Browsing by Subject "Rett syndrome"
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Item Communication intervention for children with severe neurodevelopmental disabilities: An application of telehealth as a service delivery mechanism(2016-08) Simacek, JessicaThe current study examined the efficacy of a parent-implemented communication assessment and intervention package with coaching via telehealth (i.e., video conferencing) on the acquisition of early communication skills for three young children (3- 4 years old) with severe neurodevelopmental disabilities. Assessment included a structured descriptive assessment (3 participants) and functional analysis (2 participants) to identify communicative contexts and idiosyncratic/potentially communicative responses for the participants. Following assessment, three communicative contexts with high levels of idiosyncratic responses were embedded with Functional Communication Training (FCT). To investigate the efficacy of FCT, participants’ use of aided augmentative and alternative communication (AAC) responses and idiosyncratic responses were measured in an adapted multiple probe design across contexts. All three participants acquired the targeted AAC responses; whereas, prior to intervention, none of the participants engaged in easily recognizable communication forms. Idiosyncratic responses were functionally related to the reinforcers in the communicative contexts, as demonstrated by changes to response patterns during differential reinforcement. Parents implemented the interventions with a high level of fidelity to the coached procedures. At the conclusion of the study, parents rated the interventions as ‘highly acceptable.’ These results provide empirical evidence to telehealth-coached, parent-implemented FCT as an intervention to improve early communication skills for young children with severe neurodevelopmental disabilities. Implications are considered in regards to telehealth as a mechanism to improve access to communication intervention.Item Functional communication training in Rett syndrome(2013-06) Byiers, Breanne J. L.Rett syndrome (RTT) is associated with a range of serious neurodevelopmental consequences including severe impairments in communication. Currently, no evidence-based communication interventions exist for the population (Sigafoos et al., 2009), and there is limited empirical evidence that individuals with RTT are able to demonstrate operant motor behaviors, (e.g., behaviors that are controlled by the individual in order to create an effect on the environment). The purpose of the current study was to examine the effectiveness of functional assessment (FA) and functional communication training (FCT) methods for teaching a clinical case series of girls and women (aged 4-47 years) with classic RTT to request preferred events or items using an augmentative communication device. Functional analysis (FA) was used to identify the communicative function of potential communicative acts (PCAs) identified during parent interviews and observations. Subsequently, each participant was taught to activate a voice-output switch to request the functional reinforcer identified in the FA. Using ABA and ABAB single case experimental designs, the degree to which each participant alternated between the PCA and switch activation according to changes in the environmental consequences (e.g., reinforcement vs. extinction for a particular response) was examined. Clear experimental effects of the intervention condition were observed on at least one response for six of the seven participants. The remaining participant did not complete the study. Overall, these results suggest that individuals with RTT can use intentional motor behaviors, and are responsive to environmental consequences. These results have important implications for the development of appropriate communication interventions for this population.Item Using functional analysis to test whether idiosyncratic and challenging behavior in Rett syndrome is sensitive to social reinforcement contingencies.(2012-07) Dimian, AdeleRett syndrome (RS) is a severe neurodevelopmental disability that results in cognitive impairment, loss of functional and communication skills, and an emergence of idiosyncratic behaviors. There is little behavioral research to date using functional analysis to examine the operant properties of behaviors exhibited by individuals with RS. The purpose of this study was to test whether functional analysis technology could be applied to a broader range of idiosyncratic behaviors observed in a clinical sample of six girls and women living with RS. Brief functional analyses were conducted to evaluate target behaviors including breath holding, vocalizations, vocal upsets, hand mouthing, and self-injury. Results indicate that four out of the six analyses conducted with the participants produced differentiated results. Further research is needed to evaluate how identifying idiosyncratic behaviors that are sensitive to reinforcement contingencies can inform treatment for this population in areas of pronounced deficits such as communication.