Continuity of Treatment: Toilet Training in Multiple Community Settings

Abstract

This study investigates the toilet training of four severely handicapped autistic children who regularly participated in a number of diverse community settings. In the context of a multiple baseline design, the children were first provided a systematic toilet training program in only some of the environments. In a subsequent "continuity" condition, the same toilet training pro gram was systematically and simultaneously im plemented within all of the children's environments. Results showed no consistent trends towards acquisi tion when training was provided in only some of the settings, even when the program was in progress for over two years. However, the continuity approach which coordinated all of the children's daily activities produced immediate and steady gains in successful toileting. This success was evident with children who had long histories of unsuccessful training attempts as well as with a child who had no previous exposure to toilet-training programs of any kind, These data are discussed in terms of the need for and benefits of con tinuity of treatment across settings for severely handi capped individuals.As a result of legislation (e.g., PL 94-142) and the development of effective training strategies, increas ing numbers of severely handicapped children are residing in community settings and participating in a variety of community-based programs and facilities.

Parent Training in Autism Spectrum Disorder: What’s in a Name?

“…Self-guided resources such as No More Meltdowns (Baker, 2008); Understanding Why Problem Behaviors Occur (Frea, Koegel, & Koegel, 1994); Toilet Training in Children with Severe Handicaps (Dunlap, Koegel, & Koegel, 1984) are available for clinicians and parents. As principles of applied behavior analysis (ABA) are commonly used in the treatment of disruptive behavior and focal problems in children with ASD, programs tend to be highly individualized, time-limited, and target problem-specific, with varying degrees of parental involvement (Odom, Boyd, Hall, & Hume, 2010; Odom et al, 2003).…”

A Randomized Clinical Trial Comparison Between Pivotal Response Treatment (PRT) and Adult-Driven Applied Behavior Analysis (ABA) Intervention on Disruptive Behaviors in Public School Children with Autism

“…al., 2005). However, the effects of the intervention may have been greater with coordination across environments (Dunlap, Koegel, & Kern, 1984). Another concern is that although the adult-directed ABA SLPs were receiving active feedback from an organization in California, which included the use of systematic prompting and prompt fading, may have been outdated.…”

Project DATA (Developmentally Appropriate Treatment for Autism)

“…Each child had a resource coordinator, who served as the liaison for the classroom, the extended day program, the family, and any other family-negotiated services providers. This collaboration was important for facilitating optimal outcomes for children and reducing stress on the family (e.g., Donnegan, Ostrosky, & Fowler, 1996;Dunlap et al, 1984). In addition, the resource coordinator was the transition facilitator as the children prepared to leave our program.…”

“…2. They include highly supportive teaching environments and generalization strategies (Dunlap, Koegel, & Koegel, 1984; Gaylord-Ross, Haring, Breen, & Pitts-Conway, 1984;McBride & Schwartz, 2003). 3.…”