Parent‐conducted rapid assessment of attention types for the treatment of attention‐maintained problem behavior

When praise is not a reinforcer for alternative behavior in the treatment of attention‐maintained problem behavior, further pretreatment assessments are warranted to develop an effective treatment. The current study reports a replication of the pretreatment rapid assessment of attention types (RAAT) procedures, implemented by the parents of a 19‐year‐old female with attention‐maintained problem behavior. After administering staff and parent‐conducted RAATs, a parent‐implemented treatment, (a) produced clinically significant decreases in problem behavior, and (b) confirmed that the RAAT identified an attention‐type that served as a reinforcer for appropriate alternative behavior. This study extends the findings of Strohmeier et al. by reporting results of a parent‐conducted RAAT and treatment evaluation. The findings highlight the practical importance of pretreatment assessment of attention‐types, with emphasis on caregiver involvement, to develop effective treatments for attention‐maintained problem behavior.     

Further investigation of differential reinforcement of alternative behavior without extinction for escape‐maintained destructive behavior

Previous research indicates that manipulating dimensions of reinforcement during differential reinforcement of alternative behavior (DRA) for situations in which extinction cannot be implemented is a potential approach for treating destructive behavior. Therefore, we replicated and extended previous research by determining (a) the conditions under which DRA without extinction decreased and maintained low levels of destructive behavior and (b) whether intervention effects maintained during reinforcement schedule thinning for the alternative response (i.e., compliance). Results showed that effective treatments were developed in the absence of extinction by manipulating the quality of reinforcement for compliance for 2 participants and by combining manipulations of the magnitude and quality of reinforcement for compliance for the other 2 participants. However, maintaining treatment effects during reinforcement schedule thinning required combining the magnitude and quality of reinforcement for 3 of the 4 participants. We discuss the clinical utility of this approach, review limitations of the study, and suggest directions for future research.     

Reducing attention‐maintained behavior through the use of positive punishment,differential reinforcement of low rates,and response marking

A differential reinforcement of low (DRL) rates procedure was implemented as a changing criterion design with positive punishment and response marking to reduce attention‐maintained behavior of screaming, profanity, and disruptive behaviors of three adolescent males. One participant was diagnosed with static encephalopathy and attention deficit hyperactivity disorder (ADHD) and severe mental retardation, the other two were diagnosed with Down syndrome, one with moderate mental retardation, and the other with severe mental retardation. Through response marking, a verbal warning was delivered immediately following the initial occurrence of a target behavior. A special token (positive punishment) was immediately delivered with a verbal cue and placed on a behavior board following the next occurrence of that behavior. Appropriate requests (hand‐raising) for attention was acknowledged and reinforced with verbal praise. The DRL procedure, combined with positive punishment and response marking, was successful in decreasing the frequency of targeted behaviors amongst all participants. Copyright © 2009 John Wiley & Sons, Ltd.     

The effects of presession attention on problem behavior maintained by different reinforcers

The effect of presession attention on the later occurrence of problem behavior was examined with elementary-school children with a range of disabilities. Results of analogue functional analyses suggested an escape function, an attention function, or both. Following the analogue functional analyses, the effects of two antecedent conditions (10-min ignore vs. 10-min attention) were compared on problem behavior in subsequent test conditions. For participants who displayed attention-maintained problem behavior, the test condition involved contingent attention for problem behavior. For participants who displayed escape-maintained problem behavior, the test condition involved contingent escape for problem behavior. Results indicated that participants who displayed attention-maintained problem behavior displayed less problem behavior following presession exposure to attention than when ignored. No such effect was found for presession attention on escape-maintained problem behavior. We discuss matching antecedent-based interventions to the results of functional analysis.     

Assessment and treatment of problem behavior maintained by escape from attention and access to tangible items.

The results obtained from two consecutive functional analyses conducted with a 6‐year‐old child with autism are described. In the initial functional analysis, the highest rates of problem behavior occurred in the play condition. In that condition, the delivery of attention appeared to occasion problem behaviors. A second functional analysis was conducted wherein an escape from attention condition and a tangible condition were added. In the second functional analysis, higher rates of responding were observed in the escape from attention and tangible conditions. The results suggested that problem behavior was maintained by negative reinforcement in the form of escape from attention and positive reinforcement in the form of gaining access to preferred tangible items. Problem behavior was treated using functional communication training combined with noncontingent reinforcement.     

Altering the timing of academic prompts to treat destructive behavior maintained by escape

Following a functional analysis showing that destructive behavior was reinforced by escape, we altered the aversiveness of task demands by interspersing easy and difficult tasks and by presenting a corrective prompt as an antecedent event the next time a previously failed item was presented; this procedure was compared with one in which the corrective prompt was provided as an immediate consequence. Results of a reversal design showed that the antecedent prompt acted as an establishing operation and reduced destructive behavior to zero.     

Parent‐implemented treatment for automatically maintained stereotypy

Automatically maintained stereotypy is common among children with autism spectrum disorder. The purpose of this study was to evaluate the effect of a multicomponent parent‐implemented intervention on the reduction of motor stereotypy for a child with autism. A 2‐year‐old child and her father participated in this study. The effect of a parent‐implemented intervention was evaluated using an alternating treatment design. The results indicated that the parent‐implemented treatment package including differential reinforcement, response blocking, and a competing stimulus decreased automatically maintained motor stereotypy.     

Prompting procedures as establishing operations for escape‐maintained behavior

In the current study, we report on a young man with Nager's Syndrome, mild mental retardation, and deafness who exhibited severe problem behavior during demand situations. Initial functional analysis suggested that problem behavior was maintained by gaining escape from instructional demands. However, further analysis suggested that the individual was responding to escape the prompting procedure rather than the work tasks themselves. Copyright © 2006 John Wiley & Sons, Ltd.     

An evaluation of the properties of attention as reinforcement for destructive and appropriate behavior

The analogue functional analysis described by Iwata, Dorsey, Slifer, Bauman, and Richman (1982/1994) identifies broad classes of variables (e.g., positive reinforcement) that maintain destructive behavior (Fisher, Ninness, Piazza, & Owen-DeSchryver, 1996). However, it is likely that some types of stimuli may be more effective reinforcers than others. In the current investigation, we identified 2 participants whose destructive behavior was maintained by attention. We used concurrent schedules of reinforcement to evaluate how different types of attention affected both destructive and appropriate behavior. We showed that for 1 participant praise was not an effective reinforcer when verbal reprimands were available; however, praise was an effective reinforcer when verbal reprimands were unavailable. For the 2nd participant, we identified a type of attention that effectively competed with verbal reprimands as reinforcement. We then used the information obtained from the assessments to develop effective treatments to reduce destructive behavior and increase an alternative communicative response.     

Effects of teacher attention on study behavior

The effects of contingent teacher attention on study behavior were investigated. Individual rates of study were recorded for one first-grade and five third-grade pupils who had high rates of disruptive or dawdling behavior. A reinforcement period (in which teacher attention followed study behavior and non-study behaviors were ignored) resulted in sharply increased study rates. A brief reversal of the contingency (attention occurred only after periods of non-study behavior) again produced low rates of study. Reinstatement of teacher attention as reinforcement for study once again markedly increased study behavior. Follow-up observations indicated that the higher study rates were maintained after the formal program terminated.     

Diaphragmatic breathing as treatment for escape‐maintained aggression

Coping skills, such as diaphragmatic breathing, are commonly recommended to help individuals work through challenging situations. We evaluated diaphragmatic breathing as treatment for aggression of three individuals diagnosed with autism spectrum disorder or Angelman syndrome. Functional analysis results demonstrated that each participant engaged in aggression maintained by social‐negative reinforcement. Diaphragmatic breathing treatment without extinction was conducted in a work context and involved prompting diaphragmatic breathing contingent on precursors to aggression; treatment was effective in reducing the rate of aggression for one of three participants. For the two other participants, other reinforcement‐based interventions (differential reinforcement of other behavior or functional communication training with extinction) were necessary to decrease aggression.     

Further evaluation of treatment duration on the resurgence of destructive behavior

Translation of promising procedures for mitigating treatment relapse has received considerable attention recently from researchers across the basic–applied continuum. One procedure that has demonstrated mixed support involves increasing the duration of treatment as a strategy for blunting resurgence. In a recent translational study, Greer et al. (2020) failed to detect a mitigation effect of increased treatment duration on the resurgence of destructive behavior. However, design limitations may have been responsible. The present study corrected these limitations by (a) employing a sequential design to decrease the possibility of multiple-treatment interference, (b) evaluating more treatment durations, (c) arranging treatments of fixed durations, and (d) conducting treatments of more extreme duration in a different clinical sample. Despite these improvements in experimental rigor and the testing of more extreme boundary conditions, the present study also failed to detect a mitigation effect of increased treatment duration. Likely explanations are discussed.     

The evaluation and treatment of aggression maintained by attention and automatic reinforcement.

In the current investigation, we used direct and indirect methods to assess and treat several topographies of aggression that were hypothesized to have separate operant functions in a young boy with severe mental retardation and pervasive developmental disorder. First, a functional analysis of aggression, using the methods described by Iwata, Dorsey, Slifer, Bauman, and Richman (1982/1994), was conducted and produced inconclusive results. Next, indirect methods were used to develop a second functional analysis, which showed that chin grinding (firmly pressing and grinding his chin against the skin and bones of others) persisted independent of social contingencies and that the other topographies of aggression (e.g., hitting, kicking) were maintained by social positive reinforcement (attention). A treatment designed to decrease aggression maintained by attention—functional communication training with extinction—reduced all forms of aggression except chin grinding. This latter topography of aggression, which we hypothesized was maintained by automatic reinforcement, was reduced when the response-reinforcer relation was interrupted through response blocking and the child was provided with an alternative form of chin stimulation.     

Assessment and treatment of problem behavior maintained by mand compliance

We modified functional analysis procedures to include a condition in which we reinforced problem behavior by complying with a child's mands. After identifying compliance with mands as a reinforcer, we evaluated the efficacy of a token system with a response‐cost contingency and incorporated discriminative stimuli to signal when mands would be reinforced. The token system with response cost effectively reduced problem behavior. Similar procedures may be beneficial when continuous adult compliance is not possible, when adults want to control when they will comply with the child's mands, or to build a child's tolerance for adult‐directed situations.     

The impact of gender on the assessment of body checking behavior

Body checking includes any behavior aimed at global or specific evaluations of appearance characteristics. Men and women are believed to express these behaviors differently, possibly reflecting different socialization. However, there has been no empirical test of the impact of gender on body checking. A total of 1024 male and female college students completed two measures of body checking, the Body Checking Questionnaire and the Male Body Checking Questionnaire. Using multiple group confirmatory factor analysis, differential item functioning (DIF) was explored in a composite of these measures. Two global latent factors were identified (female and male body checking severity), and there were expected gender differences in these factors even after controlling for DIF. Ten items were found to be unbiased by gender and provide a suitable brief measure of body checking for mixed gender research. Practical applications for body checking assessment and theoretical implications are discussed.     

A preliminary evaluation of treatment duration on the resurgence of destructive behavior

Quantitative models of resurgence (e.g., Behavioral Momentum Theory, Resurgence as Choice) suggest that resurgence is partly a function of the duration of extinction exposure, with longer histories of extinction producing less resurgence. This prediction is supported by some laboratory research and has been partially supported by clinical translations that did not isolate the effects of extinction exposure prior to testing for resurgence. The degree to which different histories of extinction impact the likelihood of treatment relapse in therapeutic applications of differential reinforcement is of great interest to the clinical community, including insurance carriers and other financial providers. In the present study, we isolated the effects of extinction history for severe destructive behavior across 6 participants referred for treatment services and examined resurgence of destructive behavior when alternative reinforcement terminated. Our within-subject evaluation showed no difference in the level of resurgence or persistence of destructive behavior following short and long exposures to differential reinforcement with extinction. We discuss our failure to replicate in relation to experimental-design considerations for investigating this and other relapse phenomena in future research with clinical populations.     

The effect of supervisor and trainee therapist gender on supervision discourse

The effects of supervisor and trainee therapist gender on supervision discourse were examined in this study. Forty episodes of supervision discourse, with ten drawn from each of four types of supervision systems were videotaped. The systems were (1) male supervisor and male trainee therapist; (2) male supervisor and female trainee therapist; (3) female supervisor and male trainee therapist; and (4) female supervisor and female trainee therapist. The episodes of supervision discourse were analysed using a supervision discourse coding system which showed adequate inter-rater reliability. For supervisors, the coding system allowed a directive discourse style and a collaborative discourse styled to be coded. A cooperative discourse style and a resistant discourse style could be coded for trainee therapists. Two statistically significant findings of considerable theoretical and clinical importance emerged. First, contrary to stereotypic expectations, discourse characterized by a directive supervision style and a resistant trainee therapist style was more common for systems containing a female supervisor than for those containing a male supervisor. Second, for same gender supervisor-trainee-therapist supervision systems, a collaborative systemic supervision style was correlated with both cooperative and resistant trainee therapist styles. This discourse pattern did not occur for opposite gender supervision systems, indicating that a collaborative supervision discourse style is consistently associated with trainee therapist parti-cipation (either cooperatively or resistantly) within same gender pairings of supervisors and trainee therapists. These results are discussed in light of relevant literature on gender, power and supervision process and the limitations of the study are considered.     

Effects of instructions and reinforcement-feedback on human operant behavior maintained by fixed-interval reinforcement

In three experiments, human subjects were trained on a five-component multiple schedule with different fixed intervals of monetary reinforcement scheduled in the different components. Subjects uninstructed about the fixed-interval schedules manifested high and generally equivalent rates regardless of the particular component. By comparison, subjects given instructions about the schedules showed orderly progressions of rates and temporal patterning as a function of the interreinforcement intervals, particularly when feedback about reinforcement was delivered but also when reinforcement-feedback was withheld. Administration of the instructions-reinforcement combination to subjects who had already developed poorly differentiated behavior, however, did not make their behavior substantially better differentiated. When cost was imposed for responding, both instructed and uninstructed subjects showed low and differentiated rates regardless of their prior histories. It was concluded that instructions can have major influences on the establishment and maintenance of human operant behavior.