An analysis of stimuli that influence compliance during the high-probability instruction sequence

When we evaluated variables that influence the effectiveness of the high-probability (high-p) instruction sequence, the sequence was associated with a precipitous decrease in compliance with high-p instructions for 1 participant, thereby precluding continued use of the sequence. We investigated the reasons for this decrease. Stimuli associated with the low-p instruction were systematically added and removed in the context of the high-p instructions, and results suggest that the stimuli associated with the low-p instruction influenced compliance with the high-p instructions.     

The effects of a high-probability instruction sequence and response-independent reinforcer delivery on child compliance

We compared the effects of a high-probability (high-p) instruction sequence and a fixed-time (FT) schedule of reinforcement on the compliance of 2 typically developing children. A multielement experimental design with a reversal component was implemented according to a multiple baseline across participants arrangement. Both the high-p and FT conditions resulted in increased compliance for both participants during the multielement sessions. These results suggest that it may be possible to increase compliance without a response requirement of the type arranged in the high-p instruction sequence.     

Increasing compliance with medical examination requests directed to children with autism: effects of a high-probability request procedure

The purpose of this study was to evaluate the effectiveness of a high-probability (high-p) request sequence as a means of increasing compliance with medical examination tasks. Participants were children who had been diagnosed with autism and who exhibited noncompliance during general medical examinations. The inclusion of the high-p request sequence effectively increased compliance with medical examination tasks. In addition, the procedure was efficient, could be implemented by parents and medical professionals, and did not involve aversive procedures.     

Use of the high-probability instructional sequence and escape extinction in a child with food refusal

We used the high-probability (high-p) instructional sequence with and without escape extinction in the treatment of food refusal. Acceptance increased and refusal decreased only with the introduction of escape extinction. These results raise important questions about the high-p sequence in the treatment of food refusal.     

Some variables affecting children's compliance with instructions

Children were given instructions to perform different tasks. Compliance was studied as a function of several variables: the prevailing pattern of reinforcement for different instructions, the availability of a competing reinforced activity, and the similarity among tasks. Rate of compliance tended to decrease when the probability of reinforcement for compliance decreased, or when a competing reinforced activity was available. Differential reinforcement over the tasks did not always produce discriminative responding even under favorable conditions. Novel instructions obtained compliance at the same rate as that for frequently repeated instructions, independent of the novel instruction's past or present reinforcement history. Greater discrimination in responding was found when tasks were less similar. Results imply that sets of instructions may form a response class, with characteristics similar to those found in studies of generalized imitation.     

A method to establish stimulus control and compliance with instructions

We evaluated a unique procedure to establish compliance with instructions in four young children diagnosed with autism spectrum disorder (ASD) who had low levels of compliance. Our procedure included methods to establish a novel therapist as a source of positive reinforcement, reliably evoke orienting responses to the therapist, increase the number of exposures to instruction–compliance–reinforcer contingencies, and minimize the number of exposures to instruction–noncompliance–no reinforcer contingencies. We further alternated between instructions with a high probability of compliance (high‐p instructions) with instructions that had a prior low probability of compliance (low‐p instructions) as soon as low‐p instructions lost stimulus control. The intervention is discussed in relation to the conditions necessary for the development of stimulus control and as an example of a variation of translational research.     

Effects of response independent delivery of preferred items and the high‐probability instructional sequence on compliance

The use of the high‐probability (high‐p) instructional sequence to increase compliance, which includes issuing a series of instructions with which a participant is likely to comply immediately before issuing a low‐probability instruction, has received mixed support in the literature. Previous research has suggested that the delivery of response independent reinforcement may be as effective to increase compliance, at least for some types of instructions. In this study, we examined the effects of response independent reinforcement and the high‐p sequence on compliance with two types of instructions with two young children. Results show that neither procedure was effective for increasing compliance for either type of instruction; however, contingent access to a high preference item increased compliance. Results are discussed in terms of the conditions under which response independent delivery of high‐preference items and the high‐p instructional sequence might be effective to increase compliance.     

Differential reinforcement with and without instructional fading

We evaluated a differential-reinforcement-based treatment package for the reduction of problem behavior during instructional situations. Differential reinforcement of alternative behavior (DRA; compliance) was implemented across two conditions. During one condition, instructions were presented approximately once every other minute. This condition was considered the terminal goal for treatment. During the second condition, the rate of instructions was gradually increased (beginning at zero and ending when instruction rate was similar to the first condition). Results indicated that DRA with instructional fading resulted in less problem behavior than DRA without instructional fading. These results are similar to previous studies regarding the utility of instructional fading.     

Effects of reinforcement and response-cost history on instructional control

The present study compared the effects of reinforcement or punishment versus no additional consequences for instruction following on instructional control and subsequent rule-governed insensitivity. In two experiments, adult participants were presented with repeated choices between a short progressive-time schedule and either a fixed time-schedule or a longer progressive-time schedule. In Experiment 1, three groups were given an initially accurate instruction relative to the direct contingency. A control group experienced no additional consequences for compliance with instructions, whereas compliance resulted in additional points for a second group, and noncompliance led to the subtraction of points for a third group. In a subsequent phase, instructions became inaccurate and there were no additional consequences for compliance or noncompliance for any group. Consistent with previous results, rule-governed insensitivity was observed in all participants. Experiment 2 employed the same procedure, except instructions were inaccurate throughout all sessions, and compliance in the subsequent phase resulted in diminishing points per session. Reinforcement for following instructions increased instructional control and subsequent rule-governed insensitivity. This increase was maintained even after the termination of additional consequences, a result that supports theoretical suggestions that a history of reinforcement for complying with instructions and rules is an important factor in rule-governed insensitivity.     

Effects of differential reinforcement and task difficulty on preschoolers' compliance with teacher instructions

Preschool children in day schools were given instructions to complete certain tasks. Four tasks were given of two types and two levels of difficulty. In each condition compliance with at most one instruction (one task) was reinforced. In two similar experiments, with six children, general results were: compliance with easy tasks was maintained without reinforcement when any task compliance was reinforced; compliance for hard tasks remained high only when that specific task was reinforced. Thus, generalization of compliance with instructions varied with task difficulty. The setting and procedure for both studies were designed to reduce possible coercive features of laboratory studies of generalized performance. Results show generalized performance can occur under naturalistic conditions. The effect of effort, as a response characteristic affecting generalized performance, is discussed.     

Replication of a high-probability request sequence with varied interprompt times in a preschool setting

An intervention for noncompliance consisting of a series of requests promoting a high probability of compliance followed either 5 s or 20 s later by a request with a low probability of compliance was implemented with a preschool child with autism. Results indicated that applications of the request sequence with a shorter interprompt time resulted in higher rates of compliance, and longer interprompt times resulted in near-baseline rates of compliance.     

An examination of response covariation in the behavioral treatment of identical twin boys with multiple behavioral disorders

This study examined the response covariation phenomenon in the behavioral treatment of a noncompliant, nonattentive child with autism in a school setting. The treatment consisted of reinforcement for compliance and attention. Results showed that the reinforcement of compliance was associated with increased levels of compliance, attending, and directed verbalizations. Sequential scatterplot data analysis suggested that compliance and attending directly covaried as a function of the reinforcement for compliance contingency. The results of this multiple treatment study suggests that reinforcement of compliance had the broadest positive effect for the subject since positive collateral changes were observed in attending and directed verbalizations when compliance was reinforced.     

Increasing compliance with wearing a medical device in children with autism

Health professionals often recommend the use of medical devices to assess the health, monitor the well-being, or improve the quality of life of their patients. Children with autism may present challenges in these situations as their sensory peculiarities may increase refusals to wear such devices. To address this issue, we systematically replicated prior research by examining the effects of differential reinforcement of other behavior (DRO) to increase compliance with wearing a heart rate monitor in 2 children with autism. The intervention increased compliance to 100% for both participants when an edible reinforcer was delivered every 90 s. The results indicate that DRO does not require the implementation of extinction to increase compliance with wearing a medical device. More research is needed to examine whether the reinforcement schedule can be further thinned.     

Partial remediation of speaker and listener behaviors in people with severe dementia

We investigated the effects of contingent reinforcement (Intervention 1) and contingent reinforcement with modeling (Intervention 2) on speaker and listener behaviors in 5 people with severe dementia. Intervention 1 generally increased listener behavior; there was no clear effect on tacting, but echoic behavior increased in the one case investigated. Given the weak baseline repertoires of these clients and the paucity of other effective interventions, even the small increases in verbal behaviors found here are important. Further gains may be achieved, for example, if reinforcement opportunity per trial type were to be increased from one to several per day or if participants were trained to echo the listener stimulus in mand compliance tasks.     

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.     

THE USE OF POSITIVE AND NEGATIVE REINFORCEMENT IN THE TREATMENT OF ESCAPE-MAINTAINED DESTRUCTIVE BEHAVIOR

We identified 3 clients whose destructive behavior was sensitive to negative reinforcement (break from tasks) and positive reinforcement (access to tangible items, attention, or both). In an instructional context, we then evaluated the effects of reinforcing compliance with one, two, or all of these consequences (a break, tangible items, attention) when destructive behavior produced a break and when it did not (escape extinction). For 2 clients, destructive behavior decreased and compliance increased when compliance produced access to tangible items, even though destructive behavior resulted in a break. For 1 client, extinction was necessary to reduce destructive behavior and to increase compliance. Subsequently, when the schedule of reinforcement for compliance was faded for all clients, destructive behavior was lower and fading proceeded more rapidly when compliance produced multiple functional reinforcers (i.e., a break plus tangible items or attention) and destructive behavior was on extinction. The results are discussed in terms of the effects of relative reinforcement value and extinction on concurrent operants.     

Reinforcement and instructions with mental patients

An attempt was made to modify a socially desirable response of mental patients. It was found that instructions to the patients had no enduring effect unless accompanied by reinforcement. Also, it was found that reinforcement was not effective unless the reinforcement procedure was accompanied by instructions that specified the basis for the reinforcement. Maximum change in behavior was obtained when the reinforcement procedure took advantage of the existing verbal repertoire of the patients. A significant methodological finding was that substantial modification of the behavior of psychotics could be achieved by briefly delaying, rather than withholding, food reinforcement.