Effects of sociodramatic play training on children with autism

We assessed the effects of teaching sociodramatic play to three children with autism. The training was conducted using a variation of Pivotal Response Training (PRT), a program traditionally used to teach language to children with autism. Measures of play skills, social behavior, and language skills were obtained before treatment, after treatment, and at a followup period. The correlation between language and pretend play was explored, as was the relationship between sociodramatic play and social competence. Positive changes were observed in play, language, and social skills. These changes generalized across toys and settings, although little generalization to other play partners occurred. Effects of play training with children with autism and maintenance of behavior change is discussed.This research was supported by U. S. Public Health Service research grants MH39434 (Laura Schreibman, Principal Investigator) and MH28210 (Robert L. Koegel, Principal Investigator) from the National Institute of Mental Health. The authors thank Tami Schiern, Jay Goldschmidt, and Stacy Amano for assistance in data collection and reliability; Karen Pierce and Doug Anderson for reviewing an earlier draft of the paper, and in particular the families and teachers who participated in the project.     

Stimulus complexity and autistic children's responsivity: Assessing and training a pivotal behavior

Interdisciplinary research suggests that autistic children's limitations in responding to environmental stimuli may be directly related to the number of components contained in the stimuli; as the number of components increases, such children hypothetically would exhibit greater difficulties in responding. The central purpose of this experiment was to assess whether such children indeed exhibit greater difficulties in responding as the number of components contained in an environmental stimulus was increased from one to four. If the children's responsivity was a function of stimulus complexity, a second focus of this experiment was to assess the feasibility of teaching them to respond to a complex environmental stimulus containing up to four components and to determine whether the effects of the intervention would generalize to other situations involving complex structured and social stimuli. Data gathered using a multiple baseline design across behaviors and children indicate that all of the children exhibited fewer correct responses to a stimulus as the number of stimulus components was increased from one to four. The results further showed that the training program used in this investigation was effective in producing some generalized increases in the children's responses to complex structured and social stimuli. Conceptualizing autistic children's responses to complex multicomponent stimuli as a pivotal target behavior that can be operationally defined may have important implications for understanding and altering the children's responsivity and development.This investigation was supported in part by U.S. Department of Education, Special Education Program Research Contract No. RFP82-021 and U.S. Public Health Service Research Grants MH28210 from the National Institute of Mental Health. The investigation was conducted as the first author's dissertation while in the joint doctoral program at the University of California, Sant Barbara, and the University of California, San Francisco Medical School. The authors are grateful to Robert L. Koegel, Sanford E. Gerber, Thomas G. Haring, Michael M. Merzenich, and Roberta Babbitt for their valuable comments and to Terry Antonious, Shannon Bliss, Tricia Krakauer, Sarah Mitnick, Clodagh Murphy, and Erica Styles who provided assistance during the investigation.     

Rapid eye movement (REM) activity in normal and autistic children during REM sleep

Thirty normal children (aged 3–68 months) and 16 autistic children (aged 36–62 months) were recorded during nonmedicated sleep and data pertaining to rapid eye movements (REM) were measured during the first three REM periods of the night. When time of night from which data were gathered was held constant, normal children showed a significant relationship between age and the organization of eye movements into discrete bursts. When autistic children were compared to age-matched normal controls, they showed an immaturity in this phenomena, their results being similar to those found in children less than 18 months of age. Such an immaturity could result from dysfunction at a number of diverse levels and sites in the central nervous system.Supported by the Grant Foundation, by U.S. Public Health Service Research Scientist Development Award MH47361 to Dr. Tanguay, and by U.S. Public Health Service Grants MH26047, MH13517, HD04612 and HD05958. Computing assistance was obtained from the Health Sciences Computing Facility, UCLA, sponsored by National Institute of Health Grant RR-3.     

The effects of physical exercise on self-stimulation and appropriate responding in autistic children

A major problem encountered with autistic children is their characteristic self-stimulatory behavior, which frequently interferes with on-task responding and other appropriate behaviors. However, the experimental literature suggests that with many populations, increased physical activity might positively influence subsequent responding. Therefore, the purpose of this study was to investigate the use of increased physical activity (in this experiment, jogging) as a possible method of decreasing subsequent self-stimulatory behaviors as well as increasing subsequent appropriate responding. Seven autistic children with exceptionally high levels of self-stimulatory behavior participated in the investigation. Self-stimulatory and appropriate behaviors were measured both before and after jogging in a repeated-reversal design. The results demonstrated the following: (1) Brief jogging sessions produced decreases in subsequent levels of self-stimulatory behaviors and also produced increases in appropriate play and academic responding; (2) These changes after jogging were evident in three different experimental settings: during academic responding on preschool level tasks in a clinic; during ball-playing in an outside play area; and in a quiet room, while no other activity was occurring; (3) Supplementary measures obtained in an applied classroom setting showed a similar relationship with both increases in on-task activity and general interest ratings for school tasks following the jogging sessions.This research was supported by Public Health Service research grants MH28210 and MH28231 from the National Institute of Mental Health, and by U. S. Office of Education research grant G007802084 from the Bureau of Education for the Handicapped. We are grateful for the assistance of Stephen C. Luce, Julie Kasanoff, Marie Nugent, Robin Gaines, Gina Deluchi, Rosanna Conti, Carl Bendroff, David Rotholz, Christine Chivas, Katherine Kuba, Linda Diaa, Diane Gilchrist, and Virgina Kostigen. We are especially grateful for the help and comments of Jill Hodgett and Glen Dunlap throughout this investigation.     

A natural language teaching paradigm for nonverbal autistic children

The purpose of this study was to attempt to improve verbal language acquisition for nonverbal autistic children by manipulating traditional teaching techniques so they incorporated parameters of natural language interactions and motivational techniques. Within a multiple baseline design, treatment was conducted in a baseline condition with trials presented serially in a traditional analogue clinical format where the therapist presented instructions, prompts, and reinforcers for correct responses. Then, these variables were manipulated in the natural language teaching condition such that (a) stimulus items were functional and varied, (b) natural reinforcers were employed, (c) communicative attempts were also reinforced, and (d) trials were conducted within a natural interchange. Treatment and generalization data demonstrated that manipulation of these variables resulted in broadly generalized treatment gains. Implications for language intervention are discussed.This Investigation was supported by U.S. Public Health Service Research Grants MH 28210 and MH 28231 from the National Institute of Mental Health, by U.S. Department of Education, Contract No. 300-82-036, and by Biomedical Research Support Grant RR07099-17 from the National Institute of Health. However, the opinions expressed herein do not necessarily reflect the position or policy of any of the above-mentioned agencies. The authors would like to express appreciation to Jean Bramer, Karen Kozloff, Sue Risi, Ilene Schwartz, Connie Wehara, and Mary Zimmer for assisting in the clinical treatment, data collection, and conceptual input during this research.     

Measuring musical abilities of autistic children

Three normal children with reported musical ability and three autistic children were tested for the ability to imitate individual tones and series of tones delivered by voice, piano, and synthesizer. Accuracy of imitation was judged by two independent observers on the basis of pitch, rhythm, and duration. The autistic children overall performed as well as or better than the age-matched normal children. These results are discussed and their implications for future neurological and clinical research are considered.This research was supported by P. H. S. Research Grants MH-28210 and MH-28231 from the National Institute of Mental Health and by U. S. Office of Education Grant G007802084 from the Bureau of Education for the Handicapped. The authors wish to express their appreciation for the cooperation and support of the Devereaux Foundation, Goleta, California, throughout this investigation.     

The influence of vigorous versus mild exercise on autistic stereotyped behaviors

A major problem encountered in many autistic children is their high rate of stereotypic behavior, which has been shown to interfere with on-task responding and other appropriate behaviors. Since the experimental literature indicates that physical exercise can positively influence both appropriate and inappropriate behaviors, including the children's stereotypic behaviors, the purpose of this study was to investigate whether the specific type of exercise (i.e., mild vs. vigorous) would differentially affect subsequent stereotyped behaviors. The results demonstrated that (1) 15 minutes of mild exercise (ball playing) had little or no influence on the children's subsequent stereotyped responding, and (2) 15 minutes of continuous and vigorous exercise (jogging) was always followed by reductions in stereotyped behaviors. These results are discussed in relation to cognitive, physiological, and educational implications. This research was supported by United States Public Health Service research grants MH 28210 and MH 28231 from the National Institute of Mental Health, and by Research Contract No. 300-82-0362 from the U.S. Department of Education-Special Education Program. The authors are grateful for the contributions of Diane Gilchrist, Julie Martin, Karen Sallus, Lynne Bonngard, Bill Krutzen, Lee Kern, John Burke, and Rob O'Neill.     

A controlled crossover study of triiodothyronine in autistic children

A placebo-controlled crossover study of behavioral effects of triiodothyronine (T₃) was conducted in 30 young clinically euthyroid autistic children. Multiple independent raters and multiple rating scales were used. Except for a few symptoms that were reduced on T₃, the drug did not differ from placebo. Time itself accounted for most of the improvement in the whole sample. As a group, the lower IQ children responded to T₃. The individual children who were responders could not be defined by any parameter.This study was supported in part by Public Health Service Grant No. MH04665 from the National Institute of Mental Health. The authors wish to express their gratitude to Dr. Nancy Branom (Department of Radiology) and Dr. Ralph David (Department of Pediatrics) for their collaboration, to Mrs. Kathleen Nash, R.N., and Mrs. Sara Sol for their efforts in this study, and to Smith, Kline & French Laboratories for the medication supply.     

Introduction to special issue commemorating the 10th anniversary of September 11, 2001

Dr Boscarino was in the World Trade Center complex on September 11, 2001 when the first plane struck the Twin Towers. His World Trade Center work was supported in part by grants from the National Institute of Mental Health (Grants # R01 MH66403 and R21-MH-086317) and the Pennsylvania Department of Health (Contract #4100042573).     

The acquisition of grammatical morphemes in autistic children: A critique and replication of the findings of Bartolucci,Pierce, and Streiner, 1980

The correct use of 13 morpheme rules by a group of 16 autistic children was investigated. The percentages of different morphemes used correctly correlated significantly with the results reported in an earlier study of Bartolucci, Pierce, and Streiner (1980), and internal consistency among the autistic children suggested some evidence of rule learning. As in the Bartolucci study, there were no significant correlations with the data presented by DeVilliers and DeVilliers (1973) for younger children. However, the conclusions drawn by Bartolucci et al. regarding the deviant nature of syntax acquisition by autistic children are questioned on various methodological grounds. More satisfactory ways of comparing language development in different groups of children are discussed. The work reported in this study was funded by a generous grant from the Department of Health and Social Security. The home-based treatment program discussed was a collaborative project undertaken with Dr. M. Berger, Mrs. R. Hemsley, Mrs. D. Holbrook, Dr. L. Hersov, Prof. M. Rutter, and Dr. W. Yule of the Institute of Psychiatry and Maudsley Hospital, London.     

Producing speech use in nonverbal autistic children by reinforcing attempts

It has been extremely difficult to teach speech to severely handicapped nonverbal autistic children. However, an overview of the literature suggests the possibility that selecting aspects of motivation as a central target behavior, rather than concentrating on motor speech production per se, may improve the effectiveness of teaching speech to these children. Therefore, the purpose of this experiment was to compare two different reinforcement conditions; one in which successive motor approximations of speech sounds were reinforced; and a motivation condition in which attempts to produce speech sounds were reinforced, without any motor shaping of speech. The results, replicated within a repeated reversal disign, showed that reinforcing speech attempts was more effective than reinforcing motor speech sounds with respect to (a) the children's interest, enthusiasm, happiness, and general behavior during treatment; and (b) improvements in the children's speech production. The results are discussed in terms of their relationship to the literature on normal parent-child speech interaction, success and failure, and learned helplessness.This research was supported by Public Health Research Grants No. MH28210 and MH39434 from the National Institute of Mental Health, U.S. Department of Education (Special Education Program) Research Contract No. 300-82-0362, and a grant from the California Community Foundation.     

Parents of children with emotional disorders: Issues for consideration and practice

Parents with children who have serious emotional disorders face significant personal and family issues in their parental role. Professionals providing services to these families must be sensitive to a variety of issues if they are to provide an emphathic context when these families are seeking help. This paper will explore the stress these families incur, the loss they experience, and the resources needed for coping and the preservation of family integrity. Practice implications will be addressed.This article was partially developed with funding from the National Institute on Disability and Rehabilitation Research, U.S. Department of Education and the National Institute of Mental Health, U.S. Department of Health and Human Services (NIDRR grant number G008435137). The content of this article does not necessarily reflect the views or policies of the funding agencies.     

Collateral effects of parent training on family interactions

Recent research suggests that using naturalistic teaching paradigms leads to therapeutic gains in clinic settings for children with autism and related disorders. More recent studies are demonstrating that implementing these strategies within a parent training format may produce collateral effects in other areas of family life. The present experiment assessed collateral effects of two very different parent training paradigms during unstructured dinnertime interactions in the family setting. One paradigm focused on teaching individual target behaviors (ITB) serially, and the other focused on a recently developed naturalistic paradigm that teaches the pivotal responses (PRT) of motivation and responsivity to multiple cues. Two groups of families were randomly assigned to each of the parent training conditions. Pretraining and post- parent- training videotapes of dinnertime interactions were scored in a random order across four interactional scales (level of happiness, interest, stress, and style of communication). Results obtained for the four interactional scales showed that the families in both conditions initially scored in the neutral range, and the ITB training paradigm produced no significant influence on the interactions from pretraining to posttraining. In contrast, however the PRT parent training paradigm resulted in the families showing positive interactions on all four scales, with the parent-child interactions rated as happier, the parents more interested in the interaction, the interaction less stressful, and the communication style as more positive.This research was supported in part by U.S. Public Health Service Research Grants MH28210 and MH39434 from the National Institute of Mental Health, and by U.S. Department of Education Grants G0087C0234 and H023C30070. The authors are grateful for the assistance of Sherilyn M. Young. We also acknowledge Kristin Abbott and Emily McGrath for helping with scoring the tapes.     

Training HIV specialists for community mental health

There is a critical need for trained HIV mental health specialists who possess the knowledge and attitudes necessary to meet the challenges of the HIV epidemic. A model for an intensive and experiential continuing education tutorial is briefly described, and evaluative data are presented. Upon completion of the three-day workshop, participants show an increase in HIV-related knowledge and a positive shift in attitudes regarding working with people affected by HIV disease.Dr. Friedrich is Visiting Assistant Professor in the Department of Community Mental Health and Associate Director of the USF Center for HIV Education and Research.Dr. Gaies is Staff Psychologist with American Biodyne, Inc., and former Coordinator of the Department's Clinical Tutorial.Dr. Achenbach is Visiting Associate Professor in the Department of Law and Mental Health.Funding to develop the HIV Clinical Tutorial was provided under grant #BRT-000044-02-0, Health Resources and Services Administration, U.S. Department of Health and Human Services.     

The effects of schedule of reinforcement on stimulus overselectivity in autistic children

Recent research demonstrated that when autistic children are presented a discrimination task with multiple cues, they typically respond to an abnormally limited number, usually one, of the available cues. This phenomenon, termed stimulus overselectivity, has been implicated as a possible basis for many of the behavioral deficits characteristic of autism. The present investigation was conducted to systematically analyze the effects of changing the schedules of reinforcement during discrimination training on subsequent stimulus overselectivity. Twelve autistic children were taught a discrimination involving multiple visual cues, with a CRF schedule of reinforcement. The children were then overtrained on either the same (CRF) schedule or on a partial (VR3) reinforcement schedule. Subsequent overselectivity on single-cue test trials was then assessed. Results suggested that significantly less overselectivity occurred when the children were presented with the VR3 reinforcement schedule during overtraining. These results are discussed in terms of variables influencing overselectivity and in terms of implications for designing treatment procedures for autistic children.This research was supported by USPHS Research Grants MH 28231 and MH 28210 from the National Institute of Mental Health and by U.S. Office of Education Research Grant G007802084 from the Bureau for the Education of the Handicapped. The authors wish to thank John Burke, Marjorie Charlop, and Julie Williams for their assistance in this research.     

Emotionally handicapped youth in transition: Issues and principles for program development

Seriously emotionally handicapped adolescents face significant transition issues as they move through our system of care and attempt to assume adult role responsibilities in the community. Service delivery efforts must be sensitive to these issues and begin to realistically address the transition needs of this population. Nine integrative principles are discussed which appear essential when developing transition services.This article was developed with funding from the National Institute on Disability and Rehabilitation Research, U.S. Department of Education and the National Institute of Mental Health, U.S. Department of Health and Human Services (NIDRR grant number G008435137). The content of this publication does not necessarily reflect the views or policies of the funding agencies.     

Training social initiations to a high-functioning autistic child: Assessment of collateral behavior change and generalization in a case study

The present case study used a multiple treatment design to assess the effects of two interventions—Peer social initiations and target child initiations— on the social and disruptive behavior of a high-functioning autistic child. Intervention included initiation training and videotaped feedback highlighting successful and unsuccessful initiations. During Interventions 1 and 2, nonhandicapped peers were trained to initiate social interaction with the autistic child, resulting in an increase in social interaction which dramatically decreased in a reversal phase. Social interaction quickly increased again in Intervention 3 when the autistic child was trained to initiate interaction using the same procedures. During Interventions 1 and 2 no decrease in the autistic child's disruptive behaviors was observed; however during Intervention 3 these behaviors decreased to a low rate. Social validation, generalization, and maintenance of these behavior changes are discussed.This research was supported by U.S. Public Health Service research grants MH 39434 and MH 28210 from the National Institute of Mental Health. The authors are grateful for the participation of the children and the parents. We thank the teachers for their cooperation in the school setting. We also thank Lauren Loos, Kim Litzenberg, and Wendy Kaneko for all their assistance on scoring procedures and data collection and Jamie Reed-Sutton for her assistance collecting social validation data.     

Support groups for parents of children with emotional disorders: A comparison of members and non-members

This study involving more than 800 parents whose children have emotional disorders focuses on comparisons between parents who are members of support groups and those who are not. While no difference was found between members and non-members on most demographic variables, members reported needing and using more information and services and found each more difficult to locate than nonmembers. Thirty-one percent of all respondents identified involvement with other parents as the most helpful activity in coping with their child's problems.This publication was developed with funding from the National Institute on Disability and Rehabilitation Research, U.S. Department of Education and the National Institute of Mental Health, U.S. Department of Health and Human Services, (NIDRR grant number G0087C0222-88).     

Effects of L-dopa in autism

A study was designed to determine if blood serotonin concentrations could be lowered in autistic children by the administration of L-dopa and, if so, to observe possible clinical or physiological changes. Following a 17-day placebo period, four hospitalized autistic boys (3, 4, 9, and 13 years of age) received L-dopa for 6 months. Results indicated a significant decrease of blood serotonin concentrations in the three youngest patients, a significant increase in platelet counts in the youngest patient, and a similar trend in others. Urinary excretion of 5HIAA decreased significantly in the 4-year-old patient and a similar trend was noted in others. No changes were observed in the clinical course of the disorder, the amount of motility disturbances (hand-flapping), percent of REM sleep time, or in measures of endocrine function (FSH and LH). Possible mechanisms by which L-dopa lowered blood serotonin concentrations, increased platelet counts, and yet failed to produce other changes are discussed.This research was supported by grants from the Veteran's Administration Research Service; Public Health Research Grants HD 01-58 and AM 08775; National Institute of Health Grant RR-3 to the Health Sciences Computer Facility, UCLA; The National Institute of Child Health and Human Development Grant 04612 from the Mental Retardation Center, UCLA; and by the Department of Mental Hygiene, State of California.The authors wish to express their appreciation to Dr. Joseph Beckerman, Miss Ann Catino, Dr. Gunnar Heuser, Dr. Charles Markham, Miss Gwen McAfee, Miss Terry Preston, Dr. J. Raymond, Mr. Martin B. Scharf, and Dr. Tjiauw-Ling Tan for their assistance and participation in this study.     

Characteristics of clients and continuity of care into the community

Two-thirds of the patients referred from psychiatric hospitals to a posthospital social rehabilitation center did not follow through on the referral. Patients who participated in the rehabilitation service were more dependent in several areas of functioning than were those who did not participate. Implications of these findings are discussed in terms of the continuity of care into the community.This report is based on a presentation to the Eastern Psychological Association Convention in April, 1968. The research was supported in part by grant no. MH 818 from the National Institute of Mental Health, U.S. Department of Health, Education, and Welfare. Gratitude is expressed to Henry Tanaka for constructive comments on an earlier draft of this paper.