaviour in children with Autism Spectrum Disorder. Findings suggest that PEM and HLM complement each other and both add invaluable information to the overall treatment results. Future research should consider using both PEM and HLM when analysing single subject designs, specifically grouped data with variability.

THE USE OF COGNITIVE INTERVIEWS TO EVALUATE THE LIVING CONDITIONS SURVEY

Cognitive interviews were used to evaluate two draft versions of a financial survey in Jamaica. The qualitative version used a few open-ended questions, and the quantitative version used numerous close-ended questions. A secondary analysis based on the cognitive interview literature was used to guide a content analysis of the aggregate data of both surveys. The cognitive interview analysis found that the long survey had fewer respondent errors than the open-ended questions on the short survey. A grounded theory analysis then examined the aggregate cognitive data, showing that the respondents attached complex meanings to their financial information. The main limitation of this study was that the standard assessments of quantitative and qualitative reliability and validity were not utilized. Further research should utilize statistical methods to compare and contrast aggregated cognitive interview probe responses on open and close ended surveys.

Exploring the Therapeutic Alliance in Cognitive-Behavior Therapy with Children with Autism Spectrum Disorder: An Interpretative Phenomenological Approach

Abstract The therapeutic alliance (TA) is the most studied process of adult psychotherapeutic change (Zack et al., 2007) and has been found to have a moderate but robust relationship with therapeutic outcome regardless of treatment modality (Horvath, 2001). The TA is loosely described as the extent to which the therapist and the participant connect emotionally and work together towards goals. Conceptualizations of the TA with children have relied on adult models, even though it is widely acknowledged that the pediatric population will rarely willingly commit to therapy, nor readily admit to any challenges that they may be experiencing (Keeley, Geffken, McNamara & Storch, 2011). For children with Autism Spectrum Disorder (ASD) the therapeutic alliance may require an even greater retheorizing considering the communicative and social difficulties of this particular population. Despite this need, research on children with ASD and the therapeutic TA is almost non-existent. In this qualitative study, transcripts from semi-structured interviews with mothers of children with ASD were analyzed using Interpretative Phenomenological Analysis (IPA). IPA closely examines how individual people make sense of their life experiences using a theme-by-theme approach. The three interviewees were mothers whose children were participants in a nine-week Cognitive Behaviour Therapy (CBT) group for obsessive-compulsive behaviours (OCB). A total of four superordinate themes were identified: (i) Centralization and disremembering the TA, (ii) Qualities of the therapist, (iii) TA and the importance of time, and (iv) Signs of a healthy TA. The mothers’ perspectives on the TA suggest that, for them and their children, a strong TA was a required component of the therapy. Implications for clinicians and researchers are discussed.

Autonomic and Electrophysiological Correlates of Cognitive Control in Aging

This thesis tested a model of neurovisceral integration (Thayer & Lane, 2001) wherein parasympathetic autonomic regulation is considered to play a central role in cognitive control. We asked whether respiratory sinus arrhythmia (RSA), a parasympathetic index, and cardiac workload (rate pressure product, RPP) would influence cognition and whether this would change with age. Cognitive control was measured behaviourally and electrophysiologically through the error-related negativity (ERN) and error positivity (Pe). The ERN and Pe are thought to be generated by the anterior cingulate cortex (ACC), a region involved in regulating cognitive and autonomic control and susceptible to age-related change. In Study 1, older and younger adults completed a working memory Go/NoGo task. Although RSA did not relate to performance, higher pre-task RPP was associated with poorer NoGo performance among older adults. Relations between ERN/Pe and accuracy were indirect and more evident in younger adults. Thus, Study 1 supported the link between cognition and autonomic activity, specifically, cardiac workload in older adults. In Study 2, we included younger adults and manipulated a Stroop task to clarify conditions under which associations between RSA and performance will likely emerge. We varied task parameters to allow for proactive versus reactive strategies, and motivation was increased via financial incentive. Pre-task RSA predicted accuracy when response contingencies required maintenance of a specific item in memory. Thus, RSA was most relevant when performance required proactive control, a metabolically costly strategy that would presumably be more reliant on autonomic flexibility. In Study 3, we included older adults and examined RSA and proactive control in an additive factors framework. We maintained the incentive and measured fitness. Higher pre-task RSA among older adults was associated with greater accuracy when proactive control was needed most. Conversely, performance of young women was consistently associated with fitness. Relations between ERN/Pe and accuracy were modest; however, isolating ACC activity via independent component analysis allowed for more associations with accuracy to emerge in younger adults. Thus, performance in both groups appeared to be differentially dependent on RSA and ACC activation. Altogether, these data are consistent with a neurovisceral integration model in the context of cognitive control.

Mobile Books: Effect of Engagement on Students’ Motivation and Cognitive Strategy Use

This mixed methods research explores the role of reading engagement in 30 grade 1 students’ motivation to read mobile electronic storybooks (eBooks) and cognitive strategies used during eBook reading. Data collection comprised motivation and parent questionnaires, behavioural observation checklists, cognitive strategies rubric, and teacher interviews. Students’ emotional engagement with and enjoyment of mobile eBooks corresponded to 4 motivational aspects of intrinsic motivation: curiosity, control, choice, and challenge. Post-intervention results indicated that most student participants enjoyed answering eBook comprehension questions and preferred eBooks to print books; by the end of the study, all had access to a mobile device at home. A majority of participants were actively engaged during mobile eBook reading sessions and persisted in answering embedded eBook comprehension questions, which together reflected students’ behavioural engagement and time-on-task during mobile reading. Students’ off-task behaviours related to iPads’ accessibility features and inherent reader-friendliness. All participants successfully answered evaluative questions requiring them to activate prior knowledge, and experienced higher levels of difficulty with making personal connections. The study highlights the importance of making school-based literacy practices relevant to students’ outside worlds, and discusses implications for teacher educators, administrators, curriculum developers, and eBook and other digital developers concerning the need for greater collaboration in order to more closely align technology resources with national curriculum expectations.

The influence of cognitive resources on compensatory arm responses

The purpose of this study was to determine the influence of an ongoing cognitive task on an individual’s ability to generate a compensatory arm response. Twenty young and 16 older adults recovered their balance from a support surface translation while completing a cognitive (counting) task of varying difficulty. Surface electromyographic (EMG) recordings from the shoulders and kinematics of the right arm were collected to quantify the compensatory arm response. Results indicated that the counting task, regardless of its difficulty as well as the age of the individual, had minimal influence on the onset or magnitude of arm muscle activity that occurred following a loss of balance. In contrast to previous research, this study’s findings suggest that the cortical or cognitive resources utilized by the cognitive task are not relied upon for the generation of compensatory arm responses and that older adults are not disproportionately affected by dual-tasking than young adults.

Examining the Learning Effects of Segmented Model Demonstrations on the Motor & Cognitive Learning of the Basketball Jump Shot

The purpose of the present experiment was to determine whether learning is optimized when providing the opportunity to observe either segments, or the whole basketball jump shot. Participants performed 50 jump-shots from the free throw line during acquisition, and returned one day later for a 10 shot retention test and a memory recall test of the jump-shot technique. Shot accuracy was assessed on a 5-point scale and technique assessed on a 7-point scale. The number of components recalled correctly by participants assessed mental representation. Retention results showed superior shot technique and recall success for those participants provided control over the frequency and type of modelled information compared to participants not provided control. Furthermore, participants in the self-condition utilized the part-model information more frequently than whole-model information highlighting the effectiveness of providing the learner control over viewing multiple segments of a skill compared to only watching the whole model.

Evaluating Knowledge of a Function-based Cognitive-Behavioural Treatment for Obsessive Compulsive Behaviour in Autism Spectrum Disorder

Children with Autism Spectrum Disorder (ASD) have restricted and repetitive behaviours (RRBs) which may be similar to obsessions and compulsions in Obsessive Compulsive Disorder (OCD). These behaviours can be intrusive and interfere in the lives of the child and their family. Preliminary studies have shown success in using adapted Cognitive Behavioural Therapy (CBT) to treat these behaviors in children with high functioning ASD. Using a hypothetical vignette, this thesis attempted to examine procedural knowledge that the children and their parents gained while participating in a CBT treatment that was evaluated in a Randomized Controlled Trial. For both parents and children, there was a significant increase in number of strategies generated from pre to post-treatment. Further, children in the experimental group generated significantly more strategies than the treatment as usual (TAU) group post-intervention. There was no significant correlation between number of strategies generated and the child’s treatment success, age, or IQ.

Effects of Cerebral Blood Flow and PETCO2 on Cognitive Function During Passive Heat Stress

This thesis tested whether cognitive performance during passive heat stress may be affected by changes in cerebrovascular variables as opposed to strictly thermally-induced changes. A pharmacological reduction in cerebral blood flow (CBF) using indomethacin along with a hypocapnia-induced CBF reduction during passive heat stress (Tre ~1.5°C above baseline) were used to investigate any cerebrovascular-mediated changes in cognitive performance. Repeated measures analysis of variance indicated that One-Touch Stockings of Cambridge (OTS) performance was not affected by a significant reduction in CBF during passive heat stress. More specifically, OTS accuracy measures did not change as a result of either a reduction in CBF or increasing passive heat stress. However, it was found that OTS response time indices improved with increasing passive heat stress independent of CBF changes. In conclusion, a significant reduction in CBF does not cause additional changes in performance of an executive functioning task during severe passive heat stress.

The Impact of Directed Mirror Focus and Technique Cues on Psychological, Cognitive and Emotional Exercise Correlates in an Introductory Weight Training Orientation

The purpose of the study was to investigate whether teaching inactive and low active women to use mirrors for form and technique purposes could lessen the negative impact of mirrors on self-presentational concerns, affect, and self-efficacy. Eligible women (N = 82) underwent a one-on-one weight training orientation with a personal trainer. Participants were randomized into one of four experimental groups, each unique in the type of feedback (general or technique-specific) and the degree of focus on the mirror for technique reinforcement. Questionnaires assessed study outcomes pre- and post-orientation. Results indicated groups did not significantly differ on any post-condition variables, when controlling for pre-condition values (all p’s >.05). All groups showed outcome improvements following the orientation. This suggests that during a complex task, a personal trainer who emphasizes form and technique can facilitate improvements to psychological outcomes in novice exercisers, independent of the presence of mirrors or directional cues provided.

The Beneficial Effects of Motivational Self-Talk on Endurance Performance and Cognitive Function in the Heat

The role of psychological strategies on endurance performance and cognitive function in the heat is unclear. This thesis tested the effects of a two-week motivational self-talk (MST) intervention - specific to heat stress - on endurance capacity and cognitive function in the heat (35°C 50% RH). The study utilized a pre-test / post-test design testing endurance capacity using a time to exhaustion test (TTE) after exercise-induced hyperthermia. Cognitive function (e.g executive function) was tested at baseline in thermoneutral (22°C 30% RH), before (R1) and after the TTE (R2). MST led to a significant improvement (~30%) in TTE and significantly faster completion time with fewer errors made on executive function tasks at baseline and R2, but not in R1, while there were no differences in the control group. Overall, these results indicate that using a top-down regulation strategy consisting of self-contextualized MST can improve physical and cognitive performance in the heat.

Supporting social-cognitive development in the elementary years: The role of executive function and self-regulation

Every day we make decisions that have repercussions. Sometimes the effects are immediate and intended; other times the effects might be unintended or might not be apparent for years. As parents or educators, part of our role is to support the development of children’s decision-making skills, helping them to develop patterns of adaptive decision-making that will serve them well in their current lives and into the future. Part of successful decision-making involves self-control, a system served by the brain’s executive functions (EF). This involves the ability to put aside immediate reactions and base decisions on a variety of important considerations. Social-cognitive development, the ongoing improvement of the ability to get along with others and to understand others’ emotions, expressions, motivations, and intents, relies, to a large degree, on the same EF systems. The current paper explores the interaction of these two factors (the role of EF in social-cognitive development), explores the research to determine the most effective approaches to improving both factors, and develops a handbook providing activities for educators to use while supporting the growth of both EF and social-cognitive skills. Results of a needs assessment reveal that the majority (59%) of educators surveyed had never used a social skills improvement program in their classrooms, while a full 95% believed that social skills are important or very important for a student’s academic success.