Our purpose in this systematic review was to identify, evaluate, and summarize the single-case research design studies examining behavioral interventions to address self-injurious behavior for young children with autism spectrum disorder. We identified 24 studies published between 2000 and 2016 that met the inclusion criteria. We reviewed and coded each study across five content areas using systematic procedures. These content areas consisted of the methodological quality of single-case research designs, children's demographic information, conditions under which the intervention was implemented, characteristics of intervention, and outcomes. Our findings indicate that procedural integrity data were reported for only one study and social validity for two studies. The majority of studies were implemented by researchers or therapists in the school setting. For 24 of 30 children included in the studies reviewed, the authors taught a replacement behavior selected on the basis of an assessment conducted prior to intervention. All authors reported a decrease in the self-injurious behavior post-intervention. A limited number of authors examined generalization and maintenance of low rates of self-injurious behavior. Limitations of the present review and future directions and implications for research and practice are discussed.
In this study, we extended the literature on the generalization of negatively-reinforced mands in three young children with autism spectrum disorder (ASD). First, we used example and nonexample stimuli embedded in mand training to teach a new, socially appropriate, negatively-reinforced mand to reject unpreferred food items while continuously assessing mand discrimination. Second, we evaluated the discriminated generalization of the newly acquired mand by using untrained example and nonexample stimuli. Finally, we conducted maintenance probes to examine if the new, discriminated mand occurred over time in the absence of training. Results suggest that our mand training produced acquisition of a discriminated negatively-reinforced mand in all three children. Data indicate that the newly acquired, discriminated mand generalized to untrained food items and was maintained after training was discontinued. We discuss the conceptual significance and clinical implications of using example and nonexample stimuli to produce acquisition, generalization, and maintenance of negatively-reinforced mands in young children with ASD and language delays.
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