CARD founder Dr. Doreen Granpeesheh is a pioneering researcher in the treatment of autism. After leading the seminal study at UCLA that demonstrated the effectiveness of applied behavior analysis (ABA) in treating the symptoms associated with autism, Dr. Granpeesheh continued her commitment to advance research on ABA at CARD, making CARD one of the nation’s largest non-governmental organizations investing in autism research. CARD research has contributed to the successful effort to mandate insurance funding of ABA throughout the United States and led to the seismic shift from home to center-based ABA when research demonstrated that children may double their rate of skill acquisition in a center environment. 

Highlights

Highlights

  • The current study explored subtypes of autism spectrum disorder (ASD) based on engagement in challenging behaviors and investigated differences in treatment response across the subgroups. 
  • Seven clusters were found and each cluster was characterized by a single dominant challenging behavior. 
  • Treatment response significantly differed for some clusters, with clusters characterized by self-injurious behavior and aggression demonstrating lower skill acquisition.
  • Interventions targeting self-injurious behavior and aggression may be worth prioritizing in treatment.

How to Cite

Gardner-Hoag, J., Novack, M. N., Parlett-Pelleriti, C., Stevens, E., Dixon, D. R., & Linstead, E. (2021). Unsupervised machine learning for identifying challenging behavior profiles to explore cluster-based treatment efficacy in children with autism spectrum disorder: Retrospective data analysis study.  JMIR Medical Informatics, 9(6), 1-16. http://dx.doi.org/10.2196/27793

Highlights

  • The current study explored the effectiveness of telehealth direct therapy at improving skill acquisition in individuals with autism spectrum disorder (ASD).
  • Telehealth direct therapy was effective for patients across varying symptom severity levels and age ranges to address a variety of skills using discrete trial training (DTT) and natural environment training strategies.
  • Varying degrees of caregiver assistance may be required depending on the patient’s level of need
  • Telehealth is a viable supplemental or alternative treatment modality even as we move beyond the COVID-19 pandemic.

How to Cite

Nohelty, K., Bradford, C. B., Hirschfeld, L., Miyake, C., & Novack, M. N. (2021). Effectiveness of telehealth direct therapy for individuals with autism spectrum disorder. Behavior Analysis in Practice. https://doi.org/10.1007/s40617-021-00603-6 

Highlights

  • The current paper described the Telehealth Therapy Treatment Integrity Measure (TTTIM), an instrument developed to measure the treatment integrity of applied behavior analysis (ABA) therapy delivered via telehealth to patients with autism spectrum disorder (ASD). 
  • The TTTIM is a 44-item tool that may be completed during telehealth therapy sessions to measure performance and guide training of behavior technicians implementing telehealth services.
  • The TTTIM helps alleviate the urgent need for treatment quality assurance of telehealth direct therapy brought on by the COVID-19 pandemic and helps pave the way for the practice of telehealth direct therapy moving forward.

How to Cite

Nohelty, K., Hirschfeld, L., & Miyake, C. (2021). A measure for supporting implementation of telehealth direct therapy with treatment integrity. Behavior Analysis in Practice, 14, 422-433. https://doi.org/10.1007/s40617-020-00543-7

Highlights

  • The current study evaluated the effectiveness of an immersive virtual reality training in teaching street-crossing skills to children with autism spectrum disorder (ASD).
  • The virtual reality training was found to effectively teach three children with ASD to identify when it is safe to cross the street in the natural environment. 
  • Immersive virtual reality is promising for the treatment of ASD, particularly for skills involving gestures that may be challenging to target in contrived or natural environment settings.

How to Cite

Dixon, D. R., Miyake, C. J., Nohelty, K., Novack, M. N., & Granpeesheh, D. (2020). Evaluation of an immersive virtual reality safety training used to teach pedestrian skills to children with autism spectrum disorder. Behavior Analysis in Practice, 13(3), 631–640. https://doi.org/10.1007/s40617-019-00401-1

Highlights

  • The current study evaluated the effectiveness of Camp Discovery, a mobile application developed by the Center for Autism and Related Disorders (CARD), which incorporates the principles of applied behavior analysis (ABA) to teach skills across a wide variety of domains.
  • Camp Discovery was found to be effective in teaching receptive language skills to children with autism spectrum disorder (ASD). 
  • Evidence-based computer-based interventions, like Camp Discovery, show promise for supplementing existing interventions and increasing access to treatment.

How to Cite

Novack, M. N., Hong, E., Dixon, D. R., & Granpeesheh, D. (2019). An evaluation of a mobile application designed to teach receptive language skills to children with autism spectrum disorder. Behavior Analysis in Practice, 12(1), 66-77. https://doi.org/10.1007/s40617-018-00312-7

Highlights

  • The current study used unsupervised machine learning to identify behavioral subtypes of autism spectrum disorder (ASD).
  • Sixteen subgroups were identified, and the hierarchy of those subgroups suggest there may be two unique subtypes of ASD, each with a spectrum of severity.
  • The ASD subgroups were found to have unique behavioral profiles as well as differentiated treatment response.
  • These findings may lead to advancements in targeted treatments for individuals with ASD based on subtype membership.

How to Cite

Stevens, E., Dixon, D. R., Novack, M. N., Granpeesheh, D., Smith, T., & Linstead, E. (2019). Identification and analysis of behavioral phenotypes in autism spectrum disorder via unsupervised machine learning. International Journal of Medical Informatics, 129, 29-36. https://doi.org/10.1016/j.ijmedinf.2019.05.006

Highlights

  • The current study identified the most commonly treated challenging behaviors for individuals with autism spectrum disorder (ASD) receiving behavioral intervention.
  • Stereotypy, noncompliance, and aggression were the most commonly treated topographies of challenging behaviors, and escape was the most commonly reported function of behavior.
  • A text analysis conducted on the operational definitions of the treated challenging behaviors found a high degree of overlap between typographies of behaviors (i.e., aggression, disruption, and tantrum; noncompliance and tantrum; obsessive behavior and stereotypy; self-injurious behavior and aggression). 

How to Cite

Hong, E., Dixon, D. R., Stevens, E., Burns, C. O., & Linstead, E. (2018). Topography and function of challenging behaviors in individuals with autism spectrum disorder. Advances in Neurodevelopmental Disorders, 2(2), 206-215. https://doi.org/10.1007/s41252-018-0063-7

Highlights

  • The current study compared rates of skill mastery between individuals with autism spectrum disorder (ASD) receiving behavioral intervention in center-based and home-based treatment settings. 
  • Participants who received center-based services were found to have significantly higher rates of skill acquisition than participants who received home-based services.
  • Participants who received both center-based and home-based services were found to master 100% more targets per hour when treatment was conducted in the center in comparison to their home.

How to Cite

Dixon, D.R., Burns, C.O., Granpeesheh, D., Amarasinghe, R., Powell, A., & Linstead, E. (2017). A program evaluation of home and center-based treatment for autism spectrum disorder. Behavior Analysis in Practice, 10(3), 307–312. https://doi.org/10.1007/s40617-016-0155-7

Highlights

  • The current study examined the impact of treatment intensity on the mastery of learning objectives in individuals with ASD (autism spectrum disorder) receiving behavioral intervention. 
  • Higher treatment intensity was found to predict greater treatment gains.
  • Using artificial neural networks, 60% of the variance in skill mastery was accounted for by treatment hours alone without considering patient-specific factors, such as age or severity of symptoms.

How to Cite

Linstead, E., Dixon, D. R., French, R., Granpeesheh, D., Adams, H., German, R., … Kornack, J. (2017). Intensity and learning outcomes in the treatment of children with autism spectrum disorder. Behavior Modification, 41(2), 229–252. https://doi.org/10.1177/0145445516667059

Highlights

  • The current study investigated the differential impact of treatment intensity and duration across various skill domains.
  • Academic and language skill domains were found to have the greatest response to treatment intensity and duration.
  • Greater understanding of the differential effect of treatment intensity and duration across skill domains may help clinicians make informed decisions regarding the allocation of treatment hours to improve treatment efficiency and maximize outcomes.

How to Cite

Linstead, E., Dixon, D.R., Hong, E., Burns, C.O., French, R., Novack, M.N., & Granpeesheh, D. (2017). An evaluation of the effects of intensity and duration on outcomes across treatment domains for children with autism spectrum disorder. Translational Psychiatry, 7(9), 1-6. https://doi.org/10.1038/tp.2017.207

Highlights

  • The current study examined the impact of supervision on skill mastery in individuals with autism spectrum disorder (ASD) receiving behavioral intervention.
  • In comparison to treatment intensity alone, supervision intensity in conjunction with treatment intensity was found to only slightly improve skill mastery. 
  • Supervisor credentials were found to be significant in that individuals receiving supervision from a Board Certified Behavior Analyst (BCBA) mastered significantly more targets. 
  • Years of experience as a clinical supervisor had a small but significant effect on skill mastery.
  • Supervisor caseload was not found to be a significant predictor.

How to Cite

Dixon, D. R., Linstead, E., Granpeesheh, D., Novack, M. N., French, R., Stevens, E., … Powel, A. (2016). An evaluation of the impact of supervision intensity, supervisor qualifications, and caseload on outcomes in the treatment of autism spectrum disorder. Behavior Analysis in Practice, 9(4), 339–348. https://doi.org/10.1007/s40617-016-0132-1

Review Papers

  • Racial biases held by behavior analysts may impact the clinical care of patients with autism spectrum disorder (ASD).
  • This review analyzes implicit bias through a behavioral lens and provides guidance for behavior analysists to reduce discrimination based on race in their practice.
  • Recommendations are made to assess and decrease clinicians’ implicit biases to reduce racial discrimination during patient, caregiver, and staff interactions.

How to Cite

Jaramillo, C., & Nohelty, K.  (2021). Guidance for behavior analysts in addressing racial implicit bias. Behavior Analysis in Practice.

Highlights

  • This review was conducted to describe existing research that used supervised machine learning algorithms to analyze large autism spectrum disorder (ASD) datasets. 
  • Although existing research was limited, various supervised machine learning algorithms have been used to make binary predictions, often based on diagnoses, to aid ASD diagnosis and screening efforts, explore the role of genetics in ASD, and identify potential ASD biomarkers (e.g., using neuroimaging). 
  • The use of supervised machine learning methods to analyze large collections of ASD data is a promising area for future research.

How to Cite

Hyde, K. K., Novack, M. N., LaHaye, N., Parlett-Pelleriti, C., Anden, R., Dixon, D. R., & Linstead, E. (2019). Applications of supervised machine learning in autism spectrum disorder research: A review. Review Journal of Autism and Developmental Disorders, 6(2), 128-146. https://doi.org/10.1007/s40489-019-00158-x

Highlights

  • This systematic literature review was conducted to identify factors related to staff retention in behavior technicians working with individuals with autism spectrum disorder (ASD). 
  • While existing research was limited, various employee factors (e.g., negative implicit attitudes toward individuals with ASD, commitment to philosophy, coping strategies, personality traits, and self-efficacy) and organizational factors (e.g., satisfaction with hours, pay, supervisor support, training, and work demands) were found to be associated with burnout, job satisfaction, and/or intention to turnover. 
  • While satisfaction with pay and reports of being under scheduled were associated with intention to turnover in behavior technicians, objective measures of pay and hours were not found to be significant, which highlights the subjective nature of these factors.

How to Cite

Novack, M. N., & Dixon, D. R. (2019). Predictors of burnout, job satisfaction, and turnover in behavior technicians working with individuals with autism spectrum disorder. Review Journal of Autism and Developmental Disorders, 6(4), 413-421. https://doi.org/10.1007/s40489-019-00171-0

Highlights

  • This systematic literature review was conducted to identify trends in sensory processing assessments used in autism spectrum disorder (ASD) research. 
  • The majority of assessment measures used in ASD research relied on informant-report rather than behavioral observation, and some assessments lacked well-established psychometric properties. 

How to Cite

Burns, C., Dixon, D. R., Novack, M., & Granpeesheh, D. (2017). A systematic review of assessments for sensory processing abnormalities in autism spectrum disorder. Review Journal of Autism and Developmental Disorders, 4(3), 209–224. https://doi.org/10.1007/s40489-017-0109-1

Book Chapters

    • This chapter is an update to a previously published chapter on the history of functional analysis. 
    • Developments in the use of functional analyses are described across methodologies, populations, behaviors, settings and individuals, idiosyncratic variables, and duration. 
    • Future directions for the field are discussed.

    How to Cite

    Nohelty, K., Burns, C., & Dixon, D.  (2021). A brief history of functional analysis: An update. In J. L. Matson (Ed.), Functional assessment for challenging behaviors and mental health disorders. New York, NY: Springer. https://doi.org/10.1007/978-3-030-66270-7_2 

  • There is limited research focused on the treatment of individuals with autism spectrum disorder (ASD) and co-occurring intellectual disability (ID).
  • This chapter provides an overview of evidence-based comprehensive and focused interventions for ASD, with a focus on philosophy, treatment setting, patient demographics, and available research on treating individuals with co-occurring ID.

How to Cite

Novack, M. N., Nohelty, K., & Dixon, D. R. (2020). Treatment of autism spectrum disorders in dual diagnosis. In J. L. Matson (Ed.), Handbook of dual diagnosis: Assessment and treatment in persons with intellectual disorders (pp. 505-529). New York, NY: Springer. https://doi.org/10.1007/978-3-030-46835-4_30

  • This chapter provides a history of the oversight of treatment research starting with the Declaration of Helsinki. 
  • Ethical guidelines regarding the protection of participants and cost-benefit considerations are reviewed. 
  • Procedures implemented by universities, states, and federal review boards are discussed.

How to Cite

Burns, C. O., Hong, E., & Dixon, D. R. (2017). Institutional review boards and standards. In J. L. Matson (Ed.), Handbook of treatments for autism spectrum disorder (pp. 59–66). New York, NY: Springer. https://doi.org/10.1007/978-3-319-61738-1_4

  • Pica, characterized by the ingestion of nonfood substances, is a common feeding disorder among individuals with developmental disabilities (DD). 
  • Pica requires immediate intervention as it can cause serious medical problems and even death.
  • This chapter provides an overview of the etiology, screening, and treatment of pica.
  • Behavioral strategies, including antecedent modifications, response-contingent interventions, and punishment-based interventions, have been effectively implemented to reduce pica.

How to Cite

Hong, E., & Dixon, D. R. (2017). Pica in individuals with developmental disabilities. In J. L. Matson (Ed.), Handbook of childhood psychopathology and developmental disabilities treatment (pp. 287–299). New York, NY: Springer. https://doi.org/10.1007/978-3-319-71210-9_17

Highlights

  • Teaching safety skills to individuals with intellectual and developmental disabilities (IDD) is essential as they are at an increased risk for injury.
  • Research has focused on teaching a variety of safety skills to individuals with IDD, including fire safety, first aid, accident prevention, fall prevention, pedestrian, self-protective, and emergency telephone skills.
  • Behavioral strategies such as modeling, prompting, role-playing, and feedback have been shown to be effective in teaching safety skills to individuals with IDD.

How to Cite

Jang, J., Mehta, A., & Dixon, D. R. (2016). Safety skills. In Singh. N. (Ed.), Handbook of evidence-based practices in intellectual and developmental disabilities (pp. 923–941). New York, NY: Springer. https://doi.org/10.1007/978-3-319-26583-4_36