Assessment of impulsivity and the development of self-control in students with attention deficit hyperactivity disorder.

We examined a combined approach of manipulating reinforcer dimensions and delay fading to promote the development of self‐control with 3 students diagnosed with attention deficit hyperactivity disorder. First, we administered a brief computer‐based assessment to determine the relative influence of reinforcer rate (R), reinforcer quality (Q), reinforcer immediacy (I), and effort (E) on the students' choices between concurrently presented math problems. During each session, one of these dimensions was placed in direct competition with another dimension (e.g., RvI involving math problem alternatives associated with high‐rate delayed reinforcement vs. low‐rate immediate reinforcement), with all possible pairs of dimensions presented across the six assessment conditions (RvQ, RvI, RvE, QvI, QvE, IvE). The assessment revealed that the choices of all 3 students were most influenced by immediacy of reinforcement, reflecting impulsivity. We then implemented a self‐control training procedure in which reinforcer immediacy competed with another influential dimension (RvI or QvI), and the delay associated with the higher rate or quality reinforcer alternative was progressively increased. The students allocated the majority of their time to the math problem alternatives yielding more frequent (high‐rate) or preferred (high‐quality) reinforcement despite delays of up to 24 hr. Subsequent readministration of portions of the assessment showed that self‐control transferred across untrained dimensions of reinforcement.     

Behavioral assessment of impulsivity: a comparison of children with and without attention deficit hyperactivity disorder

We conducted a brief computer-based assessment involving choices of concurrently presented arithmetic problems associated with competing reinforcer dimensions to assess impulsivity (choices controlled primarily by reinforcer immediacy) as well as the relative influence of other dimensions (reinforcer rate, quality, and response effort), with 58 children. Results were compared for children with attention deficit hyperactivity disorder (ADHD) who were and were not receiving medication, and with typically developing children without ADHD. Within-subject and between-groups analyses of the ordinal influence of each of the reinforcer dimensions were conducted using both time- and response-allocation measures. In general, the choices of children with ADHD were most influenced by reinforcer immediacy and quality and least by rate and effort, suggesting impulsivity. The choices of children in the non-ADHD group were most influenced by reinforcer quality, and the influence of immediacy relative to the other dimensions was not statistically significant. Results are discussed with respect to the implications for assessment and treatment of ADHD.     

ASSESSING INFLUENTIAL DIMENSIONS OF REINFORCERS ON CHOICE IN STUDENTS WITH SERIOUS EMOTIONAL DISTURBANCE

We examined how reinforcer rate, quality, delay, and response effort combined to influence the choices of 6 youths with learning and behavior difficulties, and the viability of an assessment methodology derived from matching theory for determining differential responsiveness to those reinforcer and response dimensions. The students were given two concurrent sets of math problems that were equal on two dimensions but competed on two other dimensions (e.g., one set yielded higher rate and lower quality reinforcement than the other). Competing dimensions were counterbalanced across the six conditions of the initial assessment phase, permitting assessment of each dimension on time allocation. The conditions resulting in the most and least time allocated to one problem set alternative relative to the other were then replicated. Time allocated to each of the problems within sets was differentially affected by the reinforcer and/or response dimensions, with allocation patterns varying across students. The results are discussed in the context of implications for the design of treatments and extrapolations from basic research on matching and behavioral economics.     

Zebrafish choice behavior is sensitive to reinforcer rate,immediacy, and magnitude ratios

Behavioral flexibility has, in part, been defined by choice behavior changing as a function of changes in reinforcer payoffs. We examined whether the generalized matching law quantitatively described changes in choice behavior in zebrafish when relative reinforcer rates, delays/immediacy, and magnitudes changed between two alternatives across conditions. Choice was sensitive to each of the three reinforcer properties. Sensitivity estimates to changes in relative reinforcer rates were greater when 2 variable-interval schedules were arranged independently between alternatives (Experiment 1a) than when a single schedule pseudorandomly arranged reinforcers between alternatives (Experiment 1b). Sensitivity estimates for changes in relative reinforcer immediacy (Experiment 2) and magnitude (Experiment 3) were similar but lower than estimates for reinforcer rates. These differences in sensitivity estimates are consistent with studies examining other species, suggesting flexibility in zebrafish choice behavior in the face of changes in payoff as described by the generalized matching law.     

Rapid acquisition of preference in concurrent chains when alternatives differ on multiple dimensions of reinforcement

Pigeons responded in a concurrent-chains procedure in which terminal-link reinforcer variables were changed unpredictably across sessions. In Experiment 1, the terminal-link schedules were fixed-interval (FI) 8 s and FI 16 s, and the reinforcer magnitudes were 2 s and 4 s. In Experiment 2 the probability of reinforcement (100% or 50%) was varied with immediacy and magnitude. Multiple-regression analyses showed that pigeons' initial-link response allocation was determined by current-session reinforcer variables, similar to previous studies which have varied only immediacy (Grace, Bragason, & McLean, 2003). Sensitivity coefficients were positive and statistically significant for all reinforcer variables in both experiments. Analyses of responding within individual sessions showed that final levels of preference for dominated sessions, in which all reinforcer variables favored the same terminal link, were more extreme than for tradeoff sessions in which at least one reinforcer variable favored each alternative. This result implies that response allocation was determined by multiple reinforcer variables within individual sessions, consistent with the concatenated matching law. However, in Experiment 2, there was a nonlinear (sigmoidal) relationship between response allocation and relative value, which suggests the possibility that reinforcer variables may interact during acquisition, contrary to the matching law.     

Assessing factors that influence young children's food preferences and choices

Researchers have identified an unbalanced diet as a key risk factor in the etiology of many chronic diseases (World Health Organization, 2003 ). Although researchers have found that numerous factors influence children's food choices, no assessment exists to identify these factors. In Experiment 1, we established preliminary empirical evidence of children's preferences for healthier and less‐healthy foods, and found that 16 of 21 children preferred less‐healthy foods to healthier foods. In Experiment 2, we established the utility of an analogue, competing parameters assessment designed to approximate children's food choices in the natural environment. We identified either quality or immediacy as the most influential parameters governing four of four childrens' food choices. We found that effort influenced the efficacy of these reinforcer parameters in a predictable manner for one of four children.     

Independence of terminal-link entry rate and immediacy in concurrent chains

In Phase 1, 4 pigeons were trained on a three-component multiple concurrent-chains procedure in which components differed only in terms of relative terminal-link entry rate. The terminal links were variable-interval schedules and were varied across four conditions to produce immediacy ratios of 4:1, 1:4, 2:1, and 1:2. Relative terminal-link entry rate and relative immediacy had additive and independent effects on initial-link response allocation, and the data were well-described by a generalized-matching model. Regression analyses showed that allowing sensitivity to immediacy to vary across components produced only trivial increases in variance accounted for. Phase 2 used a three-component concurrent-schedules procedure in which the schedules were the same as the initial links of Phase 1. Across two conditions, the relative reinforcer magnitude was varied. Sensitivity to relative reinforcer rate was independent of relative magnitude, confirming results of prior studies. Sensitivity to relative reinforcer rate in Phase 2 did not vary systematically across subjects compared to sensitivity to relative entry rate in Phase 1, and regression analyses confirmed again that only small increases in variance accounted for were obtained when sensitivities were estimated independently compared with a single estimate for both phases. Overall, the data suggest that conditioned and primary reinforcers have functionally equivalent effects on choice and support the independence of relative terminal-link entry rate and immediacy as determiners of response allocation. These results are consistent with current models for concurrent chains, including Grace's (1994) contextual choice model and Mazur's (2001) hyperbolic value-added model.     

IMPULSIVITY IN STUDENTS WITH SERIOUS EMOTIONAL DISTURBANCE: THE INTERACTIVE EFFECTS OF REINFORCER RATE,DELAY, AND QUALITY

We conducted two studies extending basic matching research on self-control and impulsivity to the investigation of choices of students diagnosed as seriously emotionally disturbed. In Study 1 we examined the interaction between unequal rates of reinforcement and equal versus unequal delays to reinforcer access on performance of concurrently available sets of math problems. The results of a reversal design showed that when delays to reinforcer access were the same for both response alternatives, the time allocated to each was approximately proportional to obtained reinforcement. When the delays to reinforcer access differed between the response alternatives, there was a bias toward the response alternative and schedule with the lower delays, suggesting impulsivity (i.e., immediate reinforcer access overrode the effects of rate of reinforcement). In Study 2 we examined the interactive effects of reinforcer rate, quality, and delay. Conditions involving delayed access to the high-quality reinforcers on the rich schedule (with immediate access to low-quality reinforcers earned on the lean schedule) were alternated with immediate access to low-quality reinforcers on the rich schedule (with delayed access to high-quality reinforcers on the lean schedule) using a reversal design. With 1 student, reinforcer quality overrode the effects of both reinforcer rate and delay to reinforcer access. The other student tended to respond exclusively to the alternative associated with immediate access to reinforcers. The studies demonstrate a methodology based on matching theory for determining influential dimensions of reinforcers governing individuals' choices.     

Effects of reinforcer delays on choice as a function of income level

Three rats earned their daily food ration by responding during individual trials either on a lever that delivered one food pellet immediately or on a second lever that delivered three pellets after a delay that was continuously adjusted to ensure substantial responding to both alternatives. Choice of the delayed reinforcer increased when the number of trials per session was reduced. This result suggests that models seeking closure on choice effects must include a parameter reflecting how preference changes with sessionwide income. Moreover, models positing that reinforcer probability and immediacy (1/delay) function equivalently in choice are called into question by the finding that probability and immediacy produce opposing effects when income level is changed.     

An evaluation of stimulant medication on the reinforcing effects of play

Although a vast literature has indicated that stimulant medications are effective for reducing inappropriate behavior in children with attention deficit hyperactivity disorder (ADHD), the effects of stimulant medication on ancillary behaviors (e.g., play) have yet to be investigated with the same rigor. We used a reinforcer assessment procedure to evaluate the effects of medication on the play and social behavior of 5 preschool children who had been diagnosed with ADHD. Conditions included (a) social reinforcement (i.e., playing with friends), (b) alone play, and (c) quiet time (i.e., resting). Results indicated that 1 of the 5 participants selected fewer social reinforcers and more nonsocial reinforcers (alone play or quiet time) while on medication. The findings indicate that the reinforcer assessment procedure may be a viable way to evaluate medication effects on an ongoing basis and to inform treatment decisions.     

Reinforcer pathology,probabilistic choice,and medication adherence in patients with multiple sclerosis

The reinforcer pathology model posits that core behavioral economic mechanisms, including delay discounting and behavioral economic demand, underlie adverse health decisions and related clinical disorders. Extensions beyond substance use disorder and obesity, however, are limited. Using a reinforcer pathology framework, this study evaluates medical adherence decisions in patients with multiple sclerosis. Participants completed behavioral economic measures, including delay discounting, probability discounting, and a medication purchase task. A medical decision-making task was also used to evaluate how sensitivity to mild side effect risk and efficacy contributed to the likelihood of taking a hypothetical disease-modifying therapy. Less steep delay discounting and more intense (greater) medication demand were independently associated with greater adherence to the medication decision-making procedure. More generally, the pattern of interrelations between the medication-specific and general behavioral economic metrics was consistent with and contributes to the reinforcer pathology model. Additional research is warranted to expand these models to different populations and health behaviors, including those of a positive health orientation (i.e., medication adherence).     

Accumulated reinforcers increase academic responding and suppress problem behavior for students with Attention‐Deficit Hyperactivity Disorder

We compared rates of academic responses and problem behavior during mathematics with distributed and accumulated reinforcer arrangements for 3 students with Attention‐Deficit Hyperactivity Disorder who engaged in chronic, severe problem behavior. All 3 students engaged in more academic responding and less problem behavior when reinforcers accumulated throughout the session, relative to conditions in which reinforcers were distributed throughout the session or withheld completely. We then conducted concurrent‐chain analyses to evaluate student preference for the reinforcer arrangements. Two students preferred distributed reinforcers, even though this arrangement continued to produce problem behavior. One student preferred accumulated reinforcers. Our data replicate previous findings regarding the efficacy of accumulated‐reinforcer arrangements, but suggest that students do not always prefer the most efficacious reinforcer arrangement.     

Determinants of pigeons' choices in token-based self-control procedures

Four pigeons were exposed to a token-based self-control procedure with stimulus lights serving as token reinforcers. Smaller-reinforcer choices produced one token immediately; larger-reinforcer choices produced three tokens following a delay. Each token could be exchanged for 2-s access to food during a signaled exchange period each trial. The main variables of interest were the exchange delays (delays from the choice to the exchange stimulus) and the food delays (also timed from the choice), which were varied separately and together across blocks of sessions. When exchange delays and food delays were shorter following smaller-reinforcer choices, strong preference for the smaller reinforcer was observed. When exchange delays and food delays were equal for both options, strong preference for the larger reinforcer was observed. When food delays were equal for both options but exchange delays were shorter for smaller-reinforcer choices, preference for the larger reinforcer generally was less extreme than under conditions in which both exchange and food delays were equal. When exchange delays were equal for both options but food delays were shorter for smaller-reinforcer choices, preference for the smaller reinforcer generally was less extreme than under conditions in which both exchange and food delays favored smaller-reinforcer choices. On the whole, the results were consistent with prior research on token-based self-control procedures in showing that choices are governed by reinforcer immediacy when exchange and food delays are unequal and by reinforcer amount when exchange and food delays are equal. Further, by decoupling the exchange delays from food delays, the results tentatively support a role for the exchange stimulus as a conditioned reinforcer.     

Effects of reinforcer rate and reinforcer quality on time allocation: Extensions of matching theory to educational settings

We examined how 3 special education students allocated their responding across two concurrently available tasks associated with unequal rates and equal versus unequal qualities of reinforcement. The students completed math problems from two alternative sets on concurrent variable-interval (VI) 30-s VI 120-s schedules of reinforcement. During the equal-quality reinforcer condition, high-quality (nickels) and low-quality items ("program money" in the school's token economy) were alternated across sessions as the reinforcer for both sets of problems. During the unequal-quality reinforcer condition, the low-quality reinforcer was used for the set of problems on the VI 30-s schedule, and the high-quality reinforcer was used for the set of problems on the VI 120-s schedule. Equal- and unequal-quality reinforcer conditions were alternated using a reversal design. Results showed that sensitivity to the features of the VI reinforcement schedules developed only after the reinforcement intervals were signaled through countdown timers. Thereafter, when reinforcer quality was equal, the time allocated to concurrent response alternatives was approximately proportional to obtained reinforcement, as predicted by the matching law. However the matching relation was disrupted when, as occurs in most natural choice situations, the quality of the reinforcers differed across the response options.     

Choice and reinforcement delay

Previous studies of choice between two delayed reinforcers have indicated that the relative immediacy of the reinforcer is a major determinant of the relative frequency of responding. Parallel studies of choice between two interresponse times have found exceptions to this generality. The present study looked at the choice by pigeons between two delays, one of which was always four times longer than the other, but whose absolute durations were varied across conditions. The results indicated that choice is not uniquely determined by the relative immediacy of reinforcement, but that absolute delays are also involved. Models for concurrent chained schedules appear to be more applicable to the present data than the matching relation; however, these too failed to predict choice for long delays.     

Language preference and reinforcing efficacy of praise in bilingual children with disabilities

We conducted a stimulus preference assessment to identify preference for praise delivered in English versus Spanish for bilingual students. Next, a concurrent-operant reinforcer assessment was used to evaluate the reinforcer efficacy of praise in each language. Participants showed limited to no preference for one language over another. One participant showed a slight preference for Spanish praise and Spanish praise functioned as a slightly more potent reinforcer. If a participant did not prefer a specific language of praise (i.e., undifferentiated preference or equal percentage of approaches), both languages were considered to be similarly reinforcing.     

Adolescent drug use in Mexico and among Mexican American adolescents in the United States: environmental influences and individual characteristics

The authors compared high school students in Baja California Norte (BCN), Mexico (n = 775), with Mexican American students in Los Angeles (LA), California (n = 516). The students' use of cigarettes, alcohol, marijuana, cocaine, inhalants, and other illicit drugs were compared, because these vary by gender, country, and their age of first drug use and are influenced by demographic variables, individual characteristics, and environmental influences. More BCN students than LA students had used alcohol, but more LA than BCN students had used illicit drugs and initiated drug use earlier. When demographic variables were influential, they were most powerful and increased the risk for drug use more than environmental factors or individual characteristics. Environmental factors were most influential for boys' drug use, whereas environmental and demographic variables were most influential for girls' drug use.     

Supervision of Psychosocial Skills in Genetic Counseling

Little has been written about how genetic counseling supervisors can help students develop psychosocial skills in their clinical rotations. The authors describe several approaches supervisors can use, ranging from preventive measures (e.g., normalizing anxiety), to skill-enhancing interventions (e.g., modeling and thinking aloud), to more direct approaches (e.g., immediacy, confrontation) that may be necessary for students who are reluctant, or even resistant, to using psychosocial skills with their clients.