Dyad function-based cognitive behavioural therapy as a treatment for obsessive compulsive disorder in two school aged children with high functioning autism

Children with High-Functioning Autism (HF A) are more vulnerable to developing Obsessive Compulsive Disorder (OCD) than typically developing children and those with Low-Functioning Autism (Gadow et al., 2005). This study used a multiple baseline design across behaviours (Cooper, Heron, & Heward, 2007) to investigate if a two phase function-based Cognitive Behaviour Therapy (CBT) would decrease obsessive compulsive behaviours (OCBs) in two children ages 7 and 9 who met criteria for OCD and HF A. This multimodal treatment package consisted of treatment enhancements to meet the children's cognitive, linguistic, and social challenges associated with their HF A diagnosis, as well as a manual and accompanied children's workbook (Vause, Neil, & Feldman, in progress). In line with previous research conducted on CBT as a treatment for OCD in this population (e.g., Wood et at, 2009), the children in this study experienced clinically significant decreases in their OCBs as a result of receiving the CBT protocol.

I Believe in me, not OCB: Evaluation of Group Function-Based CBT as a Treatment for Obsessive Compulsive Behaviour in Four Children with HFA

Researchers have conceptualized repetitive behaviours in individuals with Autism Spectrum Disorder (ASD) on a continuum oflower-Ievel, motoric, repetitive behaviours and higher-order, repetitive behaviours that include symptoms ofOCD (Hollander, Wang, Braun, & Marsh, 2009). Although obsessional, ritualistic, and stereotyped behaviours are a core feature of ASD, individuals with ASD frequently experience obsessions and compulsions that meet DSM-IV-TR (American Psychiatric Association, 2000) criteria for Obsessive-Compulsive Disorder (OCD). Given the acknowledged difficulty in differentiating between OCD and Autism-related obsessive-compulsive phenomena, the present study uses the term Obsessive Compulsive Behaviour (OCB) to represent both phenomena. This study used a multiple baseline design across behaviours and ABC designs (Cooper, Heron, & Heward, 2007) to investigate if a 9-week Group Function-Based Cognitive Behavioural Therapy (CBT) decreased OCB in four children (ages 7 - 11 years) with High Functioning Autism (HFA). Key treatment components included traditional CBT components (awareness training, cognitive-behavioural skills training, exposure and response prevention) as well as function-based assessment and intervention. Time series data indicated significant decreases in OCBs. Standardized assessments showed decreases in symptom severity, and increases in quality of life for the participants and their families. Issues regarding symptom presentation, assessment, and treatment of a dually diagnosed child are discussed.

Investigating Changes in Parent Knowledge about Obsessive Compulsive Behaviour Following Group Function-Based Cognitive Behavioural Therapy for Children with High Functioning Autism

This study investigated improvements in parent knowledge of effective intervention strategies following participation in a group function-based CBT treatment (GFbCBT) package for children with comorbid OCD and ASD. Nineteen parents of children ages 7-12 years with High Functioning Autism (HFA) participated in the 9-week treatment program. Key components of treatment included psychoeducation and mapping, cognitive-behavioural skills training, function-based interventions and exposure and response prevention (ERP). Treatment sessions also included direct parent education, which followed a behavioural skills training model (Miltenberger, 2008). Parent knowledge (N = 19) was measured pre and post treatment using a vignette about a child demonstrating obsessive-compulsive behaviour. Results of a one-tailed pairwise t-test indicated statistically significant changes (p=.036) in overall parent knowledge following participation in treatment. Statistically significant changes were also found in parents’ ability to generate ERP and function-based intervention strategies. These results provide preliminary evidence that parents benefit from active involvement in the GFbCBT treatment package.

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.

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.

Using fuction-based CBT with parent involvement to treat OCD in two school-age children with high-functioning autism

Obsessive Compulsive Disorder (OCD) involves excessive worry coupled with engaging in rituals that are believed to help alleviate the worry. Pervasive Developmental Disorders (PODs) are characterized by impairments in social interaction, communication, and the presence of repetitive and/or restrictive behaviours (American Psychiatric Association, 2000). Research suggests that as many as 81% of children with a POD also meet criteria for a diagnosis ofOCD. Currently, only a handful of studies have investigated the use of Cognitive Behavioural Therapy (CBT) in treating OCD in children with autism (Reaven & Hepburn, 2003 ; Sze & Wood, 2007; Lehmkuhl, Storch, Bodtish & Geflken, 2008). In these case studies. the use of a multi-modal CBT treatment package was successful in alleviating OCD behaviours. The current study used function-based CBT with parent involvement and behavioural supplements to treat 2 children with POD and OCD. Using a multiple baseline design across behaviours and participants, parents reported that their child 's anxiety was alleviated and these gains were maintained at 6-month follow-up. According to results of the Children 's Yale-Brown Obsessive Compulsive Scale (Goodman, Price, Rasmussen, Riddle, & Rapoport, 1986) from preto post-test, OCD behaviours of the children decreased II"om the severe to the mild range. In addition, the parents rated the family's level of interference related to their child 's OCD as substantially lower. Last, the CBT treatment received high ratings of consumer satisfaction.

Functional analysis and treatment of OCD-related behaviour in a child with Autism Spectrum Disorder

Research indicates that Obsessive-Compulsive Disorder (OCD; DSM-IV-TR, American Psychiatric Association, 2000) is the second most frequent disorder to coincide with Autism Spectrum Disorder (ASD; Leyfer et aI., 2006). Excessive collecting and hoarding are also frequently reported in children with ASD (Berjerot, 2007). Although functional analysis (Iwata, Dorsey, Slifer, Bauman, & Richman, 1982/1994) has successfully identified maintaining variables for repetitive behaviours such as of bizarre vocalizations (e.g., Wilder, Masuda, O'Connor, & Baham, 2001), tics (e.g., Scotti, Schulman, & Hojnacki, 1994), and habit disorders (e.g., Woods & Miltenberger, 1996), extant literature ofOCD and functional analysis methodology is scarce (May et aI., 2008). The current studies utilized functional analysis methodology to identify the types of operant functions associated with the OCD-related hoarding behaviour of a child with ASD and examined the efficacy of function-based intervention. Results supported hypotheses of automatic and socially mediated positive reinforcement. A corresponding function-based treatment plan incorporated antecedent strategies and differential reinforcement (Deitz, 1977; Lindberg, Iwata, Kahng, and DeLeon, 1999; Reynolds, 1961). Reductions in problem behaviour were evidenced through use of a multiple baseline across behaviours design and maintained during two-month follow-up. Decreases in symptom severity were also discerned through subjective measures of treatment effectiveness.

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.

What children value : a scale to guide health promotion programs

Objective. Physical activity is important for the health of all human beings. Although it is important to develop good health promotion programs for children to increase participation in physical activity, to date there appear to be no programs based on what kids value beyond health and physical activity itself. This study proposed to create a scale with strong content and face validity that could uncover what any given population of children value in life regardless of their participation in physical activity and that experts feel could be related to physical activity. These findings will allow the development of targeted health promotion programs to increase children's participation in regular physical activity. Method In this study, a combination of qualitative and quantitative approaches was used. Data were gathered from seven experts in the field, sixty-seven children in grades three to five, five parents, and three teachers. From these data response groupings were created and sent to four experts to be given single word names. The resulting nine theme names were re-worked into "child-friendly" language. Four children were then asked to discuss theme names to see if they liked and understood them. The next step involved asking children and experts to rank order the nine themes, the children in general and the experts in terms of relevance to physical activity. From these results, possible versions of the scale were then created using the combined expert/children rankings. Each version was examined for content validity. Two versions of a scale resulted. These were sent to experts, parents, teachers and children in order to determine which one they liked better and to suggest any foreseeable problems. Once this information was collected, a beta (final prototype) version of the scale was created. Results. Nine common theme names were created from the response groupings. All four children agreed that they did understand and like each of the nine theme names. Experts and teachers agreed that full coverage of the content had been achieved. Children suggested a single wording change from "Being Accepted" to "Being Included". Five themes were selected for inclusion. The beta version of the scale included 12 forced choice statements, the first ten comparing all themes against one another followed by two anchor statements. Conclusion. At the outset it was recognized that it is essential to know what children think is important in their lives in order to serve as potential benefits in the development of effective physical activity promotion programs. This study developed a scale which could be used to determine what a population of children feel is important in order to focus health promotion programs for physical activity. The scale has strong face and content validity.

An international investigation on the validity of the CSAPPA scale in screening for developmental coordination disorder /

The main objective of the present investigation was to continue the research initiated by Hay and colleagues (2004) in examining the efficacy of the Children's Self-Perceptions of Adequacy in and Predilection for Physical Activity (CSAPPA) scale as a proxy for the short form of the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP-SF) in screening for Developmental Coordination Disorder (DCD) in children. To better appreciate DCD knowledge outside Canada, the measurements of this investigation were expanded in Greece. A translated Greek CSAPP A scale and the BOTMP-SF were administered for the first time in Greek children. A second objective was to investigate the relationship between DCD and various risk factors of coronary artery disease (CAD) in Canadian and Greek children. A sample of 591 (Ms=322; Fs=269) Canadian and 392 (Ms=211; Fs=181) Greek children, aged 9 to 13 years, consented to the BOTMP-SF, CSAPP A Scale, participation in physical activity questionnaire, Leger 20-meter Multistage Shuttle Run test, and body fat using bioelectric impedance. Prevalence of DCD in Canada and Greece was 8% and 19%, respectively. Significant agreement (pscale to the BOTMP-SF test in both countries. Canadian children revealed significantly lower percent body fat, CSAPPA scores, and participation in physical activity, as well as higher aerobic fitness levels and BOTMP-SF compared to their Greek peers. Clumsiness was associated with increased percent body fat and low aerobic fitness values. Physical activity was a significant mediator in the clumsiness-aerobic fitness relationship. It is concluded that the CSAPPA scale is an accurate, practical, and inexpensive screening tool for DCD, and that motoric competence is associated with aerobic fitness through physical activity participation.

SAVOURING ABILITIES SCALE (SAS): THE DEVELOPMENT OF A STRENGTHS - BASED ASSESSMENT FOR THERAPEUTIC RECREATION PROFESSIONALS

The purpose of this study was to develop and evaluate an assessment that measured savouring leisure. The assessment items developed were reviewed for content validity by eight international therapeutic recreation (TR) educators and administrators as well as eleven TR practitioners. An exploratory factor analysis was conducted to determine the most suitable items for the assessment. The results suggest that the original three subscale design needed to be modified to five. The reliability of the total assessment is α=.84. Statistical analysis for construct validity reveal 58.52% of the variance explained, and a moderate correlation was found between this study and other savouring assessments. The implications of the shift in conceptualization are reviewed through discussing factor analysis issues, the lived experience of savouring leisure, and the impact of the content validity process. This study contributes to the ongoing dialog of savouring leisure. Recommendations for future research are discussed.

Palmer's Pocket Scale with Rules for its Use in Solving Arithmetical and Geometrical Problems

The book is signed by S.D. Woodruff. A label the book indicates that it was also owned by "Band, of De Vere Gardens in Toronto".

Dynamics in large scale networks

In this thesis we study the properties of two large dynamic networks, the competition network of advertisers on the Google and Bing search engines and the dynamic network of friend relationships among avatars in the massively multiplayer online game (MMOG) Planetside 2. We are particularly interested in removal patterns in these networks. Our main finding is that in both of these networks the nodes which are most commonly removed are minor near isolated nodes. We also investigate the process of merging of two large networks using data captured during the merger of servers of Planetside 2. We found that the original network structures do not really merge but rather they get gradually replaced by newcomers not associated with the original structures. In the final part of the thesis we investigate the concept of motifs in the Barabási-Albert random graph. We establish some bounds on the number of motifs in this graph.

A Scalability Study and New Algorithms for Large-Scale Many-Objective Optimization

Many real-world optimization problems contain multiple (often conflicting) goals to be optimized concurrently, commonly referred to as multi-objective problems (MOPs). Over the past few decades, a plethora of multi-objective algorithms have been proposed, often tested on MOPs possessing two or three objectives. Unfortunately, when tasked with solving MOPs with four or more objectives, referred to as many-objective problems (MaOPs), a large majority of optimizers experience significant performance degradation. The downfall of these optimizers is that simultaneously maintaining a well-spread set of solutions along with appropriate selection pressure to converge becomes difficult as the number of objectives increase. This difficulty is further compounded for large-scale MaOPs, i.e., MaOPs possessing large amounts of decision variables. In this thesis, we explore the challenges of many-objective optimization and propose three new promising algorithms designed to efficiently solve MaOPs. Experimental results demonstrate the proposed optimizers to perform very well, often outperforming state-of-the-art many-objective algorithms.