Evaluating Treatments for Functionally Equivalent Problem Behavior Maintained by Adult Compliance with Mands During Interactive Play

A primary goal of behavioral interventions is to reduce dangerous or inappropriate behavior and to generalize treatment effects across various settings. However, there is a lack of research evaluating generalization of treatment effects while individuals with functionally equivalent problem behavior interact with each other. For the current study, the severe problem behavior of two participants with developmental disabilities was targeted for assessment and treatment. Results of a functional analysis indicated that for both participants, problem behaviors occurred when destructive behavior produced reinforcement of participant mands . The use of a multiple schedule that alternated between differential reinforcement of other behaviors and differential reinforcement of alternative behavior (mands) was sufficient to produce a significant reduction in problem behavior for one participant; the addition of differential reinforcement of alternative behaviors via compliance was necessary for the second participant. Extended treatment sessions, which focused on interaction between the two participants, involved one therapist concurrently implementing each participant’s treatment while they were directed to play with one another (a situation that previously evoked problem behavior). Results show that each participant’s treatment produced low to zero rates of problem behavior even during extended interactions.     

Multiple reinforcement contingencies to reduce aggression,self-injury and dysfunctional verbal behaviors in an adult who is sensory impaired

Differential reinforcement of other behavior (DRO) and differential reinforcement of low rates of responding (DRL) have been effective techniques in reducing maladaptive behaviors in therapeutic settings. Reported studies of these reinforcement-based procedures indicate that they are usually implemented in isolation, targeting only a single behavior or class of behaviors. In this study, multiple DRO and DRL contingencies were utilized concurrently in reducing two distinct classes of behaviors with a 26 year-old blind man with moderate retardation. One class of behaviors included socially inappropriate verbalizations, while the other included aggressive, self-injurious and environmentally destructive behaviors. Distinct contingencies were established according to the functions of the targeted behaviors and their severity and separate schedules of reinforcement were derived from baseline frequencies. Over a period of 20 months, the differential reinforcement interventions resulted in rapid reduction of behaviors in both classes to near-zero rates and frequencies were maintained at this low level while contingency schedules were systematically lengthened. Collateral effects are discussed including performance in functional academics and participation in community integration activities.     

Behavior modification with culturally deprived school children: two case studies

Techniques of behavior modification were employed with two second-grade Negro girls in a demonstration school for culturally deprived children to increase the girls' appropriate classroom behaviors. A classification system that provided for continuous categorization of behavior was used to code the children's behavior in two classroom situations. Data were also taken on the type, duration, and frequency of the teachers' verbal interactions. The study included four conditions: Baseline, Modification I, Postmodification, and Modification II. The treatment variable was positive social reinforcement-attention and approval contingent upon desirable classroom behaviors-which was presented, withheld, or withdrawn (timeout from social reinforcement). Withholding of social reinforcement was contingent upon inappropriate attention-getting behaviors. Timeout from social reinforcement was contingent upon behaviors classified as aggressive and resistive. After 25 days of Modification I, desirable behavior increased markedly for each girl. The teachers were then asked to return to their Baseline level of performance. The resultant behaviors demonstrated that for one girl, behavior was still primarily under the control of the treatment contingencies. For the second child, many desirable behaviors that had increased in frequency during Modification I remained high, but inappropriate behaviors increased. When treatment was reinstated, the amount of time spent in desirable behaviors increased and remained high for both girls. Three checks during the three months following data collection showed that these behaviors continued to remain high.     

Use of a token economy to eliminate excessive inappropriate social behavior in an adult with developmental disabilities

Adults with developmental disabilities frequently have both deficits in appropriate social skills and excesses in inappropriate social behavior (Matson, LeBlanc, & Weinheimer, 1999). Typically, published treatment studies have focused on social skills training procedures that teach and promote the use of new social behaviors. However, only a few studies have focused on management of existing social behaviors that are problematic because they occur excessively or in an inappropriate context (Wright, Herzog, & Seymour, 1992). The current study focuses on management of three types of inappropriate social behavior in a 26‐year‐old male with moderate mental retardation: inappropriate social interactions, inappropriate sexual behavior, and verbal aggression. A token economy with response cost procedure was implemented using a DRO interval as the basis for earning tokens. Using a multiple‐baseline design across behaviors, each of the three types of inappropriate social behavior was successfully treated. After demonstrating the success of the procedure, the DRO interval was increased while maintaining the reductions in inappropriate social behaviors. Appropriate behaviors such as initiating conversation, shaking hands, etc maintained throughout the intervention. Copyright © 2000 John Wiley & Sons, Ltd.     

Effects of using self-recording and self-observation in reducing disruptive behavior

In an attempt to reduce the levels of disruptive behavior, six participants in a school for students with behavior disorders were shown edited videotapes depicting themselves appropriately engaged in classroom activities. The participants were first exposed to a training condition in which both appropriate and inappropriate behaviors of a peer were either observed or observed and recorded. In the intervention condition, the participants either self-observed and self-recorded their behaviors from videotape or simply observed themselves on videotape. The results showed idiosyncratic effects across both conditions. Measures of treatment integrity and treatment acceptability were also conducted. The results of this study are compared with similar research investigating self-observation interventions.     

Improvement of retardates' mealtime behaviors by timeout procedures using multiple baseline techniques

Undesirable mealtime behaviors of a hospital cottage of retardates were reduced by contingent timeout procedures applied by ward personnel successively to one undesirable behavior after another, in a multiple baseline design. In some cases the timeout procedure was to remove the subject from the room until the meal was finished; in other cases (depending on the health of the child and the initial rate of the behavior to be reduced), timeout consisted of a 15-sec removal of the child's meal tray. Undesirable behaviors were defined as stealing, using fingers inappropriately, messy use of utensils, and pigging (eating directly with mouth or eating spilled food). Timeout was applied to these behaviors in that order, and in each case led to a marked and useful reduction in the behavior throughout the group. As these undesirable behaviors were reduced, more appropriate mealtime behaviors emerged: as inappropriate use of fingers declined (under contingent timeout), messy utensil behavior increased; later, as messy utensil behavior declined (under contingent timeout), a defined category of neat utensil behavior increased. Weights of the subjects were monitored steadily throughout the study and showed essentially no change.     

The teacher as observer and experimenter in the modification of disputing and talking-out behaviors

Disputing and talking-out behaviors of individual pupils and entire classroom groups in special education classes and regular classes from white middle-class areas and from all black poverty areas ranging from the first grade to junior high school were studied. The classroom teacher in each case acted as the experimenter and as an observer. Various means of recording behaviors were used and reliability of observation was checked by an outside observer, another teacher, a teacher-aide, a student, or by using a tape recorder. Observation sessions varied from 15 min to an entire school day. After baseline rates were obtained, extinction of inappropriate disputing or talking-out behaviors and reinforcement of appropriate behavior with teacher attention, praise and in some cases a desired classroom activity or a surprise at the end of the week brought a decrease in undesired verbalizations. A reversal of contingencies brought a return to high levels of inappropriate talking with a return to low levels when reinforcement for appropriate talking was reinstated. The experiments demonstrated that teachers in a variety of classroom settings could obtain reliable observational records and carry out experimental manipulations successfully using resources available in most schools.     

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.     

REDUCING AGGRESSIVE AND SELF-INJURIOUS BEHAVIOR OF INSTITUTIONALIZED RETARDED CHILDREN THROUGH REINFORCEMENT OF OTHER BEHAVIORS1

Aggressive and self-injurious behaviors of four retarded children were reduced by combining various techniques with the differential reinforcement of other behaviors (DRO). In one study, aggressive responses of a severely retarded child were reduced when DRO was combined with a 30-sec timeout. In a second study, various aggressive classroom behaviors were reduced when the child was told “no” for an inappropriate response but earned puzzle pieces for periods of time when inappropriate responses did not occur. Exchangeable tokens were given to a third subject for every 15 min in which aggressive responding did not occur, while each inappropriate response resulted in the loss of all tokens accrued. Responding was decreased to a level far below baseline. For a fourth child, self-injurious responses were followed by “no”, and intervals of time in which no self-injurious responding occurred earned candy. The rate of this behavior reduced significantly. In each case, the DRO procedure combined with the other techniques proved to be manageable for the teacher and successful in reducing the inappropriate behavior.     

Efficacy of functional analysis for informing behavioral treatment of inappropriate mealtime behavior: A systematic review and meta‐analysis

Children diagnosed with a feeding disorder often exhibit inappropriate mealtime behavior such as throwing or swiping food, which can exacerbate feeding difficulties during treatment. We conducted a meta‐analysis of 86 behavioral treatments for inappropriate mealtime behavior from 23 studies to assess the extent to which treatments based on a pretreatment functional analysis were more efficacious than those treatments not based on a functional analysis. Procedural escape extinction and attention extinction for inappropriate mealtime behavior, as well as differential reinforcement for food acceptance or consumption, represented the most common treatments independent of whether a functional analysis was conducted. No difference was detected between treatments that were and were not based on a functional analysis, and mean effect size across measures was identical (79%). The requirement of a pretreatment functional analysis for inappropriate mealtime behavior is equivocal given that standard care often includes efficacious treatment components that are not informed by a functional analysis.     

Training elementary aged peer behavior managers to control small group programmed mathematics

The effects of a training procedure and two maintenance contingencies on consequence-dispensing behavior were investigated. Four peer behavior managers were trained to supervise small groups of subjects (four to six per group) working in programmed math materials and were compared with a teacher skilled in the use of social and point reinforcement and response cost. Manager training was differentially effective in accelerating manager's rates of appropriate social and point dispensing. Having manager reinforcement contingent upon manager consequence-dispensing resulted in moderately higher rates of appropriate social and point dispensing for three of four subjects than did having manager reinforcement contingent upon group study behavior. Two managers exposed to the group performance contingency before the manager performance contingency increased inappropriate social and point-dispensing behaviors to pretraining baseline levels. Subsequent change to the manager performance contingency was effective in reducing the inappropriate dispensing behavior of only one of the two managers.     

Prevalence of severe behavior disorders in persons with mental retardation and treatment procedures used in community and institutional settings

A statewide survey of moderate and severe behavior disorders in persons with mental retardation in institutional and community settings was conducted. Information on the treatment procedures used and the adequacy of available resources in both settings was also gathered. Results indicated that community staff had considerably less experience than institutional staff in dealing with serious behavior disorders exhibited by persons with substantial cognitive and physical impairments. The types of aberrant behaviors with the highest prevalence rates showed differences in the institutions and the community. The largest differences in prevalence rates for severe behavior disorders in the two settings occurred for aggressive and self-injurious behaviors. Community staff thus had appreciably less experience than institutional staff in designing interventions for severe aggressive and self-injurious behaviors. About half of the identified individuals in both settings received psychotropic medications. Institutional staff were most likely to use restrictive behavioral procedures than community staff. Findings indicated that the most restrictive procedures were used primarily with only certain severe behavior disorders. Subjective ratings of the overall effectiveness of interventions were lower by community than institutional staff. The usefulness of the obtained data base for statewide planning in the area of behavioral supports is discussed.     

The application of operant conditioning techniques in a secondary school classroom

The effects of teacher praise and disapproval on two target behaviors, inappropriate talking and turning around, were investigated in a high school English class of 25 students. The contingencies were applied to all students in the experimental class utilizing a multiple baseline experimental design in which the contingencies were aimed first at decreasing inappropriate talking behavior and then at decreasing inappropriate turning behavior. Observations were made of both student and teacher behavior. The results demonstrated that the combination of disapproval for the target behaviors and praise for appropriate, incompatible behaviors substantially reduced the incidence of the target behaviors in the experimental class. Observations of these behaviors in a control class of 26 students taught by the same teacher revealed no particular changes. The findings emphasize the importance of teacher-supplied social contingencies at the secondary school level.     

Decreasing classroom misbehavior through the use of DRL schedules of reinforcement

In three studies, reinforcing low rates of responding reduced inappropriate behaviors. In the first study, the talking-out behavior of one TMR student was reduced when the teacher allowed 5 min of free time for a talk-out rate less than 0.06 per minute. In a second study, the talking-out behavior of an entire TMR class was reduced when reinforcement was delivered for a response rate less than 0.10 per minute. In a third study, successively decreasing DRL limits were used to reduce off-task verbalizations of an entire high school business class. In each case, the DRL procedure proved manageable for the teacher and successful in reducing misbehavior.     

GENERALITY AND SIDE EFFECTS OF OVERCORRECTION1

The effects and side effects of overcorrection for self-stimulatory behaviors of two children in a specialized day-care program were evaluated. For one child, a “hand” overcorrection procedure involving arm and hand exercises was introduced contingent upon inappropriate hand movements and later contingent upon inappropriate foot movements. After “hand” overcorrection was withdrawn for inappropriate foot movements, a “foot” overcorrection procedure involving foot and leg exercises was introduced contingent upon inappropriate foot movements. For a second child, the “hand” overcorrection procedure was introduced contingent upon inappropriate hand movements during a free-play period, and later contingent upon inappropriate vocalizations at naptime. “Hand” overcorrection was withdrawn and then re-introduced sequentially for both behaviors. Several concurrent behaviors were measured to assess multiple effects of treatment. Results for both children indicated the “hand” overcorrection procedure suppressed inappropriate hand movements and inappropriate behaviors that were topographically dissimilar. In addition, inverse relationships were observed between the second child's inappropriate hand movements and appropriate toy usage during free play and between his inappropriate vocalizations and inappropriate foot movements during naptime. Results suggest that overcorrection procedures that are effective for one behavior can be used to reduce the frequency of topographically different behaviors. This finding is discussed in terms of its practical implications for therapists.     

Exploring the reinforcement of compliance with "do" and "don't" requests and the side effects: a partial replication and extension

The side effects of reinforcing compliance to "do" and "don't" requests were examined in this study. The study was designed to do two things: (1) further establish that "do" and "don't" requests are functionally distinct and (2) determine which "don't" requests will show the same ability as "do" requests in effecting a change in topographically different inappropriate behaviors. Three children (2 boys and 1 girl), ages 5 yr. 2 mo. to 6 yr. 7 mo., participated. The design of the study was ABAC counterbalanced across subjects. With all three children reinforcement of "do" requests led to increased compliance with "do" requests without concurrent increase in compliance to "don't" requests. Also, reinforcing compliance to "don't" requests resulted in increased compliance to "don't" requests without concurrent increase in compliance to "do" requests. An undesirable side effect to the treatment was also noted. Two children showed a tendency to increase their rates of inappropriate behavior concurrent with increases in compliance to "don't" requests. Probable causes for this effect and concerns about the reinforcement of "don't" requests were discussed.     

SEVERE CLASSROOM BEHAVIOR PROBLEMS: TEACHERS OR COUNSELLORS

This experiment was designed to determine the relative effectiveness of teacher and counselling approaches in the reduction of disruptive or inappropriate classroom behavior. Inappropriate classroom behavior frequencies of 12 academically low achieving, seventh-grade, black male students, with a reported high rate of inappropriate classroom behavior, were recorded. Three groups, with nearly equal mean inappropriate behaviors, were randomly assigned to one of three treatment conditions: behavioral counselling, client-centered counselling, or no counselling. Each counselling group received fifteen 30-minute counselling sessions, at a rate of two to three times a week. In addition to counselling, all students subsequently received teacher approval within the classroom. Results indicated that the teacher was able to reduce inappropriate behavior more than any counselling group. There were also indications that behavioral counselling, but not client-centered counselling, was moderately helpful in reducing inappropriate classroom behavior.     

Effects of feedback and behavior contracting on head trauma persons' inappropriate sexual behavior

Three individuals who were traumatically brain injured (TBI) demonstrated inappropriate sexual behaviors. All three participants engaged in touching the genitals of members of the opposite sex and one made sexual comments. In the first two cases, hourly feedback was used initially to reduce the touching. Next, behavior contracting was paired with feedback to further reduce it. In the third case, inappropriate touching and sexual comments were both decreased using only feedback.     

Provision of leisure activities for the reduction of challenging behavior

Behavioral treatment of challenging behaviors, such as aggression, self-injury, property destruction, and stereotyped movement is often a priority in residential facilities for persons with developmental disabilities. If these behaviors occur when the client is otherwise unengaged, a potentially effective treatment may be to provide alternative activities. In the present study, 3 adults with severe disabilities were observed. During baseline, these 3 individuals frequently displayed challenging behavior at times when they were otherwise unengaged. Opportunities to participate in leisure activities were then provided to each client in a multiple-baseline design. Provision of leisure opportunities was associated with increased adaptive behavior and collateral reductions in problem behaviors. The effectiveness of the intervention procedures suggest that these challenging behaviors may have been related to the lack of alternative activities.