درمان ایدیوپاتیک راه رفتن با پنجه پا در کودکان مبتلا به اوتیسم با استفاده از راه رفتن نقطه ای با بلندگوی شنوایی و بازگشت عادت

This study aimed to examine the effectiveness of a simplified habit reversal procedure (SHR) using differential reinforcement of incompatible behaviour (DRI) and a stimulus prompt (GaitSpot Auditory Squeakers) to reduce the frequency of idiopathic toe-walking (ITW) and increase the frequency of correct heel-to-toe-walking in three children with autism. The study involved a delayed multiple baseline changing criterion design across individuals. Firstly, a baseline phase was conducted to determine the number of intervals where ITW occurred. Secondly, the GaitSpot Auditory Squeakers were paired with reinforcers. Thirdly, children wore GaitSpot squeakers over the heels of their feet under their shoes for a small number of 10 min sessions and when weight was placed on their heel, a squeak was emitted which was subsequently reinforced. Fourthly, the length of time the children wore the GaitSpot Auditory Squeakers was extended. Finally, the GaitSpot Auditory Squeakers were faded out and tests for generalisation and maintenance of heel-to-toe walking were conducted. The intervention produced substantial reductions in ITW across all participants though degree of reduction differed. The role of SHR and additional modifications for the treatment of ITW are discussed.