The effects of graduated exposure, modeling, and contingent social attention on tolerance to skin care products with two children with autism

doi:10.1016/j.ridd.2005.05.009

Research in Developmental Disabilities

Volume 27, Issue 6, November–December 2006, Pages 585-598

https://doi.org/10.1016/j.ridd.2005.05.009 Get rights and content

Abstract

Children with autism may display unusual or fearful responses to common stimuli, such as skin care products. Parents of children with autism have often reported that their children will not allow the application of these types of substances to their skin and if the parent persists, the children become extremely upset and anxious. Such responding can interfere with adaptive functioning. The purpose of this study was to evaluate the effects of a treatment package involving graduated exposure to steps in an avoidance hierarchy, modeling, and social attention on the responding of two children with autism who displayed fearful responses to skin care products. Both avoidance and acceptance responses to skin care products were measured. Both changing criteria and multiple baseline experimental designs were employed to assess the effects of the intervention package. The results suggest that the package was successful in teaching tolerance of skin products for both children.

Section snippets

Participants

The participants were two young children with autism, independently diagnosed using the Childhood Autism Rating Scale (CARS) (Schopler, Reichler, DeVellis, & Daly, 1980). Four-year-old Duke had a CARS score in the mild to moderate range (33) and was also diagnosed as having a “severe language disorder”. He was intolerant to skin lotion and his mother requested assistance in applying lotion to prevent severe dry skin. She usually attempted to apply lotion after his bath in the evening. She

Results

Interobserver agreement on all measures of Sam's behavior Sam ranged between 75 and 100%. Baseline IOA for rejecting responses was 97%, for accepting responses was 91%, and for steps completed was 100%. Scores for rejecting responses in all treatment sessions scored ranged between 75 and 100%. Scores for positive responses in all treatment sessions scored ranged between 86 and 100%. IOA for steps completed during sessions was 100%.

Discussion

The results of this study show that graduated exposure together with modeling and contingent social attention were successful in teaching tolerance of skin products for Duke and Sam. Not only did the children tolerate application of these products, but verbal and nonverbal accepting responses increased in frequency while rejecting responses decreased in frequency. For Duke, his mother reported 3 years later that he still had no problems with lotion or similar tactile stimuli. Follow up with Sam

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The effects of graduated exposure, modeling, and contingent social attention on tolerance to skin care products with two children with autism

Abstract

Section snippets

Participants

Results

Discussion

Some current dimensions of applied behavior analysis

Journal of Applied Behavior Analysis

Transmission of patterns of self-reinforcement through modeling

Journal of Abnormal and Social Psychology

Vicarious reinforcement and imitative learning

Journal of Abnormal and Social Psychology

Imitation of film-mediated aggressive models

Journal of Abnormal and Social Psychology

Tactile defensiveness in children with developmental disabilities: responsiveness and habituation

Journal of Autism and Developmental Disorders

The effects of tactile defensiveness and tactile discrimination on in-hand manipulation skills

American Journal of Occupational Therapy

Behavioral staff management: An analogue study of acceptability and its behavioral correlates

Behavioral Residential Treatment

Annotation: Treatment of childhood phobias

Journal of Child Psychology and Psychiatry

Mothers as effective experimenter's for autistic children's phobias

Journal of Applied Behavior Analysis