training staff to conduct brief preference...

Training Staff to Conduct Training Staff to Conduct Brief Preference Brief Preference

Assessments Assessments Michele R. Bishop & Amy L. Kenzer

Center for Autism and Related Disorders, Inc.

Accepted for publication in Research in Autism Spectrum Disorders July, 2011

Introduction

• Identification of effective reinforcers is fundamental in ABA-based interventions

• Skill acquisition (e.g., Carr, Nicolson, & Higbee, 2000)• Response reduction (e.g., Roane, Lerman, & Vorndran, 2001)

Introduction

• Training others to conduct preference assessments– Paired stimulus (Lavie & Sturmey, 2002)

• Written instruction, video-modeling, in-vivo rehearsal & feedback– Paired stimulus and MSWO (Roscoe & Fisher, 2008)

• Simulated role-play with adults, video feedback– Paired stimulus, MSWO, and single stimulus (Lerman et al., 2008)

• Lecture, discussion, role-play, modeling and prompting, practice with feedback

Introduction

• Training others to conduct preference assessments– Comprehensive preference assessments

• Focus on how to conduct• Excludes identification of opportunities to conduct and

interpretation of data• Implementation in EIBI therapy sessions

• Frequent & systematic assessment of preference is necessary– Preferences change over time (Carr et al., 2000; Hanley et al., 2006;

Mason et al., 1989; Zhou et al., 2001)

– Pre-session preference assessments can increase correct responding in subsequent session (Gast et al., 2000; Mason et al., 1989)

• Mason et al. – 1 teaching lesson, 10 min• EIBI therapy session – many teaching lessons, several hours

– Regular assessment of preference during EIBI therapy session• Comprehensive preference assessments are impractical• Brief preference assessment require less time to identify reinforcers

Introduction

Introduction

• Brief preference assessments– Brief free operant (Roane et al., 1998)

• Not practical to conduct frequently• Does not allow for a discrete ranking of stimuli

– Brief MSWO (Carr et al., 2000)• Difficult to discriminate between many stimuli in an array

– Brief paired-stimulus (Mason et al., 1989) • One trial, two stimuli, immediately prior to teaching session• Items previously identified as preferred during SS preference

assessment• Average of 30s to 1min• Effective reinforcer, extremely brief, timely administration

Introduction

• Limitations– One trial may be insufficient for items of unknown preference

• Items a child is interacting with• Items based on caregiver report• Novel items

– Preference for items identified in comprehensive preference assessments may change

• Requiring additional preference assessments

Purpose

• Extend research on preference assessment training– Group classroom instruction

• Identification of opportunities to conduct• Correct implementation• Interpretation of data • Within context of EIBI therapy sessions• Brief paired-stimulus preference assessment

– Based on Mason et al. (1989) – no single-stimulus preference assessment, same item selected on 2 consecutive trials

• Evaluate didactic training and need for in-vivo feedback

Method

• Participants– 11 direct care staff providing home-based behavioral

therapy for children with autism

• Setting– Clinic

• Classroom instruction training

– Child’s home• Direct observations & in-vivo feedback• Regularly scheduled therapy session• Discrete trials teaching (DTT)

Method

• Data analysis– Percent of correct brief preference assessment steps

• Identification of opportunity• Correct implementation• Immediate interpretation of data

– Number of different stimuli assessed

– Time required to complete brief preference assessment

– Number of trials needed to identify preferred stimulus

– Percent correct on a pre/post written test

Method

• Experimental design– Multiple probe design across participants

• 11 participants were included in 4 concurrent multiple probe sequences

– Phases• Baseline observations• Didactic training• Post-instruction observation• In-vivo feedback*

– (Roscoe et al., 2006)• Post in-vivo feedback observation*• 4 week follow-up observation

Method

• Baseline– 1 hour observation, regular therapy session– Instructions prior to observations

• Run approximately 5 DTT programs

• Group classroom instruction– Lecture, video modeling, role-play & feedback– Approximately 1 hour– Pre/post test

Method

• Group classroom instruction, cont. – Content

• Review reinforcement & reinforcers• Types of reinforcers • Guidelines for delivering reinforcers • Importance of preference assessments • When to conduct a brief preference assessment• Types of stimuli to include• Conducting brief paired-stimulus preference assessments• How to interpret the data

Method

• Group classroom instruction, cont. – Conducting brief paired-stimulus preference

assessments• When to conduct

– New trial block – Return from a break – Child refuses item when delivered – Child does not consume/play with item – Child requests a different item

Method


assessments• What to include

– Indirect assessments – Direct observation – Capture/contrive establishing operations – Novel stimuli

Method


assessments• How to conduct

– Select 2 items & present them to the child– Have the child select one (“Pick one,” “Which one do you

want”)– Select a 3rd item and present it with the item previously

selected– Have the child select one– Continue until the child selects the same item twice in a

row

Method


assessments• How to conduct

– Video modeling (8 video clips)» Child selects the same item on 1st two trials» Child selects a different item on 2nd trial» Child selects both items» Child requests a 3rd item

Method

• Post-instruction observation– 1 hour observation, regular therapy session– Instructions prior to observations


Method

• In-vivo feedback– Less than 75% correct during post-instruction

observation– Trial-by-trial, least-to-most prompting

• Minimum of 20 min• Vocal feedback • Modeling

• Post in-vivo observation– 1 hour observation, regular therapy session– Instructions prior to observations


Method

• Follow-up observation– Conducted 4 weeks after mastery– 1 hour observation, regular therapy session– Instructions prior to observations


Results

• Group classroom instruction– Scores on pre/post test improved

• Pre test average: 32% (range: 21% to 57%)• Post test average: 77% (range: 43% to 100%)

Results

Results

• Number of different stimuli assessed increased– Average of 0.9 stimuli prior to skill acquisition– Average of 8.4 stimuli following mastery– Average of 3.4 stimuli identified for use per session

• Time required to complete– Average of 20.5 s – Average of 2.8 trials– Average of 4.5 preference assessment per session

Discussion

• Group classroom training usually sufficient– In-vivo feedback necessary for 4 participants

– Partially supports results of Roscoe et al. (2006) • Complexity of EIBI therapy session may contribute to poor

generalization

• Feasible to conduct frequent preference assessment during therapy sessions– Session activities influence motivating operations– Frequent assessment detects shifts in preference

Discussion

• Greater variety of stimuli assessed– Possibility of identifying and developing new preferences

• Children with ASD frequently select staff-reported low preference and novel stimuli (Kenzer & Bishop, 2011)

• New preference can developed through repeated exposure to non-preferred stimuli (Lim et al., 2001)

Discussion

• Limitations– Interaction between didactic and in-vivo training

• In-vivo without didactic

– Future research• Relationship between in-vivo feedback and group classroom

instruction• Relationship between preference assessment teaching method

and maintenance of skills learned– 3 participants with moderate maintenance did not receive in-vivo

feedback

Discussion

• Limitations, cont.– No reinforcer assessment to evaluate stimuli identified

using brief preference assessment– Future research

• Examine reinforcing effects stimuli identified• Relationship between rate of skill acquisition, method used to

identify preferred stimuli, and how often preference assessments are conducted

• Most effective training procedures for use within EIBI therapy

Conclusions

• Train staff to conduct brief preference assessments– Delivery of preferred stimuli is essential in EIBI – Practical to conduct brief preference assessments during

therapy sessions

training staff to conduct brief preference...

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