Effectiveness of Self-Instructional Mediator Training in Applied Behaviour Analysis

Interventions using applied behaviour analysis (ABA) are widely used with children with autism spectrum disorders (ASD). Individuals who work with this population are important to target for ABA education. This study evaluated the efficacy of a self-directed program in increasing parent and student ABA knowledge and skills, self-efficacy, and new skill development in children with ASD. Study 1 was a pilot study of the newly developed evaluation materials. Study 2 tested the self-instructional package with three parents of children with ASD, three university students, and eight children diagnosed with ASD. Parents and students were given the Simple Steps ABA training package to use independently and were measured using a multiple baseline across participants and/or skills design. After training, ABA knowledge scores and self-efficacy showed variable improvement as did children’s appropriate behaviours. These results suggest that more research is needed to determine the efficacy of a self-instructional ABA package.

Decision analysis of the effectiveness of lung cancer screening using autofluorescence bronchoscopy and computed tomography

Background: Lung cancer (LC) is the leading cause of cancer death in the developed world. Most cancers are associated with tobacco smoking. A primary hope for reducing lung cancer has been prevention of smoking and successful smoking cessation programs. To date, these programs have not been as successful as anticipated. Objective: The aim of the current study was to evaluate whether lung cancer screening combining low dose computed tomography with autofluorescence bronchoscopy (combined CT & AFB) is superior to CT or AFB screening alone in improving lung cancer specific survival. In addition, the extent of improvement and ideal conditions for combined CT & AFB screening were evaluated. Methods: We applied decision analysis and Monte Carlo simulation modeling using TreeAge Software to evaluate our study aims. Histology- and stage specific probabilities of lung cancer 5-year survival proportions were taken from Surveillance and Epidemiologic End Results (SEER) Registry data. Screeningassociated data was taken from the US NCI Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO), National Lung Screening Trial (NLST), and US NCI Lung Screening Study (LSS), other relevant published data and expert opinion. Results: Decision Analysis - Combined CT and AFB was the best approach at Improving 5-year survival (Overall Expected Survival (OES) in the entire screened population was 0.9863) and in lung cancer patients only (Lung Cancer Specific Expected Survival (LOSES) was 0.3256). Combined screening was slightly better than CT screening alone (OES = 0.9859; LCSES = 0.2966), and substantially better than AFB screening alone (OES = 0.9842; LCSES = 0.2124), which was considerably better than no screening (OES = 0.9829; LCSES = 0.1445). Monte Carlo simulation modeling revealed that expected survival in the screened population and lung cancer patients is highest when screened using CT and combined CT and AFB. CT alone and combined screening was substantially better than AFB screening alone or no screening. For LCSES, combined CT and AFB screening is significantly better than CT alone (0.3126 vs. 0.2938, p< 0.0001). Conclusions: Overall, these analyses suggest that combined CT and AFB is slightly better than CT alone at improving lung cancer survival, and both approaches are substantially better than AFB screening alone or no screening.

An exploration of interdisciplinary practice through an examination of specific disciplinary interpretations of stereotypic behaviour

As identified in the literature, a lack of understanding of the functional properties and triggers of stereotypic behaviour exists. When looking at this behaviour from an Applied Behaviour Analysis (ABA) framework, limitations are evident around identifying specific sensory modalities and functional properties of such behaviour. Antecedents particularly are difficult to identify and interpret. Therefore an interdisciplinary approach to assessment using two types of professional services commonly received by individuals with autism was proposed. However before this approach could be investigated the current interpretations of Stereo typic behaviour by each professional must be examined along with perceptions of interdisciplinary collaboration. The purpose of this study was to use an in-depth qualitative analysis to reveal the interpretations of stereotypy and collaboration from the perspectives of two particular professionals. The results of the study demonstrated that occupational therapists and behaviour analysts likely have different interpretations of the same behaviour,that consultation is the common model used to interact with other disciplines, and that professionals may have mixed feelings toward interdisciplinary practices as an approach to stereotypic behaviour. Strengths and limitations of the study were highlighted along with specific directions for future research.

Perspectives of Parents of Children with Autism Spectrum Disorder on a Community-Based Parent Education Program

In 2012 a community-based agency that oversees Intensive Behaviour Intervention services for young children diagnosed with Autism Spectrum Disorder (ASD) began delivering newly developed curricula to parents of eligible children. The curricula’s intent was to inform parents about ASD and Applied Behaviour Analysis, to increase their awareness of available community resources, and assist them to be active and engaged in their child’s learning. This mixed-method study used a program-specific survey and focus groups to explore the perspectives parents had on their involvement in these education sessions. Through constant comparison analysis 4 major and 3 minor themes emerged. In general, parents acknowledged that this parent education program included relevant content and a favourable delivery format. The study summarized a number of well-articulated, practical suggestions parents provided. Implications for practice would be applicable to educators interested in providing quality group-based education to parents of young children with ASD.