An evaluation of a punisher assessment for decreasing automatically reinforced problem behavior

We extended research on the identification and evaluation of potential punishers for decreasing automatically reinforced problem behavior in four individuals with autism spectrum disorder. A punisher selection interview was conducted with lead clinicians to identify socially acceptable punishers. During the treatment evaluation, treatment phases were introduced sequentially and included noncontingent reinforcement (NCR), NCR and differential reinforcement of alternative behavior (DRA), and NCR‐and‐DRA with punishment. During the NCR‐and‐DRA with punishment phase, four to five potential punishers were evaluated using a multielement design. Dependent measures included the target problem behavior, appropriate item engagement, and emotional responding. For all participants, NCR‐and‐DRA was not effective and punishment was necessary. However, the most effective punisher identified in the context of NCR‐and‐DRA differed across participants.     

The effects of noncontingent reinforcement on task disengagement following failure of differential reinforcement treatment

Following the failure of applications of differential reinforcement (DR), the effects of reinforcement delivered noncontingently (NCR) on task disengagement and task completion were evaluated within reversal designs for three children with autism spectrum disorder. In Experiment 1, we compared DR and NCR schedules that combined positive and negative reinforcement. In Experiment 2, we replicated the results of Experiment 1 and then evaluated NCR schedules composed solely of negative reinforcement and NCR schedules that combined negative reinforcement with high-or low-preferred stimuli. In Experiment 3, we further analyzed NCR schedules that included different types and qualities of positive reinforcement, but without the inclusion of negative reinforcement. The results showed that NCR schedules using positive reinforcers can be effective as a treatment for task disengagement, but the type and preference of the reinforcer can alter effectiveness. These results are interpreted in terms of the motivating operations associated with task disengagement.     

Noncontingent reinforcement for the treatment of severe problem behavior: An analysis of 27 consecutive applications

Noncontingent reinforcement (NCR) is a commonly used treatment for severe problem behavior displayed by individuals with intellectual and developmental disabilities. The current study sought to extend the literature by reporting outcomes achieved with 27 consecutive applications of NCR as the primary treatment for severe problem behavior. All applications of NCR were included regardless of treatment outcome to minimize selection bias favoring successful cases. Participants ranged in age from 5 to 33 years. We analyzed the results across behavioral function and with regard to the use of functional versus alternative reinforcers. NCR effectively treated problem behavior maintained by social reinforcement in 14 of 15 applications, using either the functional reinforcer or alternative reinforcers. When we implemented NCR to treat problem behavior maintained by automatic reinforcement, we often had to add other treatment components to produce clinically significant effects (five of nine applications). Results provide information on the effectiveness and limitations of NCR as treatment for severe problem behavior.     

NONCONTINGENT REINFORCEMENT AS TREATMENT FOR SEVERE PROBLEM BEHAVIOR: SOME PROCEDURAL VARIATIONS

Noncontingent reinforcement (NCR) as a treatment for problem behavior has typically included (a) continuous access to reinforcers at the onset of treatment and (b) extinction. We extended research on NCR by conducting a three-phase preliminary investigation of these components. In Phase 1, a functional analysis showed that the problem behavior of 3 participants with developmental disabilities was maintained by tangible positive reinforcement. In Phase 2, treatment started with the initial NCR interval based on the latency to the first problem behavior during baseline. In Phase 3, treatment consisted of NCR without extinction to determine whether extinction was an essential treatment component. Results showed that the initial NCR schedule based on latency (Phase 2) and NCR without extinction (Phase 3) were effective for reducing rates of problem behavior compared with baseline. Findings are discussed regarding the initial schedule of reinforcement and extinction as components of NCR.     

Effects of noncontingent reinforcement on problem behavior and stimulus engagement: the role of satiation, extinction, and alternative reinforcement

This study examined the effects of noncontingent reinforcement (NCR) with and without extinction on problem behavior and stimulus engagement (consumption of reinforcement) of 4 participants. Reductions in problem behavior using NCR have frequently been attributed to both satiation of the reinforcer and extinction. In the current study, aspects of the NCR treatment effects were difficult to explain based solely on either a satiation or an extinction account. Specifically, it was found that stimulus engagement remained high throughout the NCR treatment analysis, and that problem behavior was reduced to near-zero levels during NCR without extinction. The implications of these findings are discussed with respect to the satiation and extinction hypotheses frequently described in the applied literature. Findings from basic studies examining the effects of response-independent schedules are presented, and are used as the basis for a matching theory account of NCR-related effects. It is proposed that reductions in problem behavior observed during NCR interventions may be a function of the availability of alternative sources of reinforcement.     

Sensitivity to reward and punishment in major depressive disorder: Effects of rumination and of single versus multiple experiences

In the current study, we examined the postulation that rumination makes it difficult for depressed individuals to learn the exact probability that different stimuli will be associated with punishment. To do so, we induced rumination or distraction in depressed and never-depressed participants and then measured punishment and reward sensitivity with a probabilistic selection task. In this task, participants first learn the probability that different stimuli will be associated with reward and punishment. During a subsequent test phase in which novel combinations of stimuli are presented, participants’ sensitivity to reward is tested by measuring their tendency to select the stimuli that were most highly rewarded during training, and their sensitivity to punishment is tested by measuring their tendency to not select the stimuli that were most highly punished during training. Compared with distraction, rumination led depressed participants to be less sensitive to the probability that stimuli will be associated with punishment and relatively less sensitive to punishment than reward. Never-depressed participants and depressed participants who were distracted from rumination were as sensitive to reward as they were to punishment. The effects of rumination on sensitivity to punishment may be a mechanism by which rumination can lead to maladaptive consequences.     

Variable-time reinforcement schedules in the treatment of socially maintained problem behavior

Noncontingent reinforcement (NCR) consists of delivering a reinforcer on a time-based schedule, independent of responding. Studies evaluating the effectiveness of NCR as treatment for problem behavior have used fixed-time (FT) schedules of reinforcement. In this study, the efficacy of NCR with variable-time (VT) schedules was evaluated by comparing the effects of VT and FT reinforcement schedules with 2 individuals who engaged in problem behavior maintained by positive reinforcement. Both FT and VT schedules were effective in reducing problem behavior. These findings suggest that VT schedules can be used to treat problem behavior maintained by social consequences.     

FUNCTIONAL COMMUNICATION TRAINING WITH AND WITHOUT EXTINCTION AND PUNISHMENT

Functional communication training has been reported to be a promising treatment for severe behavior problems. In this study, functional communication training alone and combined with extinction and/or punishment was evaluated for 4 clients with severe retardation, behavior problems, and communication deficits. The participants were inpatients on a hospital unit for treatment of severe behavior disorders. They received individualized interventions based on functional assessment that included reinforcement of a communication response with the same function as their destructive behavior. Results showed that for some patients, functional communication training was not sufficient to produce clinically significant reductions in destructive behavior, and the combination of training plus punishment produced the largest and most consistent reductions.     

The Influence of Function,Topography, and Setting on Noncontingent Reinforcement Effect Sizes for Reduction in Problem Behavior: A Meta-analysis of Single-Case Experimental Design Data

Richman et al. (J Appl Behav Anal 48:131–152, 2015) completed a meta-analytic analysis of single-case experimental design data on noncontingent reinforcement (NCR) for the treatment of problem behavior exhibited by individuals with developmental disabilities. Results showed that (1) NCR produced very large effect sizes for reduction in problem behavior, (2) NCR implemented with the functional reinforcer resulted in a slightly larger effect size compared to NCR using nonfunctional reinforcers, and (3) schedule thinning for the delivery of reinforcers typically produced temporary and modest increases in levels of problem behavior. The purpose of the current study was to conduct follow-up analyses to determine whether treatment implementation setting, topography, or the function of problem behavior influenced the treatment effect size for problem behavior exhibited by individuals with developmental disabilities. Follow-up analyses showed that NCR effect sizes were very similar across inpatient and outpatient settings and across aggression and property destruction versus self-injurious behaviors. Results showed that NCR effect size for treatment of problem behavior maintained by a form of social reinforcement was slightly greater than problem behavior maintained by automatic reinforcement. Results are discussed in terms of applying NCR in school settings as an initial treatment for problem behaviors that can interfere with academic, adaptive, and vocational skill acquisition for students with developmental disabilities.     

Noncontingent reinforcement without extinction plus differential reinforcement of alternative behavior during treatment of problem behavior

The effects of noncontingent reinforcement (NCR) without extinction during treatment of problem behavior maintained by social positive reinforcement were evaluated for five individuals diagnosed with autism spectrum disorder. A continuous NCR schedule was gradually thinned to a fixed‐time 5‐min schedule. If problem behavior increased during NCR schedule thinning, a continuous NCR schedule was reinstated and NCR schedule thinning was repeated with differential reinforcement of alternative behavior (DRA) included. Results showed an immediate decrease in all participants’ problem behavior during continuous NCR, and problem behavior maintained at low levels during NCR schedule thinning for three participants. Problem behavior increased and maintained at higher rates during NCR schedule thinning for two other participants; however, the addition of DRA to the intervention resulted in decreased problem behavior and increased mands.     

COMBINING NONCONTINGENT REINFORCEMENT AND DIFFERENTIAL REINFORCEMENT SCHEDULES AS TREATMENT FOR ABERRANT BEHAVIOR

Research has shown that noncontingent reinforcement (NCR) can be an effective behavior-reduction procedure when based on a functional analysis. The effects of NCR may be a result of elimination of the contingency between aberrant behavior and reinforcing consequences (extinction) or frequent and free access to reinforcers that may reduce the participant's motivation to engage in aberrant behaviors or mands. If motivation is momentarily reduced, behavior such as mands may not be sensitive to positive reinforcement. In this study, for 3 children with aberrant behavior maintained by tangible positive reinforcement, differential-reinforcement-of-alternative-behavior schedules were superimposed on NCR schedules to determine if mands could be strengthened. Results for the participants indicated that NCR did not preclude reinforcement of mands.     

EVALUATION OF CLIENT PREFERENCE FOR FUNCTION-BASED TREATMENT PACKAGES

Functional communication training (FCT) and noncontingent reinforcement (NCR) are commonly prescribed treatments that are based on the results of a functional analysis. Both treatments involve delivery of the reinforcer that is responsible for the maintenance of destructive behavior. One major difference between the two treatment procedures is that client responding determines reinforcement delivery with FCT (e.g., reinforcement of communication is delivered on a fixed-ratio 1 schedule) but not with NCR (e.g., reinforcement is delivered on a fixed-time 30-s schedule). In the current investigation, FCT and NCR were equally effective in reducing 2 participants' destructive behavior that was sensitive to attention as reinforcement. After the treatment analysis, the participants' relative preference for each treatment was evaluated using a modified concurrent-chains procedure. Both participants demonstrated a preference for the FCT procedure. The results are discussed in terms of treatment efficacy and preference for control over when reinforcement is delivered. In addition, a method is demonstrated in which clients with developmental disabilities can participate in selecting treatments that are designed to reduce their destructive behavior.     

Depressive rumination and the C957T polymorphism of the DRD2 gene

Depressed individuals who ruminate have difficulties learning from punishment and suppressing task-irrelevant information. The C957T polymorphism of the DRD2 gene, which affects functioning of D2 dopamine receptors (DRD2) that are expressed predominantly in the indirect pathway of the basal ganglia, has been found to influence suppression and punishment learning. Given these associations, we examined in the present study whether depressive rumination is related to the C957T polymorphism in 317 clinically depressed individuals and 317 never-depressed control individuals. A 2 × 2 (diagnostic group ×C957T polymorphism) analysis of variance conducted on depressive rumination scores yielded a significant interaction of group and C957T: Individuals with two 957C alleles reported higher levels of depressive rumination than did individuals with one or two 957T alleles if they were depressed, but not if they were healthy. The present findings suggest that the dopaminergic system and DRD2 are related to the frequency of maladaptive rumination in depressed individuals. Thus, DRD2 may be an important target for the pharmacological treatment of depressive rumination.     

Individual and combined effects of noncontingent reinforcement and response blocking on automatically reinforced problem behavior

Noncontingent reinforcement (NCR) and response blocking are 2 common interventions for problem behavior maintained by automatic reinforcement. We implemented NCR and blocking with 1 boy and found this combined intervention to be effective at decreasing high rates of automatically reinforced pica. With another child, we compared the effects of blocking alone to the combined intervention. With the third child, we compared NCR alone and blocking alone to the combined intervention. Results showed that the combined intervention was effective at reducing automatically reinforced problem behavior while moderate to high levels of item engagement maintained. When evaluated individually, neither NCR nor blocking was sufficient to reduce problem behavior to clinically significant levels.     

A Comparison of Noncontingent Plus Contingent Reinforcement to Contingent Reinforcement Alone on Students’ Academic Performance

Noncontingent reinforcement (NCR) can be described as time-based or response-independent delivery of stimuli with known reinforcing properties. Previous research has shown NCR to reduce problem behavior in individuals with developmental disabilities and to interfere with the acquisition of more desired alternative behavior. To date, however, little research has examined the effects of NCR on children’s academic performance. The present study examined the effects of NCR on the completion of math computation worksheets by 3 students in an elementary school setting. An ABCB reversal design was used to compare an NCR schedule in combination with contingent reinforcement to contingent reinforcement alone. Results showed that digits correct per session decreased to baseline levels for all 3 students during implementation of the NCR plus contingent reinforcement condition. Implications of these results for the reductive effects of NCR are discussed.     

A method for identifying satiation versus extinction effects under noncontingent reinforcement schedules

We evaluated one method for determining whether response suppression under noncontingent reinforcement (NCR) is a function of satiation or extinction. Three individuals with developmental disabilities who engaged in self-injurious behavior (SIB) or aggression participated. Results of functional analyses indicated that their problem behavior was maintained by social-positive reinforcement. NCR procedures, individualized for each participant, were implemented in a multiple baseline across subjects design and were associated with decreases in all participants' problem behavior. Identification of the mechanism by which NCR produced these effects was based on examination of cumulative records showing response patterns during and immediately following each NCR session. Satiation during NCR should lead to a temporary increase in responding during the post-NCR (extinction) period due to a transition from the availability to the unavailability of reinforcement (satiation to deprivation). Alternatively, extinction during NCR should reveal no increase in responding during the extinction period because the contingency for the problem behavior would remain unchanged and the transition from satiation to deprivation conditions would be irrelevant. Results suggested that the operative mechanisms of NCR were idiosyncratic across the 3 participants and appeared to change during treatment for 1 of the participants.     

Signaling stimulus presentation during treatment with noncontingent reinforcement: Visual versus vocal signals

The independent effects of two signals implemented during treatment with noncontingent reinforcement (NCR) were examined. First, functional analyses showed that problem behavior exhibited by two individuals with developmental disabilities was sensitive to social positive reinforcement. A reversal design was then used to compare the effectiveness of a timer (NCR‐visual) to a vocal statement (NCR‐vocal) indicating when the stimulus would be returned in the context of a NCR procedure. Results showed that NCR reduced problem behavior for both participants. In addition, for one participant, the NCR‐visual condition reduced problem behavior to a greater degree than the NCR‐vocal condition. Copyright © 2009 John Wiley & Sons, Ltd.     

Treatment efficacy of noncontingent reinforcement during brief and extended application

We evaluated the long-term therapeutic effects of noncontingent reinforcement (NCR). In Experiment 1, NCR effects were examined with 2 participants' arbitrary responses; in Experiment 2, NCR was used as treatment with 3 participants whose self-injurious behavior (SIB) was maintained by automatic reinforcement. In both experiments, NCR consisted of continuous access to a highly preferred leisure item and was implemented initially during 10-min and later during 120-min sessions. Varied reinforcers (leisure items) were subsequently introduced during 120-min sessions to determine if treatment effects might be extended. Finally (Experiment 2 only), NCR was implemented throughout the day in participants' homes. Results of Experiments 1 and 2 showed that reinforcers obtained through object manipulation can compete with those obtained automatically by engaging in SIB during brief NCR sessions. However, data from the 120-min sessions indicated that satiation to a specific leisure item might occur over periods of time more typical of those during which treatment would be implemented. Access to a variety of highly preferred leisure items extended the effectiveness of NCR for some individuals. When NCR was implemented throughout the day (Experiment 2), therapeutic effects were shown to be maintained for up to 1 year.     

On the relative contributions of noncontingent reinforcement and escape extinction in the treatment of food refusal

In the current investigation, we evaluated the relative effects of noncontingent reinforcement (NCR), escape extinction, and a combination of NCR and escape extinction as treatment for the feeding problems exhibited by 4 children. For each participant, consumption increased only when escape extinction was implemented, independent of whether NCR was present or absent. These results were consistent with prior research suggesting that positive reinforcement alone is insufficient for increasing consumption, and that escape extinction often is necessary to increase and maintain food acceptance. However, NCR appeared to decrease inappropriate behavior for some participants.     

THE ROLE OF ATTENTION IN THE TREATMENT OF ATTENTION-MAINTAINED SELF-INJURIOUS BEHAVIOR: NONCONTINGENT REINFORCEMENT AND DIFFERENTIAL REINFORCEMENT OF OTHER BEHAVIOR

Because there are potentially serious limitations to differential reinforcement of other behavior (DRO) (which is probably the most widely used treatment procedure for behavior problems), we examined an alternative procedure—noncontingent reinforcement (NCR). Three females with developmental disabilities, all of whom engaged in severe self-injurious behavior, participated. During a pretreatment functional analysis, each subject's self-injury was shown to be differentially sensitive to social attention as a maintaining consequence. Next, each subject was exposed to a DRO treatment and an NCR treatment. During DRO, attention was delivered contingent on the absence of self-injury for prespecified intervals. During NCR, attention was delivered on a fixed-time schedule that was not influenced by the subject's behavior. Results showed that both procedures were highly effective in reducing self-injury, probably because the functional reinforcer for self-injury was used during treatment. Furthermore, there was evidence that NCR attenuated several of the limitations of DRO. These results are particularly interesting in light of the long experimental history of NCR as a control rather than as a therapeutic procedure.