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This book describes methods for improving the maintenance and generalization of behavior analytic treatment outcomes for individuals with autism. It introduces the concept of durability not just treatments that maintain across days or weeks, or that generalize to a few new settings, but those that remain successful under increasingly challenging situations (e.g., over years, during changing reinforcement conditions, across service providers). Chapters address key topics, such as preventive care, early behavioral intervention, treatment of severe destructive behavior, teaching skills across the lifespan, and medication management. In addition, the book addresses ethical and cultural considerations as they relate to treatment maintenance and concludes with perspectives from autistic voices and caregivers. Chapters include case examples highlighting durable outcomes as well as schematics and materials (e.g., data sheets) to assess and maintain treatment gains.
Key areas of coverage include:
- Behavioral persistence, durability of treatment effects, and relapse across the following domains.
- Early learner and academic skills.
- Toileting and self-care skills, feeding behavior, and verbal behavior.
- Social skills and socially reinforced destructive behavior.
- Automatically reinforced destructive behavior.
List of contents
Chapter 1 Defining Durability.- Chapter 2 Preventing Challenging Behavior in Autistic Children.- Chapter 3 The Profound Impact of Early Intervention on Autistic Outcomes.- Chapter 4 Sustaining Toileting and Intimate-Care Skills.- Chapter 5 From Purees to Portion-Based Meals: Building Complex Feeding Repertoires for Children with Feeding Difficulties.- Chapter 6 Shaping Complex Verbal Behavior Across the Lifespan.- Chapter 7 Maintaining and Generalizing Social Skills for Individuals with Autism.- Chapter 8 Considerations Toward Increased Treatment Adherence for School-Based Behavior Analysts.- Chapter 9 Preparing for Adulthood: Generalization of Functional Living Skills.- Chapter 10 Promoting Cooperation with Dental and Medical Procedures.- Chapter 11 Durability in the Treatment of Socially Reinforced Destructive Behavior.- Chapter 12 Longevity of Treatment Effects for Automatically Maintained Problem Behavior.- Chapter 13 Toward Behavioral Stability with Psychotropic Medication.- Chapter 14 Skill Maintenance and Special Considerations for Aging Autistic Clients.- Chapter 15 The Critical Role of the Implementer.- Chapter 16 A Pursuit of the Generalization of DRA Treatment Effects.- Chapter 17 Ethical and Cultural Considerations When Supporting Individuals with Autism.- Chapter 18 Lifelong Care for Autistic Individuals: A Parent s Perspective.- Chapter 19 Lifelong Care for Autistic Individuals: An Advocate s Perspective.
About the author
Daniel Mitteer, Ph.D., BCBA-D, is a faculty member at the Marcus Autism Center, where he oversees cases involving the assessment and treatment of severe destructive behavior (e.g., aggression, self-injurious behavior). Dr. Mitteer is an assistant professor at the Emory University School of Medicine and BCBA-D at Children’s Healthcare of Atlanta. Prior to his time in Atlanta, Dr. Mitteer completed his M.A., Ph.D., and postdoctoral fellowship at the University of Nebraska Medical Center’s Munroe-Meyer Institute under the mentorship of Drs. Brian Greer and Wayne Fisher. He then served as a faculty member with Drs. Greer and Fisher at the Children’s Special Hospital–Rutgers University Center for Autism Research, Education, and Services in New Jersey from 2020–2024. He has published more than 40 peer-reviewed articles and book chapters and collaborated on numerous grants, with the bulk of his papers and grant collaboration examining ways of addressing behavioral durability and treatment relapse.
