Study Guide 11
What are the 6 erroneous assumptions about full inclusion in the context of universal education?
1- special education can work itself out of business by developing interventions that can be implemented in general education and prepare general educators to take over what special educators do. 2- all education should be special, that good teaching is good teaching regardless of the nature of the student, and therefore special education is not really special. 3- discrimination of one kind is like discrimination of any other kind, that diversity is diversity, and we should not discriminate one kind of diversity from another. 4- Special education will not be necessary if general education reform is successful. 5- That if general education is tiered then the problem of special education is solved. 6- All students, including those with disabilities, should be held to high standards.
How can a BCBA be involved in evaluating the effects of medications? (Video - Pharmacology and Autism)
A BCBA can be involved in evaluating the effects of medication by doing individualized clinical assessments. A BCBA try to collaborate with the physician to implement evaluation and then define and measure behavior to continuously monitor progress. This situation is ideal, although it does not happen frequently.
What are the ways Weedan et al. (2010) say that behavior analysts can become active members of the groups responsible for a given individual's medication?
A analyst can define and measure target response and make data-based treatment decisions. In order to be part of the group responsible for a client's medication a behavior analyst must have knowledge of the language used by physicians to describe behavior disorders and what behaviors are prescribed certain medications. Also, it is important to know which physicians are make data-based decisions, developing productive and professional relationships, and offer their services to parents or caregivers of your clients.
According to 6400 regulations, under what conditions would timeout procedures be restrictive? (Foxx et al., chapter 30)
A time out procedure under the 6400 definition is restrictive if the individual resists or refuses to leave an activity or area.
Describe how the Sundland Hospital event changed the system for behavior analytic services in Florida (Foxx et al., chapter 30)
After the event at Sundland a task force of behavior analysts to create state guidelines for the provision of behavioral services and techniques. The guidelines became the basis for the behavioral programming manual that regulated services through the early 1990s. The manual included levels of restriction based on the procedures. More restrictive interventions required approval from the Behavior Plan Review Committee.
Straw Man-
Agency groups using their power and platform to complete their agendas, and deem most of the behavioral approaches aversive, abusive and restrictive.
Why does Dr. Poling say "hope is reason's greatest enemy?" (Video - Pharmacology and Autism)
Because it gives way to other treatments like medications that seem easier than behavioral interventions that can be more effective. When parents caregivers hope for the medications to work they will look for evidence of effectiveness.
What commonly used behavior analytic procedure, generally considered the beginning of any least restrictive approach hierarchy, would be labeled as a restrictive procedure under the 6400 definition? To whom do the 6400 regulations apply? (Foxx et al., chapter 30)
Contingent praise or reinforcement. The 6400 definination applies to individuals over the age of 21.
Describe, using specific numbers, how the average life span of people with IDD changed over the course of twentieth century. Do the same for people with Down syndrome. (Braddock, 1999)
Currently the average life span of people with IDD is 66.2 years, compared to 1930s which was 18.5 years and 1970 which was 59.1 years. For individuals with Down syndrome the average age of death in the 1920s was 9 years, raised to 30.5 years in 1960, and in 1993 to 55.8 years.
What should a BCBA look for when considering measuring side effects of drugs? (Video - Pharmacology and Autism)
Focuses on physiological side effects. Monitor for behavioral side effects like sleep patterns, attention, daily performance, social ability, and effects of target behavior. Also, medication adherence issues, if the client is taking the medications when they are supposed to.
According to Weeden, Ehrhart, and Poling (2010), at that time, what was the only FDA approved atypical antipsychotic for use with people with autism? What is it approved for and what is the youngest age it is approved for?
In 2006, risperidone or Risperdal, an atypical antipsychotic, was approved for treating irritability in people with autism between the ages of 5 and 17.
What are two medications that have potential MO effects and how might those effects impact behavior analytic procedures?
Methylphenidate (Ritalin) abolishing operation and reduces the value of edible reinforcers. Risperidone/Risperdal, increases the value of edibles, EO effect.
What are the four common problems with studies used to evaluate the effectiveness of psychotropic medications for ASD? (Video - Pharmacology and Autism)
Short term studies, weak outcome measures very little direct measurement of behavior, untoward (unintended) effects, and medication interactions not studies. Aripipazole and Risperdone are FDA approved.
Describe, according to Braddock (1999), the top four out-of-home placements for individuals with IDD in the United States, as of 1996 (I realize this is out dated, but from what I have seen, although numbers have changed, the top four have not)
Small group homes, supervised apartments, foster care, and supported living placements.
What is one outcome of collaboration with physicians? (Video - Pharmacology and Autism)
The BCBA can gather information about behavior effects while the client is using the drug, then feed that information back to the physician to work with them on the effects of the drug. Sometimes the two work well together and medication use may even reduce due to this collaboration.
Where do the majority of people with developmental disabilities reside? (Braddock, 1999)
The majority of people with DD live with their family caregivers.
What kinds of behaviors are typically treated with psychotropic medications currently? Also, what drugs are currently approved to treat these behaviors? (Video - Pharmacology and Autism)
The medications are use to treatment troublesome behaviors or behavioral symptoms like reducing inappropriate responses of aggression to self and others and tantrums. The drugs that are being used are risperidone, Risperdal, aripiprazole, and abiliphy.
According to Kauffman et al. (chapter 5), what is and is not the central issue of the Full Inclusion Movement (FIM)?
The place rather than the specifics of appropriate instruction itself has become the central issue in the FIM. It is not the interventions and knowledge that is in special education training and research.
What was the significance of Alabama's regulations? (Foxx et al., chapter 30)
The regulations in Alabama were brought on by the want to create quality services for adults with IDD. There were only 4 BCBAs in the state and they needed to find a way to regulate and evaluate the services given to individuals with IDD. They accomplished creating regulations by forming a committee composed of service providers, several BCBAs, and the department of mental health developmental disabilities division to make the minimum requirements for professional writing, implementation, and overseeing behavior plans. The major significance of the Alabama regulations is that although they did not have many BCBAs to oversee service delivery, procedures based on the principles of ABA were used with adults with IDD. This means that even if an agency does not have enough staff to apply or monitor procedures according to regulations, they can still be trained to do so.
According to Weeden et al., what is the "use" of other medications when those medications are prescribed to improve the behavior of autism? Is that allowed, and under what conditions?
The use of other medications prescribed to improve behavior of people with autism the use of the drug is off-label, this means that the drug is prescribed for a purpose other than for what the FDA intended it to be used for. This is allowed only if the use is backed by scientific evidence that the drug use will be effective.
Are the medications that physicians currently prescribe used to treat the core symptoms of ASD? Why or why not? Can psychotropic drugs commonly prescribed result in skill acquisition? (Video - Pharmacology and Autism)
There are no drugs that are currently being used to treat the core symptoms of autism like impaired communication, impaired social interaction, and restricted behavioral repertoire. They are not being used effectively, but there is little evidence that these drugs can strengthen the repertoire.
Kauffman et al. are clear on what they do and do not have a problem with. What do they support and what "is the idea to which [they] object"?
They support the inclusion of many students with disabilities in general education classrooms for academic instruction. They support the inclusion of even more students with disabilities in non-instructional school activities. They believe that inclusion in school activities may be more appropriate than inclusion in academic instruction. They object to the focus on inclusion rather than instruction, not appropriate inclusion is what they object to.
Choose one sense or system from the Normal Age .pdf. Describe the changes that would be expected for normal adults and how adults with IDD might experience those changes. Then, identify one aspect of behavioral services that might be impacted by that change. That is, how would a behavior analyst working with an aging IDD population adjust or accommodate such changes.
Vision- adults with IDD may experience gradual decline of vision. The typical changes in vision related to age are changes in lens, pupil size, eye dryness, and depth perception. Also, the aging population is at risk of age related eye diseases like glaucoma. People with IDD may show signs of vision loss through certain behaviors like eye squinting, head tilting, and rubbing eyes. A behavior analyst should be aware of the signs of vision loss and recommend to the clients caregivers to make an appointment with a specialist to correct the problem. If the client needs desensitization of the eye doctors office, the BCBA can make a procedure to implement with their technicians. In the meantime, a BCBA can accommodate the client by make the text in their center and program larger for the client to read and be sensitive to the side effects of vision loss like allowing the client to adjust to changes in light.
What are the five common and serious shortcomings of many published studies on the effects of psychotropic drugs in people with intellectual and developmental disabilities (note that the article uses MR, but as discussed the first day, that terminology has since been changed). (Weeden et al., 2010)
a. Failure to demonstrate clinically significant as opposed to statically significant, drug effects. b. Weak experimental designs, such as open label case studies. c. Inadequate evaluation of possible adverse effects, including untoward behavioral effects such as general response suppression. d. Failure to examine desired and untoward effects over a sufficient period of time (people may receive drugs for years, even decades, but few long term exposure studies have appeared) e. Failure to examine possible drug interactions. People with developmental disabilities frequently receive two or more psychotropic meds at the same time, but no studies have examined how or if drug combinations interact.
Summarize, in your own words, the three conclusions presented in reviews of the relevant literature. (Weeden et al., 2010)
a. Several different drugs may be of value in reducing challenging behavior in people with autism. Among the individuals drugs shown to be useful are medications classified as atypical antipsychotics, typical antipsychotics, tricyclic antidepressants, serotonin-specific reuptake inhibitors, and opioid antagonists. b. Individual differences in response to a given drug are common and the factors responsible for the variability are unknown. c. Side effects, the nature and severity of which differ across drugs and individuals, sometimes appear and limit a drug's clinical value.
Psychotropic drugs-
are medications prescribed with the intent of improving an individual's mood, cognition, or overt behavior.
Full Inclusion-
that all students, regardless of handicapping condition or severity, will be in a regular classroom/program full time. All services must be taken to the child in that setting.
Faux Fixe
the soft social science of humans that determines what services are available for people with developmental disabilities.