No abstract

The present study evaluated graduated exposure and positive reinforcement in a compliance training intervention package with an adolescent female who had autistic disorder, intellectual disability, and long-standing avoidance of routine medical examination. Intervention consisted of slowly introducing her to a 12-step examination hierarchy and reinforcing compliant responding within a changing criterion experimental design. Reinforcement for appropriate alternative behavior and modeling were also components of intervention. A behavioral clinician first implemented procedures that were subsequently generalized to nurses. The participant learned to comfortably tolerate a medical examination that she had resisted for nearly 2 years. We discuss clinical and research implications of the case.

In order to improve discrimination accuracy between Autism Spectrum Disorder (ASD) and similar neurodevelopmental disorders, a data mining procedure, Classification and Regression Trees (CART), was used on a large multi-site sample of PDD Behavior Inventory (PDDBI) forms on children with and without ASD. Discrimination accuracy exceeded 80 %, generalized to an independent validation set, and generalized across age groups and sites, and agreed well with ADOS classifications. Parent PDDBIs yielded better results than teacher PDDBIs but, when CART predictions agreed across informants, sensitivity increased. Results also revealed three subtypes of ASD: minimally verbal, verbal, and atypical; and two, relatively common subtypes of non-ASD children: social pragmatic problems and good social skills. These subgroups corresponded to differences in behavior profiles and associated bio-medical findings.

While the use of computer-based communication, video recordings, and other "electronic" records is commonplace in clinical service settings and research, management of digital records can become a great burden from both practical and regulatory perspectives. Three types of challenges commonly present themselves: regulatory requirements; storage, transmission, and access; and analysis for clinical and research decision-making. Unfortunately, few practitioners and organizations are well enough informed to set necessary policies and procedures in an effective, comprehensive manner. The three challenges are addressed using a demonstrative example of policies and procedural guidelines from an applied perspective, maintaining the unique emphasis behavior analysts place upon quantitative analysis. Specifically, we provide a brief review of federal requirements relevant to the use of video and electronic records in the USA; non-jargon pragmatic solutions to managing and storing video and electronic records; and last, specific methodologies to facilitate extraction of quantitative information in a cost-effective manner.

Agenesis of the corpus callosum (AgCC) is a congenital disorder that disrupts the development of neurological structures connecting the right and left hemispheres of the brain. In addition to neurological symptoms, many individuals with AgCC demonstrate marked deficits in social, communication, and adaptive skills. This paper presents two case studies of congenital AgCC in siblings with socioemotional and behavioral symptoms consistent with developmental disability, but with notably different symptom presentations and clinical needs. Conclusions from these cases suggest that unique symptom profiles of individuals with AgCC warrant careful consideration for referral to appropriate academic and habilitative services.