The Thompson Center for Autism and Neurodevelopment hosted its Student Poster Session at the 17th Annual Thompson Center Autism Conference in October. The session had the most poster submissions to date as well as record-breaking attendance. There were a variety of posters showcasing the breadth of neurodevelopmental research in the fields of psychology, special education, physical therapy, social work, occupational therapy, applied behavior analysis, and educational, school, and counseling psychology. Congratulations to the following winners of this session:
1st Place: Evaluation Of A Latency-Based Competing Stimulus Assessment (LBCSA) by Madison Imler – MU Special Education ABA
A competing stimulus assessment (CSA) is used in the treatment of automatically maintained problem behavior to identify items that compete with the sensory consequences that are associated with the targeted problem behavior. This study aimed to evaluate a more efficient means of conducting a CSA by evaluating the effectiveness of a latency-based competing stimulus assessment (LBCSA). During the LBCSA, a therapist presented potential competing stimuli to the participants, and contingent on the occurrence of problem behavior the session was terminated. The primary researcher recruited three participants that attend a Midwest university-affiliated applied behavioral intervention clinic. To be included in this study, the individual had an ASD diagnosis and was referred to the study by the participant’s Board Certified Behavior Analyst (BCBA). The participants included Tucker who was a 12-year-old male that engaged in property destruction in the form of ripping, picking off, or crushing items. Tinley was a 6-year-old female that engaged in vocal stereotypy in the form of noncontextual vocalizations. Walter was a 10-year-old male who engaged in property destruction by throwing items. All sessions took place within individual rooms at the clinical facility. If the targeted problem behavior was property destruction, the session room was baited with items selected by consulting with the participant’s current clinical team. The primary dependent variables that were measured in this study were the frequency of problem behavior, latency to targeted problem behavior, and percentage of engagement with the competing stimuli. Each problem behavior was individually defined as the primary researcher consulted with the participant’s clinical team, and directly observed the targeted behavior before the start of baseline. In this study, the researchers utilized a multielement design to identify competing stimuli with short latency to disruptive behavior and competing stimuli with long latency to disruptive behavior. In addition, researchers evaluated the comparison of short-latency and long-latency items by utilizing a multielement design embedded within a reversal (ABAB) design. This study contributes to the literature by providing practitioners, educators, and staff with additional resources to further develop function-based interventions. These efficient and effective procedures also allow for behavior analysts to have a more practical and time-efficient assessment to train service providers (Luiselli et al., 2020). Overall, the use of the LBCSA increased the efficiency of the CSA and identified effective competing stimuli for the three participants that engaged in automatically maintained problem behavior. These findings suggest that using the LBCSA will improve the efficiency of conducting a CSA and make the application of the assessment more feasible for practitioners, educators, and staff members. As a result, the LBCSA will positively impact the development of effective treatments for automatically maintained problem behavior.
2nd Place: Feasibility of Transcutaneous Vagal Nerve Stimulation in Youth with ASD by Roee Dar – MU School of Medicine
The purpose of this pilot study is to evaluate the feasibility and tolerability of auricular transcutaneous vagal nerve stimulation (tVNS) as a non-pharmacological, non-invasive anxiolytic therapy in children and teens with autism spectrum disorder (ASD). Feasibility and tolerability were assessed by treatment compliance and participant feedback. Youth with ASD frequently suffer from anxiety as a comorbid condition that can be pharmacologically resistant (Kirsch et al., 2020). tVNS offers a minimal-risk method of shifting autonomic nervous system activity away from the sympathetic overactivation that contributes to anxiety (Lamb et al., 2017). tVNS has been studied in adult and pediatric populations with various neuropsychiatric conditions (Yap et al., 2020) but not as treatment for anxiety in youth with ASD. Methods & Results This is an open-label feasibility trial conducted from October 2021–September 2022. Participants with diagnosed ASD aged 7-17 were identified for recruitment through the Thompson Center Database or flyers at the Thompson Center Clinic. Baseline participant anxiety was assessed using the Revised Childhood Anxiety Sensitivity Index (CASI-R), Parent Rated Anxiety Scale-ASD (PRAS-ASD), and both a clinician- and a caregiver-version of the Clinical Global Impression of Severity. Only participants scoring moderate or high anxiety on the CASI-R were eligible for participation. Participants were then calibrated, fitted, and trained along with their caregivers to use the Soterix© mini-CT Stimulator transcutaneous electrical nerve stimulation device. Caregivers were instructed to administer a pre-programmed 60-minute period of electrode stimulation to their child nightly for two weeks. Compliance was measured with the device log and defined as use of the device on at least 80% of the nights during a participant’s trial. Caregivers were given an administration and behavior log to maintain throughout the study. At the two-week follow-up visit, all baseline assessments were repeated in addition to the clinician- and caregiver-versions of the Clinical Global Impression – Improvement Scale (CGI-I), and the caregiver log was returned. Of the fifteen enrolled participants, ten were compliant and included in data analysis of anxiety measures. Excluded participants included two that failed the baseline anxiety requirement, one that withdrew consent pre-treatment, and two that were non-compliant. Mean compliance of the twelve participants that received the device was 87%. The device was well tolerated by participants, with comments including “best sleep I ever had” and “it feels good”. Reasons for non-compliance included technical difficulties and failure to incorporate the device into a nightly routine. Among compliant participants, average anxiety measures on the CASI-R decreased by 7.9 points (SD = 6.3) and on the PRAS-ASD by 15.1 points (SD = 11.9). The median impression by clinicians and caregivers on the CGI-C was “minimally improved” anxiety. Implications for the Field tVNS treatment in youth with ASD is feasible and tolerable with potential benefits for anxiety. The results of this pilot study will inform larger, randomized control trials assessing the efficacy of tVNS as anxiolytic treatment. tVNS can potentially offer a simple, minimal-risk therapy that can reduce the pharmacological burden on youth with ASD while improving their independence and quality of life.
3rd Place: Intraindividual Variability in Subjective Sleep and Average Fatigue in Parents of Children on the Autism Spectrum by Braden Hayse – MU Clinical Psychology
Intraindividual Variability in Subjective Sleep and Average Fatigue in Parents of Children on the Autism Spectrum Background: Fatigue is related to various adverse health outcomes. Mean levels of some common sleep variables, such as total sleep time (TST), sleep onset latency (SOL), and wake after sleep onset (WASO), have been associated with fatigue. However, intraindividual variability (IIV) of sleep parameters might play an independent role in sleep’s relationship with fatigue. Understanding fatigue is particularly important for parents of children with autism spectrum disorder (ASD) given fatigue’s negative associations with positive parenting and implementation of child interventions. Objective: The objective of this preliminary study was to examine linear associations between IIV of subjective sleep parameters and mean fatigue levels in parents of children on the autism spectrum. Methods: The sample included 66 parents who expressed interest in a behavioral treatment sleep study for their school-aged children diagnosed with ASD (6-12 years old; NCT04545606). All parents (Mage=37.03, SD=6.53; 91% female) completed daily electronic diaries over a two-week baseline period. Daily fatigue rating was collected using a visual analog scale (0-100) and averaged within individuals. Within-individual standard deviations of subjective TST, SOL, and WASO were calculated to estimate IIV. Data were analyzed in R (v4.1.2) using multiple linear regression models controlling for participant age, gender, and individual respective sleep parameter means. Results: Bivariate correlations between sleep variable IIV and average fatigue indicated a positive association between TST variability and average fatigue, r(64)=0.33, p<0.01. Multiple regression analyses showed that greater IIV of TST was associated with higher average fatigue (β=0.14, 95%CI [0.01, 0.27], sr2=0.06, p=0.041). No significant associations were found between average fatigue level and IIV of WASO or SOL. Conclusion: Results suggest that greater TST variability may be one factor independently contributing to higher fatigue levels in parents of children on the autism spectrum, which warrants further examination of sleep variability and its associations in this population. Increased insight into the connection between parent fatigue and sleep might inform the importance of considering sleep interventions for both children and parents, and potential subsequent indirect treatment benefits. Future research could explore IIV of additional sleep parameters, fatigue IIV as an outcome, alternative methods of sleep measurement, and study designs that address causation.