The use of auditory feedback and edible reinforcement to decrease toe walking among children with autism

Wilder, David A.; Ertel, Hallie; Hodges, Ansley C.; Thomas, Rachel; Luong, Nga

doi:10.1002/jaba.607

Cited by 11 publications

(9 citation statements)

References 14 publications

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“…Several studies endorse the use of video recording for gait assessment in both orthopedic and neurological conditions (Brunnekreef et al, 2005; Damsted et al, 2015; Dickens & Smith, 2006; Wren et al, 2005). Furthermore, gait video recording has previously been utilized as an outcome measure to evaluate the efficacy of interventions in individuals with ASD and TTB, as evidenced by four case studies (Hodges et al, 2018; Marcus et al, 2010; Persicke et al, 2014; Wilder et al, 2020). The video‐recording approach allows both reviewing the tasks and using a slow‐motion technique.…”

Section: Discussionmentioning

confidence: 99%

“…Remarkably, among the included studies, only one quantified TTB by calculating the mean percentage of flat-footed steps using a video-recording approach (Persicke et al, 2014). In the following years, using the same approach, other studies quantified TTB but they calculated the mean percentage of toe steps (Hodges et al, 2018;Wilder et al, 2020Wilder et al, , 2022. Recently, Barkocy et al (2021) quantified TTB using a gait analysis approach.…”

Section: Quantitative Assessmentmentioning

confidence: 99%

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Quantitative assessment of tip‐toe behavior in individuals with autism spectrum disorder and intellectual disability: A cross‐sectional study

Valagussa,

Purpura,

Balatti

et al. 2023

Autism Research

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The term “toe walking” describes walking on the toes with a lack of heel strike upon initiation of the stance phase of gait. In individuals with autism spectrum disorder (ASD), this phenomenon, or “tip‐toe behavior” (TTB), can be present in a substantial proportion of subjects even during standing. In this study, we investigated TTB in 50 persons with ASD (age range 4–26 years). We evaluated TTB through an observational/report‐based assessment protocol. Subsequently, we employed a new structured video‐based coding protocol based on standardized video recordings, focusing on static and dynamic conditions. Finally, the findings of the two protocols were compared. Twenty‐four subjects with TTB were identified and classified according to three functional groups: TTB1, present only during running (6 subjects); TTB2, present during walking and running (11 subjects); and TTB3, present during standing, walking, and running (7 subjects). Moreover, we found that TTB3 subjects exhibited a significantly higher quantity of TTB compared with subjects in the TTB1 and TTB2 groups during both standing and walking tests. Additionally, a high quantity of TTB in the static test was found to be related to a high quantity of TTB in the dynamic test. Variables such as age, autism severity, intellectual disability, and gender were not significantly associated with the mean percent of TTB both in static and dynamic tests in multivariate analysis. This structured video‐based coding approach appears feasible and useful for assessing TTB in individuals with ASD and it has the potential to provide insights into TTB trajectories and aid in designing possible interventions.

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Section: Discussionmentioning

confidence: 99%

Section: Quantitative Assessmentmentioning

confidence: 99%

Quantitative assessment of tip‐toe behavior in individuals with autism spectrum disorder and intellectual disability: A cross‐sectional study

Valagussa,

Purpura,

Balatti

et al. 2023

Autism Research

View full text Add to dashboard Cite

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“…Behavioral interventions for ITW include punishment‐based procedures (Charlop et al., 1988), differential reinforcement (Lancioni et al., 2013), stimulus control procedures (Hodges et al., 2018), and feedback paired with reinforcement (Wilder et al., 2020). Charlop et al.…”

Section: Introductionmentioning

confidence: 99%

“…Finally, Wilder et al. (2020) evaluated a feedback procedure to reduce ITW. Specifically, these researchers used gait spot squeakers, which strap around participant's shoes and produce an audible squeak contingent upon an appropriate heal‐to‐toe step, to reduce ITW.…”

Section: Introductionmentioning

confidence: 99%

“…Behavioral interventions for ITW include punishment-based procedures (Charlop et al, 1988), differential reinforcement (Lancioni et al, 2013), stimulus control procedures (Hodges et al, 2018), and feedback paired with reinforcement (Wilder et al, 2020). Charlop et al (1988) compared the varied presentation of three punishment procedures to the presentation of a single punisher to decrease a number of challenging behaviors, including ITW.…”

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confidence: 99%

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Evaluation of shoe inserts to reduce toe walking in young children with autism

Wilder

Ingram

Hodges

2021

Behavioral Interventions

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Toe walking is relatively common among children with autism spectrum disorder and, if untreated, can contribute to a number of medical problems. Previous research has suggested that toe walking may vary by walking surface. Some (e.g., rough) surfaces may inhibit toe walking, whereas other surfaces may encourage it. In the current study, we first conducted a functional analysis screening to verify that toe walking exhibited by two young children with autism was maintained by automatic reinforcement. Next, we assessed toe walking on a variety of surfaces, including tile, artificial grass, and grip tape. Finally, we placed inserts of the surface associated with the lowest level of toe walking into each participant's shoes. The inserts were effective to nearly eliminate toe walking by one participant and reduce toe walking to low levels for the second participant. To decrease the second participant's toe walking further, we added a hand-on-shoulder procedure, which was also effective. We discuss the results in terms of the putative mechanisms responsible for the reduction.

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Further evaluation of a hands‐on‐shoulder plus praise procedure to reduce toe walking

Wilder,

Sheppard,

Izquierdo

et al. 2023

Behavioral Interventions

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Idiopathic toe walking (ITW) refers to ambulation with a toe‐to‐toe gait in the absence of a known cause. Although it is exhibited by typically developing children, it is more common among children with autism spectrum disorder (ASD). Persistent ITW can cause several long‐term medical problems, including ankle deformities and balance and posture abnormalities. In the current study, we first conducted a series of no interaction or alone conditions to verify that ITW exhibited by four children with ASD persisted in the absence of social consequences. We then evaluated a hands‐on‐shoulder plus praise procedure in which gentle pressure is applied to participants' shoulders to prompt their heels to contact the ground, along with praise for appropriate steps in order to reduce ITW. Results suggest that the procedure was effective with all participants, and measures of social validity indicate that caregivers approved of the procedure. We discuss the results in terms of the putative mechanisms responsible for the effects of the procedure as well as the conditions under which the procedure might be used.

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The use of auditory feedback and edible reinforcement to decrease toe walking among children with autism

Cited by 11 publications

References 14 publications

Quantitative assessment of tip‐toe behavior in individuals with autism spectrum disorder and intellectual disability: A cross‐sectional study

Quantitative assessment of tip‐toe behavior in individuals with autism spectrum disorder and intellectual disability: A cross‐sectional study

Evaluation of shoe inserts to reduce toe walking in young children with autism

Further evaluation of a hands‐on‐shoulder plus praise procedure to reduce toe walking

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