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Instructional Fading – A Path to Increased Productivity

October 3, 2016 3:00 pm Published by

At the QSAC Preschool and Day School, we apply proactive strategies to increase prosocial behavior and decrease or prevent the occurrence of problem behavior. The proactive strategies that we implement are part of a system of Positive Behavior Intervention and Supports (PBIS). PBIS is a decision making framework that improves staff and student behavior through reward systems, careful environmental manipulation, and the use of evidence based practices and ongoing data analysis to monitor staff and student progress. Our PBIS framework includes 13 proactive/preventative strategies for increasing prosocial skills and improving overall behavior. One proactive strategy that we strive to include is instructional fading. Instructional fading allows instructors to systematically increase response requirements for students, so that students can learn to complete work sessions at a level that is as easy for them, before moving on to more difficult and longer work sessions. This blog post offers a synopsis of the research in instructional fading as an antecedent strategy. It is adapted from Maffei-Almodovar & Sturmey (2013).

Instructional fading is typically used to reduce problem behavior that functions for escape from a non-preferred activity (Butler & Luiselli, 2007; Horner, et al., 1991; Pace, Iwata, Cowdery, Andree, & McIntyre, 1993; Weeks & Gaylord-Ross, 1981; Zarcone, Iwata, Smith, Mazaleski & Lermanm, 1994) including SIB maintained by task avoidance (Iwata, et al., 1990; Repp, Felce, & Barton, 1988; Steege, Wacker, Berg, Cigrand, & Cooper, 1989).

Instructional fading consists of drastically decreasing the rate or difficulty of instructions identified as antecedents to escape maintained problem behavior and then systematically increasing the rate or difficulty of instructions to a predetermined acceptable level (Horner, Day, Sprague, O’Brien, & Heathfield, 1991; Pace et al., 1993; Weeks & Gaylord-Ross, 1981; Zarcone, Iwata, Vollmer, Jagtiani, Smith, & Mazauiski, 1993). Instructional fading is one way of possibly decreasing the momentary value of escape for a student.

Four studies have utilized instructional fading to decrease dangerous problem behavior (Butler and Luiselli, 2007; Pace, et al., 1993; Zarcone et al., 1994; Zarcone et al., 1993).  These studies were published in English and in peer-reviewed journals, included participants with identified developmental or intellectual disabilities, utilized a reversal or multiple baseline design to allow for Percentage of All Non-overlapping Data calculations (PAND), and targeted a dangerous problem behavior.  Dangerous problem behavior is defined here as a behavior likely to result in injury to the individual or to others in the immediate environment such as various forms of self-injurious behavior (SIB), aggression, elopement and property destruction.

Participants in the four studies (10 total) included seven females and three males aged two to 40 years.  Nine out of ten participants were diagnosed with moderate to profound intellectual disabilities and one was diagnosed with autism.  Experimental settings included a therapy room, two state residential facilities and one private school for children with developmental disabilities.  All 10 participants engaged in escape maintained SIB and one also engaged in escape maintained aggression.  Instructional fading interventions varied across studies to include instructional fading plus extinction (Pace, et al., 1993; Zarcone et al., 1994), instructional fading plus non-contingent escape (Butler & Luiselli, 2007) and a comparison of instructional fading plus extinction with extinction alone (Zarcone et al., 1993).

There were large effect sizes across all four studies, however, since each study utilized a slightly different variation of the instructional fading intervention, effect sizes will be reported separately for each study. Pace, et al., (1993) applied Instructional fading plus extinction to significantly reduce SIB across 3 participants (PAND = 94%.)  Zarcone, et al. (1993) compared instructional fading plus extinction with extinction alone and found that both interventions significantly reduced SIB.  Zarcone et al. (1993), however, also found that extinction alone produced less reduction in SIB (PAND = 85%) than instructional fading plus extinction (PAND = 94%).  Zarcone et al. (1994) also utilized instructional fading only applying extinction (with the rate of instructions held constant) when SIB remained high across 10 sessions.  Effect sizes for Zarcone et al. (1994) were less robust (PAND =  82%) indicating that instructional fading alone may be less effective than instructional fading plus extinction.  Finally, Butler and Luiselli (2007) implemented non-contingent escape plus instructional fading and reduced problem behavior with the most robust effect size (PAND = 100%.)

Experimenters in all four studies also reported increases in appropriate responses to instructions as instructional difficulty and frequency were faded in during interventions.  In this way, studies also reported increases in participant engagement. Instructional fading shows promise as a component in a treatment package to decrease and possibly prevent dangerous problem behavior when combined with either extinction or non-contingent escape.

At the QSAC schools, instructional fading is often included as a proactive, antecedent strategy and as part of a behavior intervention plan for escape maintained problem behavior after functional behavior assessments have been completed. Instructional fading is a tool that allows us to teach ours students to tolerate increasingly difficult task requirements. The ability to complete ever increasing work requirements is a skill that all working adults ideally possess. This is an important skill for all of our students, especially those that are preparing to enter less restrictive learning environments and work sites. Instructional fading is an avenue to increased independence that can help our students to meet their goals as independent working adults.

 

 

LMaffei-Blog-BubbleLindsay Maffei-Almodovar, MS Ed, MA, BCBA, has worked in the field special education since 2001. She joined Quality Services for the Autism Community (QSAC) in 2011 and is currently the ABA Training & Development Coordinator. She is responsible for designing, evaluating and monitoring staff training initiatives at both the preschool and Day School programs. Lindsay is a certified New York State Early Childhood General & Special Education Teacher and a Licensed Behavior Analyst. Lindsay is also a doctoral student in the Behavior Analysis Training Area of the Psychology Department at Queens College and The Graduate Center City University of New York (CUNY). Her research focuses on efficient methods of training staff members in evidence based behavior analytic procedures.

 

 

 

References

 

Butler, L.R.  & Luiselli, J. K. ( 2007). Escape-maintained problem behavior in a child with

autism: Antecedent functional analysis and intervention evaluation of noncontingent

escape and instructional fading. Journal of Positive Behavior Interventions, 9, 195

202.

 

Maffei-Almodovar, L., & Sturmey, P. (2013). Evidence-based practice and crisis intervention. In

D. D. Reed, F. D. DiGennaro Reed & J. K. Luiselli (Eds.), Handbook of Crisis

Intervention and Developmental Disabilities (pp. 46-69). New York: Springer.

 

Pace, G. A.,  Iwata, B. A., Cowdery, G. E.,  Andree, P.J., & McIntyre, T. (1993). Stimulus

(instructional) fading during extinction of self-injurious escape behavior. Journal of

Applied Behavior Analysis, 26, 205-212.

 

Zarcone, J. R., Iwata, B. A., Smith, R. G., Mazaleski, J. L., & Lerman, D. C. (1994).

Reemergence and extinction of self-injurious escape behavior during stimulus

(instructional) fading. Journal of Applied Behavior Analysis 27, 307-316.

 

Zarcone, J. R.,  Iwata, B. A., Vollmer, T. R., Jagtiani, S., Smith, R. G. & Mazauiski, J. L.(1993).

Extinction of self-injurious escape behavior with and without instructional fading.

Journal of Applied Behavior Analysis, 26, 353-360.

A Work in Progress: Ensuring Procedural Integrity within the QSAC School Programs

May 16, 2016 3:00 pm Published by

Procedural integrity is the extent to which an intervention is implemented as intended (e.g., Cooper, Heron, & Heward, 2007). There are a few other terms that have been used interchangeably with procedural integrity including treatment fidelity, treatment integrity and procedural fidelity. All of the above terms relate to the same basic theme: evidence based interventions should be applied as written to the greatest extent possible in order to achieve desired outcomes.

At the QSAC Day School and Preschool we prioritize the procedural integrity of our teaching procedures as part of our schoolwide Positive Behavior Intervention and Supports (PBIS). Our PBIS framework includes 13 evidence based proactive/preventative strategies for increasing our students’ prosocial skills and improving overall behavior. Procedural integrity of teaching procedures may be the most important of these strategies. In order for our teaching procedures to be effective, they must be implemented correctly. In order to ensure this, we employ Behavioral Skills Training (BST).

BST is an evidence based practice for disseminating behavior analytic skills to caregivers of varying backgrounds and experience levels (Dib and Sturmey, 2007; Ryan, Hemmes, Sturmey, Jacobs, & Grommet, 2007; Sarokoff and Sturmey, 2004; Seiverling, Pantelides, Ruiz, & Sturmey, 2010; Ward-Horner & Sturmey, 2008). BST packages generally consist of four components: 1) instructions, 2) modeling, 3) rehearsal, 4) feedback. At the QSAC schools, we are continually in the process of creating BST packages in order to effectively train our staff members to implement teaching procedures correctly. This process involves two basic steps. First, we break down each of our teaching procedures into multi-step behavior chains. The process of breaking down chains of behavior into their component steps is called task analysis. The task analyses developed make up the “instructions” component of the BST package. The next step in the creation of our BST packages involves the creation of a model for each teaching procedure. We typically create video models by recording experienced staff members implementing procedures correctly with our students. We then edit these recordings by adding freeze frames and embedded text to highlight important aspects of the models and make it easier for staff members to match what they see in the model with the task analyzed instructions. These recordings make up the “model” component of the BST package.

Once the necessary materials for the BST package are complete, training for a targeted teaching procedure can begin. At the QSAC Day School, our Director and our ABA coordinators train all new staff members to implement our teaching procedures using BST packages. At the QSAC Preschool, our teachers use BST to train their new teaching assistants to implement these procedures, while our Director and ABA coordinators train only new teachers. Training begins when the trainer provides the trainee with the task analysis for the targeted teaching procedure. The trainer then provides the trainee with a model of the procedure either by presenting a video model, or by performing a live model. The trainee checks off the steps of the teaching procedure on his/her task analysis as they watch the model. The trainer then observes the trainee rehearse the teaching procedure several times and provides the trainee with immediate feedback on their performance errors. These rehearsal and feedback sessions continue until the trainee meets a predetermined competency level and is able to implement the procedure independently. At both QSAC school programs, we manage an extensive database of each staff member’s training and his/her competency levels in implementing our teaching procedures. Staff competence is an important measure of school program quality. At the QSAC schools we strive to maintain a high quality program by ensuring the procedural integrity of all of our teaching procedures as part of our schoolwide PBIS system.

 

LMaffei-Blog-BubbleLindsay Maffei-Almodovar, MS Ed, MA, BCBA, has worked in the field special education since 2001. She joined Quality Services for the Autism Community (QSAC) in 2011 and is currently the ABA Training & Development Coordinator. She is responsible for designing, evaluating and monitoring staff training initiatives at both the preschool and Day School programs. Lindsay is a certified New York State Early Childhood General & Special Education Teacher and a Licensed Behavior Analyst. Lindsay is also a doctoral student in the Behavior Analysis Training Area of the Psychology Department at Queens College and The Graduate Center City University of New York (CUNY). Her research focuses on efficient methods of training staff members in evidence based behavior analytic procedures.

 

References

Cooper, J.O., Heron, T.E, and Heward, W.L. (2007). Applied Behavior Analysis (2nd Edition). Upper Saddle River, NJ: Pearson Merrill Prentice Hall.
Dib, N., & Sturmey, P. (2007). Reducing student stereotypy by improving instructors’
implementation of discrete-trial teaching. Journal of Applied Behavior Analysis, 40, 339-343.

Ryan, C. S., Hemmes, N. S., Sturmey, P., Jacobs, J. D., & Grommet, E. K. (2007). Effects of a
brief staff training procedure on instructors’ use of incidental teaching and students’ frequency of initiation toward instructors. Research in Autism Spectrum Disorders, 2,28–45.

Sarokoff, R. A., & Sturmey, P. (2004). The effects of behavioral skills training on staff implementation of discrete-trial teaching. Journal of Applied Behavior Analysis, 37, 535-538.

Seiverling, L., Pantelides, M., Ruiz, H. H., & Sturmey, P. (2010). The effect of behavioral skills
training with general-case training on staff chaining of child vocalizations within natural language paradigm. Behavioral Interventions, 25, 53–75.

Ward-Horner, J., & Sturmey, P. (2008). The effects of general-case training and behavioral skills
training on the generalization of parents’ use of discrete-trial teaching, child correct responses, and child maladaptive behavior. Behavioral Interventions, 23, 271–284.

Positive Behavior Intervention and Supports: Transition Routines

February 22, 2016 3:00 pm Published by

At the QSAC Preschool and Day School, we strive to implement as many proactive strategies as possible to increase independent prosocial behavior and to prevent and decrease the occurrence of problem behavior. These proactive strategies are part of a system of Positive Behavior Intervention and Supports (PBIS). PBIS is a decision making framework that aims to improve staff and student behavior through reward systems, careful environmental manipulation, the use of evidence based practices and ongoing data analysis to monitor staff and student progress. Our PBIS framework includes 13 proactive/preventative strategies for increasing prosocial skills and improving overall behavior. One very important proactive strategy is the use of student and staff schedules to ensure predictable, seamless transition routines. As transitions between and within activities are often difficult for individuals with Autism Spectrum Disorders (ASD), transition routines including activity schedules can serve as one antecedent strategy to increase independence and decrease problem behavior, thereby alleviating the need for intense staff support (Pierce, Spriggs, Gast & Luscrea, 2013).

An activity schedule is a group of photographs, videos, computer images, drawings, symbols or text, sequentially arranged on a display for individuals to follow. They can include single or multiple items in sequence. Activity schedules can be used between routines as a transitional tool or within routines to cue specific steps of an activity (Banda & Grimmit, 2008).

Banda and Grimmit (2008) conducted a systematic review of studies using activity schedules to improve social interaction skills and decrease problem behaviors. Behaviors targeted for increase included social exchanges and initiations, on-task and on-schedule behavior, independent daily living skills and independent play skills and behaviors targeted for decrease included hitting, kicking, biting, crying, and screaming, other undefined problem behaviors during transitions and long latencies in completing transitions. While most studies focused exclusively on either increasing or decreasing one target behavior, four focused on increasing on-task behavior while simultaneously decreasing problem behaviors. Nine studies utilized photograph, computer or video activity schedules, two used line drawings, one used PECS icons (Bondy & Frost, 1993, 1994) and one used text. All interventions were applied by psychologists, teachers, and/or graduate assistants.

 

According the results of their review, Banda and Grimmit (2008) reported that activity schedules enhanced social interactions and on-task behavior and decreased problem behavior during transitions. The authors noted that in several studies reporting generalization across settings and persons and in five studies reporting social validity measures, caregivers indicated activity schedules as beneficial and efficient in improving learner behavior.

At the QSAC Preschool and Day School, we have prioritized the use of activity schedules to aid in all student transition routines. Our teachers also often use extra cues to aid in the predictability of a routine such as frequent time warnings (e.g. “ Five more minutes until lunch”), musical cues and other sound cues (e.g. a bell) to indicate when it will be time for students or staff to review their respective schedules and change activities accordingly. Schedule use is also an important transitional skill for students. At QSAC Day School, in particular, we are currently working on teaching our students working in vocational training to follow and be responsible for their own daily schedules. Transitioning activities following a schedule is an essential skill for all those striving to work and live as independently as possible. It is one of a myriad of important prosocial skills targeted at the QSAC Preschool and Day School via our PBIS framework.

 

 

LMaffei-Blog-BubbleLindsay Maffei-Almodovar, MS Ed, MA, BCBA, has worked in the field special education since 2001. She joined Quality Services for the Autism Community (QSAC) in 2011 and is currently the ABA Training & Development Coordinator. She is responsible for designing, evaluating and monitoring staff training initiatives at both the preschool and Day School programs. Lindsay is a certified New York State Early Childhood General & Special Education Teacher and a Licensed Behavior Analyst. Lindsay is also a doctoral student in the Behavior Analysis Training Area of the Psychology Department at Queens College and The Graduate Center City University of New York (CUNY). Her research focuses on efficient methods of training staff members in evidence based behavior analytic procedures.

 

References

Banda, D. R., & Grimmett, E. (2008).Enhancing social and transition behaviors of persons with

autism through activity schedules: A review. Education and Training in Developmental

Disabilities, 43, 324-333.

 

Maffei-Almodovar, L., & Sturmey, P. (2013). Evidence-based practice and crisis

intervention.In D. D. Reed, F. D. DiGennaro Reed & J. K. Luiselli (Eds.), Handbook of Crisis Intervention and Developmental Disabilities (pp. 46-69). New York: Springer.

 

Pierce, J. M., Spriggs, A. D., Gast, D. L., & Luscre, D. (2013). Effects of visual activity

schedules on independent classroom transitions for students with autism. International

Journal of Disability, Development and Education, 60, 253-269.

doi:10.1080/1034912X.2013.812191

 

Pyramidal Training, Research and the Right to Effective Treatment

November 30, 2015 3:00 pm Published by

Staff members serving people with developmental disabilities are often required to implement several behavior analytic procedures with only limited training soon after being hired.  Often, organizations that employ direct care staff have few qualified staff trainers, high rates of absenteeism and frequent staff turnover (Seavey, 2004; (Zaharia & Baumeister, 1979).

Pyramidal training allows supervisors, consultants or other experienced behavior analysts to train just a few direct care workers in agency required skills and then train these direct care workers to implement training packages targeting the same skills with their newly hired co-workers (Jones, Fremouw and Carples, 1977; Page, Iwata and Reid, 1982).

Pyramidal training reduces the burden on clinical supervisors of having to train every newly hired staff member and eliminates the need to hire additional staff trainers and consultants. It also allows trainees to practice skills in the general teaching environment which aids in the maintenance and generalization of the acquired skills (Van den Pol, Reid & Fuqua, 1983).

Published studies on pyramidal training have shown that the training design is effective for disseminating a variety of target skills such as classroom management tactics, discrete trial teaching procedures, implementation of client treatment plans, provision of positive social interaction, mand training and preference assessment.

Jones, Fremouw and Carples (1977) used a 1.5 hour training session to train three elementary school teachers to use a classroom management skills package and then to conduct role-playing and give corrective feedback in order to train their peers. These three teachers then trained 12 other elementary school teachers to use the classroom management skills package and this decreased student problem behavior.

Page, Iwata and Reid (1982) used written instructions, verbal instructions, discussion, rehearsal, verbal feedback and graphic feedback to train three institutional supervisors to discriminate correct teaching behaviors on the part of direct care staff and to instruct, prompt, and praise the occurrence of those behaviors.  Improvements in 45 direct care staff members’ teaching behavior were a function of training and feedback provided to their supervisors.

Shore, Iwata , Vollmer, Lerman and Zarcone (1995) used instructions, rehearsal and feedback to train one supervisor to implement client treatment programs, train seven direct care staff members in program implementation, and monitor the programs. Staff implementation of client treatment procedures and client behavior improved as a result of supervisor training.

Schlosser, Walker and Sigafoos (2006) used a one day workshop consisting of presentation, modeling, coaching, rehearsal and feedback to train three direct care staff members to provide opportunities for communication to children with developmental disabilities who were non-vocal. These three staff members then trained five additional staff members in the procedures. Staff members increased the number of opportunities for communication provided to their students as a result of training and student prompted and unprompted communications increased.

Finn and Sturmey (2009) used Behavioral Skills Training (BST) to train four habilitation specialists to train four of their co-workers to provide positive vocal, gesture, manual sign and physical interactions to adults with psychiatric disorders and developmental disabilities in a day habilitation setting.  The frequency and proportion of positive interactions and improved between trainees and clients as a result of the peer-to-peer training.

In an unpublished dissertation, Nigro-Bruzzi (2010) also used BST to train three supervisors to use BST to train three teacher assistants to conduct mand training. Supervisor use of BST was efficient in training 3 teacher assistants to conduct mand training accurately. All teacher assistants generalized staff teaching skills across children and the children showed increases in their percentages of unprompted mands.

The above studies made important contributions to the staff training research because they demonstrated the efficiency of the pyramidal training model to disseminate a variety of behavior analytic skills. However, the above studies also all presented with an important limitation.

None of the above studies that included learner participants throughout baseline and training detailed the ways in which they minimized harm to participating individuals with developmental and intellectual disabilities during baseline data collection. Baseline data collection refers here to those data collected on trainee performance before training. This type of data collection would require an untrained staff member to attempt to implement an evidence-based procedure with an individual with a disability.

Van Houten et al. (1988) detailed the importance of ensuring that all recipients or potential recipients of treatment designed to change behavior have a right to the most effective treatment procedures available. When research is conducted in the applied setting with individuals reliant on the hosting school, habilitation center or agency for their daily programming needs, the responsibility to ensure that learners access the above therapeutic rights falls upon the hosting school, habilitation center or agency and the experimenters. In other words, the burden of meeting baseline logic requirements should not be shouldered by recipients of behavior change programs, but by their providers and the researchers themselves. This distinction is especially important when it comes to research in the area of staff and caregiver training.

In behavioral research outside of the staff and caregiver training area, experimenters are often testing a behavior change procedure that is not yet evidence based. In these instances, it could first be argued that withholding of a particular therapy during baseline data collection is of little consequence, because the learner would not be exposed to the experimental procedure during regular therapy anyway. Second, recipients and their families complete lengthy informed consent processes when they will be involved in a study to test an experimental behavior change procedure. Third, learner participants may incur a benefit if they are exposed to an experimental treatment that is beneficial during the course of research participation, because they would not have been exposed to the procedure outside of the context of the research.

The three points above do not necessarily apply when it comes to staff training research. Staff training research most often targets the training of staff members and caregivers in already established, evidence based behavior change procedures. Therefore, when researchers expose learners to untrained staff members during baseline data collection procedures, they are withholding effective treatment from the learners in the interest of the research project, because the learners would access the effective provision of these services outside of the research context. Even in cases where parental consent or assent have been attained, this situation does not seem ideal in light of Van Houten (1988). In particular, when researchers evaluate the extent to which a pyramidal training program is effective for training staff in evidence based behavior change procedures, it behooves the researcher to explore ways of doing so that are least harmful to the learners with whom the targeted staff members work. This is even more important when the learners in question have been assigned to a particular therapeutic setting because they engage in behavior that is potentially dangerous to themselves and others and does not allow them to participate in less restrictive settings. In these situations, exposing learners to untrained staff members for the sake of baseline data collection not only results in the withholding of effective treatment from the learner, but also increases the risk of dangerous situations arising for both untrained staff members and learners when untrained staff members inevitably make instructional errors during baseline.

In closing, it is important for both school representatives and parents to discuss the risks of students being exposed to untrained staff members thoroughly with any researchers seeking to evaluate staff training packages at their program. Researchers, in turn, have a responsibility minimize these risks to the greatest extent possible by planning evaluations that do not involve exposing learners to untrained staff.

 

 

LMaffei-Blog-Bubble

Lindsay Maffei-Almodovar, MS Ed, MA, BCBA, has worked in the field special education since 2001. She joined Quality Services for the Autism Community (QSAC) in 2011 and is currently the ABA Training & Development Coordinator. She is responsible for designing, evaluating and monitoring staff training initiatives at both the preschool and Day School programs. Lindsay is a certified New York State Early Childhood General & Special Education Teacher and a Licensed Behavior Analyst. Lindsay is also a doctoral student in the Behavior Analysis Training Area of the Psychology Department at Queens College and The Graduate Center City University of New York (CUNY). Her research focuses on efficient methods of training staff members in evidence based behavior analytic procedures.

 

 

References:

Baumeister, A. A., & Zaharia, E. S. (1987). Withdrawal and commitment of basic-care staff in residential programs. In S. Landesman, P. M. Vietze, M. J. Begab, S. Landesman, P. M. Vietze, M. J. Begab (Eds.) , Living environments and mental retardation (pp. 229-267). Washington, DC, US: American Association on Mental Retardation.

Finn, L. L., & Sturmey, P. (2009). The effect of peer-to-peer training on staff interactions with adults with dual diagnoses. Research In Developmental Disabilities, 30(1), 96-106. doi:10.1016/j.ridd.2007.11.004

Jones, F. H., Fremouw, W., & Carples, S. (1977). Pyramid training of elementary school teachers to use a classroom management ‘‘skill package’’. Journal of Applied Behavior Analysis,10, 239–253.

Nigro-Bruzzi, D. (2011). The effects of pyramidal training on staff behavior and manding in children with autism. Dissertation Abstracts International, 71, 5107. Page, T. J., Iwata, B. A., & Reid, D. H. (1982). Pyramidal training: A large-scale application with institutional staff. Journal Of Applied Behavior Analysis, 15(3), 335-351. doi:10.1901/jaba.1982.15-335

Schlosser, R. W., Walker, E., & Sigafoos, J. (2006). Increasing Opportunities for Requesting in Children with Developmental Disabilities Residing in Group Homes through Pyramidal Training. Education And Training In Developmental Disabilities, 41(3), 244-252. Seavey, D. (2004). The cost of frontline turnover in long-term care. Better Jobs Better Care, IFAS/AAHSA.

Shore, B. A., Iwata, B. A., Vollmer, T. R., Lerman, D. C., & Zarcone, J. R. (1995). Pyramidal staff training in the extension of treatment for severe behavior disorders. Journal Of Applied Behavior Analysis, 28(3), 323-332. doi:10.1901/jaba.1995.28-323

Van den Pol, R. A., Reid, D. H., & Fuqua, R. W. (1983). Peer training of safety-related skills to institutional staff: Benefits for trainers and trainees. Journal of Applied Behavior Analysis, 16, 139–156.

Van Houten, R., Axelrod, S., Bailey, J. S., Favell, J. E., Foxx, R. M., Iwata, B. A., & Lovaas, O. (1988). The right to effective behavioral treatment. Journal Of Applied Behavior Analysis, 21(4), 381-384. doi:10.1901/jaba.1988.21-381

 

 

 

ABOUT US

QSAC is a New York City and Long Island based nonprofit that supports children and adults with autism, together with their families, in achieving greater independence, realizing their future potential, and contributing to their communities in a meaningful way by offering person-centered services.

QSAC pursues this mission through direct services that provide a supportive and individualized setting for children and adults with autism to improve their communication, socialization, academic, and functional skills.