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Effects of Antecedent Manipulations and Social Reinforcement to Increase Lateral Positioning in a Premature Infant with Obstructive Sleep Apnea

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Abstract

Recent research suggests supine positioning for sleeping infants is the safest position to prevent breathing related difficulties; however doing so can significantly increase obstruction in apneic infants resulting in decreased sleep quality. We implemented a multi-component treatment package compromised of antecedent interventions and parent-mediated social reinforcement to increase lateral positioning in a premature infant with obstructive sleep apnea. Results indicate that the intervention increased lateral positioning in the participant by over 80 % in the final phase of the study, indicating efficacy of the intervention. Limitations and suggestions for future research are discussed.

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Acknowledgments

We would like to thank our young participant as well as his family for their continued participation.

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Authors and Affiliations

  1. School of Psychology, Fielding Graduate University, 2020 De La Vina St, Santa Barbara, CA, 93105, USA

    Harry Voulgarakis, Cheryl Giacomelli & Debra Bendell-Estroff

  2. The Center for Children with Special Needs, Glastonbury, CT, USA

    Solandy Forte

  3. Institute for Behavioral Studies, Endicott College, Boston, MA, USA

    Solandy Forte

  4. David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA

    Debra Bendell-Estroff

  5. San Diego School of Medicine, University of California, San Diego, CA, USA

    Henry Krous

Authors
  1. Harry Voulgarakis
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  2. Solandy Forte
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  3. Cheryl Giacomelli
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  4. Debra Bendell-Estroff
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  5. Henry Krous
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Corresponding author

Correspondence to Harry Voulgarakis.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from the parents of all individual participants included in the study.

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Summary for Clinicians

• A single case analysis was completed with a premature infant suffering obstructive sleep apnea using a rigorous, multi-element treatment package.

• Antecedent manipulations such as placement of a stimulus are generally simple to implement, yet effective in increasing socially valid behavioral outcomes while, in this study, also increasing physiologically necessary outcomes.

• Utility of behavioral methods is effective in various populations and can be advantageous beginning in early infancy.

• Parent attention when combined with other manipulations is effective for shaping sleeping posture in infants.

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Voulgarakis, H., Forte, S., Giacomelli, C. et al. Effects of Antecedent Manipulations and Social Reinforcement to Increase Lateral Positioning in a Premature Infant with Obstructive Sleep Apnea. Behav Analysis Practice 10, 83–86 (2017). https://doi.org/10.1007/s40617-016-0141-0

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  • DOI: https://doi.org/10.1007/s40617-016-0141-0

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