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.     

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of engagement was significantly higher when positive practice overcorrection was in place than when overcorrection was withdrawn.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.     

A STIMULUS CONTROL PROCEDURE TO DECREASE MOTOR AND VOCAL STEREOTYPY

A changing criterion design was used to examine the effects of two stimuli (a green card and a red card), conditioned via discrimination training, on reducing motor and vocal stereotypy in a youngster with autism while he looked at books. During discrimination training, motor and vocal stereotypy was not interrupted in the presence of a green stimulus, but was interrupted in the presence of a red stimulus using manual guidance and appropriate behavior was reinforced. After the participant demonstrated successful discrimination of the stimuli (i.e., the absence of stereotypy in the presence of a red stimulus and the engagement in stereotypy in the presence of a green stimulus), intervention began. During intervention, upon meeting criterion for latency to engage in motor and vocal stereotypy in the presence of the red stimulus for a target duration, the participant was provided access to the green stimulus, which signaled that motor and vocal stereotypy would not be interrupted. The criterion latency to engage in stereotypy in the presence of the red stimulus was systematically increased. Simultaneously, the duration of access to the green stimulus was systematically decreased. The red and green stimuli were faded from poster boards to colored 10 × 10 cm cards, and stimulus control was generalized to the participant's classroom and to a community setting (i.e., public library). Results are discussed in terms of discrimination training as a useful intervention for reducing motor and vocal stereotypy. Copyright © 2011 John Wiley & Sons, Ltd.     

Further evaluation of methods to identify matched stimulation

The effects of preferred stimulation on the vocal stereotypy of 2 individuals were evaluated in two experiments. The results of Experiment 1 showed that (a) the vocal stereotypy of both participants persisted in the absence of social consequences, (b) 1 participant manipulated toys that did and did not produce auditory stimulation, but only sound-producing toys decreased his vocal stereotypy, and (c) only noncontingent music decreased vocal stereotypy for the other participant, but sterotypy paradoxically increased when toys were presented with music. Using a three-component multiple schedule, the results of Experiment 2 showed that the vocal stereotypy of both participants remained below preintervention levels following the removal of auditory stimulation and that 1 participant's vocal stereotypy increased following the removal of contingent reprimands. These patterns suggest that auditory stimulation functioned as an abolishing operation for vocal stereotypy and reprimands functioned as an establishing operation for vocal stereotypy. Together, the two experiments provide a method for identifying alternative stimulation that may substitute for automatically reinforced behavior.     

Artificial intelligence for the measurement of vocal stereotypy

Both researchers and practitioners often rely on direct observation to measure and monitor behavior. When these behaviors are too complex or numerous to be measured in vivo, relying on direct observation using human observers increases the amount of resources required to conduct research and to monitor the effects of interventions in practice. To address this issue, we conducted a proof of concept examining whether artificial intelligence could measure vocal stereotypy in individuals with autism. More specifically, we used an artificial neural network with over 1,500 minutes of audio data from 8 different individuals to train and test models to measure vocal stereotypy. Our results showed that the artificial neural network performed adequately (i.e., session-by-session correlation near or above .80 with a human observer) in measuring engagement in vocal stereotypy for 6 of 8 participants. Additional research is needed to further improve the generalizability of the approach.     

THE UTILITY OF ASSESSING MUSICAL PREFERENCE BEFORE IMPLEMENTATION OF NONCONTINGENT MUSIC TO REDUCE VOCAL STEREOTYPY

We conducted a modified paired‐choice preference assessment and used a multielement design to examine the effects of noncontingent access to high‐ and low‐preference music on vocal stereotypy exhibited by children with autism. For 3 of the 4 participants, high‐preference music (a) produced lower levels of vocal stereotypy than low‐preference music and (b) reduced vocal stereotypy when compared to a no‐interaction condition. Results underscore the potential importance of assessing musical preference prior to using noncontingent music to reduce vocal stereotypy.     

Effects of three types of noncontingent auditory stimulation on vocal stereotypy in children with autism

We evaluated the effects of 3 types of noncontingent auditory stimulation (music, white noise, recordings of vocal stereotypy) on 2 children with autism who engaged in high rates of vocal stereotypy. For both participants, the music condition was the most effective in decreasing vocal stereotypy to near-zero levels, resulted in the highest parent social validity ratings, and was selected as most preferred in treatment preference evaluations.     

The effects of verbal operant training and response interruption and redirection on appropriate and inappropriate vocalizations

Past research has shown that response interruption and redirection (RIRD) can effectively decrease automatically reinforced motor behavior (Hagopian & Adelinis, 2001). Ahearn, Clark, MacDonald, and Chung (2007) found that a procedural adaptation of RIRD reduced vocal stereotypy and increased appropriate vocalizations for some children, although appropriate vocalizations were not targeted directly. The purpose of the current study was to examine the effects of directly targeting appropriate language (i.e., verbal operant training) on vocal stereotypy and appropriate speech in 3 children with an autism spectrum disorder. The effects of verbal operant (i.e., tact) training were evaluated in a nonconcurrent multiple baseline design across participants. In addition, RIRD was implemented with 2 of the 3 participants to further decrease levels of vocal stereotypy. Verbal operant training alone produced slightly lower levels of stereotypy and increased appropriate vocalizations for all 3 participants; however, RIRD was required to produce acceptably low levels of stereotypy for 2 of the 3 participants.     

Effects of socially appropriate singing on the vocal stereotypy of children with autism spectrum disorder

This study evaluated the effects of children with autism spectrum disorder engaging in socially acceptable singing on their vocal stereotypy. A multiple‐baseline across four participants with embedded multielement designs was used to assess the effects of the singing intervention upon later occurrence of vocal stereotypy for each participant. Results showed that fewer instances of vocal stereotypy occurred during and after singing intervention sessions. Additionally, two children began to emit appropriate singing after intervention, which suggests that the topography of their vocal stereotypy (e.g., monosyllabic or screeching sounds) was altered to some extent. Overall, results suggest positive implications for teaching appropriate vocal behaviors as functional replacements for vocal stereotypy.     

Immediate and subsequent effects of differential reinforcement of other behavior and noncontingent matched stimulation on stereotypy

A three‐component multiple‐schedule and brief reversals were used to examine the effects of differential reinforcement of other behavior (DRO) and noncontingent matched stimulation (NMS) on the automatically reinforced mouthing of a child with autism. Both DRO and NMS decreased immediate engagement in mouthing, but NMS produced larger reductions in the behavior. Furthermore, NMS produced subsequent effects (i.e., when the treatment was withdrawn) similar to those of prior access, whereas DRO marginally increased subsequent engagement in mouthing. The results suggest that NMS was a functionally matched intervention for mouthing. Implications for the assessment and treatment of stereotypy and applications for future research are discussed. Copyright © 2010 John Wiley & Sons, Ltd.     

Effects of prior access and environmental enrichment on stereotypy

A young boy's stereotypy was first evaluated in two daily 30 min sessions (one in the morning and one in the afternoon) during a free operant (FO) condition. Results from the two daily sessions during FO showed that stereotypy was lower during the second session of the day, suggesting that prior access had affected later engagement in stereotypy. The effects of environmental enrichment (EE) with music, EE music plus a guitar, and EE music plus a guitar plus contingent music loss on stereotypy were also evaluated. Unexpectedly, the results showed that the presence of music increased stereotypy during both daily sessions; however, contingent music loss decreased stereotypy and simultaneously increased untargeted guitar play. Increases in stereotypy during both daily sessions suggest that music may have increased the reinforcing value of stereotypy. Copyright © 2004 John Wiley & Sons, Ltd.     

Evaluation of the immediate and subsequent effects of response interruption and redirection on vocal stereotypy

We evaluated 2 3-component multiple-schedule sequences-a response interruption and redirection (RIRD) treatment sequence and a no-interaction control sequence-using a multielement design. With this design, we were able to evaluate the immediate and subsequent effects of RIRD on 2 participants' vocal stereotypy. For both participants, RIRD produced an immediate decrease in vocal stereotypy and did not result in a subsequent increase.     

Differential associations of leisure music engagement with resilience: A network analysis

Background/ObjectiveSeveral factors associated with resilience as the maintenance of mental health despite stress exposure can be strengthened through participation in leisure time activities. Since many people listen to or make music in their leisure time, the aim of the present study was to provide insights into the architecture of how resilience relates to passive and active music engagement.Method511 participants regularly listening to and/or making music completed an online survey on resilient outcomes (i.e., mental health and stressor recovery ability), different resilience factors (e.g., optimism, social support), quantitative music engagement (i.e., time spent with music listening/making) and qualitative music engagement (i.e., use of music listening/making for mood regulation).ResultsBivariate correlations showed that subjects spending more time with music making reported better stressor recovery ability and less mental health problems, while partial correlational network analysis revealed no unique associations for quantitative music engagement. Regarding qualitative music engagement, people using music-based mood regulation reported lower mental health, mindfulness, and optimism, but also higher social support. A more heterogeneous pattern emerged for single music-based mood regulation strategies.ConclusionsOur findings highlight the importance of the individual (mal-)adaptive use of music, painting a more nuanced picture of music engagement and resilience.     

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.     

THE EFFECTS OF RESPONSE INTERRUPTION AND REDIRECTION AND SERTRALINE ON VOCAL STEREOTYPY

Although response interruption and redirection (RIRD) has been shown to be successful in reducing vocal stereotypy, recent reports have suggested that selective serotonin reuptake inhibitors (SSRIs) may also reduce these behaviors. The purpose of the current investigation was to examine the effects of RIRD with and without sertraline on automatically maintained vocal stereotypy of a 4‐year‐old boy with autism. Results suggested that vocal stereotypy decreased when RIRD was implemented and that sertraline did not affect the participant's vocal stereotypy.     

Further evaluation of response interruption and redirection as treatment for stereotypy

The effects of 2 forms of response interruption and redirection (RIRD)-motor RIRD and vocal RIRD-were examined with 4 boys with autism to evaluate further the effects of this intervention and its potential underlying mechanisms. In Experiment 1, the effects of motor RIRD and vocal RIRD on vocal stereotypy and appropriate vocalizations were compared for 2 participants. In Experiment 2, the effects of both RIRD procedures on both vocal and motor stereotypy and appropriate vocalizations were compared with 2 additional participants. Results suggested that RIRD was effective regardless of the procedural variation or topography of stereotypy and that vocal RIRD functioned as a punisher. This mechanism was further explored with 1 participant by manipulating the schedule of RIRD in Experiment 3. Results were consistent with the punishment interpretation.     

EFFECTS OF VERBAL REPRIMANDS ON TARGETED AND UNTARGETED STEREOTYPY

Results of brief functional analyses indicated that motor and vocal stereotypy persisted in the absence of social consequences for five participants diagnosed with autism spectrum disorder (ASD). Subsequently, effects of a stimulus control procedure involving contingent reprimands for each participant's higher probability (targeted) stereotypy were evaluated. Results indicated that contingent verbal reprimands (i) decreased the targeted stereotypy for all five participants, (ii) decreased the untargeted stereotypy for two of five participants, and (iii) increased the untargeted stereotypy for one of five participants. Although response suppression was not achieved for any participant, three participants maintained low levels of the target stereotypy with one or two reprimands during 5‐min sessions. Furthermore, two of those participants maintained near‐zero levels of motor and vocal stereotypy during 10‐min sessions. These findings suggest that signaled verbal reprimands may be a practical intervention for reducing stereotypy in some children with ASD. Some limitations of the findings and areas of future research are briefly discussed. Copyright © 2014 John Wiley & Sons, Ltd.     

A comparison of response interruption and redirection and competing items on vocal stereotypy and appropriate vocalizations

The current study compared the reductive effects of response interruption and redirection (RIRD) and competing items (including sound-producing and nonsound-producing toys) on the vocal stereotypy exhibited by two children diagnosed with Autism Spectrum Disorder. Sound-producing toys reduced vocal stereotypy relative to nonsound-producing toys and RIRD reduced stereotypy and increased rates of appropriate vocalizations to a greater extent than providing competing items. These findings replicate and extend previous literature suggesting that RIRD and sound-producing competing items are effective methods to treat vocal stereotypy.     

Musical structure modulates semantic priming in vocal music

It has been shown that harmonic structure may influence the processing of phonemes whatever the extent of participants' musical expertise [Bigand, E., Tillmann, B., Poulin, B., D'Adamo, D. A., & Madurell, F. (2001). The effect of harmonic context on phoneme monitoring in vocal music. Cognition, 81, B11-B20]. The present study goes a step further by investigating how musical harmony may potentially interfere with the processing of words in vocal music. Eight-chord sung sentences were presented, their last word being either semantically related (La girafe a un tres grand cou, The giraffe has a very long neck) or unrelated to the previous linguistic context (La girafe a un tres grand pied, The giraffe has a very long foot). The target word was sung on a chord that acted either as a referential tonic chord or as a congruent but less referential subdominant chord. Participants performed a lexical decision task on the target word. A significant interaction was observed between semantic and harmonic relatedness suggesting that music modulates semantic priming in vocal music. Following Jones' dynamic attention theory, we argue that music can modulate semantic priming in vocal music, by modifying the allocation of attentional resource necessary for linguistic computation.     

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.