Reducing Escape without Escape Extinction: A Systematic Review and Meta-Analysis of Escape-Based Interventions

Chazin, Kate T.; Velez, Marina; Ledford, Jennifer R.

doi:10.1007/s10864-021-09453-2

Cited by 16 publications

(6 citation statements)

References 70 publications

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“…Several decision rules were applied to specify the data to be included in effect size calculations: (a) data were included from studies identified as high quality (SCARF quality score ≥1.75, Chazin et al, 2021), (b) as many as the final five data points in baseline and intervention phases were included (consistent with Kahng et al, 2002, and Shawler et al, 2019), (c) for alternating treatment designs data from the most effective intervention were used, (d) for reversal or withdrawal designs only A-B phase contrasts were calculated (not B-A contrasts), only data sets with phase replication were included (e.g., ABAB, ABA, and BAB, Kahng et al, 2002), and those replications involving terminal versions of the intervention were included, (e) for changing criterion designs initial baseline and final phase data were included, (f) primary intervention data were used, exclusive of generalization or maintenance data, or data representing fading of the intervention’s original demand or reinforcement schedules, and (g) SIB data displayed inconsistently with the study design (and therefore unable to be extracted) were excluded.…”

Section: Methodsmentioning

confidence: 99%

A Meta-Analysis of Treatment for Self-Injurious Behavior in Children and Adolescents With Intellectual and Developmental Disabilities

Moore,

Lee,

Freeman

et al. 2024

Behav Modif

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Self-injurious behavior (SIB) among children and youth with developmental disabilities has not diminished in prevalence despite the availability of effective interventions, and the impact on quality of life for people and their families is devastating. The current meta-analysis reviews SIB intervention research between 2011 and 2021 using single-case experimental designs with children and youth up to 21 years old and provides a quantitative synthesis of data from high-quality studies including moderator analyses to determine effects of participant and study characteristics on intervention outcomes. Encouraging findings include a high level of effectiveness across studies in the decrease of SIB (Tau- U = −0.90) and increase of positive behavior (Tau- U = 0.73), as well as an increase in studies (relative to prior reviews) reporting intervention fidelity, generalization, maintenance, and social validity. However, our findings shed limited light on potential moderating variables in the development of interventions for children and youth who exhibit SIB. Of the potential moderators of intervention effects, only implementer (researcher/therapist vs. parent/caregiver) and setting (clinic vs. home) were significantly associated with improved outcomes. We discuss the need for more robust involvement of natural communities of implementers in SIB intervention research to better equip them to effectively and sustainably meet the needs of people they care for. We also discuss the importance of creating systems enabling broad access for children with SIB to effective interventions in service of reducing burden for people, families, and society over time.

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Section: Methodsmentioning

confidence: 99%

A Meta-Analysis of Treatment for Self-Injurious Behavior in Children and Adolescents With Intellectual and Developmental Disabilities

Moore,

Lee,

Freeman

et al. 2024

Behav Modif

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“…It can also be noted that escape extinction was only used in Halbur et al (2021) with little difference in outcomes compared to the other papers, meaning it is possible to increase face mask-wearing in autistic individuals without this intervention component. This is an important finding, as escape extinction can present several issues, such as impaired relationships, restricted autonomy, and increased risk of injury (Chazin et al, 2022). Regarding the generalization of mask-wearing, six studies provided generalization data (Ertel, 2020;Ertel et al, 2022;Halbur et al, 2021;Hough, 2022;Lillie et al, 2021;Sivaraman et al, 2021), and all but one (Hough, 2022) found that results were able to be transferred to novel settings and/or novel face coverings.…”

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

Increasing Face Mask Wearing in Autistic Individuals Using Behavior Analytic Interventions: A Systematic Review and Meta-analysis

Cowell,

Vostanis,

Langdon

2023

J Autism Dev Disord

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The current review aimed to evaluate the effectiveness of behavior-analytic procedures in increasing face mask-wearing in autistic individuals. This comes following recommended guidance during the COVID-19 pandemic. A systematic review and meta-analysis were completed of peer-reviewed and grey literature. Six databases were searched and seven studies using single-case experimental designs met the eligibility criteria which were then quality appraised. Data were extracted on participant characteristics, study design, independent and dependent variables, fidelity, generalization, maintenance, and social validity outcomes. Both the non-overlap of all pairs and Baseline Corrected TAU were used to estimate effect size. Two studies were rated strong and borderline strong quality and five were rated as adequate or below. All studies showed positive outcomes for mask-wearing, with an average of 0.92 for non-overlap of all pairs and 0.47 for Baseline Corrected Tau effect sizes. The most common and effective procedures for increasing mask-wearing were graded exposure and differential and positive reinforcement. Factors such as mode of delivery, implementer, and setting did not appear to influence study outcomes. Procedures were found to be rated as acceptable by parents and professionals in five of the studies. The existing literature on increasing face mask-wearing in autistic individuals provides promising findings to add to existing literature around increasing tolerance to medical equipment and hygiene practices in autistic populations. However, these findings are based on a small sample size, with six of the studies taking place in the United States with varying study quality.

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“…It is clinically important to help our clients build more adaptive topographies of self-advocacy and assent-withdrawal, other than engaging in what the neurotypical society would label as inappropriate or maladaptive behavior. It is fortunate that substantial research has been published on procedures for managing escape-maintained challenging behavior without extinction and the research continues to develop (see Chazin et al, 2022 , for a systematic review of 39 studies). By basing our procedures on the assumption that a client has a fundamental right to choose to assent to treatment in the moment, we may be more likely to ensure that we expose clients to challenging situations when they themselves value it, or at a minimum, when there is sufficient beneficial positive reinforcement that the client finds such challenges “worth it.”…”

Section: Criticism 2: Applied Behavior Analysis Overrelies On Complia...mentioning

confidence: 99%

Affirming Neurodiversity within Applied Behavior Analysis

Mathur,

Renz,

Tarbox

2024

Behav Analysis Practice

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Criticisms of applied behavior analysis (ABA) from the autistic community continue to intensify and have an appreciable impact on research, practice, and conversation in stakeholder groups. ABA providers aspire to increase quality of life for autistic people; thus, it is imperative for providers to listen with humility and openness to the population we serve. Autistic individuals have unparalleled expertise in their own lives and their own communities. The concerns raised by the autistic community cannot, morally or ethically, be swept aside. There may be a misguided and harmful tendency to devalue concerns due to the speaker’s identification as autistic or due to their difference in professional credentials. The concept of neurodiversity can help the ABA field respond to these concerns and collaborate with the largest stakeholders of our services, the autistic clients we serve. This article summarizes some of the key criticisms that autistic advocates raise concerning ABA, discusses the social model of disability and the neurodiversity paradigm, and proposes practical guidance to help the field of ABA integrate neurodiversity and thereby evolve our research and practice. By openly acknowledging the criticisms against ABA and recognizing how we can do better as a field, we believe we can take practical steps towards a profession and a society that more fully embraces inclusion.

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Reducing Escape without Escape Extinction: A Systematic Review and Meta-Analysis of Escape-Based Interventions

Cited by 16 publications

References 70 publications

A Meta-Analysis of Treatment for Self-Injurious Behavior in Children and Adolescents With Intellectual and Developmental Disabilities

A Meta-Analysis of Treatment for Self-Injurious Behavior in Children and Adolescents With Intellectual and Developmental Disabilities

Increasing Face Mask Wearing in Autistic Individuals Using Behavior Analytic Interventions: A Systematic Review and Meta-analysis

Affirming Neurodiversity within Applied Behavior Analysis

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