COMPUTER‐ASSISTED MEASUREMENT OF WOUND SIZE ASSOCIATED WITH SELF‐INJURIOUS BEHAVIOR

We evaluated an inexpensive, efficient, and noninvasive technique for measuring tissue damage produced by self‐injurious behavior (SIB). The technique involved computerized measurement of wound surface area (WSA) based on digital photographs. In Study 1, we compared photographic measurement to a more commonly used procedure, transparency measurement, in estimating WSA of 20 wound models. Results showed that both methods were reliable and that there was a high degree of correspondence between the 2 sets of measures. In Study 2, we compared photographic WSA measures to direct‐observation measures in documenting changes over time in the SIB exhibited by a woman with Prader‐Willi syndrome. Results showed that increases and decreases in observed SIB during baseline and treatment conditions corresponded with changes in WSA measures, indicating that the computer‐assisted photographic technique may be useful as a corroborative measure or as a primary measure when direct observation of SIB is not feasible.     

A FUNCTIONAL ANALYSIS OF HAIR PULLING

We experimentally assessed the functions of hair pulling and hair manipulation of a 19-year-old woman (Kris) with moderate mental retardation and cerebral palsy. In Phase 1 a functional analysis revealed that Kris pulled and manipulated hair for the greatest amount of time in the alone condition, suggesting that the behaviors were maintained by some form of automatic reinforcement (Vaughan & Michael, 1982). In Phase 2 we assessed the nature of the sensory stimulation that maintained hair pulling by providing continuous access to previously pulled or cut hair and, thereafter, by having Kris wear a rubber glove. The results suggested that hair pulling was maintained by digital-tactile stimulation (automatic positive reinforcement). These findings are discussed, and recommendations for further analyses of automatically reinforced habit behaviors are provided.     

ANALYSIS OF SOCIAL VARIABLES WHEN AN INITIAL FUNCTIONAL ANALYSIS INDICATES AUTOMATIC REINFORCEMENT AS THE MAINTAINING VARIABLE FOR SELF‐INJURIOUS BEHAVIOR

Self‐injurious behavior (SIB) that occurs at high rates across all conditions of a functional analysis can suggest automatic or multiple functions. In the current study, we conducted a functional analysis for 1 individual with SIB. Results indicated that SIB was, at least in part, maintained by automatic reinforcement. Further analyses using protective equipment (i.e., a helmet with face shield) revealed an attention function for the SIB.     

FUNCTIONAL ANALYSIS AND TREATMENT OF RUMINATION USING FIXED‐TIME DELIVERY OF A FLAVOR SPRAY

A functional analysis suggested that rumination exhibited by an adult with autism was maintained by automatic reinforcement. Next, a preference assessment with three flavor sprays (i.e., flavored sprays used by dieters) showed that apple pie spray was most preferred. Finally, the effects of fixed‐time delivery of the apple pie spray on levels of rumination were evaluated. The spray reduced rumination, and the participant was taught to self‐administer the spray.     

FUNCTIONAL ANALYSIS AND TREATMENT OF INAPPROPRIATE VERBAL BEHAVIOR

The present study examined the possible function of inappropriate verbal behavior of an adult man who had been diagnosed with both mental retardation and psychosis. Results of a functional analysis indicated that inappropriate verbal utterances were maintained by attention. An intervention consisting of the differential reinforcement of appropriate verbal behavior effectively reduced the inappropriate behavior.     

THERAPIST‐ AND SELF‐MONITORED DRO CONTINGENCIES AS A TREATMENT FOR THE SELF‐INJURIOUS SKIN PICKING OF A YOUNG MAN WITH ASPERGER SYNDROME

The use of differential reinforcement of other behavior (DRO) has decreased, at least partially due to the development of less effortful alternative behavioral interventions (e.g., noncontingent reinforcement; Vollmer, Iwata, Zarcone, Smith, & Mazaleski, 1993). The effort associated with DRO contingencies may be lessened by incorporating self‐monitoring components in which clients are responsible for the delivery of reinforcers for their own behavior. The current study evaluates the effectiveness of DRO in the treatment of self‐injury when implemented first by the therapist and subsequently by the client.     

TRIAL-BASED FUNCTIONAL ANALYSIS AND FUNCTIONAL COMMUNICATION TRAINING IN AN EARLY CHILDHOOD SETTING

Problem behavior is common in early childhood special education classrooms. Functional communication training (FCT; Carr & Durand, 1985 ) may reduce problem behavior but requires identification of its function. The trial‐based functional analysis (FA) is a method that can be used to identify problem behavior function in schools. We conducted trial‐based FAs and FCT with 3 children in an early childhood special education setting. All trial‐based FAs resulted in identification of behavioral functions, and subsequent FCT led to reductions in problem behavior and increases in communication.     

FUNCTIONAL ANALYSIS AND TREATMENT OF SEVERE PICA

A two-phase functional analysis of a profoundly retarded 19-year-old male's pica facilitated the design of an effective intervention containing no aversive components. In the first analysis, frequent staff-client interaction resulted in 25% and 66% less pica than limited and no interaction, respectively. Paradoxical effects were obtained in the second analysis, where no protective helmet resulted in 38% and 26% less pica than the helmet with face shield and helmet without face shield, respectively. On the basis of these analyses, limited interaction and no helmet conditions were combined in an effective, staff-implemented treatment at a medium-sized institution.     

FUNCTIONAL ANALYSIS AND TREATMENT OF CIGARETTE PICA

A series of analyses was conducted to assess and treat the pica of cigarette butts by a young man with mental retardation and autism. First, we demonstrated that pica was maintained in a condition with no social consequences when the available cigarettes contained nicotine but not when the cigarettes contained herbs without nicotine. Second, a choice assessment (Fisher et al., 1992) confirmed that tobacco was preferred over the other components of the cigarette (e.g., paper, filter, etc.). Third, an analogue functional analysis (Iwata, Dorsey, Slifer, Bauman, & Richman, 1982/1994) demonstrated that cigarette pica was maintained independent of social consequences. Fourth, a treatment designed to interrupt the hypothesized response—reinforcer relationship reduced consumption of cigarettes to zero. Finally, because cigarette pica occurred primarily when the individual was alone or under minimal supervision, a procedure based on stimulus control was developed to improve the effectiveness of the intervention in these situations.     

FUNCTIONAL ANALYSIS AND TREATMENT OF EYE POKING

In four studies we analyzed the eye poking of a youth with profound disabilities. In Study 1, a functional analysis showed that eye poking occurred during the no-attention condition, but not during demand, attention, or recreation conditions. The analysis did not identify socially mediated variables involved in the maintenance of eye poking; rather, eye poking may have been maintained by consequences produced directly by the response. In Study 2 we had the student wear goggles to prevent potential reinforcement from finger—eye contact. The results of Study 2 indicated that eye-poking attempts were reduced when the student wore goggles. We then tested in Study 3 the effects of two alternative topographies of stimulation. Study 3 demonstrated that eye poking was reduced when a video game was provided as a competing source of visual stimulation, and that music was less effective in reducing eye poking. In Study 4, a contingency analysis using the video game was conducted in an attempt to (a) reduce the frequency of eye poking and (b) study whether the video game functioned as a reinforcer. The results of Study 4 demonstrated substantive reductions in the frequency of eye poking, and suggested that the video game served as a reinforcer.     

NONCONTINGENT REINFORCEMENT: A FURTHER EXAMINATION OF SCHEDULE EFFECTS DURING TREATMENT

We conducted 2 studies to determine whether dense and thin NCR schedules exert different influences over behavior and whether these influences change as dense schedules are thinned. In Study 1, we observed that thin as well as dense NCR schedules effectively decreased problem behavior exhibited by 3 individuals. In Study 2, we compared the effects of 2 NCR schedules in multielement designs, one with and the other without an extinction (EXT) component, while both schedules were thinned. Problem behavior remained low as the NCR schedule with EXT was thinned, but either (a) did not decrease initially or (b) subsequently increased as the NCR schedule without EXT was thinned. These results suggest that dense schedules of NCR decrease behavior by altering its motivating operation but that extinction occurs as the NCR schedule is thinned. The benefits and limitations of using dense or thin NCR schedules are discussed.     

FIRST PERSON PLURAL: SELF‐UNITY AND SELF‐MULTIPLICITY IN THEOLOGY'S DIALOGUE WITH PSYCHOLOGY

In contradistinction to the contemporary human sciences, recent theological accounts of the individual‐in‐relation continue to defend the concept of the singular continuous self. Consequently, theological anthropology and the human sciences seem to offer widely divergent accounts of the sense of self‐fragmentation that many believe pervades the modern world. There has been little constructive interdisciplinary conversation in this area. In this essay I address the damaging implications of this oversight and establish the necessary conditions for future dialogue. I have three primary objectives. First, I show how the notion of personal continuity acquires philosophical theological significance through its close association with the concept of personal particularity. Second, through a discussion of contemporary accounts of self‐multiplicity, I clarify the extent of theological anthropology's disagreement with the human sciences. Third, I draw upon narrative accounts of identity to suggest an alternative means of understanding the experiential continuity of personhood that maintains the tension between self‐plurality, unity, and particularity and thereby reconnects philosophical theological concerns with human‐scientific analyses of the human condition. Narrative approaches to personhood are ideally suited to this purpose, and, I suggest, offer an intriguing solution to understanding and resolving the problem of self‐fragmentation that has caused recent theological anthropology so much consternation.     

FUNCTIONAL ANALYSIS AND TREATMENT OF EYE POKING WITH RESPONSE BLOCKING

A functional analysis of eye poking by a 4-year-old female with severe disabilities and visual impairments showed that high rates occurred in all conditions. We conducted a series of probes to identify the maintaining variable for eye poking following an undifferentiated functional analysis. Results showed that eye poking decreased only when we interrupted finger-eye contact by blocking the response.     

FUNCTIONAL ANALYSIS AND TREATMENT OF ELOPEMENT ACROSS TWO SCHOOL SETTINGS

The elopement of a child with Asperger syndrome was assessed using functional analyses and was treated in two school settings (classroom and resource room). Functional analyses indicated that elopement was maintained by access to attention in the resource room and obtaining a preferred activity in the classroom. Attention- and tangible-based interventions were compared in an alternating treatments design in both settings. Results validated the findings of the functional analyses. Implications for the assessment and treatment of elopement are discussed.     

A BRIEF FUNCTIONAL ANALYSIS OF AGGRESSIVE AND ALTERNATIVE BEHAVIOR IN AN OUTCLINIC SETTING

We conducted a brief functional analysis to identify maintaining variables for aggressive behavior and an alternative replacement response during a 90-min outpatient evaluation of 3 individuals with severe handicaps. During the initial analogue assessment, which focused on identifying maintaining contingencies for aggressive behavior, each participant displayed a substantially greater frequency of aggressive behavior during one condition than during any other. The contingency that produced the highest percentage of aggressive behavior was then presented for the occurrence of a specific alternative behavior (a mand). During this contingency reversal phase, each participant displayed a substantial reduction in aggressive behavior and a substantial increase in alternative behavior, thus providing a direct analysis of the equivalency of the contingency for maintaining either behavior.     

Functional analysis of self-injurious behavior and its relation to self-restraint

Some individuals who engage in self-injurious behavior (SIB) also exhibit self-restraint. In the present study, a series of three functional analyses were conducted to determine the variables that maintained a participant's SIB, one without restraint items available, one with a preferred and effective form of self-restraint (an airplane pillow) available noncontingently, and one with this item delivered contingent on SIB. Results suggested that SIB was reinforced by escape and by access to self-restraint materials, self-restraint appeared to be maintained by automatic reinforcement, and continuous access to highly preferred restraint materials effectively suppressed SIB.