The effect of motivating operations on the transfer from tacts to mands for children diagnosed with autism

This study examined the effect of motivating operations (MO) on the emergence of a mand following tact training. Two children with autism were taught to tact a high-preferred (HP) edible identified through a preference assessment. The children were then tested to see if a mand for the HP edible emerged under deprivation (24+ h) and pre-session exposure (immediately prior to the mand test) test conditions. Following tact training, both participants manded for the HP edible in the deprivation condition but little to no responding occurred in the pre-session exposure condition. The results from this study suggest that a tact-to-mand transfer may occur under certain conditions.     

Teaching intraverbal behavior to children with autism

Skinner's conceptual analysis of language has influenced one model of early and intensive behavioral intervention with children, which incorporates verbal operants including mands, tacts, intraverbals, etc. Many studies have examined the mand and tact relations, with little focus on teaching intraverbal behavior. In the present experiment, children with autism were taught intraverbals using a transfer-of-stimulus-control procedure (i.e., tact to intraverbal) in combination with errorless learning (i.e., delayed prompting). Three children were successfully taught to name items associated with preselected categories (e.g., “What are some colors?”) with limited generalization to a fourth, non-targeted category, and limited maintenance of skills.     

Brief Report: Effects of Tact Training on Emergent Intraverbal Vocal Responses in Adolescents with Autism

The present study evaluated the emergence of intraverbal responses following tact training with three adolescents diagnosed with autism spectrum disorders. Participants were taught to tact the name of a cartoon character (e.g., “What is the name of this monster?” [“Simon”]) and that character’s preferred food (e.g., “What food does this monster eat?” [“Chips”]). Following tact training, test probes revealed the emergence of untrained vocal intraverbals. Specifically, in the absence of pictures, participants stated the name of the character when given the food preference (e.g., “Which monster eats chips?”), and stated the food when given the character name (e.g., “What food does Simon eat?”). The findings are discussed with reference to the growing literature on verbal behavior and derived relational responding.     

Comparisons of intervention components within augmentative and alternative communication systems for individuals with developmental disabilities: A review of the literature

Decisions regarding augmentative and alternative communication (AAC) for individuals with developmental disabilities (e.g. what AAC to use and how to teach a person to use a specific AAC modality) should involve consideration of different intervention component options. In an effort to elucidate such decisions and options, this review synthesized 14 studies, published between 2004 and 2012, comparing different AAC intervention components including different symbol sets, instructional strategies, or speech output within aided AAC systems, and different verbal operants within unaided AAC. Evidence supported the following: (a) different instructional strategies such as building motivation, using errorless learning, or adding video models to picture exchange interventions may improve the acquisition or rate of acquisition of picture exchange mands, (b) limited data supports training mimetic (imitated) or mand signs over tacts and (c) differences in symbol sets and speech output levels appeared to have little effect on AAC-based mand acquisition, but listener-based differences should be considered. These findings have implications for future research and clinical practice.     

A further evaluation of the effects of listener training on derived categorization and speaker behavior in children with autism

Previous research has shown that children with autism may accurately categorize visual stimuli after learning to both tact (i.e., speaker behavior) and receptively discriminate (i.e., listener behavior) them using common category names. The purpose of the current study was to further evaluate the effects of category listener training alone on the development of Visual Categorization and Category Tacts with four children diagnosed with autism. We administered standardized language assessments to evaluate participants’ skills prior to beginning the study and used a non-concurrent multiple-baseline design across participants. Two of the participants whose language assessments identified both speaker and listener scores greater than 36 months, passed Visual Categorization and Category Tact testing with previously unfamiliar stimuli following Category Listener training. The two participants whose language assessments identified a deficit in either speaker or listener scores failed Visual Categorization and Category Tact testing following Category Listener training. These results suggest that both speaker and listener behavior may be required for the emergence of untrained categorization and tacting following listener training.     

Collateral effects of mand training for children with autism

Proponents of the verbal behavior approach to instruction for individuals with autism have identified mand training as a starting point for early intervention. Mand training is a process whereby the learner is taught to request highly preferred items under conditions when those items are most valuable. A hypothesized benefit of this approach is that mand training has a collateral effect on nontargeted behavior, though empirical support for this hypothesis is currently tenuous. The present investigation examined the collateral effects of vocal mand training compared to vocal request training for 3 previously nonvocal children with autism. Levels of orienting toward a speaker, compliance with instruction, and overall problem behavior were measured across experimental conditions and analyzed using an alternating treatment design. Results indicate that problem behavior for all participants occurred at lower levels during mand training than request training and that the level of nontargeted social behavior (i.e., orienting and compliance) was higher during mand training for 2 participants and was similar across both conditions for the final participant. The results support the hypothesis that mand training can have a collateral impact on nontargeted behavior, though explicit instruction of social behaviors may also need to be embedded within mand training procedures.     

Errorless acquiescence training: a potential "keystone" approach to building peer interaction skills in children with severe problem behavior

Errorless acquiescence training (EAT) was developed as a graduated, success-focused, and short-term intervention for building social skills. The approach focuses on building the skill of acquiescence (i.e., teaching children to be flexible with the needs and will of peers). The authors predict that acquiescence would serve as a keystone, that is, a skill that when trained produces widespread improvements in child behavior, including reductions in antisocial behavior. The authors provide EAT to eight children referred to a clinical classroom for severe antisocial behavior. Consistent with errorless paradigms, key intervention components present at the initiation of intervention are systematically faded at a slow enough rate to ensure continued prosocial interactions throughout and following treatment. Children demonstrate substantial increases in acquiescent responding and other prosocial behavior as well as covariant reductions in antisocial behaviors. Acquiescence is discussed in terms of its potential as a keystone for prosocial responding in children with antisocial behavior.     

Intervention for tact as reporting in children with autism

Many children with autism have severe difficulty in ‘reporting’ on events at schools to mothers at home despite their ability to tact some objects and actions in discrete trial setting. Many studies have attempted to establish tact as labeling in children with autism. Few studies, however, have attempted to establish tact as a functional communication skill. The conditions under which children with autism acquired tact regarding objects and events that are remote in time and space from the listener was investigated in three children with autism. A multiple-baseline design was implemented to evaluate intervention effects. Animated cartoons or still pictures were used as stimuli and the children were required to walk to see a stimulus, observe it, walk back to an adult listener, and tact what they had seen. In the baseline condition, no participants were able to sufficiently tact after moving 1-m from the stimulus. Then tacting was trained using vocal prompts. Through this procedure, all children acquired tact for untrained events that were remote in time and space from their mothers.     

A biopsychosocial deconstruction of "personality change" following acquired brain injury

The judgement of personality change following acquired brain injury (ABI) is a powerful subjective and social action, and has been shown to be associated with a range of serious psychosocial consequences. Traditional conceptualisations of personality change (e.g., Lishman, 1998) have largely derived from individualist concepts of personality (e.g., Eysenck, 1967). These assume a direct link between neurological damage and altered personhood, accounting predominantly for their judgements of change. This assumption is found as commonly in family accounts of change as in professional discourse. Recent studies and perspectives from the overlapping fields of social neuroscience, cognitive approaches to self and identity and psychosocial processes following ABI mount a serious challenge to this assumption. These collectively identify a range of direct and indirect factors that may influence the judgement or felt sense of change in personhood by survivors of ABI and their significant others. These perspectives are reviewed within a biopsychosocial framework: neurological and neuropsychological deficits, psychological mechanisms and psychosocial processes. Importantly, these perspectives are applied to generate a range of clinical interventions that were not identifiable within traditional conceptualisations of personality changes following ABI.     

Neuromuscular electrical stimulation improves severe hand dysfunction for individuals with chronic stroke: a pilot study

Restoring hand function is difficult post-stroke. We sought to determine if applying neuromuscular electrical stimulation (NMES) was beneficial for reducing severe hand impairments. Subjects with chronic stroke (N=8; 3 Fe, 5 M; 58.3 +/- 6.9 y/o) received 10 sessions of NMES using two different methods applied in a counterbalanced order. In one intervention, we applied NMES (active) in a novel fashion using multiple stimulators on the forearm flexors and extensors to assist subjects with grasping and releasing a tennis ball. In the other intervention, the NMES ('passive') stimulated repeated wrist extension and flexion. Motor performance was assessed prior to and immediately following the interventions and at retention. Upper extremity (UE) Fugl-Myer scores significantly improved (p < 0.002) immediately following either intervention. Significant improvement was also observed in the Modified Ashworth Spasticity Scale (MASS) (p < 0.03), immediately following intervention, primarily due to the NMESpassive treatment (p < 0.034). Subjects performed grasping tasks significantly faster (p < 0.0433) following interventions, with performance speeds on dexterous manipulation increasing approximately 10% for NMESactive immediately following intervention, compared to only 0.1% improvement following NMESpassive. Generally, improvements in motor speed remained 10 days following NMESactive intervention, although slightly diminished. In conclusion, severe hand impairment was reduced after a short duration of NMES therapy in this pilot data set for individuals with chronic stroke. NMES-assisted grasping trended towards greater functional benefit than traditional NMES-activation of wrist flexors/extensors.     

The "where" and "what" in developmental dyscalculia

Developmental dyscalculia (DD) is a congenital deficit that affects the ability to acquire arithmetical skills. Individuals with DD have problems learning standard number facts and procedures. Estimates of the prevalence rate of DD are similar to those of developmental dyslexia. Recent reports and discussions suggest that those with DD suffer from specific deficits (e.g., subitizing, comparative judgment). Accordingly, DD has been described as a domain-specific disorder that involves particular brain areas (e.g., intra-parietal sulcus). However, we and others have found that DD is characterized by additional deficiencies and may be affected by domain-general (e.g., attention) factors. Hence "pure DD" might be rather rare and not as pure as one would think. We suggest that the heterogeneity of symptoms that commonly characterize learning disabilities needs to be taken into account in future research and treatment.     

Abnormal semantic network for "animals" but not "tools" in patients with Alzheimer's disease

The effects of Alzheimer's disease (AD) on the organization of semantic knowledge (i.e., the semantic network) for living (e.g., animals) and non-living (e.g., tools) categories was examined. Multidimensional scaling and Pathfinder analyses of data from triadic comparison tasks showed that the semantic network for "animals", but not the network for "tools", was abnormal in patients with AD. Specifically, patients with AD tended to use a different primary dimension than control subjects for categorizing animals and their network was characterized by atypical associations between concepts. The differences in the integrity of the AD patients' networks for "animals" and "tools" was not likely to be an artifact of differences in the difficulty in identifying the stimuli in the two categories as all stimuli were identified on simple naming or matching tasks. These findings support the results of previous studies that have shown the presence of category-specific semantic deficits in patients with AD.     

Sequential cognitive-behavioral therapy for children with obsessive-compulsive disorder with an inadequate medication response: a case series of five patients

Few data have been reported on the efficacy of cognitive-behavioral therapy (CBT) for youth with obsessive-compulsive disorder (OCD) who have not responded to prior treatment with medication. Given this, we report an open trial of CBT for children who have remained symptomatic following medication trials. Five children with OCD who had an inadequate response to psychotropic medications (e.g., limited response and/or unable to be titrated to a complete dose due to side effects) received treatment in a 3-week intensive CBT program. Assessments were conducted at baseline and after treatment. All participants were classified as treatment responders (much improved or very much improved) and the severity of clinician-rated OCD symptoms and impairment significantly decreased after the intervention. Although a number of limitations of this preliminary report exist, this study provides preliminary support for the utility of an intensive intervention for youth with OCD who have had an inadequate response and/or adverse side effects.     

Maintenance effects of working memory intervention (Cogmed) in children with symptomatic epilepsy

PurposeTo extend previous research documenting the benefits of working memory (WM) intervention (Cogmed) immediately post-intervention in children with epilepsy by assessing the 3-month maintenance effects.MethodsParticipants involved in a previous randomized clinical trial (RCT) were invited to participate if they completed Cogmed within the last 3 months (n = 15) and additional participants (n = 13) were prospectively recruited. Standardized assessments of near-transfer effects (i.e., visual and auditory attention and WM) were completed prior to and immediately after intervention and at 3-month follow-up. An additional measure assessing the far-transfer effect of fluid reasoning was administered prior to intervention and at 3-month follow-up.ResultsParticipants exhibited gains in auditory and visual attention and WM immediately following intervention and gains were generally sustained at 3-month follow-up. Intervention did not improve visual-verbal WM or fluid reasoning. The clinical variables studied (i.e., age of seizure onset, seizure frequency, epilepsy duration, and overall intellectual functioning) did not elucidate reliable relationships with intervention.ConclusionsWorking memory training is possibly efficacious in improving related skills which are maintained for 3 months in children with active epilepsy. No transfer to fluid reasoning was documented. Further investigation by means of a large-scale RCT which includes a placebo and both objective and subjective measures of the impact of training on daily functioning is warranted.     

Enhancing the treatment attendance of mentally ill chemical abusers

Patients dually-diagnosed with mental illness and chemical abuse often comply poorly with treatment. The present study tested the hypothesis that attendance at a day treatment program could be increased by offering modest incentives for regular participation. Fifty-three patients, enrolled in a voluntary day treatment program for the mentally ill chemical abuser, were studied for twelve weeks. Attendance was monitored for (a) 4 weeks prior to the incentive intervention; (b) 4 weeks during which an incentive was provided for regular attendance; and (c) 4 weeks following the incentive. The incentive consisted of modest rewards (e.g., coupons from a local restaurant) offered at the end of the week to all patients who attended the program for at least 5 hours a day on at least 3 days in a given week. The results demonstrated that modest incentives can enhance the attendance patterns of the dually-diagnosed.     

Treatment of hand mouthing in individuals with severe to profound developmental disabilities: a review of the literature

This paper reviews studies investigating the assessment and treatment of hand mouthing in individuals with severe to profound developmental disabilities. A literature search identified 101 studies carried out between 1969 and 2004. The trend in the studies indicated a shift away from aversive interventions in the last 10 years, so this review included studies conducted from 1995. Twenty-three studies were identified within this period and were included in this review. The 23 studies were sorted into seven intervention categories and one assessment category. The seven intervention categories included (a) antecedent interventions, (b) multicomponent interventions (e.g., differential reinforcement and response effort), (c) pharmacological interventions, (d) interventions that utilized reinforcement, (e) response blocking interventions, (f) response effort interventions, and (g) sensory stimulation interventions. The one assessment category included studies that investigated the function of hand mouthing. One main finding in these studies was that the various intervention strategies led to decreases in hand mouthing in individuals with severe to profound developmental disabilities. This finding is discussed in relation to its effect on issues of health, adaptive behavior, and social functioning. A second finding indicated that hand mouthing is often maintained by automatic reinforcement (i.e., non-social contingencies). The implications of this finding are discussed in terms of how assessments and treatments associated with automatically maintained challenging behavior might be more effectively linked. Potential issues for future research are also examined.     

Neurotoxicity with combined use of lithium and thioridazine.

Four cases on a combination of lithium and thioridazine developed severe neurotoxic symptoms, e.g., delirium, seizures, encephalopathy and grossly abnormal EEG's. All patients had been on lithium without thioridazine prior to and after the neurotoxic episode with no complications or EEG changes. The possible risk of combining lithium and neuroleptics (thioridazine) is discussed and repeated EEGs are recommended as a preventive measure.     

Ex vivo and in vitro studies of transgene expression in rat astrocytes transduced with lentiviral vectors.

Implantation of cells genetically modified to express therapeutic genes into the brain has been proposed as a potential treatment for neurodegenerative diseases. In the current study embryonic rat-derived astrocytes were cultured and transduced with a lentiviral vector expressing the reporter gene green fluorescent protein (GFP) and subsequently grafted into the adult rat brain. The proportion of GFP expressing cells was stable, albeit small (1%), at all survival times, up to 6 weeks, the longest time point studied. In parallel in vitro studies, the astrocytes were lentivirally transduced to express either one of the two isoforms of glutamate decarboxylase (GAD(65) or GAD(67)) or glial cell line-derived neurotrophic factor (GDNF). When transducing 293T cells with the two GAD vectors, released GABA could be measured using high-performance liquid chromatography. Further studies of rat astrocytes transduced with the same vectors resulted in a level of GAD activity about 10 times higher than the activity of an intact rat striatum. One hundred thousand astrocytes transduced with LV-GDNF released approximately 27 ng of GDNF per hour. Thus, taken together, our observations provide support for the use of rat astrocytes in ex vivo gene transfer of these proteins in animal models of CNS disorders, e.g., Parkinson's disease or epilepsy.