Burke, R. V., The Prevention Group Research Team, Schlueter, C., Bader, E., and Authier, K. (2018). Post-adoption services for high risk families and their children: Preliminary results of a state-wide intervention. The American Journal of Family Therapy, 46, 122-138,
Despite well-documented post-adoption needs of adoptive families, most states provide no or very limited post-adoption services. This study describes Right Turn (RT), a state-wide program for strengthening adoptive families and preventing adoption dissolution. Results suggest: (a) RT is serving its targeted audience of adoptive families with challenging problems indicated by older adopted children with a history of multiple placements, extended time in social services systems, and a host of mental health challenges; and (b) adoption training, family support when navigating access to postadoption services, and collaboration with adoption-competent therapists appeared to have helped improve program outcomes.
Cohrs, C. M., Shriver, M. D., Burke, R. V., and Allen, K. D. (2016). Evaluation of increasing antecedent specificity in goal statements on adherence to positive behavior-management strategies. Journal of Applied Behavior Analysis, 49, 768-779.
We evaluated the impact of antecedent speciﬁcity in goal statements on adherence to positive behavior-management strategies. Teaching staff were recruited from 2 different school settings where there were routine expectations to use behavior-speciﬁc praise in the classroom, but adherence was poor. In a concurrent multiple baseline design, the use of behavior-speciﬁc praise by 4 participants was found to be unaffected by goal statements that increasingly speciﬁed the behavior to be used and the conditions under which the behavior should occur. However, adherence by 3 of the 4 participants did change when goal statements included teacher-speciﬁed frequencies with which the behavior should occur. Results were systematically replicated in a second study in which, in a concurrent multiple baseline design, 3 participants showed marked increases in adherence when goal statements speciﬁed the target behavior, the conditions under which it should occur, and the frequency with which it should occur.
Burke, R. V., The Prevention Group Research Team, Schlueter, C., Vandercoy, J., and Authier, K. (2015). Post-adoption services for families at risk of dissolution: A case study describing two families’ experiences. Clinical Case Studies, 14, 291-306.
The vast majority of the almost 2 million adopted children in the United States remain with their adoptive family throughout their life. For an estimated 1% to 25% of adopted children, adoption ends in dissolution or disruption. This article provides an overview of the A Step Further (ASF) program as experienced by two adoptive families that were at risk of dissolution. The ASF program is an intensive educational and supportive program that provides services to help adopted children and their families remain together through challenging times. A case study design is utilized and describes case characteristics; utilization of the ASF program; staff characteristics and training; and a summary of the interventions, support services, and materials provided for families enrolled in ASF services. Cases presented reported substantial progress on parent-identified personal goals and clinically significant improvements in child behavior problems at conclusion of the program. At 1-year post ASF services, parents reported that the child of focus remained with his adoptive family. Preliminary evidence suggests that ASF is targeting families at risk of dissolution and having a high level of success at keeping adoptive and guardianship families intact. Limitations and implications for clinicians and students are discussed.
Allen, K. D., Vatland, C., Bowen, S. L., & Burke, R. V. (2015). An evaluation of parent-produced video self-modeling to improve independence in an adolescent with intellectual developmental disorder and an autism spectrum disorder: A controlled case study. Behavior Modification, 39, 542-556.
We evaluated a parent-created video self-modeling (VSM) intervention to improve independence in an adolescent diagnosed with Intellectual Developmental Disorder (IDD) and Autism Spectrum Disorder (ASD). In a multiple baseline design across routines, a parent and her 17-year-old daughter created self-modeling videos of three targeted routines needed for independence in the community. The parent used a tablet device with a mobile app called “VideoTote” to produce videos of the daughter performing the targeted routines. The mobile app includes a 30-s tutorial about making modeling videos. The parent and daughter produced and watched a VSM scene prior to performing each of the three routines in an analogue community setting. The adolescent showed marked, immediate, and sustained improvements in performing each routine following the production and implementation of the VSM. Performance was found to generalize to the natural community setting. Results suggest that parents can use available technology to promote community independence for transition age individuals.
Guck, T. P., Burke, R. V., Rainville, C., Hill-Taylor, D., Wallace, D. P. (2015). A brief primary care intervention to reduce fear of movement in chronic low back pain patients. Translational Behavioral Medicine: Practice, Policy, Research, 5, 113-121.
Fear avoidance model of chronic pain-based interventions are effective but have not been successfully implemented into primary care. It was hypothesized that speed walking times and key measures of the fear avoidance model would improve following the brief intervention delivered in primary care. A brief primary care-based intervention (PCB) that included a single educational session, speed walking (an in vivo desensitization exposure task), and visual performance feedback was designed to reduce fear avoidance beliefs and improve function in 4 patients with chronic low back pain. A multiple baseline across subjects with a changing criterion design indicated that speed walking times improved from baseline only after the PCB intervention was delivered. Six fear avoidance model outcome measures improved from baseline to end of study and five of six outcome measures improved from end of study to follow-up. This study provides evidence for the efficacy of a brief PCB fear avoidance intervention that was successfully implemented into a busy clinic for the treatment of chronic pain.
McTate, E. A., Badura Brack, A. S., Handel, P. J., & Burke, R. V. (2013). A program intervention for pediatric bipolar disorder: Preliminary results. Child and Family Behavior Therapy, 35, 279-292.
Effectiveness of a behaviorally based day treatment program for young children diagnosed with Pediatric Bipolar Disorder (PBD) was evaluated using pre and post treatment mean scores from the Child Behavior Checklist (CBCL). Data were evaluated in aggregate and using the clinically significant change method for children diagnosed with PBD, Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), Adjustment Disorder, and no diagnosis/clinical and sub-clinical groups. We found significant treatment effects for all groups except the no diagnosis/sub-clinical group on the internalizing scale and for all groups on the externalizing scale. In addition to statistically significant improvements on both the internalizing and externalizing scales of the CBCL, clinically significant change was also supported for the PBD group as well as for the ADHD, ODD, and Adjustment Disorder groups. Implications surrounding the behavioral treatment of pediatric bipolar disorder are discussed. The limitations of the study and implications surrounding the behavioral treatment of pediatric bipolar disorder are discussed.
Howard, M. R., Burke, R. V., & Allen, K. D. (2013). An evaluation of the observer effect on treatment integrity in a day treatment center for children. Behavior Modification, 37, 490-515.
Treatment integrity is an important concern in treatment centers but is often overlooked. Performance feedback is a well-established approach to improving treatment integrity but is underused and undervalued. One way to increase its value may be to expose unrealized benefits to the observer who collects the performance feedback data. This “observer effect” could increase the value of performance feedback and promote more consistent evaluation of treatment integrity. The purpose of this investigation was to evaluate the observer effect on treatment integrity. Five supervisors who worked in a day treatment center were asked to collect performance feedback data on staff members’ integrity with following a standard treatment protocol that supervisors were also expected to follow. Results showed an immediate and marked improvement in treatment integrity in three supervisors who collected but never received performance feedback. For two supervisors, this effect was reversed and replicated. Implications are discussed.
Burke, R. V, Allen, K. D., Howard, M., Downey, D., Matz, M. G., & Bowen, S. L. (2013). Tablet-based video modeling and prompting in the workplace for individuals with autism. Journal of Vocational Rehabilitation 38, 1-14.
The current study involved a preliminary job-site testing of computer software, i.e.,VideoTote, delivered via a computer tablet and designed to provide users with video modeling and prompting for use by young adults with an autism spectrum disorder (ASD) across a range of employment settings. A multiple baseline design was used to assess changes in rates of completion with a complex, 104-step shipping task by four participants diagnosed with ASD. Baseline data were collected on accuracy of task completion after exposure to typical job-training involving instruction, modeling, and practice. The intervention involved video modeling and prompting with a 13-minute video depicting an individual completing job responsibilities that entailed checking to make sure materials were in working order, replacing defective items, packing materials in a container, entering information into a computer, and attaching a label to a container. Results suggested that video modeling and prompting were effective in helping individuals with autism complete a multi-step shipping task. Participants and their parents gave the device and software high ratings as an acceptable treatment for adults with autism to use in the workplace and intervention that complies with universal design principles. Implications for competitive job opportunities for individuals with autism are discussed.
Allen, K. D., Burke, R. V, Howard, M.R., Wallace, D. P., & Bowen, S. L. (2012). Use of audio cuing to expand employment opportunities for adolescents with autism spectrum disorders and intellectual disabilities. Journal of Autism and Developmental Disorders, 42, 2410-2419.
We evaluated audio cuing to facilitate community employment of individuals with autism and intellectual disability. The job required promoting products in retail stores by wearing an air-inﬂated WalkAround costume of a popular commercial character. Three adolescents, ages 16–18, were initially trained with video modeling. Audio cuing was then used by an attendant who delivered prompts regarding when to perform job skills. The two interventions were evaluated in an interrupted time series withdrawal design during training and then again in an actual job setting. Results show video modeling was not effective. However, the audio cuing produced job performances well above the designated criteria during training and when on the job. These changes were replicated with each participant, demonstrating clear experimental control. The changes proved statistically signiﬁcant as well. Participants and parents reported high job satisfaction. The challenges of competitive employment for individuals with autism and intellectual disabilities are discussed.
Burke, R. V., Howard, M. R., Peterson, J. L., Peterson, R. W., & Allen, K. D. (2012). Visual performance feedback: Effects on targeted and non-targeted staff. Behavior Modification, 36, 687-704.
This study used a multiple baseline with reversal design to assess whether visual performance feedback (VPF) influenced targeted and nontargeted staffs’ use of behavior-specific praise (BSP) in a day-treatment program. This study expands on the typical VPF audience and assesses whether VPF can be effective with noncertified staff in a day-treatment program for young children with behavior disorders, an environment in which it is difficult to maintain high rates of BSP. In previous school-based studies, VPF has been collected by researchers and provided to targeted teaching staff. In the current study, rather than relying on researchers, the authors used staff instructors to collect VPF and assessed how that experience influenced the instructors’ use of BSP. Results suggest that VPF provided, on average, a doubling in rates of BSP use by directly targeted staff and more than a 50% increase in rates of BSP in nontargeted instructors who collected BSP data. Furthermore, three of the four participants had substantially higher praise-to-correction ratios during the VPF intervention when compared with baseline and reversal conditions. Implications for improving treatment fidelity and reducing supervision time are discussed.
Burke, R. V., Oats, R. G., Ringle, J. R., O’Neill Fichtner, L., & DelGaudio, M. (2011). Implementation of a classroom management program with urban, high risk, elementary students: Does program fidelity affect behavior and academic performance? Journal of Education for Students Placed At Risk, 16, 201-218.
Students with persistent disruptive behavior problems lose valuable time in academic lessons, are a distraction for classmates, and cause stress for teachers. Recent meta-analyses indicate that 87% to 92% of published studies on school-based interventions targeting student problem behaviors report results from demonstration projects (involving highly trained staff under ideal circumstances) rather than routine practice programs. This study investigates the routine use of a schoolwide classroom management program and its relationship to elementary students’ social and academic outcomes. Three years after training in the classroom management program, 56 second-, third-, and fourth-grade teachers in an urban school district were assessed for fidelity to the program. Program fidelity was determined via direct observation in the classroom and validated by teacher self-ratings of fidelity and administrator ratings of teacher fidelity. Dependent variables included student engagement during academic lessons, out-of-school suspension rates, and report card grades. Results indicated that high program fidelity was significantly related to greater academic engagement and fewer suspensions, but not higher report card grades. This study adds to the scant literature on implementation fidelity of routine programs with high-risk populations.
Burke, R. V., Andersen, M. N., Bowen, S. L., Howard, M., & Allen, K. D. (2010). Evaluation of two instruction methods to increase employment options for young adults with autism spectrum disorders. Research in Developmental Disabilities, 31, 1223-1233.
We evaluated the efﬁcacy of a vocational training program including behavioral skills training, and a ‘‘performance cue system’’ (i.e., a proprietary iPhone application adapted for the study) to teach targeted social-vocational skills to six young adults with an Autism Spectrum Disorder. In two separate studies, participants were employed to assist in the delivery of a ﬁre safety education program. Participants were asked to wear an inﬂatable ﬁreﬁghter WalkAround1 mascot costume and to perform 63 scripted behaviors in coordination with a ﬁre prevention specialist who was the lead program presenter. In Study 1, three participants were initially exposed to established company training procedures comprised of behavioral skills training components to determine whether they met mastery of the skills. If necessary to reach criteria, participants were then exposed to a performance cue system. In Study 2, three additional participants were provided with the performance cue system alone, and then behavioral skills training if required. A single case, multiple-baseline design across subjects was used to evaluate efﬁcacy of each intervention. Results indicate that 5 of 6 participants reached criterion only after introduction of the cue system while the sixth reached criterion with behavioral skills training alone. The program received high satisfaction ratings from participants, their parents, and consumers. Implications and potential use of the PCS in other employment settings are discussed.
Allen, K. D., Wallace, D. P., Renes, D., Bowen, S. L., & Burke, R. V. (2010). Community-based vocational instruction using videotaped modeling for young adults with autism spectrum disorders performing in air-inflated mascots. Focus on Autism and Other Developmental Disabilities, 25, 186-192.
The authors examined the benefits of video modeling to teach a unique vocational skill set to an adolescent and two young adults with Autism Spectrum Disorders. Video modeling was used to teach skills necessary to entertain customers and promote products in a retail setting while wearing a WalkAround® costume. The three participants were observed before and after watching a video model perform the skills in the costume in scripted and naturalistic scenes. Data can be interpreted to conclude that all participants learned to use the skills in combination or sequence after watching the video model. The skills generalized to an actual job opportunity. The participants reported they enjoyed the work, and comments from supervisors were positive. Implications are discussed.
Burke, R. V., Kuhn, B. R., Peterson, J. L., Peterson, R. W., & Badura Brack, A. S. (2010). Don’t kick me out: Day treatment for two preschool children with severe behavior problems. Clinical Case Studies, 9, 28-40.
Parents of young children with severe emotional and behavior problems have few services from which to choose if their child is expelled from preschool for aggressive and disruptive behavior. Two case studies provide an overview of a multicomponent, intensive, day-treatment program for children with moderate to severe behavior disorders. Proximal and distal program goals are to eliminate presenting problem behaviors and increase social competencies and to reintegrate children back to their school, preschool, or daycare, respectively. The cases presented in this study provide preliminary evidence that day treatment can be a viable option for young children with disruptive behavior disorders.
Allen, K. D., Wallace, D. P., Renes, D., Bowen, S. L., & Burke, R. V. (2010). Use of video modeling to teach vocational skills to adolescents and young adults with Autism Spectrum Disorders. Education and Treatment of Children, 33, 339-349.
As part of a collaborative project between a University Center for Excellence in Developmental Disabilities and a local private business, we examined the eﬀects of video modeling to teach vocational skills to four adolescents and young adults with Autism Spectrum Disorders. Video modeling was used to teach the participants to wear a WalkAround® mascot and entertain customers in a retail setting. Observations were conducted before and after participants watched a video model of the skills performed in both scripted and naturalistic scenes. All participants learned to use the targeted skills after watching the video model and all reported that they enjoyed the work. Implications and vocational applications are discussed.
Burke, R. V., Guck, T. P., Robinson, M. L., Powell, W., & O’Neill Fichtner, L. (2006). Overcoming resistance to implementing classroom management strategies: Use of the transtheoretical model to explain teacher behavior. Research in the Schools, 13(2), 1-12.
This paper presents an overview of the transtheoretical model (TM) of change and use of the TM to explain an experienced, urban middle school teacher’s resistance to implementing a classroom management program. The TM identifies six stages of change and nine change processes that serve as catalysts for movement through the stages (Prochaska, 2000). This instrumental case study describes a teacher who habitually raised her voice in response to student misbehavior. After assessing the frequency with which she raised her voice, she implemented classroom management strategies that led to an 82% baseline-to-intervention decrease in the use of a raised voice, another 14% decrease at 3-year follow-up, and increases in student on-task behavior. The teacher’s progression from resistance to implementation was consistent with the TM’s stages of change.
Burke, R. V., Kuhn, B. R., & Peterson, J. L. (2004). Brief report: A "storybook" ending to children’s bedtime problems: The use of a social story to reduce bedtime resistance and frequent night-waking. Journal of Pediatric Psychology, 29(5), 389-396.
Objective To evaluate the efﬁcacy and acceptability of a social story with tangible rewards to reduce children’s disruptive bedtime behavior and frequent night waking. Method Four children (ages 2 to 7), with clinically signiﬁcant disruptive bedtime behavior, received the intervention, which consisted of a social story (The Sleep Fairy) that sets forth (a) parental expectations for appropriate bedtime behavior and (b) rewards for meeting those expectations. Results Parent sleep diaries indicated that children had a 78% average decrease in frequency of disruptive bedtime behaviors from baseline to intervention, with another 7% decrease at 3-month follow-up. Night wakings, a problem for 2 children during baseline, were not a problem during intervention and follow-up. Parents reported improved daytime behavior for 3 of the 4 children. Parents gave the intervention high acceptability ratings and maintained a high level of treatment ﬁdelity. Conclusions Use of a social story helped parents implement a multicomponent intervention using a familiar bedtime routine, thereby increasing the likelihood that implementation and effects occurred. The book format makes this intervention widely available to parents and professionals, with minimal costs and inconvenience.