cf_dsm_5_intervention_matrix(Ashanti Unaka)

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Feb 20, 2024

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Week 5 Assignment: DSM-5 Potential Intervention Matrix Ashanti Unaka Psy 6311 Ana Escalante February 12 th , 2023 1
DSM-5 Potential Intervention Matrix Core Autism Symptoms and Behavior Analytic Intervention DSM-5 Domains DSM-5 Criteria: Deficits DSM-5 Examples Add: Operational Definition of at Least One Behavior (can be hypothetica l) Add: Behavior Analytic Interventio n Options Add: Peer- Reviewed Citations A. Persistent\ deficits in social communicat ion and social interaction across multiple contexts, as manifested by the following, currently or by history; must have all 3 symptoms in this domain  1. Social- emotional reciprocity  Abnormal social approach and failure of normal back- and-forth conversation; reduced sharing of interests, emotions, or affect; failure to initiate or respond to social interactions  Behavior: Initiating conversation OD: Whenever the client engages or initiates conversation with someone. The recommend ed intervention could be errorless prompting or utilization of social stories. Peer- mediated interventio n should be combined or in collaboratio n with other strategies to help promote conversatio ns and an individual’s ability to initiate one (Wong et al.,2015). 2. Nonverbal communica tive behaviors used for social interaction  Poorly integrated verbal and nonverbal communicatio n; abnormalities in eye contact and body language or deficits in Behavior: Eye Contact OD: Any instance of the client actively looking at someone who is looking at The recommend ed intervention is Differential Reinforcem ent. Differential reinforcem ent has been successfull y used to increase eye contact for children with autism (Carbone, 2
understandin g and use of gestures; total lack of facial expressions and nonverbal communicatio them. O’Brien, Sweeney- Kerwin,& Albert,2013 ) 3. Developing, maintaining , and understandi ng relationship Difficulties adjusting behavior to suit various social contexts; difficulties in sharing imaginative play or in making friends; absence of interest in peers  Behavior: Sharing Toys OD: Any instance of the client independent ly sharing toys with a peer. The recommend ed intervention is Pivotal response training Pivotal response training (PRT), will incorporate play into the interventio n from the environme nt (Ferrailoi & Harris 2011). B. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least 2 of the following, currently or by history; must have 2 of the 4 symptoms  1. Stereotype d or repetitive motor movements , use of objects, or speech  Simple motor stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases  Behavior: Echolalia OD: Point to point corresponde nce of verbal behavior, sameness in words. The recommenc ed intervention is the use of PECS, verbal prompts, or response blocking. When it comes to thinking about consequen ce interventio ns or differential reinforcem ent, we must understand that there are two forms of protocols that deal with escape (with and 3
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without blocking methods (Call et al.,2011). 2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns or verbal nonverbal behavior  Extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat food every day  Behavior: Noncomplia nce OD: When a child ignores or fails to follow a given demand. The recommenc ed intervention for this behavior is response blocking along with differential reinforceme nt, specifically DRA. When it comes to thinking about consequen ce interventio ns or differential reinforcem ent, we must understand that there are two forms of protocols that deal with escape (with and without blocking methods (Call et al.,2011). 3. Highly restricted, fixated interests that are abnormal in intensity or focus  Strong attachment to or preoccupatio n with unusual objects, excessively circumscribed or perseverative interest  Behavior: Stereotyped behavior OD: Repetitive body movements that can be exhibited as verbal or nonverbal behaviors. (Hand Flapping, The recommend ed intervention for this behavior is Differential Reinforcem ent. With differential reinforcem ent, it comes down to being consequen ces or antecedent based interventio ns used to treat repetitive 4
Clapping, Finger stemming and visual stemming) behaviors (Boyd et al.,2012). 4. Hyper- or hyporeactiv ity to sensory input or unusual interests in sensory aspects of the environmen Apparent indifference to pain/temperat ure, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement  Behavior: Self- Injurious Behavior (SIB) OD: Inflicting pain onto oneself using objects or hitting oneself with open/closed fist. The recommend ed behavior intervention is FCT and parent training. Usually kiddos engage in SIB when unable to effectively communicat e needs or wants. With proper tools, communicat ion can be increased, and SIB will decrease. When it comes to thinking about consequen ce interventio ns or differential reinforcem ent, we must understand that there are two forms of protocols that deal with escape (with and without blocking methods (Call et al.,2011). ABA Intervention Strategy Self-injurious behavior is defined as the occurrence of behavior that results in physical injury to one’s own body, also known as SIB. SIB typically seen in children diagnosed with autism, if not addressed in the early adolescent stages it could continue into adulthood. Self-injurious behaviors stem from lack of communication when a child who is diagnosed with autism is unable to communicate, they engage in maladaptive behaviors. Typically, children who engage in SIB, engage in this behavior for many reasons. Sometimes to escape from a task, access to a tangible item or simply attention. One mainstream intervention that is used to decrease SIB is called Functional Communication Training (FCT). FCT does not mean we are teaching the child words; we are more so teaching the child a meaningful and effective way to communicate. Specifically, the Picture Exchange Communication System also known as PECS is a great way to teach communication to a child with limited verbal behavior. 5
Sara is a 3-year-old non-verbal client. She has only been in ABA therapy for 2 months and engages in extreme SIB behaviors when access to attention or tangible is denied. Her behaviors consist of head banging, hair pulling and self-biting, Sara currently has to wear a helmet and protective gear. When Sara engages in SIB, the therapist uses planned ignoring, but the behaviors continue due to indifference to pain. Sara’s BCBA recommends using PECS to assist her with communicating, she will be placed on a FR1 schedule until the new behavior of appropriate manding and compliance is achieved, she will then be placed on an intermittent schedule to maintain behaviors. For example, every time Sara engages in SIB, preferred PECS will be presented to teach her how to communicate through manding. If Sara does not choose on her own due to behaviors, her high-p reinforcer will automatically be selected for a minute. Once the minute has elapsed the item will be removed, and Sara will be immediately presented with her PECS again. This will continue until Sara’s SIB behaviors has decreased. Reference Boyd, B.A., McDonough, S. G., & Bodfish, J. W. (2012). Evidence-based behavioral interventions for repetitive behaviors in autism. Journal of Autism and Developmental Disorders, 42 (6), 1236-48. https://doi.org/10.1007/s10803-011-1284-z Call, N. A., Pabico, R. S., Findley, A. J., & Valentino, A. L. (2011). Differential reinforcement with and without blocking as treatment for elopement. Journal of applied behavior analysis, 44 (4), 903-907. https://doi.org/10.1901/jaba.2011.44-903 Carbone,V. J., O’Brien, L., Sweeney-Kerwin, E. J. , & Albert, K. M. (2013). Teaching eye contact to children with autism: A conceptual analysis and single case study . Education & Treatment of Children, 36 (2), 139-159. https://doi.org/10.1353/etc.2013.0013 Ferraioli, S. J., & Harris, S. L. (2011). Teaching Joint attention to Children with Autism Through A Sibling-Mediated Behavioral Intervention. Behavioral Interventions, 26 (4),261-281. https://doi.org/10.1002/bin.336 Wong,C., Odom, S. L., Hume, K. A., Cox, A. W., Fetting, A., Kucharczyk, S., Brock, M. E., Plavnick, J. B., Fleury, V. P. & Schultz, T. R. (2015). Evidence-based practices for children, youth, and young adults with autism spectrum disorder: A comprehensive review. Journal of Autism and Developmental Disorders, 45 (7), 1951-1966. https://doi- org.library.capella.edu/10.1007/s10803-014-2351-z 6
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