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Noting that children with autism may display atypical or even fearful responses to common stimuli such as skin care products (often with a negative impact on adaptive functioning), Ellis and colleagues investigated the use of a treatment package including graduated exposure, modeling, and social attention on the fearful responses of two learners with autism. The participants in this study were two 4-year-old boys with autism, independently diagnosed using the Childhood Autism Rating Scale (CARS). Attempts by their mothers to apply skin care products (moisturizer, antibacterial cream, suntan lotion) were met with displays of physical (aggression, withdrawal) and verbal (verbal protests) resistance. All sessions of the investigation were conducted in the boys’ homes. Modeling was used if either boy failed to respond to the initial presentation of the skin care product and involved by verbal (“Hey, look, it’s all gone.”) and physical (rubbing lotion into the skin) presentations. Avoidance hierarchies were developed for each child and positive reinforcement, in the form of social praise, was presented contingent upon successful completion of each step in the hierarchy. The results of this study demonstrated that graduated exposure coupled with modeling and social reinforcement was effective in teaching tolerance of skin products to these two learners. Further, results were obtained relatively rapidly and were maintained over time with the intervention package itself being rated very positively by the each boy’s parents.

References

Ellis, E.M., Ala’i-Rosales, S.S., Glenn, S.S., Rosales-Ruiz, J., & Greenspoon, J., (2006). The effects of graduated exposure, modeling, and contingent social attention on tolerance to skin care products with two children with autism. Research in Developmental Disabilities, 27, 585-598.