FUNCTIONAL ANALYSIS AND TREATMENT OF INAPPROPRIATE VERBAL BEHAVIOR

The present study examined the possible function of inappropriate verbal behavior of an adult man who had been diagnosed with both mental retardation and psychosis. Results of a functional analysis indicated that inappropriate verbal utterances were maintained by attention. An intervention consisting of the differential reinforcement of appropriate verbal behavior effectively reduced the inappropriate behavior.     

EXPERIMENTAL ANALYSIS AND EXTINCTION OF SELF-INJURIOUS ESCAPE BEHAVIOR

Three studies are presented in which environmental correlates of self-injurious behavior were systematically examined and later used as the basis for treatment. In Study 1, 7 developmentally disabled subjects were exposed to a series of conditions designed to identify factors that maintain self-injurious behavior: attention contingent on self-injurious behavior (positive reinforcement), escape from or avoidance of demands contingent on self-injurious behavior (negative reinforcement), alone (automatic reinforcement), and play (control). Results of a multielement design showed that each subject's self-injurious behavior occurred more frequently in the demand condition, suggesting that the behavior served an avoidance or escape function. Six of the 7 subjects participated in Study 2. During educational sessions, “escape extinction” was applied as treatment for their self-injurious behavior in a multiple baseline across subjects design. Results showed noticeable reduction or elimination of self-injurious behavior for each subject and an increase in compliance with instructions in all subjects for whom compliance data were taken. The 7th subject, whose self-injurious behavior during Study 1 occurred in response to medical demands (i.e., physical examinations), participated in Study 3. Treatment was comprised of extinction, as in Study 2, plus reinforcement for tolerance of the examination procedure, and was evaluated in a multiple baseline across settings design. Results showed that the treatment was successful in eliminating self-injurious behavior and that its effects transferred across eight new therapists and three physicians. General implications for the design, interpretation, and uses of assessment studies are discussed.     

THE EFFECTS OF SEVERE BEHAVIOR PROBLEMS IN CHILDREN ON THE TEACHING BEHAVIOR OF ADULTS

Applied behavior analysts have focused on how adults can influence the problem behavior of children using a variety of behavior modification strategies. A related question, virtually unexplored, is how the behavior problems of children influence adults. This child-effects concept was explored empirically in a study involving 12 adults who were asked to teach four pairs of children in which one member of the pair exhibited problem behavior and the other typically did not. Results demonstrated that problem children displayed tantrums, aggression, and self-injury contingent on adult instructional attempts but not at other times, whereas nonproblem children showed little or no problem behavior at any time. Importantly, from a child-effects perspective, adults engaged in teaching activities with nonproblem children more often than with problem children. Also, when an adult worked with a problem child, the breadth of instruction was more limited and typically involved those tasks associated with lower rates of behavior problems. The implications of these results are discussed with respect to theories of escape behavior, current assessment practices, and intervention issues related to maintenance. The existence of child effects suggests that problem behavior may be better understood when it is conceptualized as involving a process of reciprocal influence between adult and child.     

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.     

EFFECTS OF EXTINCTION ALONE AND EXTINCTION PLUS FUNCTIONAL COMMUNICATION TRAINING ON COVARIATION OF PROBLEM BEHAVIORS

In this investigation, extinction (EXT) was applied alone or in combination with functional communication training (FCT) to less severe topographies of problem behavior while more severe topographies continued to be reinforced. EXT alone decreased less severe and increased more severe topographies of problem behavior (i.e., response covariation), whereas EXT with FCT reduced all topographies of problem behavior to near-zero levels.     

DIFFERENTIAL REINFORCEMENT OF ALTERNATIVE BEHAVIOR AND DEMAND FADING IN THE TREATMENT OF ESCAPE-MAINTAINED DESTRUCTIVE BEHAVIOR

The escape-maintained destructive behavior of a boy with autism was reduced during instructional sequences with differential reinforcement of compliance (DRA), escape extinction without physical guidance, and demand fading. The procedure decreased destructive behaviors to near-zero levels and greatly increased compliance.     

ANALYSIS OF THE REINFORCEMENT AND EXTINCTION COMPONENTS IN DRO CONTINGENCIES WITH SELF-INJURY

Previous research has shown that self-injurious behavior (SIB) maintained by positive reinforcement may be reduced under differential-reinforcement-of-other-behavior (DRO) contingencies. In this study, we conducted an analysis of the reinforcement and extinction components of DRO while treating the self-injury of 3 women with developmental disabilities. A functional analysis revealed that each subject's SIB was maintained by positive reinforcement in the form of attention. Subsequent reinforcer assessments identified preferred and nonpreferred stimuli for later use in conjunction with DRO. Results showed high rates of SIB for all 3 subjects during baseline, which persisted when DRO was implemented without the relevant extinction component (withholding of attention for SIB) for 2 of the subjects. Low rates of SIB were observed for all subjects when DRO plus extinction was implemented or when extinction was implemented alone, suggesting that extinction may be a critical component of DRO schedules.     

ON THE RELATION OF MANDS AND THE FUNCTION OF DESTRUCTIVE BEHAVIOR

When standard analogue functional analysis procedures produce inconclusive results in children with conversational speech, the child's mands may help to identify the function of destructive behavior. In the current investigation, functional analyses conducted with 2 children who exhibited self-injury, aggression, and property destruction were undifferentiated across conditions. Based on informal observations and school and parental report, an analysis was conducted using mands to help determine the function of the destructive behavior. Using a multielement design, the therapist's compliance with the child's mands occurred either on a fixed-ratio (FR) 1 schedule or contingent on destructive behavior. Destructive behavior occurred at high and consistent levels when reinforcement of mands was contingent on destructive behavior and at near-zero levels when reinforcement of mands occurred on the FR 1 schedule. Based on these results, a second analysis was conducted in which compliance to mands occurred only when the child appropriately requested it (i.e., functional communication training plus extinction) and, for 1 child, compliance with mands was terminated contingent upon destructive behavior (i.e., functional communication training plus response cost). For both children, the rates of destructive behavior decreased markedly. The results suggest that assessing the child's mands may be useful in decreasing destructive behavior when a functional analysis is inconclusive.     

REDUCTION OF SEVERE BEHAVIOR PROBLEMS IN THE COMMUNITY USING A MULTICOMPONENT TREATMENT APPROACH

Problem behavior often prevents community integration of people with developmental disabilities. Therefore, we evaluated a multicomponent approach for remediating problem behavior in public community settings (specifically, supermarkets). We selected treatments based on hypotheses about the variables controlling the problem behavior (hypothesis-driven model). The multicomponent intervention included choice making, embedding, functional communication training, building tolerance for delay of reinforcement, and presenting discriminative stimuli for nonproblem behavior. Treatment progress was monitored using measures of latency and task completion rather than traditional measures of frequency and time sampling. Results showed substantial increases in task completion and duration of time spent in supermarkets without problem behavior. Outcomes were socially validated by group-home staff and cashiers. We discuss how the intervention approach taken can resolve some of the issues involved in assessing, measuring, and treating problem behavior in the community.     

WHAT MAKES EXTINCTION WORK: AN ANALYSIS OF PROCEDURAL FORM AND FUNCTION

We examined methods for determining how extinction should be applied to different functions of self-injurious behavior (SIB). Assessment data indicated that the head banging of 3 children with developmental disabilities was maintained by different reinforcement contingencies: One subject's SIB was positively reinforced by attention from adults, the 2nd subject's SIB was negatively reinforced by escape from educational tasks, and the 3rd subject's SIB appeared to be automatically reinforced or “self-stimulatory” in nature. Three functional variations of extinction—EXT (attention), EXT (escape), and EXT (sensory)—were evaluated, and each subject was exposed to at least two of these variations in reversal or multiple baseline designs. Reductions in SIB were observed only when implementation of “extinction” involved the discontinuation of reinforcement previously shown to be responsible for maintaining the behavior. These results highlight important differences among treatment techniques based on the same behavioral principle (extinction) when applied to topographically similar but functionally dissimilar responses, and further illustrate the practical implications of a functional analysis of behavior disorders for designing, selecting, and classifying therapeutic interventions.     

EXTINCTION OF SELF-INJURIOUS ESCAPE BEHAVIOR WITH AND WITHOUT INSTRUCTIONAL FADING

Three individuals with developmental disabilities participated in a study of the treatment of self-injurious behavior (SIB) maintained by negative reinforcement (escape from educational tasks). Treatment was implemented in a multiple baseline design across subjects, in which two treatments were compared in a multielement format. Both treatment conditions included an escape-extinction component in which SIB no longer produced escape. One of the conditions also included a fading component in which the frequency of instructions was initially reduced to zero and then was gradually faded back in across sessions until the instructional rate matched that of the original baseline. Results indicated that extinction alone reduced SIB to the end-of-treatment criterion in fewer sessions than did extinction plus fading for all 3 subjects. For 2 of the 3 subjects, however, there was an initial increase in the frequency of SIB at the outset of treatment with extinction (an extinction burst) that was not observed when extinction was combined with the fading component.     

FUNCTIONAL ANALYSIS AND TREATMENT OF CIGARETTE PICA

A series of analyses was conducted to assess and treat the pica of cigarette butts by a young man with mental retardation and autism. First, we demonstrated that pica was maintained in a condition with no social consequences when the available cigarettes contained nicotine but not when the cigarettes contained herbs without nicotine. Second, a choice assessment (Fisher et al., 1992) confirmed that tobacco was preferred over the other components of the cigarette (e.g., paper, filter, etc.). Third, an analogue functional analysis (Iwata, Dorsey, Slifer, Bauman, & Richman, 1982/1994) demonstrated that cigarette pica was maintained independent of social consequences. Fourth, a treatment designed to interrupt the hypothesized response—reinforcer relationship reduced consumption of cigarettes to zero. Finally, because cigarette pica occurred primarily when the individual was alone or under minimal supervision, a procedure based on stimulus control was developed to improve the effectiveness of the intervention in these situations.     

REDUCING ESCAPE BEHAVIOR AND INCREASING TASK COMPLETION WITH FUNCTIONAL COMMUNICATION TRAINING,EXTINCTION AND RESPONSE CHAINING

The effects of functional communication training, extinction, and response chaining on 3 subjects' escape-maintained aberrant behavior were evaluated using a multielement design. Functional communication training consisted of teaching subjects a verbal response that was functionally equivalent to their aberrant behavior. Subjects initially were allowed to escape from a task contingent on the trained verbal response. In subsequent treatment phases, escape was contingent on the trained verbal response plus the completion of the specified number of steps in the task (response chaining). The number of steps was increased until a subject completed the task to obtain a break. Results showed that the treatment reduced rates of aberrant behavior and that the chaining procedure was effective in decreasing the availability of escape.     

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.     

REEMERGENCE AND EXTINCTION OF SELF-INJURIOUS ESCAPE BEHAVIOR DURING STIMULUS (INSTRUCTIONAL) FADING

Based on results of a functional analysis indicating that the self-injurious behavior (SIB) of 3 individuals was maintained by negative reinforcement (escape from instructional situations), the effects of stimulus (instructional) fading were evaluated in a multiple baseline design across subjects. The rate of instructions was reduced to zero at the beginning of treatment and was gradually increased (faded in) across sessions as long as SIB remained low. However, if SIB remained high for 10 consecutive sessions, extinction was implemented until SIB decreased, at which point extinction was withdrawn and fading was resumed. Treatment was completed when the rate of instructions was the same as in baseline (two per minute), and SIB remained below 0.5 responses per minute for two consecutive sessions. Results showed that instructional fading (without extinction) virtually eliminated SIB initially, but these effects were not maintained. All 3 subjects required multiple exposures to extinction and over 150 treatment sessions in order to meet the end-of-treatment criteria. Advantages and limitations of fading procedures without an extinction component, as well as extensions of both interventions to other clinical problems, are discussed.     

GENERATING HYPOTHESES ABOUT THE FUNCTION OF STUDENT PROBLEM BEHAVIOR BY OBSERVING TEACHER BEHAVIOR

We examined whether, as predicted by research on child effects, we could generate hypotheses about the function of student problem behavior by observing the amount of attention teachers provided to students. In the first phase of the study, we observed the amount of attention teachers distributed among small groups of students who exhibited problem behavior in individual or small-group instructional settings (problem behavior presumably maintained by attention or escape). Based on the amount of attention each student received, we generated hypotheses about the function of his or her problem behavior. In the second phase of the study, we determined the accuracy of these predictions by conducting a brief functional assessment with each student. Results confirmed that, for 14 of the 15 students, we were able to generate accurate hypotheses about the function of their problem behavior. These results suggest the potential efficacy of using the amount of attention teachers distribute among groups of students to generate empirically based hypotheses about the function of student problem behavior maintained by attention and/or escape. These results also illustrate the efficiency of this procedure; by observing teacher behavior, we were able to generate hypotheses about the function of problem behavior for several students at one time.     

MOMENTUM AND EXTINCTION EFFECTS ON SELF-INJURIOUS ESCAPE BEHAVIOR AND NONCOMPLIANCE

Previous research on applications of behavioral momentum has indicated that a high-probability (high-p) instructional sequence, in which a series of instructions for which there is a high probability of compliance is presented immediately before an instruction for which there is a low probability of compliance, is an effective method for increasing compliance. It is not dear, however, whether the procedure is effective when individuals actively attempt to escape from the instructional situation. In this study, we examined the effects of the high-p sequence, when implemented first alone and then later with an extinction component, as treatment for the self-injurious escape behavior of 2 individuals. Results showed that when the instructional sequence was implemented without extinction, rates of self-injury increased and percentage of compliance decreased. In addition, the percentage of trials occasioning escape behavior increased for both high- and low-probability instructions. When an extinction component was added to the high-p sequence, rates of self-injury and the percentage of trials containing self-injury decreased, and compliance increased. These findings suggest that extinction may be an important component of treatment when escape behavior such as self-injury accompanies noncompliance in instructional contexts and competes with compliant behavior.     

Progressing from brief assessments to extended experimental analyses in the evaluation of aberrant behavior

The role of experimental analyses in guiding treatment is well established. However, not all experimental analyses yield conclusive results. Outcomes may be inconclusive due to time limitations that preclude extended observation and detailed experimental manipulations, or may result from interactions across experimental conditions, multiple control, or other unknown factors. In this study, we describe an assessment sequence that moves through four phases beginning with relatively brief (1 to 2 hr) analyses and culminating in extended analyses that may control for experimental confounding effects (e.g., interaction effects). Data illustrating the model are presented for 20 individuals referred for severe behavior problems including self-injury, aggression, stereotypy, and tantrums. Analyses were considered to be complete only when clear and replicable response patterns emerged. Results showed that clear and replicable response patterns emerged for 85% of the participants.     

FUNCTIONAL ANALYSIS AND INTERVENTION FOR BREATH HOLDING

We conducted a functional analysis of breath-holding episodes in a 7-year-old girl with severe mental retardation and Cornelia-de-Lange syndrome. The results showed that breath holding served an operant function, primarily to gain access to attention. The intervention, consisting of extinction, scheduled attention, and use of a picture card communication system, resulted in decreased breath holding.