Use of an Antecedent Intervention to Decrease Vocal Stereotypy of a Student With Autism in the General Education Classroom

This study examined the use of an antecedent-based intervention to reduce the vocal stereotypy of a student diagnosed with Autism within the general education classroom. The student displayed frequent nonfunctional speech and disruptive vocal sounds. An antecedent-based intervention, involving the use of qualitatively different cards—to cue the student when it was appropriate or inappropriate to engage in vocal stereotypy—was designed and implemented. An adaptive alternating treatment design was utilized and conditions were randomized and counterbalanced across treatment sessions. Data on vocal stereotypy were collected using partial interval recording. The results indicated the participant was successful in discriminating between cues and decreased stereotypy during intervention compared to baseline conditions. Similar findings were found when the intervention was implemented across a second school setting.     

Analysis of response allocation in individuals with multiple forms of stereotyped behavior

Three experiments were conducted to evaluate response allocation of stereotypy during free-operant and restricted-operant conditions. Five children with autism or related developmental disabilities participated in at least one and up to three of the experiments. In Experiment 1, the stereotypic response that emerged as most probable during a free-operant phase was restricted, and response allocation was again evaluated. The results for 3 participants showed that restricting the high-probability response was correlated with covarying reductions in a nontargeted stereotypy. In Experiment 2, the effect of environmental enrichment on response allocation was evaluated. One participant reallocated behavior to appropriate object manipulation, 1 participant showed no change in behavior, and a 3rd participant reallocated behavior to object manipulation only when the putative stimulus products of the object manipulation matched those of stereotypy. In Experiment 3, additional interventions were implemented to promote response reallocation. Results showed that both response restriction and reinforcement for object manipulation decreased stereotypy and increased object manipulation. Collectively, the results of these experiments point to a need for complex evaluations of interventions for stereotypy.     

Decreasing motor stereotypy in leisure contexts: Analysis of stimulus control with response interruption and redirection

Noncontingent access to preferred stimuli and activities may decrease stereotypic behavior in individuals with autism or other developmental disorders. However, prompted engagement, response interruption and redirection (RIRD), and/or contingent access to stereotypy may be required to achieve clinically significant reductions in stereotypy. Antecedent stimuli may also be manipulated during intervention to establish stimulus control by signaling when stereotypy will receive programmed consequences. The purpose of the current project was to replicate prior research in this area by a) evaluating the effectiveness of RIRD on motor stereotypy in an adolescent with autism and b) providing contingent access to stereotypy as a function of successively longer intervals without stereotypic behavior. We also assessed the extent that these procedures gained acceptable stimulus control. Results from this project suggest RIRD and contingent access to stereotypy may effectively decrease motor stereotypy in leisure contexts, though consistent inhibitory stimulus control may be difficult to establish.     

Response interruption and redirection for vocal stereotypy in children with autism: a systematic replication

This study systematically replicated and extended previous research on response interruption and redirection (RIRD) by assessing instructed responses of a different topography than the target behavior, percentage of session spent in treatment, generalization of behavior reduction, and social validity of the intervention. Results showed that RIRD produced substantial decreases in vocal stereotypy. Limitations of this study were that behavior reduction did not generalize to novel settings or with novel instructors and that appropriate vocalizations did not improve.     

Evaluating a treatment without extinction for elopement maintained by access to stereotypy

Elopement is a common and potentially dangerous form of problem behavior. Results of a functional analysis found that the elopement of a child with autism was maintained by access to stereotypy in the form of door play. We implemented functional communication training and contingency-based delays dependent on the absence of elopement and increased the amount of time the participant waited prior to engaging in stereotypy. We also conducted treatment-extension probes, with the participant waiting up to 10 min without elopement.     

Assessment and treatment of elopement maintained by access to stereotypy

We evaluated a treatment for elopement maintained by access to stereotypic door play. First, we conducted a functional analysis of elopement that produced undifferentiated results. Next, we conducted an assessment in which we evaluated the relation between elopement and door play. Results suggested a functional relation between the 2 behaviors (i.e., elopement was maintained by contingent access to door play). Finally, we implemented functional communication training as a treatment for elopement in which access to door play was made contingent on a target appropriate communication response.     

The stability of function of automatically reinforced vocal stereotypy over time

Although prior research has suggested the function of socially reinforced problem behavior can change across time, the stability of the function of automatically reinforced behavior is largely unknown. Further, some authors have suggested automatically reinforced behavior is likely to enter into socially mediated contingencies. The present study compared 2 functional analyses conducted on the same target behavior at least 1 year apart. Participants were 6 individuals diagnosed with an intellectual or developmental disability displaying automatically reinforced vocal stereotypy. Results indicated the function of each participant's vocal stereotypy remained stable over time (i.e., no new functions were acquired); however, future research on functional stability for automatically reinforced behavior of other topographies is needed.     

Ritual Behavior in Obsessive and Normal Individuals: Moderating Anxiety and Reorganizing the Flow of Action

ABSTRACT— Ritualized behavior is characteristic of obsessive-compulsive disorder (OCD), but it is also observed in other, nonclinical contexts such as children's routines and cultural ceremonies. Such behaviors are best understood with reference to a set of human vigilance–precaution systems in charge of monitoring potential danger and motivating the organism toward appropriate precautions. Ritualized behavior focuses attention on low-level representations of actions, probably leading to some measure of intrusion suppression. Cultural rituals too may be understood in this framework.     

Analyzing the multiple functions of stereotypical behavior for students with autism: implications for assessment and treatment

We studied behavioral functions associated with stereotypical responses for students with autism. In Study 1, analogue functional analyses (attention, demand, no-attention, and recreation conditions) were conducted for 5 students. Results suggested that stereotypy was multiply determined or occurred across all assessment conditions. For 2 students, stereotypy was associated with positive and negative reinforcement and the absence of environmental stimulation. For 2 other students, stereotypy occurred at high levels across all experimental conditions. For the 5th student, stereotypy was associated with negative reinforcement and the absence of environmental stimulation. In Study 2, the stereotypy of 1 student was further analyzed on a function-by-function basis. Within a concurrent-schedules procedure, alternative responses were taught to the student using functional communication training. The results of Study 2 showed that similar topographies of stereotypy, based on qualitatively different reinforcers, were reduced only when differential reinforcement contingencies for alternative forms of communication were implemented for specific response-reinforcer relations. Our results suggest that the causes of stereotypy for students with autism are complex and that the presumed association between response topography and behavioral function may be less important than previously realized.     

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.     

Superimposition and withholding of edible consequences as treatment for automatically reinforced stereotypy

The delivery and subsequent withholding of tangible consequences has been previously investigated as an intervention for stereotypic behavior. The current investigation sought to extend previous research by evaluating its effectiveness and durability as treatment for stereotypy of 2 children who had been diagnosed with autism. Nonsocial functions for stereotypic behavior were identified via functional analysis. Edible items were then delivered contingent on stereotypy and were withheld in a subsequent condition. When the superimposition procedure failed to reduce stereotypy, environmental enrichment was implemented and was found to reduce the stereotypy of both participants.     

Differential reinforcement to decrease stereotypy exhibited by an adult with autism spectrum disorder

Motor and vocal stereotypies are behaviors commonly exhibited by individuals with autism spectrum disorder (ASD). Stereotypy may impede and interfere with learning new skills and decrease work performance in employment settings. Previous research has evaluated effective interventions for stereotypy; however, they have typically focused on treating stereotypy exhibited by children in structured settings. We evaluated the practicality of implementing a simple differential reinforcement of other behavior procedure with an adult with ASD in multiple, naturalistic environments. Results showed rapid decreases in motor and vocal stereotypies upon implementation of the intervention and maintenance of low levels of behavior. These data highlighted the successful treatment of stereotypy exhibited by an adult with a long history of exhibiting these behaviors. Treatment effects were replicated across multiple, naturalistic environments.     

Assessing and treating vocal stereotypy in children with autism

Previous research implies that stereotypic behavior tends to be maintained by the sensory consequences produced by engaging in the response. Few investigations, however, have focused on vocal stereotypy. The current study examined the noncommunicative vocalizations of 4 children with an autism spectrum disorder. First, functional analyses were conducted in an attempt to identify the function of each child's behavior. For each of the participants, it was found that vocal stereotypy was likely not maintained by the social consequences. Following assessment, response interruption and redirection (RIRD) was implemented in an ABAB design to determine whether vocal stereotypy could be successfully redirected. RIRD involved a teacher issuing a series of vocal demands the child readily complied with during regular academic programming. Vocal demands were presented contingent on the occurrence of vocal stereotypy and were continuously presented until the child complied with three consecutively issued demands without emitting vocal stereotypy. For each child, RIRD produced levels of vocal stereotypy substantially lower than those observed in baseline. For 3 of the children, an increase in appropriate communication was also observed. The children's teachers were trained to implement RIRD. Brief follow-up probes and anecdotal information implied that the treatment had a positive impact in the natural environment.     

ASSESSMENT AND TREATMENT OF DESTRUCTIVE BEHAVIOR MAINTAINED BY STEREOTYPIC OBJECT MANIPULATION

In the current investigation, 2 participants with mental retardation displayed property destruction and stereotypy, and both responses involved the same materials (e.g., breaking and tapping plastic objects). Three experiments were conducted (a) to indirectly assess the functions of these two responses, (b) to determine their relation to one another, and (c) to develop a treatment to reduce the more serious behavior, property destruction. In Experiment 1, previously destroyed materials were either present or absent, and their presence reduced property destruction but not stereotypy. In Experiment 2, matched toys (ones that produced sensory stimulation similar to stereotypy) were either present or absent, or were replaced by unmatched toys (for 1 participant). Matched toys produced large reductions and unmatched toys produced small reductions in property destruction and stereotypy. In Experiment 3, attempts to pick up undestroyed objects were either blocked or not blocked while matched toys were continuously available. Response blocking reduced property destruction (and attempts), prevented stereotypy, and increased manipulation of matched toys. These results suggest that the two aberrant responses formed a chain (e.g., breaking and then tapping the object), which was maintained by the sensory consequences (e.g., auditory stimulation) of the terminal response, and that previously destroyed material or matched toys made the initial response (property destruction) unnecessary.     

Effects of Response Blocking and Programmed Stimulus Control on Motor Stereotypy: A Pilot Study

We evaluated response blocking with programmed stimulus control, wearing tennis wrist bands, to reduce motor stereotypy in a student with autism. Response blocking was effective and subsequent analysis revealed that wearing the tennis wrist bands alone maintained low frequency stereotypy. Results suggest that controlling effects from a procedure such as response blocking can be transferred to a programmed stimulus in the absence of physical intervention.     

Intervention,stimulus control,and generalization effects of response interruption and redirection on motor stereotypy

This study evaluated the effects of response interruption and redirection (RIRD) on motor stereotypy (hand and body movements) in a child with neurodevelopmental disorders. We also assessed whether a stimulus paired with RIRD could acquire inhibitory control when tested during nonintervention conditions. Compared with baseline phases in a reversal design, RIRD decreased both hand and motor stereotypies, and there was evidence of stimulus control. Extending RIRD to a second setting was also effective. The care providers responsible for intervention implemented RIRD with fidelity, and they rated the procedure positively. Clinical and research implications from these findings are discussed.     

The role of task preference in the effectiveness of response interruption and redirection

Response interruption and redirection (RIRD) is a common treatment for automatically reinforced vocal stereotypy; it involves the contingent presentation of task instructions. Tasks that are included in RIRD are typically selected based on caregiver report, which may affect the efficacy of RIRD. The purpose of the current study was to evaluate the role of task preference in the efficacy of RIRD for four participants who engaged in vocal stereotypy. We conducted task-preference assessments and selected tasks of varying preferences to include in RIRD. For three out of four participants, the results showed that RIRD with higher preference tasks was not effective at reducing vocal stereotypy, whereas RIRD with lower preference tasks was effective for all participants.