A component analysis of "stereotypy as reinforcement" for alternative behavior

Results from several studies have suggested that the opportunity to engage in stereotypic behavior may function as reinforcement for alternative, more socially desirable behaviors. However, the procedural components of this intervention include several distinct operations whose effects have not been analyzed separately. While measuring the occurrence of stereotypy and an alternative behavior (manipulation of leisure materials), we exposed 3 participants to three or four components of a "stereotypy as reinforcement" contingency: (a) continuous access to materials, (b) prompts to manipulate materials, (c) restricted access to stereotypy (i.e., response blocking), and (d) access to stereotypy contingent on manipulating the materials. Continuous access to materials and prompting (a and b) produced negligible results. Restriction of stereotypy (c) produced a large increase in the alternative behavior of 2 participants, suggesting that response restriction per se may occasion alternative behavior. However, contingent access to stereotypy (d) was necessary to increase the 3rd participant's object manipulation; this finding provided some support for the use of stereotypy as reinforcement for alternative behavior. Finally, when transfer of the effects of intervention was assessed during periods in which active intervention components were withdrawn, the alternative behavior was maintained for 1 participant.     

Comparing response blocking and response interruption/redirection on levels of motor stereotypy: Effects of data analysis procedures

Autism spectrum disorder (ASD) is marked by deficits in social communication and the presence of restrictive and/or repetitive behaviors or interests. Motor stereotypy is a form of repetitive behavior that is common in ASD. Response Interruption and Redirection (RIRD) and response blocking (RB) are two interventions found to be efficacious in reducing motor stereotypy. However, the current literature presents with inconsistencies regarding the relative efficacy of these two procedures. Thus, we sought to replicate and extend previous literature by evaluating the efficacy of both interventions on reducing motor stereotypy among 3 individuals with ASD. We also sought to evaluate how variations in data analysis affected the interpretation of treatment outcomes. Results indicated that both interventions were equally efficacious at reducing stereotypy when analyzing data exclusive of treatment‐implementation time. However, when analyzing total session time data, RB produced greater and more sustained reductions in stereotypy across all participants. These results emphasize the importance of data analysis decision‐making in evaluating intervention outcomes.     

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.     

EFFECTS OF A PROCEDURE DERIVED FROM THE OVERCORRECTION PRINCIPLE ON MANIPULATED AND NONMANIPULATED BEHAVIORS

Positive practice overcorrection has been shown to be effective in reducing stereotypic self-stimulatory behaviors displayed by retarded and autistic individuals. In addition, the procedure also may increase the occurrence of appropriate behavior through intensive practice. In the present study, several stereotypic and one appropriate behavior (appropriate toy play) displayed by two autistic children were measured before and during treatment by a positive practice in appropriate toy play overcorrection procedure. Overcorrection was introduced for each of the targeted inappropriate behaviors in succession for both children. Results showed that overcorrection reduced all stereotypic behaviors displayed by both children. In addition, one subject displayed marked increases in the behavior practised during overcorrection, appropriate toy play, relative to its baseline rate of occurrence. The results indicate that for some individuals, overcorrection may be effective in teaching and motivating appropriate forms of behavior as well as in reducing stereotypy.     

A COMPONENT ANALYSIS OF FUNCTIONAL COMMUNICATION TRAINING ACROSS THREE TOPOGRAPHIES OF SEVERE BEHAVIOR PROBLEMS

We evaluated the separate treatment components of a functional communication training program for 3 severely handicapped persons who each displayed different topographies of aberrant behavior. Following a functional analysis of maintaining conditions for inappropriate behavior (self-injury, stereotypy, aggression), each participant was trained to emit a communicative response that functioned to solicit reinforcement. For 2 participants, consequences (time-out or graduated guidance) for inappropriate behavior were also included. Treatment continued until the participants emitted the communicative response independently and no occurrences of inappropriate behavior were observed for at least two sessions. Following treatment, the separate contributions of the treatment components for communicative responding and for inappropriate behavior were evaluated with a reversal design. The results indicated that both sets of treatment components were necessary for maximal control over aberrant behavior. These results are discussed in relation to the efficiency, history, and control over reinforcement of both appropriate and inappropriate responses.     

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.     

EFFECTS OF SPACED RESPONDING DRL ON THE STEREOTYPED BEHAVIOR OF PROFOUNDLY RETARDED PERSONS

Stereotypic responding and social behaviors of three profoundly retarded children were measured before and during application of a DRL contingency for stereotypic responding. A variant of the standard DRL procedure, spaced responding DRL, was used, in which reinforcement is delivered following a response if that response has been separated from the previous response by at least a fixed minimum time interval. Three children were treated by using a reversal design. Results showed that: (a) during baseline sessions, the children engaged in high rates of stereotypic responding and very low rates of appropriate social behavior; and (b) during DRL sessions, appropriate behavior increased markedly as stereotypic responding was reduced. The data suggest that spaced responding DRL may be effective in increasing appropriate social behavior as well as in reducing stereotypic responding.     

Toward an empirical method for identifying matched stimulation for automatically reinforced behavior: a preliminary investigation

The effects of noncontingent matched stimulation (NMS) and response blocking on a boy's stereotypic behavior were evaluated using a multiple schedule that contained three 15-min components (preintervention, intervention, and postintervention). Results showed that stereotypy was always higher after response blocking than before response blocking and was always lower after NMS than before NMS. These results suggest that response blocking may have produced deprivation for the product of stereotypy and that NMS may have provided stimulation that was similar to the product of stereotypy.     

Abatement of intractable vocal stereotypy using an overcorrection procedure

We conducted a series of reversals to compare the effects of four different treatments on vocal stereotypy emitted by a 7‐year‐old boy with autism. The results showed that (1) the level of vocal stereotypy decreased during exposure to matched stimulation but returned to high levels immediately upon its removal; (2) stereotypy did not significantly decrease during differential reinforcement of other behavior; and (3) contingent withdrawal of movies and music (i.e., response cost) was only moderately effective. However, positive practice overcorrection decreased vocal stereotypy by clinically significant levels. Further, when differential reinforcement of engagement in a Lego^® building task was implemented, the level of engagement was significantly higher when positive practice overcorrection was in place than when overcorrection was withdrawn. Copyright © 2011 John Wiley & Sons, Ltd.     

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.     

The effect of response interruption and redirection with and without a differential reinforcement of alternative behavior component on stereotypy and appropriate responses

Individuals with an Autism Spectrum Disorder (ASD) often engage in repetitive and stereotypic behaviors (American Psychological Association, 2013). Therefore, interventions that reduce stereotypy and potentially increase appropriate responses are of interest in the field of applied behavior analysis. The purpose of this study was to evaluate the isolated and additive effects of response interruption and redirection (RIRD) and differential reinforcement of alternative behavior (DRA) on both stereotypy and appropriate responses to determine whether either of these interventions alone or in combination is more effective and more efficient in increasing appropriate responses and decreasing stereotypy. Results showed that both RIRD and RIRD + DRA were effective interventions in decreasing stereotypy, but no procedure resulted in a sustained increase in appropriate responses.     

AN EVALUATION OF GENTLE TEACHING AND VISUAL SCREENING IN THE REDUCTION OF STEREOTYPY

Gentle teaching and visual screening techniques have been used to control severe behavior problems in persons with mental retardation. An alternating treatments design was used to compare gentle teaching, visual screening, and a task-training condition in the reduction of the high-level stereotypy of 3 persons with mental retardation. Following a baseline phase, a task-training condition using standard behavioral techniques was implemented to establish the effects of training the subjects on the tasks. Results showed a modest decrease in stereotypy. This phase was followed by an alternating treatments phase in which visual screening, gentle teaching, and baseline conditions were compared. Both procedures were superior to the control condition in reducing stereotypic behavior, with visual screening being more effective than gentle teaching. When compared with data from the prior phase, gentle teaching was found to be more effective than task training for 2 subjects but less effective for the 3rd, whose stereotypy increased during gentle teaching. Two succeeding phases in which visual screening was implemented across two and then all three daily conditions reduced stereotypy further to near-zero levels. An additional phase with 1 subject demonstrated that the treatment effects of visual screening were easily replicated across therapists. Mixed and idiosyncratic changes in collateral behaviors occurred. For example, “bonding,” the goal of gentle teaching, occurred at the same low levels under both treatments, contrary to the predictions of gentle teaching's proponents. The results indicate that gentle teaching may not be the universal treatment of choice for stereotypy its proponents suggest, and that it requires further empirical evaluation.     

Effects of response blocking and competing stimuli on stereotypic behavior

The effects of response blocking and competing stimuli on stereotypy and aggression were examined in an analysis conducted with a young girl diagnosed with autism and intellectual disability. A functional analysis of the stereotypic behavior revealed that blocking stereotypy increased aggression. The treatment analysis revealed that the provision of competing stimuli, without response blocking resulted in decreases in both topographies. Findings suggest that the provision of competing stimuli may be less likely to occasion other behaviors than blocking. Copyright © 2009 John Wiley & Sons, Ltd.     

EFFECTS OF NONCONTINGENT MUSIC ON VOCAL STEREOTYPY AND TOY MANIPULATION IN CHILDREN WITH AUTISM SPECTRUM DISORDERS

Noncontingent music has been shown to reduce engagement in vocal stereotypy in children with autism spectrum disorders, but its effects on appropriate collateral behavior remain unknown. Given that noncontingent music is typically implemented during periods of free play, clinicians may be concerned with the effects of the intervention on toy manipulation. Thus, we examined the immediate and subsequent effects of noncontingent music on engagement in vocal stereotypy and toy manipulation in four children with autism spectrum disorders by using a three‐component multiple schedule combined with a multi‐element design. The results suggest that noncontingent music (i) reduced immediate engagement in vocal stereotypy for three of four participants, (ii) never increased subsequent engagement in vocal stereotypy, and (iii) produced idiosyncratic effects on immediate and subsequent engagement in toy manipulation for two participants. The clinical implications of the results are discussed in terms of improving the treatment of vocal stereotypy using noncontingent music. Copyright © 2012 John Wiley & Sons, Ltd.     

ASSESSMENT OF STEREOTYPIC AND SELF-INJURIOUS BEHAVIOR AS ADJUNCTIVE RESPONSES

Certain responses of both humans and nonhumans appear to be maintained indirectly by intermittent reinforcement schedules and have been referred to collectively as adjunctive behavior. Although basic research has examined adjunctive behavior extensively, relatively few studies have been conducted with humans, particularly those with developmental disabilities who often engage in frequent and varied stereotypic behavior. This study assessed possible adjunctive characteristics of self-injurious and stereotypic behaviors using a multielement design containing two types of control conditions. Four subjects who engaged in both self-injurious behavior and stereotypy participated after variables maintaining their self-injury were identified via functional analyses. Each day, subjects were exposed to three 15-min sessions in random order: (a) noncontingent presentation of food on a fixed-time schedule (e.g., FT 30 s), (b) a massed-reinforcement (food) control, and (c) a no-reinforcement control. A variety of fixed-time schedules were examined during different experimental phases. Results of this preliminary study suggested that self-injury was not induced by intermittent reinforcement schedules, whereas the stereotypic behavior of some individuals showed characteristics of adjunctive behavior. The importance of research on adjunctive behavior and suggestions for future studies are discussed.     

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.     

FURTHER ANALYSIS OF PROBLEM BEHAVIOR IN RESPONSE CLASS HIERARCHIES

A functional analysis identified the reinforcers for 3 participants' problem behavior, but only relatively mild problem behaviors (e.g., screaming, disruption) were observed when all topographies produced tested consequences. We then conducted an extinction analysis in which specific topographies produced a reinforcer while all other topographies were on extinction. The extinction analysis confirmed that the same reinforcer identified in the initial functional analysis maintained more severe topographies of problem behavior (e.g., aggression). In addition, results of the extinction analysis indicated that 2 of the participants displayed patterns of responding consistent with a response class hierarchy hypothesis, in which less severe problem behavior frequently occurred prior to more severe topographies. The 3rd participant displayed a response pattern indicative of differential reinforcement effects.     

FUNCTIONAL ANALYSIS OF SEPARATE TOPOGRAPHIES OF ABERRANT BEHAVIOR

We conducted a functional analysis of distinct topographies of aberrant behavior displayed by 4 clients. We first analyzed the behaviors in an aggregate fashion and then separated the behaviors to formulate hypotheses about the maintaining variables for each behavior. The procedures were used in a two-phase experiment. During Phase 1, two extended functional analyses were completed, one in an inpatient unit and one in a special education classroom. During Phase 2, two brief functional analyses were completed in an outpatient clinic. Results indicated that hypotheses of separate functions for distinct behaviors can be generated using both extended and brief functional analyses when the results are graphed in the aggregate and are separated by response topography. The results also suggest that these methods can improve the accuracy of data interpretation and treatment selection.     

USING ABERRANT BEHAVIORS AS REINFORCERS FOR AUTISTIC CHILDREN

In a series of experiments, we assessed the efficacy of using autistic children's aberrant behaviors as reinforcers to increase their correct task responding. In Experiment 1, reinforcer conditions of stereotypy, food, and varied (food or stereotypy) were compared. In Experiment 2, the conditions were delayed echolalia, food, and varied (food or delayed echolalia), and in Experiment 3, perseverative behavior was compared with stereotypy and food as potential reinforcers. A multielement design was used for all comparisons, and side-effect measures were recorded during and after teaching sessions as well as at home. Results indicated that, in general, task performance was highest when brief opportunities to engage in aberrant behaviors were provided as reinforcers. Edibles were associated with the lowest performance. Furthermore, no negative side effects (e.g., an increase in aberrant behaviors) occurred. The results are discussed in terms of suggesting a more pragmatic treatment approach by addressing the contingent use of autistic children's aberrant behaviors as reinforcers.