COMPLIANCE TRAINING AND BEHAVIORAL COVARIATION IN THE TREATMENT OF MULTIPLE BEHAVIOR PROBLEMS

The present study investigated the use of a compliance-training procedure and its effect on untreated deviant child behaviors. Three children, each generally noncompliant to adult requests and with several additional problems, such as crying, aggression, and self-injurious behavior, were trained in the compliance procedure under a multiple-baséline design across therapists. Compliance was defined as the correct response to prespecified requests. Other classes of deviant child behavior were measured continuously throughout the study but not directly reinforced. The results of the study showed that (a) increases in compliance to requests were directly related to the contingencies employed; (b) decreases in untreated deviant behaviors occurred when compliance increased, even though no direct contingencies had been placed on these behaviors; and (c) the relationship between untreated deviant behaviors and compliance appeared to be maintained by a different set of events in each of the three children. The results are discussed in terms of behavioral covariation and generalization.     

EXPERIMENTAL ANALYSIS AND EXTINCTION OF SELF-INJURIOUS ESCAPE BEHAVIOR

Three studies are presented in which environmental correlates of self-injurious behavior were systematically examined and later used as the basis for treatment. In Study 1, 7 developmentally disabled subjects were exposed to a series of conditions designed to identify factors that maintain self-injurious behavior: attention contingent on self-injurious behavior (positive reinforcement), escape from or avoidance of demands contingent on self-injurious behavior (negative reinforcement), alone (automatic reinforcement), and play (control). Results of a multielement design showed that each subject's self-injurious behavior occurred more frequently in the demand condition, suggesting that the behavior served an avoidance or escape function. Six of the 7 subjects participated in Study 2. During educational sessions, “escape extinction” was applied as treatment for their self-injurious behavior in a multiple baseline across subjects design. Results showed noticeable reduction or elimination of self-injurious behavior for each subject and an increase in compliance with instructions in all subjects for whom compliance data were taken. The 7th subject, whose self-injurious behavior during Study 1 occurred in response to medical demands (i.e., physical examinations), participated in Study 3. Treatment was comprised of extinction, as in Study 2, plus reinforcement for tolerance of the examination procedure, and was evaluated in a multiple baseline across settings design. Results showed that the treatment was successful in eliminating self-injurious behavior and that its effects transferred across eight new therapists and three physicians. General implications for the design, interpretation, and uses of assessment studies are discussed.     

EVALUATION OF ERRORLESS COMPLIANCE TRAINING IN A GENERAL EDUCATION CLASSROOM

Errorless compliance training (ECT) is a success‐based, nonaversive intervention to reduce child noncompliance that has been shown to be effective in both home and special education settings. In the current study, ECT was evaluated in a multiple‐baseline across‐subjects design with three kindergarten students who displayed noncompliant behavior in their general education classrooms. The researcher delivered a range of classroom requests to each student to determine the probability of compliance for each request. Requests were then arranged in a hierarchy, ranging from those initially yielding high compliance probabilities (level 1) to those yielding low compliance (level 4). At the beginning of treatment, students were presented with a high number of level 1 requests and provided verbal praise for compliance. Over several weeks, lower probability requests were faded in. The three students demonstrated considerable improvement in compliance levels during and following treatment. Improved compliance generalized to low‐probability requests not used in treatment. When the teacher delivered requests, results of generalization were mixed. The results provide preliminary support for the use of errorless compliance training in the general education setting. Copyright © 2014 John Wiley & Sons, Ltd.     

THE CLASS SPECIFIC EFFECTS OF COMPLIANCE TRAINING WITH “DO” AND “DON'T” REQUESTS: ANALOGUE ANALYSIS AND CLASSROOM APPLICATION

Two experiments are reported in which the relationship between compliance with “do” and “don't” requests was examined with developmentally disabled children. In Experiment 1, a multiple baseline design across subjects with counterbalanced treatment conditions was used to evaluate a compliance training program composed of four phases: (a) baseline, during which no consequences were delivered for compliance, (b) reinforcement for compliance with one targeted “do” request, (c) reinforcement for compliance with one targeted “don't” request, and (d) follow-up with reinforcement on a variable ratio schedule for compliance with any “do” or “don't” request. Results of probes conducted before and after training within each condition indicated that generalized compliance occurred only with requests of the same type as the target exemplar (“do” or “don't”). In Experiment 2, these results were replicated in a classroom setting. Following collection of baseline probe data on student compliance, a teacher training program was successfully implemented to increase reinforcement of compliance first with one “do” and subsequently with one “don't” request of a target student. Results of multiple baseline probes across “do” and “don't” requests indicated that the teacher generalized and maintained reinforcement of compliance with other requests of the same type and to other students, with a resulting increase in student compliance with the type of requests reinforced. The impact of treatment on both teacher and student behavior was socially validated via consumer ratings. Implications of these findings with respect to response class formation and compliance training programs are discussed.     

Contingencies promote delay tolerance

The effectiveness of functional communication training as treatment for problem behavior depends on the extent to which treatment can be extended to typical environments that include unavoidable and unpredictable reinforcement delays. Time‐based progressive delay (TBPD) often results in the loss of acquired communication responses and the resurgence of problem behavior, whereas contingency‐based progressive delay (CBPD) appears to be effective for increasing tolerance for delayed reinforcement. No direct comparison of TBPD and CBPD has, however, been conducted. We used single‐subject designs to compare the relative efficacy of TBPD and CBPD. Four individuals who engaged in problem behavior (e.g., aggression, vocal and motor disruptions, self‐injury) participated. Results were consistent across all participants, and showed lower rates of problem behavior and collateral responses during CBPD than during TBPD. The generality of CBPD treatment effects, including optimal rates of communication and compliance with demands, was demonstrated across a small but heterogeneous group of participants, reinforcement contingencies, and contexts.     

Independent control of a pre-school child's aggression and peer interaction by contingent teacher attention

This study demonstrated the existent role of contingent teacher attention in maintaining a preschool child's aggression to his peers, as well as an imposed use of contingent teacher attention to increase his low peer interaction. Aggression and peer interaction were analyzed independently as two baselines of multiple baseline design; each was subjected to at least one reversal. The multiple baseline design was used to examine three possibilities: (1) that the high rate of aggressive behavior was in itself impeding the emergence of peer interaction; (2) that contingent teacher attention could be used to maintain a reduced rate of aggressive behavior; and (3) that a similar use of teacher attention could maintain an increased rate of peer interaction. The technique of largely ignoring the subject's aggressive behavior and attending instead to whatever child he was attacking decreased his aggressive behavior to an acceptable rate. Two reversals of this technique displayed experimental control, each recovering the high baseline rate of aggression. After the aggressive behavior was decreased for the final time, teachers attended to the subject only when he was involved in social interaction with peers, and they thus increased his social interaction to a high rate. Later, they withdrew their attention for social interaction and reversed the effect and finally then recovered it.     

Parameters of Aggressive Behavior in a Treatment-Seeking Sample of Military Personnel: A Secondary Analysis of Three Randomized Controlled Trials of Evidence-Based PTSD Treatments

Aggressive behavior is prevalent among veterans of post-9/11 conflicts who have posttraumatic stress disorder (PTSD). However, little is known about whether PTSD treatments reduce aggression or the direction of the association between changes in PTSD symptoms and aggression in the context of PTSD treatment. We combined data from three clinical trials of evidence-based PTSD treatment in service members (N = 592) to: (1) examine whether PTSD treatment reduces psychological (e.g., verbal behavior) and physical aggression, and; (2) explore temporal associations between aggressive behavior and PTSD. Both psychological (Estimate = -2.20, SE = 0.07) and physical aggression (Estimate = -0.36, SE = 0.05) were significantly reduced from baseline to posttreatment follow-up. Lagged PTSD symptom reduction was not associated with reduced reports of aggression; however, higher baseline PTSD scores were significantly associated with greater reductions in psychological aggression (exclusively; ß = -0.67, 95% CI = -1.05, -0.30, SE = -3.49). Findings reveal that service members receiving PTSD treatment report substantial collateral changes in psychological aggression over time, particularly for participants with greater PTSD symptom severity. Clinicians should consider cotherapies or alternative ways of targeting physical aggression among service members with PTSD and alternative approaches to reduce psychological aggression among service members with relatively low PTSD symptom severity when considering evidence-based PTSD treatments.     

Exploring the reinforcement of compliance with "do" and "don't" requests and the side effects: a partial replication and extension

The side effects of reinforcing compliance to "do" and "don't" requests were examined in this study. The study was designed to do two things: (1) further establish that "do" and "don't" requests are functionally distinct and (2) determine which "don't" requests will show the same ability as "do" requests in effecting a change in topographically different inappropriate behaviors. Three children (2 boys and 1 girl), ages 5 yr. 2 mo. to 6 yr. 7 mo., participated. The design of the study was ABAC counterbalanced across subjects. With all three children reinforcement of "do" requests led to increased compliance with "do" requests without concurrent increase in compliance to "don't" requests. Also, reinforcing compliance to "don't" requests resulted in increased compliance to "don't" requests without concurrent increase in compliance to "do" requests. An undesirable side effect to the treatment was also noted. Two children showed a tendency to increase their rates of inappropriate behavior concurrent with increases in compliance to "don't" requests. Probable causes for this effect and concerns about the reinforcement of "don't" requests were discussed.     

A daily diary investigation of self-reported alcohol-related direct and indirect aggression

Research supports the relationship between alcohol use and direct aggression, however, scant research has examined the association between alcohol use and indirectly aggressive behavior. Further, extant research has relied on retrospective reporting of behaviors, which may be subject to recall bias. The daily diary methodology enables the assessment of both the between- and within-subject variation, as well as reduces the likelihood of biased reporting. Consequently, the current study utilized a daily diary design to examine (a) associations between daily alcohol use and alcohol-related aggressive behaviors (i.e., direct and indirect); and (b) the co-occurrence of alcohol-related direct and indirect aggression. Participants were 105 (80% female) college student drinkers. Students completed baseline questionnaires and up to 14 consecutive, daily surveys regarding their previous day alcohol use, alcohol-related direct aggression, and alcohol-related indirect aggression. Findings revealed that alcohol use was associated with same day alcohol-related direct and indirect aggression, after controlling for baseline alcohol use. Self-reported alcohol-related direct aggression was more likely to occur on days in which self-reported alcohol-related indirect aggression occurred, after controlling for dispositional aggression, trait self-control, and baseline alcohol use. Results of the study suggest that, similar to alcohol-related direct aggression, alcohol use is associated with an increased likelihood of alcohol-related indirect aggression. Further, the co-occurrence of alcohol-related indirect and direct aggression supports that individuals may be engaging in multiple types of aggressive behaviors. Findings extend previous cross-sectional and qualitative research suggesting that indirect aggression may co-occur, perhaps increasing in severity.     

Examining the Efficacy of Parent–Child Interaction Therapy with Children on the Autism Spectrum

Externalizing behaviors are a common component of the clinical presentation of autism spectrum disorders. Although traditionally used with typically-developing children, parent–child interaction therapy (PCIT) is one behaviorally-based parent training program that has demonstrated success in increasing child compliance, reducing problem behavior, and improving parent–child communication. The study examined the efficacy of PCIT as a treatment for children with autism spectrum disorders by employing a single subject, non-concurrent multiple baseline design across three subjects. Primary findings revealed increases in child compliance, reductions in child disruptive behavior, and improved parenting skills across participants. In addition, each caregiver reported high levels of satisfaction with the intervention. Results suggested that PCIT may be a treatment option for children on the autism spectrum with co-occurring behavioral difficulties. Although the non-concurrent nature of the multiple baseline design is a limitation, this study replicates and extends previous research investigating the efficacy of PCIT with children with autism and their parents.     

Media violence, physical aggression, and relational aggression in school age children: a short-term longitudinal study

Many studies have shown that media violence has an effect on children's subsequent aggression. This study expands upon previous research in three directions: (1) by examining several subtypes of aggression (verbal, relational, and physical), (2) by measuring media violence exposure (MVE) across three types of media, and (3) by measuring MVE and aggressive/prosocial behaviors at two points in time during the school year. In this study, 430 3rd-5th grade children, their peers, and their teachers were surveyed. Children's consumption of media violence early in the school year predicted higher verbally aggressive behavior, higher relationally aggressive behavior, higher physically aggressive behavior, and less prosocial behavior later in the school year. Additionally, these effects were mediated by hostile attribution bias. The findings are interpreted within the theoretical framework of the General Aggression Model.     

The role of fantasies and dreams in the TV viewing—aggression relationship

The TV viewing habits of 391 8-year-old and 10-year-old Finnish children were related to their aggression, their aggressive and fear fantasies, and their dreams and fantasies about TV. Two measurements of aggression were made: peer-nominated aggression and self-rated aggression. TV viewing habits were measured by the amount of TV seen during a week and violence viewing, that is, how regularly violent TV serials were watched. Hypothetically, in addition to a direct relationship between TV viewing and aggression, there could also be an indirect relationship; for example, fantasizing might provide a link in the TV viewing-aggression relationship. There were significant positive correlations for the boys between TV viewing variables and aggression. There were also significant positive correlations between the amount of TV and televised violence viewing and fear and aggressive fantasies in general and with dreams and fantasies about actual TV programs seen. The correlations were less frequent for the girls. The same tendencies were evident for age groups and education. More frequent positive correlations were found with older children and regular classes than with younger children and music classes. The use of fantasy was also correlated positively with both peer-nominated and self-rated aggression. The results of the present study support the information-processing theory, which suggests that the more a child watches TV the more he or she has fantasies about the programs and rehearses the scenes viewed which, in turn, results in explicit aggressive behavior.     

Brief report: Non-intrusive operant analysis of aggressive behavior in persons with mental retardation

A procedure for operant analysis of aggressive behavior was derived from multi-element assessment methods that have been previously applied to both self-injurious and stereotypic responding. Analog sessions included No Interaction Baseline, Social Disapproval, Demand, Social Reinforcement, and Discriminated Extinction conditions, repeatedly presented within a multi-element design. Three men with differing severity of mental retardation, communicative deficits and aggressive behavior were exposed to multiple brief analog sessions embedded within their normal meal-time routines in group home settings. Mean frequencies of aggressive behavior and concurrent eating indicate that, while aggressive behavior was negatively reinforced in all three participants, both social and non-social contingencies were also prominent. The same contingencies which have been demonstrated to maintain self-injury and stereotypic behavior can therefore also maintain aggression. Results suggest the feasibility of conducting relatively non-intrusive analog assessments in community residences, and support the-extension of functional analysis across differing classes of aberrant behavior.     

Dialectical behavior therapy for the treatment of anger and aggressive behavior: A review

ObjectiveThe management of anger and aggression is a public safety issue. Dialectical behavior therapy (DBT) is a promising treatment for reducing anger and violent behavior. This mode of therapy addresses maladaptive behavior by teaching emotion regulation, distress tolerance, interpersonal effectiveness, core mindfulness, and self-management skills.MethodsThis paper reviewed DBT treatment for anger and aggressive or violent behavior. The literature search included articles from 1998 to September 2013. A total of 21 peer-reviewed articles studying the effects of DBT on anger and aggressive behavior were reviewed.ResultsAdaptations or modifications were made to standard DBT to accommodate the specific needs of the variety of populations across studies. Nine studies attempted to understand the efficacy of DBT for anger and aggressive behavior while twelve studies measured the efficacy of DBT within the context of a BPD diagnosis. There are nine randomized controlled trials (RCT) assessing DBT to reduce anger and aggressive behavior.ConclusionResearch has shown that there are potentially clinically significant results when using DBT to treat anger and aggression in various samples. Findings from this review suggest that treatments, even when modified show a positive impact on the reduction of anger and aggressive behaviors.     

Effects of a verbal warning and overcorrection on stereotyped and appropriate behaviors

In Experiment I, the effects of a verbal warning, such as is used in Overcorrection, delivered contingently on the stereotyped mouthing behavior of two autistic/retarded children were examined. A multiple baseline design across subjects was used. The results indicated that the mouthing of one child was reduced to a nearzero level and mouthing of the second child was moderately reduced. Appropriate toy play and inappropriate object manipulation failed to show systematic changes in occurrence when mouthing was decelerated. In Experiment II, the same subjects and experimental design were used to assess the effects of a positive practice Overcorrection procedure delivered contingent on mouthing behavior. Overcorrection reduced the mouthing of both subjects. There were no systematic changes in inappropriate object manipulation but one subject did demonstrate an increased occurrence of appropriate toy play. In addition, this subject often engaged in aggressive/escape behaviors during Overcorrection, suggesting that the procedure was aversive to him.     

Anger and aggression in women: Influence of sports choice and testosterone administration

We report on two studies of anger and aggression in women. One study concerns an experimental study of anger induction in aggressive and non-aggressive sportswomen. It was found that sports choice in itself, contrary to expectation, does not predict anger arousal and aggressive behavior in the laboratory. However, at an individual level the anger proneness of the subject, as measured by a questionnaire we developed, was related to the intensity of aggressive behavior and subjectively reported anger. The second study concerns the activating effects of androgens on aggression and anger proneness. In a group of 22 female-to-male transsexuals, a battery of anger proneness and aggression questionnaires was administered twice: shortly before and 3 months after the start of androgen treatment. Administration of androgens was clearly associated with an increaese in anger proneness, although there were no changes in several aspects of overt aggressive behavior. © 1994 Wiley-Liss, Inc.     

Effects of High-Probability Request Sequences on Preschoolers' Compliance and Disruptive Behavior

A high-probability request sequence was implemented with three preschool children with developmental delays within their classroom during typical activities. A multiple baseline design across subjects was used to evaluate the effects of the high-probability request sequence on compliant responding to low-probability requests and the occurrence of disruptive behavior. Results of the study indicate that the use of the high-probability request sequence was effective in increasing compliant responding to low-probability requests delivered by two different trainers for all children. No increases in disruptive behavior were noted as a result of using the high-probability request sequence. When the high-probability request sequence was withdrawn, compliant responding to low-probability requests was maintained for all children across time and in different settings.     

Observed increases in positive affect during behavioral treatment

A 15‐year‐old female diagnosed with mental retardation was admitted to an inpatient facility for the assessment and treatment of a severe behavior disorder. A behavioral treatment to reduce destructive behavior consisting of enriched environment, differential reinforcement, and time‐out was evaluated in a reversal design. Data on affect were collected during baseline and treatment phases. In addition to achieving clinically significant reductions in problem behavior, collateral improvements in positive affect were observed during treatment phases. Copyright © 2003 John Wiley & Sons, Ltd.