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It is well-documented that autism can be reliably diagnosed by age two and that early signs emerge most often between 18 and 24 months. However, despite the increased awareness and focus on early diagnosis, the average age of diagnosis is over 4 years old; even later for Black children and those who are Medicaid-eligible. In this paper, we will propose a framework for accurate and accelerated autism diagnosis for children before age three. The proposed framework emphasizes a collaborative diagnostic process, which relies heavily on Birth to Three provider knowledge and expertise. Considerations for next steps are presented. This approach could increase access to diagnosis of young children soon after first signs of autism emerge.

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Imitation is a pivotal skill for children with and without disabilities, serving both learning and social interaction functions for young children. Children with autism spectrum disorder (ASD) frequently experience delays in acquiring this skillset, demonstrating challenges in the ability and/or propensity to imitate the actions of others. Current intervention programs frequently use discrete trial teaching (DTT) or contingent imitation to support imitation development in young children with ASD. This study combined contingent imitation with DTT to teach imitation to individuals who had previously struggled with acquiring this skill. A multiple probe design across three preschool children with ASD was conducted within participants' early learning classrooms. Response to intervention varied across participants, with participants with more advanced imitation skills at study onset demonstrating greater outcomes. Combining contingent imitation with DTT may facilitate the propensity to imitate for individuals who exhibit some appropriate object engagement and are inconsistently imitating others' actions with objects. However, further research using stronger research design is needed to improve the teaching of imitation to young children with ASD who exhibit challenges with this skillset.

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Currently, certified behavior analysts are required to adhere to the ethical rules established by the Behavior Analyst Certification Board® (BACB®) known as the Professional and Ethical Compliance Code for Behavior Analysts (BACB, 2014; hereafter referred to as the BACB Code). Applying these rules without context, however, can result in an overly simplified and mechanistic approach to ethical problem solving. Ethical rules that lack guiding principles may also pose dissemination challenges for behavior analysts tasked with communicating the field's ethical ideals to nonbehavioral colleagues and stakeholders. This article describes the process that our applied behavior analysis organization used to develop a set of guiding ethical principles to supplement the BACB Code. These principles guide our members' ethical decision making and assist them in disseminating our organization's ideals. Following a description of the principle development process, we present our organization's ethical principles and discuss how behavior analysts can use them to make clinical and ethical decisions, and address dissemination challenges.

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In 2016, the Behavior Analyst Certification Board (BACB) made effective a new, revised ethical code for behavior analysts, the Professional and Ethical Compliance Code for Behavior Analysts, replacing the code that had been in effect since 2001. In this revised code, the certification board has shifted the language of the code from that of a set of guidelines to that of a set of enforceable rules. This important shift has not been well discussed in the field. This article explores the potential implications and possible consequences of such a shift and describes other ways that ethical behavior has been approached historically. The authors then propose an ethical decision-making process that might provide a better area of focus for the field of behavior analysis in seeking to develop the highest levels of ethical behavior in its professionals and provide a case example using that process to resolve an ethical dilemma.

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Imitation is an important early social communicative skill that is often impaired in young children with autism. Reciprocal imitation training is an easy-to-implement intervention that targets social imitation and can be taught to parents or other caregivers to implement at home and in the community. In this study, parents of children with autism were taught to implement reciprocal imitation training. The quality of parent fidelity of intervention implementation and rates of child spontaneous imitation were examined in three phases: baseline, post-didactic training, and after the introduction of 1:1 coaching. The results suggest that coaching improved parent fidelity with all parent participants, and this correlated to an increase in spontaneous imitation with some of the child participants.

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Combining data from a series of three planned, consecutive independent randomized controlled trials (RCTs), the present study investigates two literacy interventions for preschool children with autism spectrum disorder (ASD). For the first cohort, children were randomized to interactive book reading treatment (IBR)or a business-as-usual (BAU) control condition; in Cohort 2, children were randomized to phonological awareness treatment (PA)or BAU; in Cohort 3, children were randomized to IBR or PA. Both treatments were implemented weekly in the classroom from November to May. Combined across cohorts, data from n =47 IBR, n =42 PA, and n =44 BAU students from 57 classrooms in 8 districts were available for analysis. Model results showed that IBR had significantly greater pretest-posttest gains than the sample mean on expressive vocabulary and listening comprehension (d*=0.29 and 0.30), whereas PA had significantly greater phonological awareness gains (d*=0.39).

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The purpose of this randomized control group study was to examine the effects of a peer network intervention that included peer mediation and direct instruction for Kindergarten and First-grade children with autism spectrum disorders. Trained school staff members provided direct instruction for 56 children in the intervention group, and 39 children participated in a comparison group. Results showed children in the intervention group displayed significantly more initiations to peers than did the comparison group during non-treatment social probes and generalization probes. Treatment session data showed significant growth for total communications over baseline levels. Children in treatment also showed more growth in language and adaptive communication. Finally, teachers' ratings of prosocial skills revealed significantly greater improvements for the intervention group.

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This investigation examined communication patterns between high functioning children with autism and their families and typically developing children and their families within traditional dinner time conversation. Twenty families with a child with autism (3.5-7 years.) and ten families with typically developing children (3.5-6 years) were video recorded during dinner and their interactions were coded. Results revealed that children with autism initiated fewer bids for interactions, commented less often, continued ongoing interactions through fewer conversational turns, and responded less often to family member communication bids. Results are interpreted with respect to how communication patterns may be indicative of social communication deficits not previously examined in high functioning children with autism. Strategies for social communication interventions within the family and other natural contexts are discussed.

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Positive behavior support (PBS) emerged in the mid-1980s as an approach for understanding and addressing problem behaviors. PBS was derived primarily from applied behavior analysis (ABA). Over time, however, PBS research and practice has incorporated evaluative methods, assessment and intervention procedures, and conceptual perspectives associated with a number of additional disciplines. Recently, there has been some confusion regarding the definition of PBS and, in particular, its relationship to ABA. In this article, it was noted that the practice of PBS and ABA, in some instances, can be indistinguishable but that important differences in definitions and emphases mandate an explicit distinction. The purpose of this article is to address some of the key points of confusion, identify areas of overlap and distinction, and facilitate a constructive and collegial dialog between proponents of the PBS and ABA perspectives.

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A single subject, withdrawal design was used to investigate the effects of therapy balls as seating on engagement and in-seat behavior of young children with Autism Spectrum Disorder (ASD). In addition, social validity was assessed to evaluate teachers' opinions regarding the intervention. During baseline and withdrawal (A phases) participants used their typical classroom seating device (chair, bench or carpet square). During the intervention (B phases) participants sat on therapy balls. Results indicated substantial improvements in engagement and in-seat behavior when participants were seated on therapy balls. Social validity findings indicated that the teachers' preferred the therapy balls. This study suggests therapy balls as classroom seating may facilitate engagement and in-seat behavior and create opportunities to provide effective instruction.

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BACKGROUND AND PURPOSE: Physical therapists and occupational therapists frequently use adaptive seating devices to improve stability in sitting for children with neuromotor impairments. The purpose of this study was to examine the effects of a contoured foam seat (CFS) on postural alignment and on the ability of infants with neuromotor impairments to engage with toys. Parental perceptions regarding the use and effects of the CFS also were assessed via semistructured interviews. SUBJECTS: Subjects were 4 infants, ages 9 to 18 months, who were unable to sit independently. METHOD: A time-series, alternating-treatments design was used, with data collected under 3 conditions: (1) a regular highchair, (2) a regular highchair with a thin foam liner, and (3) a CFS used as an insert in a regular highchair. The primary dependent measures were postural alignment and engagement with toys. Engagement with toys was defined as percentage of intervals with 2 hands on a toy and percentage of intervals with no hands on a highchair tray and 1 or 2 hands on a toy. RESULTS: Results showed a sustained effect of the CFS on improving postural alignment for all subjects. Effects of the CFS on increasing the number of intervals of bimanual play were not demonstrated for any subjects, although some improvement in the infant's ability to free the arms from support was observed for 2 subjects. Mothers reported acceptability of the CFS for everyday use and described benefits for themselves and their infants. DISCUSSION AND CONCLUSION: The results support the use of a CFS for improving postural alignment. Future research on adaptive seating should focus on interventions and outcomes that help children participate in functional activities relevant to them and their families.

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