ABA TechAssessment

7/30/2019 ABA TechAssessment

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required to complete a specific activity. Schedules are often supplemented by other i

reinforcement. Schedules can take several forms including written words, pictures or

Self-management: These interventions involve promoting independence by teaching

regulate their behavior by recording the occurrence/nonoccurrence of the target behav

for doing so. Initial skills development may involve other strategies and may include

goals. In addition, reinforcement is a component of this intervention with the individu

seeking and/or delivering reinforcers. Examples include the use of checklists (using c

wrist counters, visual prompts, and tokens.

Story-based Intervention Package: These treatments involve a written description o

specific behaviors are expected to occur. Stories may be supplemented with additiona

reinforcement, discussion, etc.). Social Stories are the most well-known story-base

answer the who, what, when, where, and why in order to improve perspec

Applied Behavior Analysis is a field of practice, not a specific treatment. Treatment p

Intervention, Lovaas Therapy, Lovaas UCLA Program, Intensive Behavior Analysis,

should not be used interchangeably with the term Applied Behavior Analysis. The af

treatment approaches and methodologies that incorporate strategies and procedures frBehavior Analysis.

Other treatments for autism spectrum disorders for the purpose of this review are con

ABA. This includes the following:

1. Relationship Development Intervention (RDI),2. TEACCH or structured teaching,3. the Early Start Denver Model, and4. DIR/Floortime.

These treatments are not considered to be components of Applied Behavior Analysis

treatments for ASD.

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Practicum: Supervised at least weekly for 10% (7.5% minimum) of the total hour

Practicum. Total supervision must be at least 100 hours (75 minimum). A superv

Intensive Practicum: supervised at least twice weekly for 15% (10% minimum) o

Intensive University Practicum. Total supervision must be at least 112.5 hours (7

period is one week.

Individuals do not start accumulating experience until they have begun the coursewor

coursework requirements.

Supervisor Qualifications:

During the experience period, the supervisor must be:

1. A Board Certified Behavior Analyst in good standing, or2. Approved University Experience: A faculty member who has been approved

in the universitys approved course sequence.

The supervisor may not be the student's relative, subordinate or employee during the

supervisor will not be considered an employee of the student if the only compensatio

from the student consists of payment for supervision.

Nature of Supervision:

The supervisor must:

a. observe the clinician engaging in behavior analytic activities in the natural e

two weeks.

b. the supervisor must provide specific feedback on their performance.

c. during the initial half of the total experience hours, observation is concentrainteractions. This observation may be conducted via web-cameras, videotap

means in lieu of the supervisor being physically present.

d. supervision may be conducted in small groups of 10 or fewer for no more th

hours in each supervisory period. The remainder of the total supervision ho

must consist of direct one-to-one contact. Supervision hours may be counte

experience hours required.



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The behavior analyst:

designs programs that are based on behavior analytic principles, including asintervention methods,

involves the client or the client-surrogate in the planning of such programs,

obtains the consent of the client, and

respects the right of the client to terminate services at any time.

Describing Conditions for Program Success.

The behavior analyst describes to the client or client-surrogate the environmenecessary for the program to be effective.

Environmental Conditions that Preclude Implementation.

If environmental conditions preclude implementation of a behavior analytic precommends that other professional assistance (i.e., assessment, consultation

other professionals) be sought.

Environmental Conditions that Hamper Implementation.

If environmental conditions hamper implementation of the behavior analytic

seeks to eliminate the environmental constraints, or identifies in writing the o

Approving Interventions.

The behavior analyst must obtain the clients or client-surrogates approval iintervention procedures before implementing them.

Reinforcement/Punishment.

The behavior analyst recommends reinforcement rather than punishment wheprocedures are necessary, the behavior analyst always includes reinforcemen

behavior in the program.

Avoiding Harmful Reinforcers.

The behavior analyst minimizes the use of items as potential reinforcers that health of the client or participant (e.g., cigarettes, sugar or fat-laden food), or

marked deprivation procedures as motivating operations.

On-Going Data Collection.

The behavior analyst collects data, or asks the client, client-surrogate, or desineeded to assess progress within the program.



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maladaptive behavior by the clinicians or support staff could have adverse effects.

Potential results from malfunctioning of the technology

The technology cannot malfunction; only be misapplied.

Risk management processes for ABA practitioners?

Risk management procedures for practitioners involved in behavior analytic treatmen

Requirement of 36 continuing education credits and recertification every threrequirements are to ensure competency in the practitioners respective field a

analytic treatments of ASD (e.g., BACB approved CEUs, APA approved CE

Reportability and accountability to the Behavior Analyst Certification BoardProfessional Conduct Guidelines.

AND/OR

Reportability and accountability to the practitioners respective state licensing board

Professional conduct as outlined by that board

Key Issues to beanswered by theevidence

1) What is the strength of the evidence for specific ABA intervention treatments

Autism Spectrum Disorders (ASD)?

2) For which populations are each of these interventions appropriate?

3) What are the limitations of the treatment research reviewed?

Clarification of the review process

The CTAC review of Applied Behavior Analysis (ABA) as a treatment methodology for autism spectrumtechnical reviews of the literature completed in three publications:

1) The National Standards Project (NSP), published by the National Autism Center

2) The Technical Review of Published Research on Applied Behaviour Analysis Interventions fSpectrum Disorder published by Auckland Uniservices Limited for the New Zealand Ministryof Health (the New Zealand Review)

3) A 2010 meta-analysis by Javier Virus-Ortega published in the Journal of Clinical Psycholog



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number of studies reviewed by the NSP for that category and the corresponding number of studies that m

established (e.g. score of 3, 4, 5) which was based on the NSPs Scientific Merit Rating Scale (SMRS)

studies meeting the emerging category were included in this description for the purpose of clarity and the written paper published by the NSP.

Antecedent Package:

Summary of Strength of Evidence Classification: (Proven level vs. Emerging level vs. Unproven level)

1) Quantity of Evidence:

PROVEN: 3 or more published, peer-reviewed studies -

Study design ranking will rely on UHC hierarchy of

evidence

Total studies reviewed in this category: 109*

Number of studies meeting established rating: 4 Single

Subject Research Design (SSRD)

* the NSP report listed the antecedent package as having 99studies; a total of 109 were sent for final tally

2) SMRS Score:

PROVEN: average of at least 4.0;EMERGING: average of at least 3.0

Of the 109 studies reviewed: average SMRS score of

1.38 (range: 0-4)

Of the 4 studies: average SMRS score of 3.25 (range:3-4)

Hierarchy of Clinical Evidence (list number of studies

reviewed for each category):

***Note*** for specific breakdown of what SMRS scores

indicate at both group and single-subject level, please refer

to PPT titled CTAC Levels of Evidence and Mapping to

NSP slides 6-11

___ CMS Natl Coverage Decisions

___ Statistically robust, well-designed RCTs

___ Group observational studies (SMRS = 4)

___ Group observational studies (SMRS = 3)_1_ Single-subject observational studies (SMRS = 4)

_3_ Single-subject observational studies (SMRS = 3)

___ Natl Guidelines & Consensus Statements

___ Evidence-based guidelines from Natl Societies

3) Treatment Effects:

PROVEN: group - statistically significant effects reported in

favor of the treatment; single - functional relationship

established and replicated at least two times

This intervention category demonstrated favorableoutcomes with the following age groups:

o 3-5 yrso 6-9 yrso 10-14 yrs



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PROVEN: average of at least 4.0;

EMERGING: average of at least 3.0)

Of the 4 studies: average SMRS score of 3.25 (range3-4)






NSP slides 6-11


___ Statistically robust, well-designed RCTs___ Group observational studies (SMRS = 4)

_1_ Group observational studies (SMRS = 3)

_1_ Single-subject observational studies (SMRS = 4)_2_ Single-subject observational studies (SMRS = 3)








o 0-2 yrso 3-5 yrs

These interventions involve building foundational skills involved in regulating the behaviors of others. Jo

teaching a child to respond to the nonverbal social bids of others or to initiate joint attention interactionsobjects, showing items/activities to another person, and following eye gaze.

Modeling:

Summary of Strength of Evidence Classification: Proven level vs. Emerging level vs. Unproven level)




evidence

Total studies reviewed in this category: 56*Number of studies meeting established rating:14 Single

Subject studies

*the NSP report listed the modeling package as having 50 studies; atotal of 56 were sent for final tally

2) SMRS Score:





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EMERGING: average of at least 3.0

Of the 14 studies: average SMRS score of 3.14(range: 3-4)






NSP slides 6-11




_2_ Single-subject observational studies (SMRS = 4)_12 Single-subject observational studies (SMRS = 3)









o 15-18 yrs

These interventions rely on an adult or peer providing a demonstration of the target behavior that should

target behavior by the individual with ASD. Modeling can include simple and complex behaviors. This i

with other strategies such as prompting and reinforcement. Examples include live modeling and video m

Naturalistic Teaching Strategies:






evidence

Total studies reviewed in this category: 32

Number of studies meeting established rating: 2 groupdesign, and 5 Single Subject studies

2) SMRS Score:


Of the 32 studies reviewed: average SMRS score of1.94 (range: 0-4)


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EMERGING: average of at least 3.0 Of the 7 studies: average SMRS score of 3.29 (range3-4)



***Note*** for specific breakdown of what SMRS scoresindicate at both group and single-subject level, please refer


NSP slides 6-11



_2_ Group observational studies (SMRS = 3)_2_ Single-subject observational studies (SMRS = 4)_3_ Single-subject observational studies (SMRS = 3)









These interventions involve using primarily child-directed interactions to teach functional skills in the na

interventions often involve providing a stimulating environment, modeling how to play, encouraging con

and direct/natural reinforcers, and rewarding reasonable attempts. Examples of this type of approach inclfocused stimulation, incidental teaching, milieu teaching, embedded teaching, and responsive education

teaching.

Peer Training Package:


1) Quantity of Evidence:PROVEN: 3 or more published, peer-reviewed studies -


evidence


Number of studies meeting established rating:1 group

design, and 6 Single Subject studies

2) SMRS Score:





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Of the 7 studies: average SMRS score of 3.0 (range:3)






NSP slides 6-11



_1_ Group observational studies (SMRS = 3)

___ Single-subject observational studies (SMRS = 4)_6_ Single-subject observational studies (SMRS = 3)









These interventions involve teaching children without disabilities strategies for facilitating play and socia

on the autism spectrum. Peers may often include classmates or siblings. When both initiation training an

components of treatment in a study, the study was coded as peer training package. These interventionsother treatment packages (e.g., self-management for peers, prompting, reinforcement, etc.). Common nam

include peer networks, circle of friends, buddy skills package, Integrated Play Groups, peer initiation t

social interactions.

Pivotal Response Treatment:





evidence


Number of studies meeting established rating:4 Single

Subject studies



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2) SMRS Score:










NSP slides 6-11










favor of the treatment; single - functional relationshipestablished and replicated at least two times


o 3-5 yrs

o 6-9 yrs

This treatment is also referred to as PRT, Pivotal Response Teaching, and Pivotal Response Training. PR

pivotal behavioral areas such as motivation to engage in social communication, self-initiation, self-

responsiveness to multiple cues, with the development of these areas having the goal of very widespreadcollateral improvements. Key aspects of PRT intervention delivery also focus on parent involvement in th

on intervention in the natural environment such as homes and schools with the goal of producing natural

improvements. This treatment is an expansion of Natural Language Paradigm which is also included in t

Schedules:





evidence


Number of studies meeting established rating:4 Single

Subject studies.



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2) SMRS Score:










NSP slides 6-11





_1_ Single-subject observational studies (SMRS = 4)_3_ Single-subject observational studies (SMRS = 3)





favor of the treatment; single - functional relationshipestablished and replicated at least two times


o 3-5 yrs

o 6-9 yrso 10-14 yrs

These interventions involve the presentation of a task list that communicates a series of activities or steps

specific activity. Schedules are often supplemented by other interventions such as reinforcement. Scheduincluding written words, pictures or photographs, or work stations.

Self-management:






evidence

Total studies reviewed in this category: 22*


Subject studies

*the NSP report listed the self-management package as having


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21 studies; a total of 22 were sent for final tally

2) SMRS Score:










NSP slides 6-11









PROVEN: group - statistically significant effects reported infavor of the treatment; single - functional relationship



o 3-5 yrso 6-9 yrso 10-14 yrso 15-18 yrs

These interventions involve promoting independence by teaching individuals with ASD to regulate their

occurrence/nonoccurrence of the target behavior, and securing reinforcement for doing so. Initial skills dother strategies and may include the task of setting ones own goals. In addition, reinforcement is a comp

with the individual with ASD independently seeking and/or delivering reinforcers. Examples include the

checks, smiley/frowning faces), wrist counters, visual prompts, and tokens.

Story-based Intervention Package:








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evidence

Subject studies

2) SMRS Score:










NSP slides 6-11



___ Group observational studies (SMRS = 4)___ Group observational studies (SMRS = 3)










o 6-9 yrso 10-14 yrs

These treatments involve a written description of the situations under which specific behaviors are expecsupplemented with additional components (e.g., prompting, reinforcement, discussion, etc.). Social Stori

story-based interventions and they seek to answer the who, what, when, where, and why in or

taking.

Per the New Zealand Review:

The review method and evidence ranking by the New Zealand team was consistent with the NSP process

was based on an analysis of the specific components of the behavioral intervention package, the type of b

Ministry of Education supplied classification see table 4) and the impact of the interventions utilized (b



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community. This is based on the heavy reliance on continuous and more objective measurement of the re

demonstrate effectiveness on an individual level and give clearer indications of when treatment plan chan



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References

American Academy Of Pediatrics (2001). Policy Statement: The Pediatrician's Role in the DiagnAutistic Spectrum Disorder in Children (RE060018) Pediatrics, 107, 1221-1226.

Association for Behavior Analysis International (2009). The ABAI Model Licensing Act, Educa

Protection of the Profession.

Auckland Uniservices Limited (2009). Technical Review of Published Research on Applied Beh

for People with Autism Spectrum Disorder. Auckland Uniservices Limited. Auckland, NZ

Behavior Analyst Certification Board (2009). Standards and Applications for Examination. ww

Cohen, H., Amarine-Dickens, M., & Smith, T. (2006). Early intensive behavioral treatment: Repl

in a community setting. Developmental and Behavioral Paediatrics, 27, 145155.

Committee on Children With Disabilities (2001). Technical Report: The Pediatrician's Role in the

of Autistic Spectrum Disorder in Children. Pediatrics, 107, e85.

Cooper, J. O., Heron, T.E. and Heward, W.L. (2007)Applied Behavior Analysis, 2ndEdition. Pren

Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., Donaldson, A., & VarleControlled Trial of an Intervention for Toddlers With Autism: The Early Start Denver Model. Pediatrics

Eikeseth, S., Smith, T., Jahr, E., & Eledevik, S. (2002). Intensive behavioral treatment at school f

autism: A 1-year comparison controlled study. Behavior Modification, 26, 4968.

Eikeseth, S., Smith, T., Jahr, E., & Eledevik, S. (2007). Outcome for children with autism who betreatment between age four and seven: A comparison controlled study. Behavior Modification, 31, 2642

Filipek, P.A., Accardo, P.J., Baranek, G.T., Cook,. E.H., Dawson, C., Gordon, B., Gravel, J.S., JoLevy, S.E., Minshew, N.J., Prizant, B.M., Rapin, I., Rogers, S.J., Stone, W.L., Teplin, S., Tuchman, R.G

(1999). The screening and diagnosis of autistic spectrum disorders. Journal of Autism and Development



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Howard, J. S., Sparkman, C. R., Cohen, H. G., Green, G., & Stanislaw, H. (2005). A comparison

and eclectic treatment for young children with autism. Research in Developmental Disabilities, 26, 3593

Kazdin, A. E. & Hersen, Hersen, M. (1980). The current status of behavior therapy. Behavior M

Koegel, L.K., and R.L. Koegel (1999a). Pivotal response intervention I: Overview of approach. Jo

the Severely handicapped, 24:174-185. [148]

Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in

Journal of Consulting and Clinical Psychology, 55, 39.

Maine Administrators of Services for Children with Disabilities (2000). Report of the MADSEC

MADSEC, Manchester, ME.

McEachin, J. J., Smith, T., & Lovaas, O. I. (1993). Long-term outcome for children with autism w

behavioral treatment. American Journal on Mental Retardation, 97, 359372.

Myers, S.M., Johnson, C.P., and the Council on Children With Disabilities(2007) Management of CSpectrum Disorders, Pediatrics, 120, 1162-1182. Originally published online Oct 29, 2007; DOI: 10.154

National Autism Center (2009). The National Standards Project- Addressing the need for eviden

for autism spectrum disorders. National Autism Center. Randolph, MA.

National Research Council (2001). Educating Children with Autism, Committee on Educational I

with Autism, Division of Behavioral and Social Sciences and Education, Washington, D.C.: National Ac

Remington, B., Hastings, R. P., Kovshoff, H., degli Espinosa, F., Jahr, W., Brown, T., et al. (2007

of early intensive behavioral intervention: Outcomes for children with autism and their parents after two

American Journal of Mental Retardation, 112, 418438.

Sallows, G. O.,& Graupner, T. D. (2005). Intensive behavioral treatment for children with autism

predictors. American Journal of Mental Retardation, 110, 417438.

Satcher, D. (1999). Mental health: A report of the surgeon general. U.S. Public Health Service. B



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Schreibman, L., & Koegel, R. L. (2005). Training for parents of children with autism: Pivotal res

individualization of interventions. In E. D. Hibbs & P. S. Jensen (Eds.), Psychosocial treatment for child

Empirically based strategies for clinical practice (2nd Edition). (pp. 605-631). Washington, D. C.: AmeriAssociation.

Volkmar, F., Cook, E.H., Pomeroy, J., Realmuto, G. & Tanguay, P. (1999). Practice parameters ftreatment of children, adolescents, and adults with autism and other pervasive developmental disorders. J

Academy of Child and Adolescent Psychiatry, 38 (Supplement), 32s-54s



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Appendix A

Cross Walk Grids

Grid Key

National Standards ProjectNew Zealand Review

Virues-Ortega Review


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Table 1. Established treatments by behavioral domains as outlined in the National Standards Project.

AntecedentPackage

BehavioralPackage

ComprehensiveBehavioralPackage

J ointAttentionPackage

Modeling NaturalisticTeaching

PeerTraining

PivotalResponseTraining

Schedule

Communication

Higher CognitiveLearning

Readiness

Placement

Interpersonal

PersonalResponsibility

Self-Regulation

Problem BehaviorsRestricted,Repetitive, Non-functional

General SymptomsSensory or EmotionalRegulation

Play

Antecedent

Package

Behavioral Package

Comprehensive Behavioral

Package

J ointAttentio

nPackage

Modeling

Naturalistic Teaching

PeerTrainin

g

PivotalResponse Training

Schedules M

Autism

Aspergers

NOS

Table 2. Established treatments by ASD diagnosis as outlined in the National Standards Project



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AntecedentPackage

BehavioralPackage

ComprehensiveBehavioralPackage

J ointAttentionPackage

Modeling NaturalisticTeaching

PeerTraining

PivotalResponseTraining

Schedules Man

0-2

3-56-910-1415-1819-21

Table 3. Established treatments by age group as outlined in the National Standards Project



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Antecedent

Package

Behavioral

Package

Comprehensive

Behavioral

Package

Joint

Attention

Package

Modeling Naturalistic

Teaching

Peer

Training

Antecedent

Exposure

Behavioural

FCT

Social skills

PECS

Verbal behaviour

Reductive

Early IBI [intensive behavioural intervention]

Joint attention

Modelling

Naturalistic teaching

Peer training

PRT [pivotal response training]

Schedules

Self-management

Scripting

Table 4. NSP treatment packages mapped to NZR treatment approaches


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Com

munication

Hig

herCognitive

Lea

rning

Rea

diness

Placement

Interpersonal

Per

sonal

Res

ponsibility

Self-Regulation

Pro

blem

Beh

aviors

es

trcte,

Rep

etitive,Non-

functional

Gen

eral

Sym

ptoms

Sen

soryor

Em

otional

Reg

ulation

Play

Development of functional and

spontaneous communication

Development of cognitive

(thinking) skills

Social development and relating to

others

Development of independent

organizational skills and other

behaviors

Prevention of challenging

behaviors and substitution with

more appropriate andconventional behaviors

Reducing challenging behaviors

Engagement and Flexibility in

Developmentally Appropriate

Tasks and Play and Later

Engagement in Vocational

Activities

Receptive Language

Expressive Language

General language skills

Communication

General IQ

Non-verbal IQ

Daily living skills

Socialization

Motor skills

Adaptive Behavior CompositeTable 5. National Standards Project behavioral domains matched to New Zealand Review

and Virues-Ortega meta-analysis behavioral domains.

Proprietary Information of OptumHealth. Copyright 2011 OptumHealth Behavioral Solutions by United

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Appendix B

Reference Listing of Critical Studies for Intervention Packages

Antecedent PackageBaker, M.J . (2000). Incorporating the thematic ritualistic behaviors of children with autism into games:

Increasing social play interactions with siblings. Journal of Positive Behavior Interventions, 2(2), 66-84.

Davis, C. A., Brady, M. P., Hamilton, R., McEvoy, M. A., & et al. (1994). Effects of high probability requests onthe social interactions of young children with severe disabilities. Journal of Applied Behavior Analysis,27(4), 619-637.

Ducharme, J .M., Sanjuan, E., & Frain, T. (2007). Errorless compliance training : Success-focused behavioraltreatment of children with asperger syndrome. Behavioral Modification, 31(3), 329-344.

Grindle, C.F., & Remington, B. (2004). Teaching children with autism using conditioned cue-value andresponse-marking procedures: A socially valid procedure. Research in Developmental Disabilities,25(5), 413-429.

Behavioral Package

Apple, A.L., Billingsley, F., & Schwartz, I.S. (2005). Effects of video modeling alone and with self-managementon compliment-giving behaviors of children with high-functioning ASD. Journal of Positive BehaviorInterventions, 7(1), 33-46.

Carr, E. G., & Carlson, J . I. (1993). Reduction of severe behavior problems in the community using amulticomponent treatment approach. Journal of Applied Behavior Analysis, 26(2), 157-172.

Charlop-Christy, M. H., & Haymes, L. K. (1996). Using obsessions as reinforcers with and without mildreductive procedures to decrease inappropriate behaviors of children with autism. Journal of Autismand Developmental Disorders, 26(5), 527-546.

Charlop-Christy, M. H., & Haymes, L. K. (1998). Using objects of obsession as token reinforcers for childrenwith autism. Journal of Autism and Developmental Disorders, 28(3), 189-198.

Durand, V. M., & Carr, E. G. (1991). Functional communication training to reduce challenging behavior:

Maintenance and application in new settings. Journal of Applied Behavior Analysis, 24(2), 251-264.

Gena, A., Couloura, S., & Kymissis, E. (2005). Modifying the affective behavior of preschoolers with autismusing in-vivo or video modeling and reinforcement contingencies. Journal of Autism andDevelopmental Disorders, 35(5), 545-556.

Haring, T. G., Kennedy, C. H., Adams, M. J ., & Pitts-Conway, V. (1987). Teaching generalization ofpurchasing skills across community settings to autistic youth using videotape modeling. Journal of

Applied Behavior Analysis, 20(1), 89-96.

Harris, S. L., Handleman, J . S., & Alessandri, M. (1990). Teaching youths with autism to offer assistance.Journal of Applied Behavior Analysis, 23, 297-305.

Lee, R., & Sturmey, P. (2006). The effects of lag schedules and preferred materials on variable responding instudents with autism. Journal of Autism and Developmental Disorders, 36(3), 421-428.

McConnachie, G., & Carr, E. G. (1997). The effects of child behavior problems on the maintenance ofintervention fidelity. Behavior Modification, 21(2), 123-158.

Nuzzolo-Gomez, R., Leonard, M. A., Ortiz, E., Rivera, C. M., & Greer, R. D. (2002).Teaching children with autism to prefer books or toys over stereotypy or passivity. Journal of PositiveBehavior Interventions, 4(2), 80-87.


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Pelios, L. V., MacDuff, G. S., & Axelrod, S. (2003). The effects of a treatment package in establishingindependent academic work skills in children with autism. Education & Treatment of Children, 26(1),1-21.

Rincover, A., & Newsom, C. D. (1985). The relative motivational properties of sensory and edible reinforcers inteaching autistic children. Journal of Applied Behavior Analysis, 18(3), 237-248.

Ross, D. E., & Greer, R. D. (2003). Generalized imitation and the mand: Inducing first instances of speech inyoung children with autism. Research in Developmental Disabilities, 24(1), 58-74.

Sidener, T. M., Shabani, D. B., Carr, J . E., & Roland, J . P. (2006). An evaluation of strategies to maintain atpractical levels. Research in Developmental Disabilities, 27(6), 632-644.

Thiemann, K. S., & Goldstein, H. (2001). Social stories, written text cues, and video feedback: Effects onsocial communication of children with autism. Journal of Applied Behavior Analysis, 34(4), 425-446.

CBTYC PackageCohen, H., Amerine-Dickens, M., & Smith, T. (2006). Early intensive behavioral treatment: Replication of the

UCLA model in a community setting. Journal of Developmental and Behavioral Pediatrics, 27(2), 145-155.

Eikeseth, S., Smith, T., J ahr, E., & Eldevik, S. (2007). Outcome for children with autism who began intensivebehavioral treatment between ages 4 and 7. Behavior Modification, 31(3), 264-278.

Harris, S. L., Handleman, J . S., Gordon, R., Kristoff, B., & Fuentes, F. (1991). Changes in cognitive andlanguage functioning of preschool children with autism. Journal ofAutism and DevelopmentalDisorders, 21(3), 281-290.

Lovaas, O. (1987). Behavioral treatment and normal educational and intellectual functioning in young autisticchildren. Journalof Consulting and Clinical Psychology, 55(1), 3-9.

Sallows, G. O., & Graupner, T. D. (2005). Intensive behavioral treatment for children with autism: Four-yearoutcome and predictors.American Journal of Mental Retardation: AJMR, 110(6), 417-438.

Smith, T., Eikeseth, S., Klevstrand, M., & Lovaas, O. (1997). Intensive behavioral treatment for preschoolerswith severe mental retardations and pervasive developmental disorder.American Journal on Mental

Retardation, 102(3), 238-249.

Smith, T., Buch, G. A., & Gamby, T. E. (2000). Parent-directed, intensive early intervention for children withpervasive developmental disorder. Research inDevelopmental Disabilities, 21(4), 297-309.

Joint Attention InterventionMartins, M. P., & Harris, S. L. (2006). Teaching children with autism to respond to joint attention initiations.

Child & Family Behavior Therapy, 28(1), 51-68.

Kasari, C., Freeman, S., & Paparella, T. (2006). J oint attention and symbolic play in young children withautism: A randomized controlled intervention study. Journal of Child Psychology and Psychiatry, and

Allied Disciplines, 47(6), 611-620.

J ones, E. A., Carr, E. G., & Feeley, K. M. (2006). Multiple effects of joint attention intervention for children withautism. Behavioral Modification, 30(6), 782-834.

Rocha, M. L., Schreibman, L., & Stahmer, A. C. (2007). Effectiveness of training parents to teach jointattention in children with autism. Journal of Early Intervention, 29(2), 154-172.

Modeling PackageApple, A. L., Billingsley, F., & Schwartz, I. S. (2005). Effects of video modeling alone and with self-

management on compliment-giving behaviors of children with high-functioning ASD. Journal ofPositive Behavior Interventions, 7(1), 33-46.


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Buffington, D. M., Krantz, P. J ., McClannahan, L. E., & Poulson, C. L. (1998). Procedures for teaching

appropriate gestural communication skills to children with autism. Journal of Autism andDevelopmental Disorders, 28(6), 535-545.

Buggey, T., Toombs, K., Gardener, P., & Cervetti, M. (1999). Training responding behaviors in students withautism: Using videotaped self-modeling. Journal of Positive Behavior Interventions, 1(4), 205-214.

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