Title: The use of a self-directed learning program to provide introductory training in pivotal response treatment (also known as pivotal response teaching and pivotal response training) to parents of children with autism.
Publication: Journal of Positive Behavior Intervention. Vol. 12, No.1. 23-32.
Authors: Nefdt, N., Koegel, R.L., Singer, G., & Gerber, M.
Summary: There is increasing demand for access to effective interventions for families who have children with autism. Self-directed learning models have been successfully used with other populations as a way to reduce the service-need discrepancy. The purpose of this study was to evaluate, through a randomized clinical trial, whether the use of a self-directed learning program could result in changes in behavior for parents and their children with autism. Results indicated significant differences between treatment and control groups at posttest on all of the dependent measures. Furthermore, all of the parents who completed the self-directed learning program reported high ratings of satisfaction. The data suggest the efficacy and effectiveness of a self-directed learning program to serve as an initial step toward providing intervention for parents with children with autism.
Title: Using individualized orienting cues to facilitate first-word acquisition in non-responders with autism. (Brief report)
Publication: Journal of Autism and Developmental Disorders. Vol. 39, No. 11. 1587-1592.
Authors: Koegel, R.L., Shirotova, L., & Koegel, L.K.
Summary: Though considerable progress has been made in developing techniques for improving the acquisition of expressive verbal communication in children with autism, research has documented that 10-25% still fail to develop speech. One possible technique that could be significant in facilitating responding for this nonverbal subgroup of children is the use of orienting cues. Using a multiple baseline design, this study examined whether individualized orienting cues could be identified, and whether their presentation would result in verbal expressive words. The results suggest that using individualized orienting cues can increase correct responding to verbal models as well as subsequent word use. Theoretical and applied implications of orienting cues as they relate to individualized programming for children with autism are discussed.
Title: Improving social initiations in young children with autism using reinforcers with embedded social interactions.
Publication: Journal of Autism and Developmental Disorders. Vol. 39, No. 9. 1240-1251.
Authors: Koegel, R.L., Vernon, T.W., & Koegel, L.K.
Summary: Children with autism often exhibit low levels of social engagement, decreased levels of eye contact, and low social affect. However, both the literature and our direct clinical observations suggest that some components of intervention procedures may result in improvement in child-initiated social areas. Using an ABAB research design with three children with autism, this study systematically assessed whether embedding social interactions into reinforcers, delivered during language intervention, would lead to increased levels of child-initiated social behaviors. We compared this condition with a language intervention condition that did not embed social interactions into the reinforcers. Results indicated that embedding social interactions into the reinforcers resulted in increases in child-initiated social engagement during communication, improved nonverbal dyadic orienting, and improvements in general child affect. Theoretical and applied implications are discussed. Adapted from the source document.
Title: Empirically Supported Intervention Practices for Autism Spectrum Disorders in School and Community Settings.
Publication: In Sailor, Dunlap, Sugai, & Horner (Eds.), Issues and Practices.Handbook of Positive Behavior Support, 149-176.
Authors: Koegel, R.L., Robinson, S., & Koegel, L.K.
Summary: With the increasing numbers of children who qualify for a diagnosis of autism spectrum disorders (ASDs), researchers have also seen a contemporaneous increase in the number of interventions available to families of children with autism. Unfortunately, many interventions lack a sound research foundation and are minimally effective or ineffective altogether. Furthermore, research suggests that an eclectic approach to intervention for children with autism is less effective than a single, intensive, scientifically sound intervention in terms of improving cognition, language, and adaptive behavior (Howard, Sparkman, Cohen, Green, & Stanislaw, 2005). Because the earlier that intervention starts the higher the likelihood of more positive outcomes (L. K. Koegel, 2000), ineffective and inefficient interventions can be damaging to the development of a child with autism. In short, if we are to accelerate the habilitation process during the early years, efficacious, effective, and efficient individualized interventions are critical.
Title: Antecedent Stimulus Control: Using Orienting Cues to Facilitate First-Word Acquisition for Nonresponders with Autism.
Publication: Behaviora Analyst. Vol. 32, No. 2. 281-284.
Authors: Koegel, R.L., Shirotova, L., & Koegel, L.K.
Summary: Although considerable progress has been made in improving the acquisition of expressive verbal communication in children with autism, research has documented that a subpopulation of children still fail to acquire speech even with intensive intervention. One variable that might be important in facilitating responding for this nonverbal subgroup of children is the use of antecedent orienting cues. Using a multiple baseline design, this study examined whether individualized orienting cues could be identified, and whether their presentation would result in the production of verbal expressive words. The results showed that this antecedent stimulus control procedure produced improvements in responding to verbal models in all of the children, and subsequent gains in speech for some of the children. Theoretical and applied implications of orienting cues as they relate to antecedent stimulus control for children with autism are discussed.
Title: Behavioral Approaches to Treatment of Infants and Toddlers with Autism Spectrum Disorders.
Publications: In Volkmar and Klin (Eds.), Yale Publication: Autism Handbook, 207-242.
Authors: Koegel, L.K., Koegel, R.L., Werner, G., & Fredeen, R.M.
Summary: (From the chapter) Although few intervention studies have been published for toddlers, the variables that have produced the most positive outcomes for older children with autism spectrum disorders (ASD) are most certainly relevant to toddlers with ASD and those at risk for this diagnosis. These include parent involvement, intensive behavioral intervention (i.e., applied behavior analysis), focus on language remediation, inclusion in the natural environment with typically developing children, long-term intervention, and multicomponent interventions (i.e., focus on language, social-emotional, cognition, and behavior; Levy et al., 2006). Within this general framework, there has been a search for interventions that can produce generalized improvements and target core or pivotal areas that may affect many broad areas of functioning. Hence, the goal is to hasten the habilitation process with more effective interventions beginning at an earlier age. This chapter attempts to synthesize the current knowledge of behavioral interventions for ASD and the application of these approaches to the growing number of toddlers being diagnosed. Furthermore, this chapter also presents considerations unique to this very young population of children and suggestions for treatment delivery. Finally, the chapter concludes with a conceptualization of the next steps for supporting these very young children.
Title: Using perseverative interests to elicit joint attention behaviors in young children with autism: Theoretical and clinical implications to understanding motivation.
Publication: Journal of Positive Behavior Interventions, 9, 214-228.
Authors: Vismara, L.A., & Lyons, G.L.
Summary: Various explanations have been offered in the literature on the underlying cause of joint attention deficits in autism. ne possible explanation is that children with autism are capable of producing joint attention but are lacking the social motivation to share their interests with others. The current study used a single-subjects reversal design with alternating treatments to examine whether joint attention initiations for social sharing would occur as a collateral effect of utilizing the motivational techniques of Pivotal Response Treatment (also known as Pivotal Response Teaching and Pivotal Response Training) in conjunction with perseverative interest stimuli for three young non-verbal children with autism. Results indicated an immediate increase in joint attention initiations when perseverative, or highly-preferred, interests were incorporated within the motivational techniques of Pivotal Response Treatment. Additional findings included collateral increases in joint attention initiations toward less preferred interests, as well as improvements in the quality of interaction between the children and caregivers. Findings are discussed in terms of theoretical and clinical implications for understanding the role of motivation in facilitating the development of joint attention in autism.
Title: Large Scale Dissemination and Community Implementation of Pivotal Response Treatment: Program Description and Preliminary Data.
Publication: Research and Practice for Persons with Severe Disabilities. Vol. 32, No 2. 142-153.
Authors: Bryson, S.E., Koegel, L. K., Koegel, R.L., Openden, D., Smith, I.M., & Nefdt, N.
Summary: This paper describes a collaborative effort aimed at province-wide dissemination and implementation of pivotal response treatment (PRT) - also known as Pivotal Response Teaching and Pivotal Response Training - for young children with autism spectrum disorder (ASD) in Nova Scotia, Canada. Three critical components of the associated training model are described: (1) direct training of treatment teams (parents, one-to-one interventionists, and clinical supervisors/ leaders); (2) training of trainers; and (3) follow-up and monitoring of treatment fidelity and child progress. A major goal of the Dalhousie University/ IWK Health Centre - University of California at Santa Barbara partnership was to optimize effectiveness when translating PRT from the "lab" for dissemination in large geographical areas with community service providers. Finally, we provide data on stakeholder satisfaction with the training workshops and end by identifying features that may have contributed to our success thus far.
Title: Social Development in Individuals with High Functioning Autism and Asperger Disorder
Publication: Research and Practice for Persons with Severe Disabilities. Vol. 32, No 2. 140-141.
Authors: Koegel, R.L.
Title: Strength-based assessment for children with autism spectrum disorders. Research and Practice for Persons with Severe Disabilities.
Publication: Research and Practice for Persons with Severe Disabilities. Vol. 31, No. 2, 134-143.
Authors: Cosden, M., Koegel, L. K., Koegel, R. L., Greenwell, A., & Klein, E.
Summary: Despite improvements in interventions for children with autism, assessments tend to focus on their social, cognitive, and behavioral deficits, without similar systematic examination of their strengths. Strength-based assessment (SBA), which has been used in work with children with milder behavioral disorders, may also have value for individuals who have autism. Although not supplanting usual assessment procedures, SBA provides a method for identifying personal, familial, and broader contextual strengths. Research outside the area of autism has found that SBA can be a useful addition to assessment protocols because it provides specific information on assets that can be incorporated into interventions. Further, SBA has the potential to affect the attitudes and beliefs of parents and educators involved in the assessment, creating greater hope about the ability of the child to function well and contributing to a stronger bond between the assessor, the child, and their family. This article describes ways in which SBA can be added to typical assessment protocols for children with autism. Examples are provided on how to identify and utilize strengths that can be used for planning interventions and for building more effective working relationships between clinicians and children with autism and their families. Areas for future research are also discussed.
Title: Developing a student respite provider system for children with autism.
Publication: Journal of Positive Behavior Interventions. Vol 8, pp. 119-123
Authors: Openden, D., Symon, J. B., Koegel, L. K., Koegel, R. L.
Summary: Many any parents of children with autism and other severe disabilities report heightened levels of stress. The approach delineated here contributes to the wraparound process, one of three interrelated aspects of positive behavior support (PBS) that drive the implementation of a values-based perspective. To recruit potential respite providers, a simple form was developed. The purpose of the respite list was to develop a requested tool for families. Parents also reported collateral effects on their personal, social, and family lives by having access to respite care. Aside from benefiting the family members, the opportunity to provide respite appeared to be advantageous to the respite providers. Further, it appeared that some of the students who provided respite for the families decided to pursue careers in the field on the basis of their respite experience.
Title: Pivotal Response Treatments for Autism. (Note: Pivotal Response Treatment is also commonly known as Pivotal Response Teaching and Pivotal Response Training.)
Publication: Baltimore, MD: Paul H. Brookes.
Authors: Koegel, R. L., & Koegel, L. K.
Summary: An innovative, state-of-the-art treatment for autism, Pivotal Response Treatment (PRT) - also known as Pivotal Response Teaching and Pivotal Response Training - uses natural learning opportunities to target and modify key behaviors in young children with autism, leading to widespread positive effects on communication, behavior, and social skills. The product of 20 years of research from Robert L. and Lynn Kern Koegel--co-founders of the renowned research and training center on autism at the University of California, Santa Barbara--this proven approach is clearly presented in this single accessible volume. Keeping parents involved in every aspect of intervention, educators and therapists can use these research-supported PRT strategies to (a) improve children's academic performance; (b) advance children's communication and language skills; (c) foster social interactions and friendships with typically developing peers; (d) reduce disruptive behaviors; (e) aid early identification and intervention; and (f) reduce ritualistic behaviors and broaden children's interests. Because PRT works with each child's natural motivations and stresses functional communication over rote learning, this comprehensive model helps children develop skills they can really use. With this timely resource, educators, therapists, and parents can support children with autism as they enjoy more positive interactions, more effective communication, and higher academic achievement in natural, inclusive settings.
Title: First S.T.E.P.: A model for the early identification of children with autism spectrum disorders.
Publication: Journal of Positive Behavior Interventions, 7, 247-252.
Authors: Koegel, L. K., Koegel, R. L., Nefdt, N., Fredeen, R. M., Klein, E., & Bruinsma, Y.
Summary: Following is the abstract, taken directly from the article: This forum article outlines an innovative model, Project First Screening, Training, Education, Project, (First S.T.E.P.), for helping families build the skills to establish and sustain communication gains for young children with autism. The project is designed to address the apparent delays in identification of children at risk for Autism Spectrum Disorders. The emphasis is on a "whole family" intervention approach, and the changes that occur are not just with specific child skills but with the ability of the whole family to be more successful.
Title: Training for parents of children with autism: Pivotal responses, generalization, and individualization of interventions.
Publication: In P. S. Jensen & E. D. Hibbs (Eds.), Psychosocial Treatments for Child and Adolescent Disorders. Washington, D.C.: American Psychological Association.
Authors: Schreibman, L. and Koegel, R. L.
Summary: This chapter describes a systematic line of clinical research focusing on the involvement of parents as intervention providers for their children with autism. The authors begin with a brief description of autism and the impact of such children on their parents. The next section of the chapter describes the advantage of parent training over a program in which the child is treated exclusively by clinicians in a clinic setting. Next, the authors discuss the evolution of an optimal form of parent training. The core of this research begins with a comparison of a parent training program that treats only individual target behaviors with a parent training program that focuses on pivotal behaviors in autism (i.e., motivation and responsivity to multiple cues). Because of limitations in the generalization of this approach and continued reported high stress in parents, a third pivotal behavior, self-management, was added. Although it improved overall general intervention success, remaining heterogeneity in intervention outcome suggests the need to develop individualized intervention protocols tailored to individual children and families.
Title: Child-initiated interactions that are pivotal in intervention for children with autism.
Publication: Jensen & Hibbs (Eds.) Psychosocial Treatments for Child and Adolescent Disorders.
Authors: Koegel, L. K.,. Koegel, R. L. & Brookman L. I.
Summary: The authors review empirically supported interventions for children with communication difficulties and present their work, which focuses on a reciprocal parent-child dyad communication approach. They present in detail their model of interactive communication accentuating the child's role as an active communicative partner to enhance language procedures. They also outline the techniques used for teaching children to be active communicators. Preliminary results indicate the promising nature of this procedure, with some evidence of generalization to home settings. The treatment was successful in improving communication with widespread concomitant decreases in disruptive and inappropriate behaviors. The authors recommend that future techniques be designed to promote self-learning and independence to develop more efficient treatments for children with autism, more significant generalization and maintenance treatment gains, and greater reduction of parental stress.
Title: Extending behavior support in home and community settings. In L.M. Bambara & L. Kern (eds). Individualized Supports for Students with Problem Behaviors.
Publication: New York: Guilford Press
Authors: Koegel, L. K., Koegel, R. L., Boettcher, M., & Brookman-Frazee
Title: The effectiveness of contextually supported play date interactions between children with autism and typically developing peers.
Publication: Research and Practice for Persons with Severe Disabilities, 30, 93-102.
Authors: Koegel, R. L., Werner, G. A., Vismara, L. A., & Koegel, L. K.
Summary: Following is the abstract, taken directly from the article: Difficulties with social interaction are characteristic of autism. This study presents data illustrating the use of motivational strategies in play dates to improve the quality of social interactions between children with autism and their typically developing peers. Specifically, a multiple baseline design across participants shows how a contextual support package implemented during play dates can promote reciprocal interactions and improve affect. These results support the use of intervention strategies that target the pivotal area of motivation and provide evidence for using play dates as a context for intervention. The findings are discussed in terms of promoting quality interactions and encouraging friendship development.
Title: Toward a technology of "nonaversive" behavioral support.
Publication: Research and Practice for Persons with Severe Disabilities, 30 (1), 3-10.
Authors: Horner, R.H., Dunlap, G., Koegel, R.L., Carr, E.G., Sailor, W., Anderson, J., Albin, R.W., & O'Neill, R.E.
Summary: Following is the abstract, taken directly from the article: Nonaversive behavior management is an approach to supporting people with undesirable behaviors that integrates technology and values. Although this approach has attracted numerous proponents, more adequate definition and empirical documentation are still needed. This article presents an introduction to the nonaversive approach. Important definitions are suggested, and three fundamental elements are presented: (a) an emerging set of procedures for supporting people with severe challenging behavior; (b) social validation criteria emphasizing personal dignity; and (c) a recommendation for prohibition or restriction of certain strategies. These elements are defined in hopes of stimulating further discussion and empirical analyses of positive behavioral support.
Title: A systematic desensitization paradigm to treat hypersensitivity to auditory stimuli in children with autism in family contexts.
Publication: Research & Practice for Person with Severe Disabilities, 29, 122-134.
Authors: Koegel, R. L., Openden, D., & Koegel, L. K.
Summary: Following is an abstract from the article: Many children with autism display reactions to auditory stimuli that seem as if the stimuli were painful or otherwise extremely aversive. This article describes, within the contexts of three experimental designs, how procedures of systematic desensitization can be used to treat hypersensitivity to auditory stimuli in three young children with autism. Stimuli included the sounds from a vacuum cleaner, blender, hand-mixer, toilet flushing, and specific animal sounds from musical toys. A changing criterion design was used and data were collected on (a) the number of hierarchical steps completed as comfortable with the stimulus per week and (b) the mean level of anxiety per probe. A clinical replication was implemented using a replication of the desensitization procedures for three children. In addition, a systematic replication across three different stimuli is presented for one child in a multiple baseline. The data show that the children's responses could be modified to the point where they were comfortable with these noises. Furthermore, this level of comfort was maintained at follow-up. The discussion suggests that the extreme reactions to auditory stimuli many children with autism exhibit may be decreased with procedures that have been shown to be effective with reducing phobias, and the possibility that the reactions may be symptomatic of a phobia rather than actual pain.
Title: Joint attention and children with autism: A review of the literature.
Publication: Mental Retardation and Developmental Disabilities Research Reviews, 10(3), 169-175.
Authors: Bruinsma, Y., Koegel, R.L., & Koegel, L.K.
Summary: Following is an abstract from the article: Preverbal communication and joint attention have long been of interest to researchers and practitioners. Both attending to social partners and sharing attentional focus between objects or events and others precede the onset of a child's first lexicon. In addition, these prelinguistic acts also appear to have important implications with regard to learning to socialize. The construct of joint attention has been noted as an early developing area prior to the transition to symbolic communication. Thus, the importance of joint attention in typically developing children, and the lack thereof in children with autism, has interested researchers for use in diagnosis and intervention for autism. That is, joint attention has been gaining momentum as an area that not only helps characterize children with autism, but also as a prognostic indicator and a potential intervention goal. In this paper, the status of the literature about initiation of joint attention by young typically developing children and young children with autism was examined. Empirical studies regarding joint attention behaviors, including eye gaze alternation, the use of protodeclaratives and protoimperatives, and studies that investigated joint attention as a predictor of language acquisition were reviewed. Possible areas for future research for children with autism are discussed.
Title: A family-centered prevention approach to PBS in a time of crisis.
Publication: Journal of Positive Behavior Interventions, 5, 55-59.
Authors: Boettcher, M., Koegel, R. L., McNerney, E.K., & Koegel, L.K.
Summary: Following is an abstract from the article: This article describes a family-wide prevention approach to positive behavior support (PBS) interventions during a period of potential crisis for a family with a child with autism. Specifically, the mother in this family was to have major invasive surgery that would require extensive time for recovery. Past functional assessment data and anecdotal evidence indicated that lack of predictability, structure, supervision, and systematic behavior supports all contributed to problem behaviors in this family. As a result, a multicomponent intervention plan was implemented to prevent such problems. The procedures included the following elements: (a) priming intervention, (b) stakeholder meeting, (c) coordination of services and schedules, (d) family-wide PBS plan, and (e) ongoing support. The outcome of this intervention was that the child with autism and her siblings showed decreases in their disruptive behaviors (as opposed to the expected increases), and the family experienced other family-wide collateral positive effects from this proactive intervention approach.
Title: Facilitating social interactions in a community summer camp setting for children with autism.
Publication: Journal of Positive Behavior Intervention, 5, 249-252.
Authors: Brookman, L., Boettcher, M., Klein, E., Openden, D., Koegel R. L., Koegel, L. K.
Summary: Following is an abstract from the article: This article describes a program developed to support the participation of children with autism in a full-inclusion summer day camp program with their typically developing peers. The goal of the program was to support the children in inclusive summer recreational settings and specifically target their social development with typically developing peers. The program contained the following elements: recruiting appropriate aides, providing the aides with ongoing training and support, creating individualized social and behavioral goals for the campers, developing interventions that were contextually appropriate to the camp settings, and communicating with the families during their participation in the program. This article discusses the relevant child, family, agency, and community issues relevant to the implementation of this program.
Title: Effect of Sensory Feedback on Immediate Object Imitation in Children with Autism.
Publication: Journal of Autism and Developmental Disorders, 33, 673-683.
Authors: Ingersoll, B., Schreibman, L., & Tran, Q.
Summary: Following is an abstract from the article: This study examined the effect of sensory feedback (e.g., flashing lights and sound) on the imitation performance of children with autism and typical children group-matched for mental age. Participants were administered an immediate object-imitation task with six novel toys constructed for this study: three with a sensory effect that could be activated by imitating the modeled action and three without a sensory effect. Although overall imitation performance of the participants significantly between groups, the imitation performance of the participants with autism was significantly higher with sensory toys than with nonsensory toys. Typical participants' imitation performance did not differ between the two sets of toys. Both groups played significantly more with the sensory toys during free play, indicating that sensory toys were more reinforcing for both groups. Additional results demonstrated that typical children used significantly more social behaviors during imitation than children with autism, but they did not differ in object-oriented behaviors, replicating previous findings. It is argued that children with autism may be less motivated to imitate by social interaction, but may be motivated to imitate to receive a nonsocial reward (sensory feedback).
Title: Priming as a method of coordinating educational services for students with autism.
Publication: Language, Speech & Hearing Services in Schools, 34, 3, 228-235.
Authors: Koegel, L. K., Koegel, R. L., Frea, W., & Green-Hopkins, I.
Summary: Following is an abstract from the article: The importance of coordination of educational services has been well documented in the literature. For students with disabilities, coordinated programs result in more rapid acquisition of targeted behaviors and the increased likelihood of long-term maintenance of gains. The purpose of this study was to assess whether "priming" or exposing students with autism and disruptive behaviors to school assignments before their presentation in class would affect academic performance and problem behaviors. Two students diagnosed with autism who attended general education classrooms, both of whom exhibited numerous disruptive behaviors and low academic performance, participated in this study. A repeated reversals design was used to monitor student progress. The results demonstrated decreases in problem behavior and increases in academic responding when priming sessions occurred. Application is discussed in terms of a mechanism for speech-language pathologists to assist classroom teachers, with a systematic educational coordination plan that can quickly produce improved school performance.
Title: Empirically supported pivotal response interventions for children with autism. (Note: Pivotal Response Intervention is also commonly referred to as Pivotal Response Treatment, Pivotal Response Teaching and Pivotal Response Training.)
Publication: In Kazdin, Alan E. (ED). Yale University School of Medicine & Child Study Center (Eds), Evidence-based psychotherapies for children and adolescents. New York, Guilford Press.
Authors: Koegel, R. L., Koegel, L. K., & Brookman, L. I.
Summary: This chapter focuses on two pivotal areas, motivation and child initiations, that appear to be especially important in producing widespread improvements for children with autism. Individual child and family characteristics determine the intervention setting and target behaviors for each child. Specifically, the target behaviors are determined based on the individual child's needs, and intervention programs are developed to be consistent with a family's goals, values, and cultural identity. Much of the focus of intervention is on communication skills and appropriate social communication interactions.
Title: Teaching children with autism self-initiations as a pivotal response.
Publication: Topics in Language Disorders, 23, 134-145.
Authors: Koegel, L. K., Carter, C. M., & Koegel, R. L.
Summary: Following is an abstract from the article: The purpose of this study was to assess whether children with autism could be taught a child-initiated query as a pivotal response to facilitate the use of grammatical morphemes. Data were collected within the context of a multiple baseline design across two children who lacked the use of temporal morphemes. Results of the study indicated that both children learned the self-initiated strategy and both acquired and generalized the targeted morpheme. Additionally, generalized use of the self-initiation into other question forms and concomitant increases in mean length of utterance, verb acquisition, and diversity of verb use occurred for both children. These generalized effects and the applications of this procedure across linguistic targets are discussed.
Title: Positive behavior support: Evolution of an applied science.
Publication: Journal of Positive Behavior Interventions, 4, 4-16.
Authors: Carr, E. G., Dunlap, G., Horner, R. H., Koegel, R. L., Turnbull, A. P., Sailor, W.
Summary: Following is an abstract from the article: Positive behavior support (PBS) is an applied science that uses educational and systems change methods (environmental redesign) to enhance quality of life and minimize problem behavior. PBS initially evolved within the field of developmental disabilities and from three major sources: applied behavior analysis, the normalization/inclusion movement and person-centered values. Although elements of PBS can be found in other approaches, uniqueness lies in the fact that it integrates the following critical features into a cohesive comprehensive lifestyle change, a lifespan perspective, ecological validity, stakeholder participation, social validity, systems change and multicomponent intervention, emphasis on prevention, flexibility in scientific practices, and multiple theoretical perspectives. These characteristics are likely to produce future evolution of PBS with respect to assessment practices, intervention strategies, training, and extension to new populations. The approach reflects a more general trend in the social sciences and education away from pathology-based to a new positive model that stresses personal competence and environmental integrity.
Title: Parent education for families of children with autism living in geographically distant areas.
Publication: Journal of Positive Behavior Interventions, 4, 88-103.
Authors: Koegel, R. L., Symon, J. B., & Koegel, L. K.
Summary: Many families who are geographically distant from a center that specializes in intervention for autism are unable to access specialized services for their children. This article describes an evaluation of an intensive, week-long, center-based parent education program that teaches procedures for improving social communication for children with autism. Five representative families who participated in this program are described. Data were collected on parent implementation of target behaviors using specific motivational teaching procedures of Pivotal Response Training (also commonly referred to as Pivotal Response Teaching and Pivotal Response Treatment). Data suggest improvements in the parents' use of the procedures, parent affect, and child expressive language during a week-long parent education session. Furthermore, follow-up measures demonstrate that these positive changes generalized to the families' home communities and maintained over time. These findings suggest the feasibility of a short-term, intensive parent education program for families who live in areas that are geographically distant from an intervention center.
Publication: In M. Hersen & V. B. Van Hasselt (Eds.), Advanced Abnormal Psychology (2nd Edition) (pp 165-189). New York, N: Kluwer Academic/Plenum Publishers.
Authors: Koegel, L. K., Koegel, Valdez-Menchaca, M., Koegel, R. L., & Harrower, J.
Summary: Provides an account of the major findings that have led to the increased understanding of the behavioral manifestations of autism and the development of intervention techniques. Evidence on the etiology and intervention is reviewed within a framework that explores the possibility that neurological or physiological processes may result in an inappropriate level of social interaction which leads to disabilities in communication and other problem behaviors that characterize autism.
Title: Identifying early intervention targets for children with autism in inclusive school settings.
Publication: Behavior Modification, 25, 745-761.
Authors: Koegel, L. K., Koegel, R., Frea W., & Fredeen, R.
Summary: Following is an abstract from the article: This study assessed play and social behavior of young children with autism in inclusive school settings to identify important targets for intervention. Data were collected for 5 children (aged 3-10 yrs old) with autism and for typically developing peers. All children with autism received intervention in one-on-one settings but did not have individual education plan goals that provided systematic intervention for developing play and social skills in their school settings. Results indicated the children with autism and their typically developing peers played with a comparable number of stimulus items (e.g., toys), but the children with autism engaged in these activities for shorter durations. Both children with autism and their typically developing peers engaged in similar levels of social interaction with adults. However, the children with autism rarely or never engaged in social interactions with their peers, whereas the typically developing peers frequently engaged in social interactions with other children. The results suggest important targets for intervention.
Title: Culturally diverse families participating in behavior therapy parent education programs for children with developmental disabilities
Publication: Journal of Positive Behavior Interventions, 3, 120-123.
Authors: Santarelli, G., Koegel, R. L., Casas, J. M., & Koegel, L. K.
Summary: Following is an abstract from the article: Describes a parent education program implemented for the parents of a 6-yr-old Latino boy with autism. The authors discuss cultural diversity and raises extremely important issues regarding cultural sensitivity and cultural competence.
Title: Using choice with game play to increase language skills and interactive behaviors in children with autism
Publication: Journal of Positive Behavior Interventions, 3, 131-151.
Authors: Carter, Cynthia, M.
Summary: Following is an abstract from the article: This study examined the use of providing choice to decrease disruptive behaviors, encourage interactive play, and increase language skills in children with autism. Children with autism often exhibit significant language delays. The developmental literature suggests that language skills may be increased by engaging in play interactions, but children with autism are unlikely to engage in interactive toy and game play. Children with autism also may exhibit extreme disruptive behaviors when confronted with task situations or other interactions they would rather not partake in. However, the literature suggests that providing choice opportunities will increase responding and adaptive behaviors in children with autism. Therefore, this investigation was conducted to assess the effects of choice during language intervention on disruptive behavior, social play/pragmatic behaviors, and language development.
Participants were 3 children who exhibited problem behaviors, a lack of engagement in interactive play, and delayed acquisition of grammatical morphemes. Within a reversal (ABAB) design, a choice and no-choice condition were compared in a naturalistic language intervention procedure using play. In the choice condition, the participant was allowed to choose desired interactive toys and games to be used during the language intervention session and the order of which these games were played. In the no-choice condition, the interventionist selected the interactive games and toys to be used during the language intervention session based on previously selected (i.e., preferred) games by the child. Results indicate that when choice is permitted during language intervention within a play context, disruptive behaviors are considerably reduced, and levels of appropriate social play/pragmatic skills increase, thereby reducing interventionist redirection. Moreover, the children participating in the study only showed generalization of the targeted language structures to their home environments following intervention in the choice condition. Findings are discussed with regard to the importance of providing choice for children with autism, increasing desirable language and social behaviors in these children, and directions for future research.
Title: Pivotal areas in intervention for autism
Publication: Journal of Clinical Child Psychology, 30(1), 19-32.
Authors: Koegel, R.L., Koegel, L.K., & McNerney, E.
Summary: Following is an abstract from the article: This article discusses several core pivotal areas that appear to be influential in intervention for autism. Literature and outcome data are reviewed with respect to several core areas that appear to be particularly helpful in intervention for autism, including improving motivation, responsivity to multiple cues, self management, and self-initiation of social interactions. A conceptual framework is described, and outcome data are reviewed suggesting that when children with autism are motivated to initiate complex social interactions, it may reverse a cycle of impairment, resulting in exceptionally favorable intervention outcomes for many children. Because the peripheral features of autism can be numerous and extensive, the concept of intervention for pivotal areas of functioning may be critical if children are to be habilitated in a time and cost efficient manner.
Title: Incorporating the thematic ritualistic behaviors of children with autism into games: Increasing social play interactions with siblings.
Publication: Journal of Positive Behavior Interventions, 2, 66-84.
Authors: Baker, Mary J.
Summary: Following is an abstract from the article: Investigated an intervention increasing sibling social play interactions by incorporating the thematic ritualistic activities of children with autism into typical games. Subjects were 3 children with autism (aged 5.4-6.8 yrs) and their siblings (aged 7.6-8.6 yrs). Data collected revealed very low levels of sibling play, joint attention, and affect during the baseline condition and high levels of thematic ritualistic behaviors. In contrast, when the children with autism were taught a play interaction based on their thematic ritualistic behavior (e.g., for a child who perseverated on movies, incorporating that theme into a Bingo(R)-style game), the percentage of social interactions and joint attention increased and maintained in 1- and 3-mo follow-up measures. All of the children's affect improved, and the rate of thematic ritualistic behaviors decreased to a minimum or no occurrence. The children's social interactions also generalized to other games and settings. These results imply that children with autism can learn social skills through play and natural interactions in their environment.
Title: Interventions to facilitate communication in autism.
Publication: Journal of Autism and Developmental Disorders, 30, 383-392.
Authors: Koegel, L.K.
Summary: Following is an abstract from the article: The purpose of this article is to discuss research opportunities arising from the current literature in the area of communication. Six general themes were discussed, including (a) increasing spontaneity, initiations, and the variety of functions of language verbal and nonverbal children with autism exhibit; (b) assessing and teaching precursors relating to positive outcome; (c) the importance of family involvement in intervention programs; (d) best practices for implementation of communicative interventions; (e) the interrelationship between language and other behavioral symptoms of autism; and (f) the social and pragmatic use of language. These areas are discussed in terms of improving assessment and intervention practices to produce greater long-term communicative outcomes for individuals with autism.