ASSESSMENT AND TREATMENT OF EXCESSIVE STRAIGHTENING AND DESTRUCTIVE BEHAVIOR IN AN ADOLESCENT DIAGNOSED WITH AUTISM

Repetitive behaviors such as excessive straightening are commonly observed among individuals with autism. Attempts to prevent these behaviors may increase the likelihood of other problem behaviors. The present study was designed to assess and treat the excessive straightening and associated destructive behaviors of a 16‐year‐old boy who had been diagnosed with autism and moderate mental retardation. Following a series of functional analyses, an intervention that incorporated functional communication, extinction of destructive behavior, and blocking of repetitive straightening was demonstrated to be effective in reducing straightening and destructive behavior.     

CONTEXTUAL CONTROL OF PROBLEM BEHAVIOR IN STUDENTS WITH SEVERE DISABILITIES

We investigated the impact of contextual variation on the effectiveness of two interventions. The problem behavior of 2 students with severe disabilities was analyzed across two contexts (task and leisure). Effects of differential reinforcement of other behavior (DRO) and time-out procedures were examined in the two contexts. Results indicated that in the task context the DRO procedure effectively reduced the problem behavior and increased task performance, whereas the time-out procedure was ineffective. In addition, rate of correct task performance increased during DRO relative to baseline and time-out. In contrast, in the leisure context, the time-out procedure effectively reduced the same problem behavior and the DRO procedure was ineffective. The results are discussed in terms of contextual control of problem behavior and alternative strategies for the design of DRO procedures.     

ASSESSMENT OF SELF-INJURIOUS BEHAVIOR MAINTAINED BY ACCESS TO SELF-RESTRAINT MATERIALS

This study replicates and extends prior research showing that access to self-restraint materials can reinforce self-injurious behavior (SIB). A functional analysis was conducted showing that SIB occurred at differentially high rates when access to restraint materials (a leather jacket) was made contingent on the behavior. In addition, an alone condition during the functional analysis showed that SIB did not occur in the absence of restraint materials. Finally, a treatment analysis showed that functional communication training was effective using an alternative reinforcer.     

TRAINING AND GENERALIZATION OF AFFECTIVE BEHAVIOR DISPLAYED BY YOUTH WITH AUTISM

The purpose of this study was to teach contextually appropriate affective behavior to 4 youths with autism. Treatment consisted of modeling, prompting, and reinforcement introduced in a multiple baseline design across response categories of affective behavior. During treatment, verbal praise and tokens were delivered contingent on appropriate affective responding during training trials. Modeling and verbal prompting were used as correction procedures. Each youth received treatment in either three or four response categories. Treatment systematically increased responding within the response categories for all 4 participants, with effects being specific to the affective response categories under treatment. Treatment effects occurred across untrained scenarios, therapists, time, and settings, suggesting that generalization had occurred.     

EXTENDED REDUCTIONS IN STEREOTYPIC BEHAVIOR OF STUDENTS WITH AUTISM THROUGH A SELF-MANAGEMENT TREATMENT PACKAGE

The literature suggests that self-management treatment packages have two potential strengths for the reduction or elimination of stereotypic behavior: (a) Self-management may be used for extended periods of time in the absence of a treatment provider, and (b) self-management techniques are easily adapated and used in a wide variety of natural settings. We assessed whether students with severe autistic disabilities could learn to use a self-management treatment package to reduce their stereotypic behavior within a multiple baseline across subjects design with withdrawals. The results showed that all of the students learned to use self-management procedures to reduce greatly levels of stereotypic behavior (typically to zero), and improvement occurred for extended periods of time in new settings without the presence of a treatment provider. The results are discussed in terms of the practical value of the treatment package and in terms of the implications for understanding autism.     

TREATMENT OF MULTIPLY CONTROLLED PROBLEM BEHAVIOR

The aggressive behavior of a young boy with developmental delays occurred most frequently following a request to pick up his toys. The request ended a period of play and social interaction. This suggested the presence of multiple establishing operations. The initial treatment consisted of praise, a break, and access to the toys contingent on compliance. Results showed that aggression decreased only when we added social interaction to the break. Findings are discussed regarding treating multiply controlled problem behavior without extinction.     

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.     

ASSESSMENT OF STEREOTYPIC AND SELF-INJURIOUS BEHAVIOR AS ADJUNCTIVE RESPONSES

Certain responses of both humans and nonhumans appear to be maintained indirectly by intermittent reinforcement schedules and have been referred to collectively as adjunctive behavior. Although basic research has examined adjunctive behavior extensively, relatively few studies have been conducted with humans, particularly those with developmental disabilities who often engage in frequent and varied stereotypic behavior. This study assessed possible adjunctive characteristics of self-injurious and stereotypic behaviors using a multielement design containing two types of control conditions. Four subjects who engaged in both self-injurious behavior and stereotypy participated after variables maintaining their self-injury were identified via functional analyses. Each day, subjects were exposed to three 15-min sessions in random order: (a) noncontingent presentation of food on a fixed-time schedule (e.g., FT 30 s), (b) a massed-reinforcement (food) control, and (c) a no-reinforcement control. A variety of fixed-time schedules were examined during different experimental phases. Results of this preliminary study suggested that self-injury was not induced by intermittent reinforcement schedules, whereas the stereotypic behavior of some individuals showed characteristics of adjunctive behavior. The importance of research on adjunctive behavior and suggestions for future studies are discussed.     

TREATMENT INTEGRITY IN APPLIED BEHAVIOR ANALYSIS WITH CHILDREN

Functional analysis of behavior depends upon accurate measurement of both independent and dependent variables. Quantifiable and controllable operations that demonstrate these functional relationships are necessary for a science of human behavior. Failure to implement independent variables with integrity threatens the internal and external validity of experiments. A review of all applied behavior analysis studies with children as subjects that have been published in the Journal of Applied Behavior Analysis between 1980 and 1990 found that approximately 16% of these studies measured the accuracy of independent variable implementation. Two thirds of these studies did not operationally define the components of the independent variable. Specific recommendations for improving the accuracy of independent variable implementation and for defining independent variables are discussed.     

ANALYSIS OF THE EFFECTS OF TASK PREFERENCES,TASK DEMANDS,AND ADULT ATTENTION ON CHILD BEHAVIOR IN OUTPATIENT AND CLASSROOM SETTINGS

Two studies were conducted with children who displayed behavior problems to evaluate the effects of task preference, task demands, and adult attention on child behavior. In Study 1, we conducted brief functional analyses in an outpatient clinic to identify variables that facilitated appropriate behavior. For 8 of 10 children, distinct patterns of performance occurred; 3 children displayed improved behavior with changes in task demands, 1 child displayed improved behavior with a preferred task, and 4 children displayed improved behavior with changes in adult attention. In most cases, the children's parents carried out the assessments with adequate procedural integrity. In Study 2, we applied similar assessment methods to a classroom setting over an extended period of time. We identified independent variables controlling appropriate, on-task, and academic behavior for 2 children on two tasks, with slightly different treatment procedures across tasks for both children. In addition, the results of brief functional analyses for both children corresponded to the extended classroom assessments.     

PYRAMIDAL STAFF TRAINING IN THE EXTENSION OF TREATMENT FOR SEVERE BEHAVIOR DISORDERS

We implemented a pyramidal training procedure for staff working with individuals who exhibited self-injurious behavior (SIB), aggression, and disruption. Two adults with developmental disabilities and their direct-care staff and supervisors participated. Following successful treatment by the experimenters, two types of baselines were conducted with the clients and their direct-care staff. During an initial baseline, the staff implemented preexisting procedures. Staff members then received instruction on the new treatment procedures using training methods common throughout the institution, and data were collected during this “post-in-service” baseline. Experimenters then taught unit supervisors to implement treatment, collect and interpret data, and provide similar instructions and feedback to the staff members. The supervisor training was implemented in a multiple baseline design across subjects (clients and direct-care staff). Results showed little change following in-service training but noticeable improvements in direct-care staff behaviors and corresponding decreases in the clients' inappropriate behavior following the pyramidal training intervention with supervisors. Six additional clients (along with their direct-care staff and supervisors) participated in pre- and posttreatment replication designs, and their results provided additional support for the efficacy of the supervisor training procedures.     

BRIEF HIERARCHICAL ASSESSMENT OF POTENTIAL TREATMENT COMPONENTS WITH CHILDREN IN AN OUTPATIENT CLINIC

Seven parents conducted assessments in an outpatient clinic using a prescribed hierarchy of antecedent and consequence treatment components for their children's problem behavior. Brief assessment of potential treatment components was conducted to identify variables that controlled the children's appropriate behavior. Experimental control via a brief reversal was achieved for 6 of the 7 children, (1 child continued to behave appropriately following initial improvement in behavior). For these 6 children, improved behavior occurred with changes in treatment components. Our results extend previous studies of direct assessment procedures conducted in outpatient clinic settings.     

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.     

THE USE OF A VERBAL REPRIMAND TO DECREASE RUMINATION IN A CHILD WITH AUTISM

After a pre‐treatment screening analysis suggested that rumination exhibited by a boy with autism occurred in the absence of social consequences, we evaluated the effect of a verbal reprimand contingent on the target behavior via a reversal design. The reprimand reduced rumination to near‐zero levels; we then thinned the reprimand schedule and rumination remained infrequent. Follow‐up data collected 6, 12, and 18 months after initial treatment suggested that intervention effects were maintained. Copyright © 2014 John Wiley & Sons, Ltd.     

EVALUATION OF A MULTICOMPONENT INTERVENTION FOR DIURNAL BRUXISM IN A YOUNG CHILD WITH AUTISM

Bruxism, forceful grinding of one's teeth together, can produce destructive outcomes such as wear on the teeth and damaged gums and bone structures. The current study implemented a multicomponent intervention that consisted of vocal and physical cues to decrease rates of bruxism. A partial component analysis suggested that the vocal cue was only effective at decreasing levels of bruxism when paired with a simultaneous physical cue.     

THE TREATMENT OF SEVERE BEHAVIOR PROBLEMS IN SCHOOL SETTINGS USING A TECHNICAL ASSISTANCE MODEL

We evaluated the feasibility of local school personnel conducting functional analysis and reinforcement-based treatment procedures within actual classroom settings. Following an initial in-service workshop on functional assessment and differential reinforcement procedures, on-site technical assistance was provided two to four times per month to local school personnel working in transdisciplinary teams. Overall results suggest that local school personnel were able to implement all procedures adequately with periodic technical assistance. In addition, functional analysis was effective in identifying individual maintaining contingencies, the derived treatments were effective, and the results were maintained throughout the approximate 18 months of this investigation.