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.     

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.     

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.     

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.     

THE EFFECTS OF RESPONSE INTERRUPTION AND REDIRECTION (RIRD) AND DIFFERENTIAL REINFORCEMENT ON VOCAL STEREOTYPY AND APPROPRIATE VOCALIZATIONS

The relation between contextually appropriate vocalizations (AV) and vocal stereotypy (VS) has yet to be established within the response interruption and redirection (RIRD) literature. RIRD may promote AV by suppressing VS and/or by functioning as incompatible responses. The occurrence of VS and AV was assessed during baseline, RIRD alone, and RIRD combined with a differential reinforcement system for AV (RIRD + DRI) for a 5‐year‐old child with autism. Results showed an increase in AV once RIRD was implemented and further increases in AV and decreases in stereotypy when the token system of reinforcement for AV was implemented. Copyright © 2012 John Wiley & Sons, Ltd.     

Further evaluation of treatments for vocal stereotypy: Response interruption and redirection and response cost

The purpose of this study was to expand on research on treatments for stereotypy by evaluating the effects of response interruption and redirection (RIRD) and response cost (RC) alone and as a treatment package on vocal stereotypy. Treatment phases included RIRD, RC, and response interruption and redirection plus response cost (RIRD + RC). The efficacy of these treatments was determined by measuring duration of stereotypy in session and during treatment intervals. Vocal stereotypy decreased in all three treatment conditions; however, when data analysis included stereotypy occurring during treatment intervals, stereotypy during the RC condition occurred at similar levels as baseline for one treatment evaluation phase for Karl and both treatment evaluations phases for Jon. We discuss implications of these findings, limitations of the current study, and areas for future research.     

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.     

The role of task preference in the effectiveness of response interruption and redirection

Response interruption and redirection (RIRD) is a common treatment for automatically reinforced vocal stereotypy; it involves the contingent presentation of task instructions. Tasks that are included in RIRD are typically selected based on caregiver report, which may affect the efficacy of RIRD. The purpose of the current study was to evaluate the role of task preference in the efficacy of RIRD for four participants who engaged in vocal stereotypy. We conducted task-preference assessments and selected tasks of varying preferences to include in RIRD. For three out of four participants, the results showed that RIRD with higher preference tasks was not effective at reducing vocal stereotypy, whereas RIRD with lower preference tasks was effective for all participants.     

The Effects of Motor and Vocal Response Interruption and Redirection on Vocal Stereotypy and Appropriate Vocalizations

Stereotypy has been defined as repetitive vocal or motor behaviors that are noncontextual with invariant topographies. One intervention to reduce vocal stereotypy and increase appropriate vocalizations is response interruption and redirection (RIRD). Previous research has suggested that RIRD's behavioral mechanism consists of punishment. The purpose of this study was to extend this research by comparing two procedures, namely, vocal and motor RIRD contingent upon the occurrence of vocal stereotypy and to evaluate concomitant increases in appropriate vocalizations. A multiple treatment reversal design was used to compare the effectiveness of both interventions on five children diagnosed with an Autism Spectrum Disorder. Results suggested that both demand topographies were equally effective in reducing vocal stereotypy and increasing appropriate vocalizations. This research replicates previous findings that have suggested that RIRD is a punishment procedure. Copyright © 2015 John Wiley & Sons, Ltd.     

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.     

King,C. A., Foster,C. E., & Rogalski,K. M. (2013). Teen Suicide Risk: A Practitioner Guide to Screening,Assessment, and Management.

ABSTRACT

The purpose of this study was to investigate the use of response interruption and redirection (RIRD) to reduce vocal stereotypy in a student with Autism Spectrum Disorder in a special education classroom during group instruction. This study extends the literature on the use of RIRD, examining effectiveness with an adolescent with intellectual disability and limited functional language in a naturalistic setting. Results indicated that RIRD was effective in decreasing vocal stereotypy in this student.     

A replication of the RIRD strategy to decrease vocal stereotypy in a student with autism

This study was conducted to decrease vocal stereotypy in a student with autism. Results of functional analysis indicated that vocal stereotypy was maintained by automatic reinforcement. We used the Response Interruption and Redirection (RIRD; Ahearn, Clark, & McDonald, 2007 ) strategy to decrease the vocal behavior. An ABAB design was used. Results indicated that the RIRD intervention successfully reduced the target behavior. Results are discussed and implications for practice are provided. Copyright © 2009 John Wiley & Sons, Ltd.     

An evaluation of the effects of response interruption redirection and matched stimulation on vocal stereotypy

Stereotypy is one of the core diagnostic features of autism spectrum disorder and warrants behavioral intervention when it negatively impacts the person's life. The aim of this study was to evaluate the effectiveness of noncontingent matched stimulation (NCR‐M) compared with response interruption redirection (RIRD) on reducing levels of vocal stereotypy in the natural environment. Interventions were compared using an alternating treatments design followed by generalization and maintenance phases, which utilized lay people as instructors. Results showed that both RIRD and NCR‐M resulted in a reduction in vocal stereotypy for three out of four participants within an educational setting. An increase in appropriate vocalizations was found for two out of four participants for both interventions. These results suggest that both NCR‐M and RIRD were effective in reducing levels of vocal stereotypy, yet their effects on appropriate communication remain undetermined. Social validity scores were obtained following the study, which demonstrated that both interventions were met with approval across a variety of measures.     

The effect of response interruption and redirection with and without a differential reinforcement of alternative behavior component on stereotypy and appropriate responses

Individuals with an Autism Spectrum Disorder (ASD) often engage in repetitive and stereotypic behaviors (American Psychological Association, 2013). Therefore, interventions that reduce stereotypy and potentially increase appropriate responses are of interest in the field of applied behavior analysis. The purpose of this study was to evaluate the isolated and additive effects of response interruption and redirection (RIRD) and differential reinforcement of alternative behavior (DRA) on both stereotypy and appropriate responses to determine whether either of these interventions alone or in combination is more effective and more efficient in increasing appropriate responses and decreasing stereotypy. Results showed that both RIRD and RIRD + DRA were effective interventions in decreasing stereotypy, but no procedure resulted in a sustained increase in appropriate responses.     

Response interruption and redirection for vocal stereotypy in children with autism: a systematic replication

This study systematically replicated and extended previous research on response interruption and redirection (RIRD) by assessing instructed responses of a different topography than the target behavior, percentage of session spent in treatment, generalization of behavior reduction, and social validity of the intervention. Results showed that RIRD produced substantial decreases in vocal stereotypy. Limitations of this study were that behavior reduction did not generalize to novel settings or with novel instructors and that appropriate vocalizations did not improve.     

Intervention,stimulus control,and generalization effects of response interruption and redirection on motor stereotypy

This study evaluated the effects of response interruption and redirection (RIRD) on motor stereotypy (hand and body movements) in a child with neurodevelopmental disorders. We also assessed whether a stimulus paired with RIRD could acquire inhibitory control when tested during nonintervention conditions. Compared with baseline phases in a reversal design, RIRD decreased both hand and motor stereotypies, and there was evidence of stimulus control. Extending RIRD to a second setting was also effective. The care providers responsible for intervention implemented RIRD with fidelity, and they rated the procedure positively. Clinical and research implications from these findings are discussed.     

Decreasing motor stereotypy in leisure contexts: Analysis of stimulus control with response interruption and redirection

Noncontingent access to preferred stimuli and activities may decrease stereotypic behavior in individuals with autism or other developmental disorders. However, prompted engagement, response interruption and redirection (RIRD), and/or contingent access to stereotypy may be required to achieve clinically significant reductions in stereotypy. Antecedent stimuli may also be manipulated during intervention to establish stimulus control by signaling when stereotypy will receive programmed consequences. The purpose of the current project was to replicate prior research in this area by a) evaluating the effectiveness of RIRD on motor stereotypy in an adolescent with autism and b) providing contingent access to stereotypy as a function of successively longer intervals without stereotypic behavior. We also assessed the extent that these procedures gained acceptable stimulus control. Results from this project suggest RIRD and contingent access to stereotypy may effectively decrease motor stereotypy in leisure contexts, though consistent inhibitory stimulus control may be difficult to establish.     

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.     

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.     

Establishing stimulus control of vocal stereotypy displayed by young children with Autism

We examined the vocal stereotypy of three boys who were diagnosed with an Autism Spectrum Disorder (ASD). Results of functional analyses indicated that each participant's vocal stereotypy was maintained by non‐social consequences. For two participants, verbal reprimands were provided contingent on vocal stereotypy in the presence of a red card (RC). For the third participant, after verbal reprimands alone did not decrease vocal stereotypy, toys were withdrawn contingent on vocal stereotypy in the presence of the RC. For all three participants, vocal stereotypy was permitted without programmed consequences the presence of a green card (GC). The results showed that vocal stereotypy decreased in the presence of the RC for all three participants; however, vocal stereotypy came under inhibitory control of the RC for only one of the three participants. The potential utility of using punishment to develop stimulus control of automatically reinforced problem behavior in academic settings is briefly discussed. Copyright © 2009 John Wiley & Sons, Ltd.