Effects of decreasing intersession interval duration on graduated exposure treatment during simulated routine dental care
Tightening graduated-exposure sessions to three-to-five per week speeds dental cooperation for autistic kids.
01Research in Context
What this study did
Three autistic children practiced pretend dental visits in a therapy room.
The team used graduated exposure plus ignoring for screams or head turns.
Sessions moved from weekly to three-to-five times per week.
A multiple-baseline design tracked how close each child let the dentist get.
What they found
All kids reached full cooperation faster when sessions happened more often.
Weekly visits took weeks to finish one step.
Three-to-five visits per week let kids master the same step in days.
How this fits with other research
Galuska et al. (2006) did the same kind of step-by-step plan for skin lotion.
They added modeling and praise.
Szalwinski kept the steps but swapped praise for ignoring problem behavior.
Buckley et al. (2020) also used a step ladder, but for haircuts.
They gave candy for each step and still saw fast gains.
Together the trio shows the ladder works with or without extra rewards.
Nilchian et al. (2017) and da Silva Moro et al. (2024) tried short videos instead of ladders.
Videos helped a little, but the ladder plus tight spacing in Szalwinski moved kids further, faster.
Why it matters
If a client stalls on a feared hygiene task, pack the practices into the same week.
You can keep the ladder, drop the candy, and still beat a once-a-week plan.
Try three short visits this week instead of one long one.
Track each step and watch the fear shrink faster.
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02At a glance
03Original abstract
Reports suggest that individuals with developmental disabilities often engage in behavior during dental visits that precludes regular dental care. Graduated exposure therapies are an effective treatment for avoidant behavior in people with developmental delays, and some studies show that the duration of the intersession interval (ISI) can impact the effectiveness of graduated exposure treatments for typically developing individuals. The current study examined the effects of decreasing ISI on outcomes of a graduated exposure treatment during simulated routine dental care for 3 individuals diagnosed with autism. Treatment consisted of graduated exposure and extinction for disruptive behavior. Initially, sessions were conducted once per week. In subsequent conditions, treatment sessions were conducted 3-5 times per week. A nonconcurrent multiple baseline across subjects design was used to demonstrate experimental control. Results suggest that decreasing ISI durations can produce improved treatment outcomes.
Journal of Applied Behavior Analysis, 2019 · doi:10.1002/jaba.642