Digital Commons Network^™

Functional Analyses Of Response Chains, Brinea Charles

Theses & Dissertations

Although functional analyses (FAs) have been used to determine the cause of problem behavior and to develop effective treatment (Iwata et al., 1982/1994; Hanley et al., 2003), they may pose an increased risk of injury to the participant and others when the target response is a severe behavior (Smith & Churchill, 2002). Several studies have explored the efficacy of using response class hierarchies (precursors) in an FA, but fewer studies have explored early sub-responses in a behavior chain. Therefore, the purpose of this study was to 1) identify a systematic process for defining response chains of severe behavior and verify …

Teaching Peer Imitation To Preschool-Aged Children With Autism Spectrum Disorder Using A Video Modeling Treatment Package, Megan M. Harper

Theses & Dissertations

Peer imitation is a skill that serves to promote the acquisition of new play skills, problem-solving skills, and academic skills through observation of one’s peers. Although peer imitation is an important pre-requisite for learning from peers, many autistic children experience deficits in this area. In the present study, we evaluated a video model treatment package to teach autistic children to imitate their peers. Additionally, we conducted free play probes pre- and post-training to assess the transfer of training to a natural play setting. The results of the current study are mixed. One participant’s imitation skills generalized to the in-vivo sessions …

Translating A Pediatric Weight Management Intervention Into Medically Underserved Areas, Caitlin Golden

Theses & Dissertations

Despite substantial prevention and treatment efforts, childhood obesity remains a pressing public health concern. Disparities persist in obesity prevalence among children of lower socioeconomic status, racial and ethnic minority groups, and those residing in rural areas. The vast majority of efficacious pediatric weight management interventions (PWMIs) have been based in larger cities and urban areas delivered through inter-disciplinary teams in a hospital or medical center, and the degree to which these or other efficacious PWMIs have been translated to, and are feasible in, typical rural or micropolitan areas is unclear. This dissertation describes a dissemination strategy and a systematic approach …

Returning To Life Activities After Hematopoietic Cell Transplantation In Older Adults, Thuy T. Koll

Theses & Dissertations

The prevalence of hematopoietic cell transplant (HCT) among older adults with hematological malignancies has doubled over the last decade and continues to grow. HCT is an intense process that can impact functional status and health-related quality of life. The objective of this thesis is to describe the experience of returning to life activities after HCT in patients 60 years of age and older and the resources required to adapt and cope to limitations in physical, psychological, and cognitive function. Twenty English speaking adults 60 years and older with hematological malignancy three to twelve months post-HCT completed semi-structured interviews. Open-ended questions …

A Study To Determine The Most Important Leadership Skills For Entry-Level Public Health Practitioners, Taelyr Weekly

Theses & Dissertations

Objective: This study 1) identifies the top leadership skills needed for entry-level local public health department employees, 2) provides employee self-assessment ratings in importance, preparation, and proficiency of select leadership skills, and 3) compares the self-assessment and supervisor ratings of select leadership skills to assess how prepared and proficient employees are. Participants: A sample of positional leaders (n=15) from Nebraska’s local health departments provided results for the top leadership skills for entry-level local public health department employees. Employee self-assessment ratings (n=18) and paired samples of employees and supervisors (n=12) produced results on the importance, preparation, and proficiency of …

Teaching Children With Autism Spectrum Disorder Self-Protection Skills In Response To Bullying Situations, Maya J. Fallon

Theses & Dissertations

Children diagnosed with autism spectrum disorder (ASD) are at high risk of being bullied but research on teaching children with ASD self-protection skills for bullying situations is scant. We assessed the generality of teaching procedures used in Stannis et al. (2019) to teach adults self-protection skills with autistic children. We taught five children self-protection skills for two types of bullying (threats and unkind remarks) in a one-on-one format. In addition, we taught children a self-protection skill for repeated bullying occurrences. We first evaluated behavioral skills training to teach children to report threats of physical or material harm, provide a disapproving …

Facilitating The Emergence Of Intraverbal-Tacts In Autistic Children Via Joint Control, Michael Aragon

Theses & Dissertations

Rodriguez et al. (2022) discovered that teaching four component skills was sufficient to facilitate the emergence of intraverbal-tacts across four applications with three participants. Our study evaluated an extension of this procedure aimed at facilitating intraverbal-tacts when a child learns the component skills but continues to fail to produce intraverbal-tacts. The extension consisted of procedures that attempted to enhance the divergent control exerted by the auditory stimulus (i.e., the question) and the discriminability of joint control. Intraverbal-tacts emerged for all three participants. These results are discussed in the context of Michael et al.’s (2011) conceptual analyses of intraverbal-tacts and the …

Establishing A Generalized Qualifying Autoclitic Repertoire In Children With Autism Spectrum Disorder, Todd M. Owen

Theses & Dissertations

Autoclitics are secondary verbal operants that are controlled by a feature of the conditions that evoke a primary verbal operant (e.g., tact, mand). Among the types described by Skinner, qualifying autoclitics extend, negate, or assert a speaker’s primary verbal response and modify the intensity or direction of the listener’s behavior. In the only study to date on teaching qualifying autoclitics, Howard and Rice (1988) established generalized autoclitics that indicated weak stimulus control (e.g., “like a [primary tact]”) with four typically developing preschool children. However, generalization to newly acquired tacts was limited. In Experiment 1, we extended Howard and Rice to …

Strengthening Capacity For Clinical And Translational Science: A Multi-Method Assessment Of Research Capacity Development In A Regional Clinical And Translational Research Network, Lakaija Johnson

Theses & Dissertations

The National Institute of Health (NIH) has made significant investments to establish and maintain statewide and regional clinical and translational research (CTR) networks. These networks are designed to accelerate the translation of research discoveries from laboratory and clinical settings to improve community and population health. The National Institute of General Medical Science (NIGMS) Institutional Development Award (IDeA) Program Infrastructure for Clinical and Translational Research (CTR) [IDeA-CTR] initiative was initiated in 2012 to broaden participation in CTR in regions and territories with IDeA designation, having historically been funded by the NIH at lower levels. IDeA-CTR networks stimulate infrastructural investments in complex …

Teachering Protective Skills To Address Risk Factors Associated With Emerging Problem Behavior, Javid A. Rahaman

Theses & Dissertations

A common approach to prevention aims to proactively teach skills suited to specific situations commonly correlated with emerging problem behavior. However, an alternative approach may teach skills that generalize to various situations found to influence problem behavior (protective effect). The current study aimed to extend previous prevention programs by evaluating the efficacy of an approach to teach skills and evaluate protective effects that address challenging situations associated with emerging problem behavior. Teaching and protective effects were assessed with 4 children using a multiple probe design across challenging situations. The results suggest protective skills are needed to address situations that are …

Psychological Trauma Alters T-Lymphocyte Inflammation And Redox Through Sympathetic Mechanisms, Safwan K. Elkhatib

Theses & Dissertations

Posttraumatic stress disorder (PTSD) is a devastating psychiatric disorder characterized by distinctive symptom clusters, including intrusive memories (i.e., flashbacks), avoidance of related stimuli, affective changes, and hyperarousal. Strikingly, patients with PTSD face a significantly increased risk for a number of inflammation-driven pathologies, ranging from cardiovascular to autoimmune disease. Yet, the exact etiology of this increased risk remains unknown. The immune system is known to be strongly influenced by the sympathetic nervous system, and sympathetic overactivity is a hallmark of PTSD. Lymphoid organs, such as the spleen, are richly innervated by sympathetic nerve fibers which terminate near adaptive immune …

Giving Birth At A Critical Time: Assessing Perinatal Depression Among Syrian Refugees In Low Resource Settings, Nada Alnaji

Theses & Dissertations

Refugee mothers are at an increased risk of suffering from stress and mental health conditions during the first year after giving birth to a child. The objective of this study is to enhance the early identification of treatable mental health conditions among perinatal women living within humanitarian settings. The central hypothesis is that a culturally specific approach can be helpful for the long-term success of mental health efforts. In this study, we use qualitative interview methods to understand the cultural paradigms and predisposing factors for perinatal depression related to being a Syrian refugee in Lebanon during the COVID-19 pandemic. In …

Factors Associated With Omani’S Schoolteachers’ Reporting Behavior Of Suspected Cases Of Child Abuse And Neglect, Zeinab N. Alazri

Theses & Dissertations

Child abuse and neglect is a global problem that can result in severe negative consequences for victims and their societies. Numerous initiatives have been launched by the United Nations Children's Fund (UNICEF) to combat this problem. Recently, Sultanate Oman, an Arab country, has mandated schoolteachers to report suspected abuse and neglect cases to comply with UNICEF's recommendations. As schoolteachers spend a great deal of their time with children, they are in a good position to recognize and report suspected abuse and neglect cases so the victims can get the needed help and treatment. There is a dearth of information about …

Intention To Breastfeed: Breastfeeding Attitudes, Norms, Self-Efficacy, Social Support Network And Community Resources Of African American, Low-Income, Emerging Adult Women, Pregnant For The First Time, Sara E. Brown

Theses & Dissertations

African American (AA) women continue to have the lowest rates of breastfeeding. This continues to create a health disparity even though breastfeeding is extensively recognized in the scientific and health care communities as the optimal feeding choice for infants. This study examined the relationship between the external variables (social support network and community resources) and the explanatory variables (attitudes, norms, and perceived self-efficacy) and intention to breastfeed, for the AA, first time, low-income, emerging adult pregnant woman. The Integrated Behavior Model (IBM) was used as the theoretical framework to guide this study in better understanding the variables influencing breastfeeding intention. …

Using Prompt Delay And Instructive Feedback To Teach Pretend Play Skills To Children With Autism Spectrum Disorder, Gabriella R. Van Den Elzen

Theses & Dissertations

Pretend play involves carrying out routines, acting out roles, referencing absent or imaginary properties of objects, or substituting one object for another. Pretend play skills emerge in typically developing children by preschool age but are often absent or delayed in children with autism spectrum disorder (ASD). In the present study, we evaluated use of prompt delay, instructive feedback, and prompt delay with instructive feedback for the acquisition and maintenance of pretend play skills with children with ASD. Throughout training, we conducted free-play probes to evaluate generalization to a naturalistic setting. The results of the current study suggest that combining the …

Translational Evaluation Of Treatment Integrity Following Training With Varying Destructive Behavior Rates, Alexandra Hardee

Theses & Dissertations

Behavior analysts often use behavioral skills training to teach caregivers to implement treatment for their child’s destructive behavior with high levels of integrity. Even when trained to high levels of integrity, caregivers may revert to undesirable behaviors, and treatment integrity may decrease if high rates of destructive behavior occur (i.e., relapse). In the present study, we implemented a translational evaluation with adult participants to determine the impact of training under low- or high-rate destructive behavior on treatment integrity during subsequent treatment challenges involving exposure to high rates of destructive behavior only. Participants trained to implement the treatment package under conditions …

Health Service Utilization And Expenditure In Cardio-Metabolic Conditions In The United States Adults, Kavita Mosalpuria

Theses & Dissertations

Metabolic syndrome is multicomponent risk factor for cardiovascular diseases (CVD) and type 2 diabetes that reflects the clustering of at least 3 cardiometabolic risk factors, among hypertension, impaired glucose regulations, hypercholesterolemia, and obesity. CVD are the leading cause of death in the U.S. CVD occur at earlier age and is a major cause of death and disability among people with diabetes. As compared to Japan, 13.3% to 44% of the excess CVD mortality in the U.S. can be explained by the metabolic syndrome. The prevalence of metabolic syndrome was 34.3% in 2007 to 2014 and it increases with age. Metabolic …

Indices Of Happiness And Unhappiness During Treatment Of Pediatric Feeding Disorders, Laura Elizabeth Phipps

Theses & Dissertations

To date, there is no research on the measurement or evaluation of indices of happiness and unhappiness for children receiving behavior-analytic treatment for feeding disorders. The purpose of the current study was to measure child indices of happiness and unhappiness before and during extinction-based treatment and to evaluate the effects of noncontingent reinforcement with extinction-based treatment on indices of happiness and unhappiness. Overall, indices of happiness were idiosyncratic, and indices of unhappiness were initially higher during extinction without noncontingent reinforcement compared to with noncontingent reinforcement. Percentage of acceptance increased for all participants during both treatments, and caregiver treatment acceptability was …

Predicting Reinforcers To Increase Physical Activity In Young Children With Obesity Using The Six-Minute Walk Test, Jordan D. Lill

Theses & Dissertations

Childhood obesity continues to be a significant public health problem in the United States in which approximately 8% to 12% of American children are obese (Cunningham, Kramer, & Narayan, 2014; Mirza et al., 2018; Ogden et al., 2014). Further, 42% of American children are engaging in less than the recommended 60 minutes of daily physical activity (Troiano et al., 2008). Several treatments have been evaluated that have included goal-setting, self-monitoring, performance feedback, and access to arbitrary tangible rewards (e.g., Hyusti, Normand, & Larson, 2011; Van Camp & Hayes, 2012), but these treatments have often failed Luttikhuis et al., 2009; Nooijan …

Phase Duration And Resurgence, Sean Smith

Theses & Dissertations

Resurgence, the recurrence of responding due to a worsening of reinforcement conditions for current behavior, is a prevalent form of treatment relapse. Resurgence as Choice in Context predicts that increasing the duration of exposure to reinforcement for target responding during Phase 1 will increase resurgence magnitude, whereas increasing the duration of exposure to reinforcement for alternative responding and extinction for target responding during Phase 2 will decrease resurgence magnitude. We conducted an experiment evaluating these predictions with human participants recruited through Amazon’s Mechanical Turk platform. We varied Phase 1 and Phase 2 durations across four experimental groups. Resurgence as Choice …

An Evaluation Of Trial-Based Functional Analyses Of Inappropriate Mealtime Behavior, Ashley Andersen

Theses & Dissertations

Functional analyses allow clinicians to develop treatment targeting the variables maintaining a child’s inappropriate mealtime behavior (Bachmeyer et al., 2019). Extended functional analyses can be inefficient, potentially delaying the onset of treatment. Researchers have suggested a trial-based functional analysis can increase assessment efficiency (Saini, Fisher, et al., 2019). This study compared trial-based functional analyses to extended functional analyses to determine the variables maintaining inappropriate mealtime behavior. We compared the efficiency and acceptability and evaluated treatments informed by the analyses. Exact correspondence between analyses was low (29%); however, most treatments indicated by the trial-based functional analyses (71%) resulted in improvements in …

Essays On Rehospitalization Under The Hospital Readmission Reduction Program, Yangyuna Yang

Theses & Dissertations

The Hospital Readmission Reduction Program (HRRP), a part of the Affordable Care Act (ACA), requires the Centers for Medicare and Medicaid Services (CMS) to penalize hospitals with excess readmissions. The following conditions/procedures with high 30-day readmission rates were included in the program: Acute Myocardial Infarction, heart failure, pneumonia, chronic obstructive pulmonary disease, total hip arthroplasty and/or total knee arthroplasty, and coronary artery bypass graft (CABG). More research needs to be done regarding the national impact of the program. In addition, the risk factors of newly targeted CABG needs to be investigated robustly. Lastly, besides evaluating the risk of readmissions before …

Comparative Analysis Of National Emergency Management Charters: A Pilot Study Towards Achieving A Standardized Global Emergency Management Framework, Wael Elrayes

Theses & Dissertations

The world is facing increasing risks from a variety of threats, especially those related to extreme weather and natural disasters. The substantial and sustained impacts of major disasters are reinforcing the calls for global collaboration. Nevertheless, worldwide emergency assistance efforts are confronted with several challenges that negatively affect the disaster victims, stress international diplomatic relations, and threaten the social and national security of nations. These challenges arise from the unique nature of each national emergency management framework and the lack of global standardization and governing rules.

We conducted this qualitative study. Using a variety of qualitative analytical methods. we examined …

Translational Evaluation Of The Effects Of Alternative Reinforcer Preference On Resurgence, Madeleine D. Keevy

Theses & Dissertations

We assessed the differential effects of high- and low-preference stimuli as reinforcers during functional communication training (FCT) on resurgence of destructive behavior during extinction using a multielement design with the components signaled by color-coordinated stimuli. In baseline, analog destructive responding resulted in reinforcement in both components. Next, in the treatment phase, the therapist discontinued reinforcement for the analog destructive response and delivered a high-preference reinforcer for a functional communication response (FCR) in the HIGH component and a low-preference reinforcer for the FCR in the LOW component. In the resurgence test, the therapist discontinued reinforcement for both the FCR and analog …

Boundary Conditions Of Observational Learning In Children With Autism Spectrum Disorders, Andrew Blowers

Theses & Dissertations

Whether a child with autism spectrum disorder will exhibit observational learning may depend on their attention to a part of the observed contingency and the stimulus modalities of the observed contingency. The absence of observational learning due to one or more of these variables would constitute a boundary condition. We held attention constant and used a multiple probe design combined with a repeated acquisition design to tested observational learning across a diverse set of contingencies, which composed of a hidden-edible, hidden-toy, hidden-video, tact, receptive-identification , and intraverbal contingencies. During preteaching, two children with autism spectrum disorder showed observational learning with …

An Evaluation Of A Renewal-Mitigation Procedure For Inappropriate Mealtime Behavior, Sarah D. Haney

Theses & Dissertations

Renewal, the increase in problem behavior during extinction following a context change (e.g., transfer of intervention from clinic to home), may be particularly concerning during interventions for feeding disorders because multiple context changes are often necessary for intervention generality and maintenance (Podlesnik et al., 2017). In the current study, we tested for renewal and evaluated a renewal-mitigation procedure when we transferred the intervention from a therapist to a caregiver, from clinic to the home, and introduced Context A foods. We used an ABA arrangement to evaluate the generality of the renewal effect with 7 children with feeding disorders. Context A …

Evaluating The Generality And Social Acceptability Of Early Friendship Skills, Ciobha A. Mckeown

Theses & Dissertations

The development of prosocial skills is considered pivotal to childhood development. The friendship unit of the Preschool Life Skills program teaches early prosocial skills likely to facilitate socially desirable behaviors in young children; however, the friendship unit is the most understudied unit and has produced modest, inconsistent outcomes across children. The current study aimed to evaluate procedures necessary to (a) teach friendship skills to four children, with and without developmental disabilities, in an applied context and (b) promote the use of the skills with a same-aged peer. Teaching five friendship skills in a one-on-one approach and adding tangible reinforcement, if …

Sustaining Behavior Reduction By Transitioning The Topography Of The Functional Communication Response During Fct, Kayla R. Randall

Theses & Dissertations

Initial rates of destructive behavior tend to be lower when behavior analysts select functional communication responses (FCRs) they can physically guide (e.g., a card-touch FCR). However, destructive behavior may recur at higher rates when FCR materials go missing than when the FCR no longer produces reinforcement. In Experiment 1, we extended prior research by demonstrating less resurgence of target responding when a vocal FCR remained available but no longer produced reinforcement compared to a condition in which neither the alternative response nor reinforcement was available. In contrast to these findings, Experiment 2 replicated other prior research showing that the ability …

Evaluating The Use Of Competing Items In A Multiple Schedule During Reinforcement Schedule Thinning, Scott A. Miller

Theses & Dissertations

Multiple schedules are schedules of reinforcement that are often used to facilitate more manageable rates of a replacement behavior such as a communication response following functional communication training as an intervention for destructive behavior. Commonly, reinforcement schedule thinning involves multiple fading steps that can take more than 100 sessions to achieve therapeutic goals. The purpose of this experiment was to evaluate a method for rapidly achieving fading steps in a multiple schedule by including competing items during the extinction interval. Four children diagnosed with autism successfully reached the terminal extinction interval with a ≥80% reduction in problem behavior. Two of …

Efficacy And Efficiency Evaluation Of Real-Time Feedback For Caregiver Training, Elizabeth J. Preas

Theses & Dissertations

Children with an autism spectrum disorder often have deficits in completing activities of daily living skills independently, which then falls on the responsibility of caregivers to assist their child. Behavioral skills training is an efficacious method to train caregivers to implement various behavioral interventions that includes several training components, which can be time intensive. Alternative caregiver training methods that are effective and efficient are needed to train caregivers to implement activities of daily living skills with their child. The present study used two concurrent multiple-baseline across participants design to evaluate the effects of real-time feedback and behavioral skills training to …