Document Type

Dissertation

College

College of Arts and Sciences

Department

Psychology

Degree

PhD in Behavior Analysis

Dissertation Defense Date

2014

First Committee Member

Sassi, Jessica L.

Second Committee Member

Karsten, Amanda M.

Third Committee Member

Dickson, Chata A.

Additional Committee Member(s)

Thompson, Rachel H.

Abstract

"Disruptive behavior during dental visits can impede thorough treatment and often requires invasive approaches to deliver even basic care. Some authors report increased disruptive behavior from patients with autism spectrum disorders relative to their typical peers. The current study evaluated the efficacy of several treatment components to decrease disruptive during dental treatment including demand fading, reinforcement, and extinction. Seven students with autism spectrum disorders participated. In Study 1, modified functional analyses were conducted to confirm the function of disruptive behavior in this context. For all 7 students, the analyses confirmed disruptive behavior was maintained by escape from dental demands. In Study 2, demand fading procedures were evaluated in which the students were gradually exposed to components of a typical dental exam as disruptive behavior remained low; disruptive behavior produced a break from dental procedures. If demand fading was not sufficient to decrease disruptive behavior, extinction procedures were added. All 4 students required extinction to advance through all exam steps. In Study 3, additional strategies were used with demand fading to increase the utility of this approach. The first step in the exam where disruptive behavior occurred was broken down into smaller steps to increase the likelihood of success with this and later exam steps. Differential reinforcement was added such that students continued to access a break following disruptive behavior and accessed preferred items following each exam step completed in the absence of disruptive behavior. Two students progressed through exam steps with these modifications, while one student required the addition of extinction to advance through the entire exam."

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