Effects of decreasing intersession interval duration on graduated exposure treatment during simulated routine dental care

Szalwinski, Julia; Thomason‐Sassi, Jessica L.; Moore, Elizabeth E.; McConnell, Kelly

doi:10.1002/jaba.642

Cited by 18 publications

(6 citation statements)

References 19 publications

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“…This type of treatment approach is consistent with the literature on the use of graduated exposure to treat other escape‐maintained behavior repertoires (e.g., Schmidt et al., 2013 [nonpreferred activities]; Szalinski et al., 2019 [dental procedures]). Graduated exposure proceeds by successively fading in an aversive stimulus and differentially reinforcing compliance with an approach response (i.e., compliance with a medical procedure; Allen & Kupzyk, 2016).…”

Section: Discussionsupporting

confidence: 86%

Assessment and treatment of problem behavior maintained by escape from attention

Cengher

O’Connor

Strohmeier

2021

Behavioral Interventions

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This study describes the assessment and treatment of problem behavior for two participants whose functional analysis results identified escape from attention as the function of problem behavior. Treatment involved functional communication training to teach an appropriate alternative behavior that produced escape from attention. Additionally, in both cases, we expanded treatments by using graduated exposure to attention to facilitate increases in social interaction while maintaining low levels of problem behavior. We discuss findings as they relate to (a) functional analysis procedures to identify escape from attention as a function for problem behavior, (b) treatment strategies to reduce problem behavior, and (c) treatment strategies aimed at decreasing escape from, and avoidance of, social interaction for individuals who demonstrate this problem behavior function.

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Section: Discussionsupporting

confidence: 86%

Assessment and treatment of problem behavior maintained by escape from attention

Cengher

O’Connor

Strohmeier

2021

Behavioral Interventions

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“…“The second phase consisted of graduated exposure to the contextual variables that evoked aerophagia”. This method of gradually introducing contexts that evoke problematic behavior is consistent with graduated exposure therapy (e.g., Allen & Kupzyk, 2016 [medical procedures]; Schmidt et al, 2013 [nonpreferred activities]; Szalwinski et al, 2019 [dental procedures]), where the presumably aversive stimulus is introduced gradually and approach responses are reinforced. In our case, we increased the number of experimenters present during the session from one to two (at session 77).…”

Section: Course Of Treatment and Assessment Of Progressmentioning

confidence: 99%

“…However, such assessment and treatment approaches have been demonstrated to be highly successful for a wide range of topographies of behavior, including different other forms of self-injury, aggression, and disruption (Beavers et al, 2013). We specifically want to highlight that the use of graduated exposure procedures can be highly effective for escape-maintained behaviors that are common in individuals diagnosed with phobias (e.g., Allen & Kupzyk, 2016 [medical procedures]; Schmidt et al, 2013 [nonpreferred activities]; Szalwinski et al, 2019 [dental procedures]). Our study extended this graduated exposure literature by demonstrating the effectiveness of these procedures on behaviors that are not escape maintained.…”

Section: Recommendations To Clinicians and Studentsmentioning

confidence: 99%

Behavioral Assessment and Treatment of Aerophagia

Cengher

Strohmeier

2021

Clinical Case Studies

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Aerophagia is characterized by excessive air swallowing and can have serious negative effects on one’s health. We present the assessment and treatment of a 16-year-old girl, Khloe, with developmental disabilities and aerophagia. The initial assessment indicated that aerophagia occurred primarily to access attention in a divided attention context; however, our function-based treatment did not result in a clinically significant reduction in problem behavior. We then conducted a second assessment that indicated that Khloe’s aerophagia indeed occurred primarily in a divided attention context, but that it persisted independent of social consequences. We concluded that the divided attention context served as a motivating variable for aerophagia. Our second treatment consisted of differential reinforcement of other behavior, noncontingent access to competing stimuli, and graduated exposure to contextual variables (i.e., people and divided attention) that occasioned aerophagia. The treatment was successful in reducing rates of aerophagia. We discuss implications for assessment and treatment, as well as recommendations for clinicians and students.

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“…Researchers have also identified several evidence-based behavioral interventions that are effective for increasing cooperation or decreasing fear-correlated measures (e.g., crying or screaming) during health care procedures (for reviews, see Kupzyk & Allen, 2019 ; St. Joseph & Machalicek, 2022 ). These interventions include gradually exposing the patient to elements of the procedure (e.g., Cavalari et al, 2013 ; Grider et al, 2012 ; Kupzyk & Allen, 2019 ; Szalwinski et al, 2019 ), pairing preferred items or activities with putative aversive procedures (Gorski et al, 2004 ; Jensen et al, 2020 ; Nordahl et al, 2016 ), providing frequent breaks from the procedures (O’Callaghan et al, 2006 ), preventing escape from the procedure contingent on disruptive behavior (i.e., escape extinction; Szalwinski et al, 2019 ), and providing reinforcement for cooperation (Cavalari et al, 2013 ; Grider et al, 2012 ; Stuesser & Roscoe, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Virtual Training of Medical Students to Promote the Comfort and Cooperation of Patients with Neurodevelopmental Disabilities

Hoang

Lerman

Nguyen

2023

J Autism Dev Disord

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Patients with neurodevelopmental disabilities generally have less access to necessary medical care compared to those without disabilities. Barriers to adequate care include patient fear and uncooperative behavior during routine medical procedures and inadequate preparation of medical professionals to treat this population. Researchers have identified multiple behavior-analytic procedures for promoting comfort and cooperation during medical treatments. Efficient, cost-effective training programs are needed to widely disseminate behavior-analytic procedures to medical students and professionals. The purpose of this study was to assess the efficacy of a virtual training to prepare medical students to implement behavioral procedures that could be easily incorporated into typical wellness examinations. Seven medical students received behavioral skills training (BST) delivered remotely via the Internet. Results showed that the training successfully increased students’ correct implementation of the procedures in roleplay with the experimenter and with patients with neurodevelopmental disabilities. Responding also maintained at high levels 2 weeks after the training. These findings suggest that virtual BST is an efficient, practical approach for training health care professionals to implement general behavior management strategies to increase the comfort and cooperation of patients with NDD.

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Effects of decreasing intersession interval duration on graduated exposure treatment during simulated routine dental care

Cited by 18 publications

References 19 publications

Assessment and treatment of problem behavior maintained by escape from attention

Assessment and treatment of problem behavior maintained by escape from attention

Behavioral Assessment and Treatment of Aerophagia

Virtual Training of Medical Students to Promote the Comfort and Cooperation of Patients with Neurodevelopmental Disabilities

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