An evaluation of a punisher assessment for decreasing automatically reinforced problem behavior

We extended research on the identification and evaluation of potential punishers for decreasing automatically reinforced problem behavior in four individuals with autism spectrum disorder. A punisher selection interview was conducted with lead clinicians to identify socially acceptable punishers. During the treatment evaluation, treatment phases were introduced sequentially and included noncontingent reinforcement (NCR), NCR and differential reinforcement of alternative behavior (DRA), and NCR‐and‐DRA with punishment. During the NCR‐and‐DRA with punishment phase, four to five potential punishers were evaluated using a multielement design. Dependent measures included the target problem behavior, appropriate item engagement, and emotional responding. For all participants, NCR‐and‐DRA was not effective and punishment was necessary. However, the most effective punisher identified in the context of NCR‐and‐DRA differed across participants.     

Noncontingent reinforcement without extinction plus differential reinforcement of alternative behavior during treatment of problem behavior

The effects of noncontingent reinforcement (NCR) without extinction during treatment of problem behavior maintained by social positive reinforcement were evaluated for five individuals diagnosed with autism spectrum disorder. A continuous NCR schedule was gradually thinned to a fixed‐time 5‐min schedule. If problem behavior increased during NCR schedule thinning, a continuous NCR schedule was reinstated and NCR schedule thinning was repeated with differential reinforcement of alternative behavior (DRA) included. Results showed an immediate decrease in all participants’ problem behavior during continuous NCR, and problem behavior maintained at low levels during NCR schedule thinning for three participants. Problem behavior increased and maintained at higher rates during NCR schedule thinning for two other participants; however, the addition of DRA to the intervention resulted in decreased problem behavior and increased mands.     

Delivering alternative reinforcement in a distinct context reduces its counter‐therapeutic effects on relapse

Delivery of alternative reinforcers in the presence of stimuli previously associated with reinforcement for target behavior increases the susceptibility of target behavior to relapse. To explore contingencies that might mitigate this counter‐therapeutic effect, we trained pigeons on a procedure that entailed extinction of previously reinforced target‐key pecking, access to a distinct stimulus context contingently on refraining from target behavior (differential‐reinforcement‐of‐other‐behavior; DRO), and reinforcement of alternative‐key pecks (differential‐reinforcement of alternative behavior; DRA) in that context. This DRO‐DRA treatment was compared with standard DRA in successive conditions, counterbalanced across pigeons. Target behavior extinguished more rapidly in the Standard‐DRA condition. When alternative reinforcement was discontinued, however, there was less resurgence after DRO‐DRA than after Standard DRA. In a third condition, the DRO contingency was suspended so that the former DRA stimuli were not presented (DRO‐NAC), and resurgence was greater than in the Standard‐DRA and DRO‐DRA conditions. Reinstatement produced by response‐independent reinforcers was small and similar across conditions. Subsequent reacquisition of target‐key pecking under baseline reinforcement conditions was faster following DRO‐NAC than Standard‐DRA or DRO‐DRA. These findings suggest that DRO‐DRA might serve as a useful method in clinical settings for reducing problem behavior while minimizing the threat of posttreatment relapse.     

Resurgence following differential reinforcement of alternative behavior implemented with and without extinction

In the clinic, differential reinforcement of alternative behavior (DRA) often involves programming extinction for destructive behavior while reinforcing an alternative form of communication (e.g., a functional communication response); however, implementing extinction can be unsafe or impractical under some circumstances. Quantitative theories of resurgence (i.e., Behavioral Momentum Theory and Resurgence as Choice) predict differences in the efficacy of treatments that do and do not involve extinction of target responding when reinforcement conditions maintaining alternative responding worsen. We tested these predictions by examining resurgence following two DRA conditions in which we equated rates of reinforcement. In DRA without extinction, target and alternative behavior produced reinforcement. In DRA with extinction plus noncontingent reinforcement, only alternative behavior produced reinforcement. We conducted this study in a reverse-translation sequence, first with participants who engaged in destructive behavior (Experiment 1) and then in a laboratory setting with rats (Experiment 2). Across both experiments, we observed proportionally lower levels of target responding during and following the DRA condition that arranged extinction for the target response. However, levels of resurgence were similar following both arrangements.     

Caregiver preference for reinforcement‐based interventions for problem behavior maintained by positive reinforcement

Social validity of behavioral interventions typically is assessed with indirect methods or by determining preferences of the individuals who receive treatment, and direct observation of caregiver preference rarely is described. In this study, preferences of 5 caregivers were determined via a concurrent‐chains procedure. Caregivers were neurotypical, and children had been diagnosed with developmental disabilities and engaged in problem behavior maintained by positive reinforcement. Caregivers were taught to implement noncontingent reinforcement (NCR), differential reinforcement of alternative behavior (DRA), and differential reinforcement of other behavior (DRO), and the caregivers selected interventions to implement during sessions with the child after they had demonstrated proficiency in implementing the interventions. Three caregivers preferred DRA, 1 caregiver preferred differential reinforcement procedures, and 1 caregiver did not exhibit a preference. Direct observation of implementation in concurrent‐chains procedures may allow the identification of interventions that are implemented with sufficient integrity and preferred by caregivers.     

Manipulating parameters of reinforcement to reduce problem behavior without extinction

Differential reinforcement of alternative behavior (DRA) most often includes extinction as a treatment component. However, extinction is not always feasible and it can be counter‐therapeutic if implemented without optimal treatment integrity. Researchers have successfully implemented DRA without extinction by manipulating various parameters of reinforcement such that alternative behavior is favored. We extended previous research by assessing three participants' sensitivities to quality, magnitude, and immediacy using arbitrary responses and reinforcers that maintain problem behavior. The results were used to implement an intervention for problem behavior using DRA without extinction. Our findings indicate that arbitrary responses can be used to identify individual and relative sensitivity to parameters of reinforcement for reinforcers that maintain problem behavior. Treatment was effective for all participants when we manipulated parameters of reinforcement to which they were most sensitive, and, for two participants, the treatment was less effective when we manipulated parameters to which they were least sensitive.     

On the definition of differential reinforcement of alternative behavior

Differential reinforcement of alternative behavior (DRA) has a long history as a behavioral treatment. The term has usually been defined in a manner that suggests one form of behavior (usually some appropriate alternative) is reinforced, while another form of behavior (usually problem behavior) is placed on extinction. In this paper, we will suggest that DRA should not require extinction, either procedurally or by definition. Ideally, problem behavior would be placed on extinction when possible; however, when problem behavior is not or cannot be placed on extinction, the procedure used is still DRA. Thus, we propose the following definition: Providing greater reinforcement, along at least one dimension, contingent on the occurrence of one form or type of behavior, while minimizing reinforcement for another form or type of behavior.     

Stimulus Fading and Response Elaboration in Differential Reinforcement for Alternative Behavior

A hallmark of applied behavior analysis is the development of function‐based interventions for problem behavior. A widely recommended function‐based intervention is differential reinforcement of alternative behavior (DRA), in which reinforcement is contingent upon socially acceptable alternatives to problem behavior (e.g., teaching communication skills). Typically, DRA is introduced under rich schedules of reinforcement. Although effective for initiating behavior change, rich schedules are often impractical in the natural setting. In this study, we evaluated the extent to which a stimulus fading program could be employed to elaborate alternative behavior (mands) in two individuals diagnosed with an autism spectrum disorder. For both participants, problem behavior was reduced substantially upon implementation of the DRA procedure. Further, problem behavior rates remained low and mand rates decreased to more practical levels as the DRA behavioral requirements increased during the fading program. The fading approach demonstrated in this paper may be a useful component of intervention packages for clinicians. Copyright © 2015 John Wiley & Sons, Ltd.     

Further investigation of differential reinforcement of alternative behavior without extinction for escape‐maintained destructive behavior

Previous research indicates that manipulating dimensions of reinforcement during differential reinforcement of alternative behavior (DRA) for situations in which extinction cannot be implemented is a potential approach for treating destructive behavior. Therefore, we replicated and extended previous research by determining (a) the conditions under which DRA without extinction decreased and maintained low levels of destructive behavior and (b) whether intervention effects maintained during reinforcement schedule thinning for the alternative response (i.e., compliance). Results showed that effective treatments were developed in the absence of extinction by manipulating the quality of reinforcement for compliance for 2 participants and by combining manipulations of the magnitude and quality of reinforcement for compliance for the other 2 participants. However, maintaining treatment effects during reinforcement schedule thinning required combining the magnitude and quality of reinforcement for 3 of the 4 participants. We discuss the clinical utility of this approach, review limitations of the study, and suggest directions for future research.     

EFFECTS OF TREATMENT INTEGRITY FAILURES DURING DIFFERENTIAL REINFORCEMENT OF ALTERNATIVE BEHAVIOR: A TRANSLATIONAL MODEL

Differential reinforcement of alternative behavior (DRA) is used frequently as a treatment for problem behavior. Previous studies on treatment integrity failures during DRA suggest that the intervention is robust, but research has not yet investigated the effects of different types of integrity failures. We examined the effects of two types of integrity failures on DRA, starting with a human operant procedure and extending the results to children with disabilities in a school setting. Human operant results (Experiment 1) showed that conditions involving reinforcement for problem behavior were more detrimental than failing to reinforce appropriate behavior alone, and that condition order affected the results. Experiments 2 and 3 replicated the effects of combined errors and sequence effects during actual treatment implementation.     

Teaching children with autism to engage in peer-directed mands using a picture exchange communication system

We evaluated differential reinforcement of alternative behavior (DRA) plus prompting to increase peer-directed mands for preferred items using a picture exchange communication system (PECS). Two nonvocal individuals with autism participated. Independent mands with a peer increased with the implementation of DRA plus prompting for both participants. In addition, peers engaged in brief social interactions following the majority of mands for leisure items. These results suggest that teaching children to use PECS with peers may be one way to increase manding and social interactions in individuals with limited or no vocal repertoire.     

The effects of differential and lag reinforcement schedules on varied verbal responding by individuals with autism

Variability has been shown to be a reinforceable dimension of behavior. One procedure that has been demonstrated to increase variability in basic research is the lag reinforcement schedule. On this type of schedule, a response is reinforced if it differs from a specified number of previous responses. Lag schedules are rarely used, however, for increasing response variability in applied settings. The purpose of the present study was to investigate the effects of a lag schedule of differential reinforcement on varied and appropriate verbal responding to social questions by 3 males with autism. A reversal design with a multiple baseline across subjects was used to evaluate the effects of the lag schedule. During baseline, differential reinforcement of appropriate responding (DRA) resulted in little or no varied responding. During the intervention, a Lag 1 requirement was added to the DRA (Lag 1/DRA) resulting in an increase in the percentage of trials with varied and appropriate verbal responding for 2 of the 3 participants. In addition, an increase in the cumulative number of novel verbal responses was also observed for the same 2 participants. These results are discussed in terms of reinforcement schedules that support variability, generalization, and potential stimulus control over varied responding.     

Treatment of resistance to change in children with autism

“Resistance to change” represents a core symptom of autism that we conceptualized and assessed as resulting in part due to factors known to govern free‐operant choice. During a free‐choice baseline, participants chose between problematic, resistive responses and an appropriate alternative response. During the asymmetrical‐choice condition, we delivered their most highly preferred item if the participant chose the alternative response (i.e., differential reinforcement of alternative behavior [DRA]). During the guided‐ (Experiment 1) and singular‐ (Experiment 2) choice conditions, we prompted participants to choose the alternative response and then delivered their most highly preferred item (i.e., DRA with escape extinction). All participants learned to tolerate (Experiment 1) or choose (Experiment 2) the alternative response when we combined DRA with escape extinction. After exposure to escape extinction, two participants showed strong maintenance effects with DRA alone. We discuss these finding relative to the effects of DRA and escape extinction on resistance to change.     

A Comparison of Function-Based Differential Reinforcement Interventions for Children Engaging in Disruptive Classroom Behavior

This study provides a direct comparison of differential reinforcement of other behavior (DRO) and differential reinforcement of alternative behavior (DRA). Participants included three children in center-based classrooms referred for functional assessments due to disruptive classroom behavior. Functional assessments included interviews and brief functional analyses. An alternating treatments design was used to evaluate the relative effectiveness of function-based DRO and DRA interventions. Results indicated that both intervention procedures effectively reduced disruptive behavior, but the DRA procedure consistently resulted in greater reductions in disruptive behavior across all participants. Results are discussed in terms of directions for future functional assessment and intervention research as well as implications for applied practice.     

Pyramidal parent training using behavioral skills training: Training caregivers in the use of a differential reinforcement procedure

Six caregivers participated in a research study in which behavioral skills training (BST) was used within a pyramidal training model to train a differential reinforcement of an alternative behavior (DRA) procedure. Physical prompting was utilized to obtain correct responses across the identified alternative behavior. The caregivers were split into two tiers, comprised of three caregivers each. The experimenter trained tier‐one caregivers, who then trained tier‐two caregivers after meeting a predetermined mastery criterion. A multiple baseline design across participants research design was used to evaluate the effectiveness of correct implementation of the DRA procedure, demonstrating experimental control across participants. During baseline, caregivers did not implement DRA correctly. Following training, tier‐one and tier‐two caregivers demonstrated correct implementation of the DRA and prompting procedure. Intervention score was (M = 96%), from a baseline score of (M = 34.6%), for tier‐one participants. Intervention score was (M = 96.6%), from a baseline score of (M = 33%), for tier‐two participants. A follow‐up maintenance probe demonstrated correct implementation of the DRA procedure with prompting across both tiers of trained caregivers.     

Differential reinforcement of alternative behavior increases resistance to extinction: clinical demonstration, animal modeling, and clinical test of one solution

Basic research with pigeons on behavioral momentum suggests that differential reinforcement of alternative behavior (DRA) can increase the resistance of target behavior to change. This finding suggests that clinical applications of DRA may inadvertently increase the persistence of target behavior even as it decreases its frequency. We conducted three coordinated experiments to test whether DRA has persistence-strengthening effects on clinically significant target behavior and then tested the effectiveness of a possible solution to this problem in both a nonhuman and clinical study. Experiment 1 compared resistance to extinction following baseline rates of reinforcement versus higher DRA rates of reinforcement in a clinical study. Resistance to extinction was substantially greater following DRA. Experiment 2 tested a rat model of a possible solution to this problem. Training an alternative response in a context without reinforcement of the target response circumvented the persistence-strengthening effects of DRA. Experiment 3 translated the rat model into a novel clinical application of DRA. Training an alternative response with DRA in a separate context resulted in lower resistance to extinction than employing DRA in the context correlated with reinforcement of target behavior. The value of coordinated bidirectional translational research is discussed.     

Signaled alternative reinforcement and the persistence of operant behavior

Differential reinforcement of alternative behavior (DRA) is a treatment designed to eliminate problem behavior by reinforcing an alternative behavior at a higher rate. Availability of alternative reinforcement may be signaled, as with Functional Communication Training, or unsignaled. Whether or not alternative reinforcement is signaled could influence both the rate and persistence of problem behavior. The present study investigated whether signaling the availability of alternative reinforcement affects the rate and persistence of a concurrently available target response with pigeons. Three components of a multiple concurrent schedule arranged equal reinforcement rates for target responding. Two of the components also arranged equal reinforcement rates for an alternative response. In one DRA component, a discrete stimulus signaled the availability of response‐contingent alternative reinforcement by changing the keylight color upon reinforcement availability. In the other DRA component, availability of alternative reinforcement was not signaled. Target responding was most persistent in the unsignaled DRA component when disrupted by satiation, free food presented between components, and extinction, relative to the signaled DRA and control components. These findings suggest the discrete stimulus functionally separated the availability of alternative reinforcement from the discriminative stimuli governing target responding. These findings provide a novel avenue to explore in translational research assessing whether signaling the availability of alternative reinforcement with DRA treatments reduces the persistence of problem behavior.     

Teacher Implementation of Trial-Based Functional Analysis and Differential Reinforcement of Alternative Behavior for Students with Challenging Behavior

The purpose of this study was to examine the effects of a training package on three middle school special education teachers’ accurate implementation of trial-based functional analysis (TBFA) and differential reinforcement of alternative behavior (DRA) with their students with autism spectrum disorders or emotional and behavioral disorders in the classroom setting. We also examined the effects of the DRA on six students’ challenging and replacement behaviors. Using a multiple probe across teacher participants design, we demonstrated that all three teachers implemented TBFA during TBFA training with performance feedback conditions and DRA during DRA training with performance feedback conditions with high procedural fidelity. Further, two of three teachers generalized high procedural fidelity with a new student. Finally, results indicated a reduction in all six students’ challenging behavior and an increase in their replacement behavior after the teachers received training and performance feedback on DRA implementation. Limitations and implications for research and practice are discussed.     

A component analysis of a parent‐conducted multi‐component treatment for food selectivity

Treatment packages including differential reinforcement of alternative (DRA) behavior and escape prevention in the form of a non‐removal of the spoon procedure have been shown to successfully increase food consumption. However, when these treatment components are introduced simultaneously, the treatment component(s) responsible for behavior change cannot be determined. The purpose of this study was to conduct a sequential component analysis of the following treatment components: Bite fading, manipulation of reinforcer magnitude, and escape prevention. For two participants, food consumption did not increase until after escape prevention was introduced. For one participant, increased food consumption was observed after the magnitude of reinforcement was increased; therefore, escape prevention was not necessary. Results were maintained at a 12‐week follow‐up for all participants. Copyright © 2010 John Wiley & Sons, Ltd.     

MULTICOMPONENT ASSESSMENT AND TREATMENT OF CIGARETTE PICA

We conducted a multicomponent assessment and treatment for 4 individuals who engaged in cigarette pica. During Phase 1, three stimulus preference assessments were conducted to identify (a) the reinforcing component of the cigarette, (b) potential alternative reinforcers that may be used during treatment, and (c) whether the alternative reinforcer would compete effectively with cigarettes. Results were successful in identifying the reinforcing component of the cigarette and suggested the feasibility of using alternative reinforcers during treatment to eliminate cigarette pica. During Phase 2, the effects of two treatment procedures were evaluated. Noncontingent reinforcement (NCR) with the alternative edible reinforcer reduced the pica of 2 of the participants, but effects were not maintained when the initial dense schedule of NCR was thinned. Subsequently, differential reinforcement of alternative behavior with the alternative edible reinforcer was effective in reducing pica for 3 participants. An evaluation of nine treatment procedures failed to identify an effective intervention for the remaining participant; consequently, preventive measures were designed to minimize occurrences of cigarette pica.