Assessment and treatment of elopement maintained by access to stereotypy

We evaluated a treatment for elopement maintained by access to stereotypic door play. First, we conducted a functional analysis of elopement that produced undifferentiated results. Next, we conducted an assessment in which we evaluated the relation between elopement and door play. Results suggested a functional relation between the 2 behaviors (i.e., elopement was maintained by contingent access to door play). Finally, we implemented functional communication training as a treatment for elopement in which access to door play was made contingent on a target appropriate communication response.     

Evaluating a treatment without extinction for elopement maintained by access to stereotypy

Elopement is a common and potentially dangerous form of problem behavior. Results of a functional analysis found that the elopement of a child with autism was maintained by access to stereotypy in the form of door play. We implemented functional communication training and contingency-based delays dependent on the absence of elopement and increased the amount of time the participant waited prior to engaging in stereotypy. We also conducted treatment-extension probes, with the participant waiting up to 10 min without elopement.     

Assessment and treatment of elopement: a replication and extension

The current investigation replicated and extended the assessment and treatment methodology of elopement. The environmental variables that maintained elopement were identified in each case, and successful treatments were implemented for the 3 participants in settings that were similar to those in which elopement occurred.     

Functional analysis and treatment of elopement.

Elopement is a dangerous behavior because children who run away may encounter life-threatening situations (e.g., traffic). We conducted functional analyses of the elopement of 3 children who had been diagnosed with developmental disabilities. The results identified a maintaining reinforcer for the elopement of 1 child, but the data were difficult to interpret for 2 of the children. Subsequent reinforcer assessments were used to help to clarify the reinforcers for elopement for these 2 children. Results of the functional analyses and reinforcer assessments then were used to develop successful treatments to reduce elopement. The findings are discussed in terms of (a) the application of functional analysis methodology to elopement, (b) the use of reinforcer assessments to identify potential reinforcers when standard functional analyses are undifferentiated, and (c) the utility of assessment-based treatments for elopement.     

Treating elopement without extinction in a preschool setting

Elopement is a prevalent and dangerous behavior that is common with children with autism spectrum disorder (ASD). Due to safety, logistics, and effort on the part of stakeholders, recent research has emphasized the need for treatments that do not include extinction or response blocking. Using a multiple-baseline-across-functions design, we successfully decreased elopement with functional communication training, without additional treatment components, for one function but needed to add an additional treatment component (response blocking) for the second function for a 4 year-old boy with ASD who engaged in elopement in a preschool setting. We highlight contributions to the literature on elopement as well as directions for future research.     

Response latency as a measure of behavior in the assessment of elopement

Elopement is a common form of problem behavior but is relatively underrepresented in the functional analysis literature. One barrier to assessing elopement experimentally is the need to retrieve the subject following an instance of elopement. This retrieval confounds programmed session contingencies when the goal is to obtain repeated measurement of free‐operant behavior. The current study evaluated latency to elopement as an alternative to free‐operant measurement. We first compared response latency to allocation in 5‐min sessions and then measured latency alone in a trial‐based format. The identified reinforcers matched across both data analysis modalities in the session‐based assessments, and the trial‐based functional analysis showed a significant time savings in identifying the function of behavior over a session‐based assessment. Results indicated that elopement serves idiosyncratic social functions in young children with intellectual and developmental disabilities, and that a latency‐based assessment saves time while yielding equally clear results.     

Functional analysis and treatment of elopement for a child with attention deficit hyperactivity disorder

We conducted a functional analysis of elopement in an outdoor setting for a child with a diagnosis of attention deficit hyperactivity disorder. A subsequent treatment consisting of noncontingent attention and time-out was demonstrated to be effective in eliminating elopement. Modifications of functional analysis procedures associated with the occurrence of elopement in a natural setting are demonstrated.     

Assessment and treatment of problem behavior maintained by escape from attention and access to tangible items.

The results obtained from two consecutive functional analyses conducted with a 6‐year‐old child with autism are described. In the initial functional analysis, the highest rates of problem behavior occurred in the play condition. In that condition, the delivery of attention appeared to occasion problem behaviors. A second functional analysis was conducted wherein an escape from attention condition and a tangible condition were added. In the second functional analysis, higher rates of responding were observed in the escape from attention and tangible conditions. The results suggested that problem behavior was maintained by negative reinforcement in the form of escape from attention and positive reinforcement in the form of gaining access to preferred tangible items. Problem behavior was treated using functional communication training combined with noncontingent reinforcement.     

Differential reinforcement with and without blocking as treatment for elopement

Blocking is a frequent component of treatments for elopement. Unfortunately, blocking may not always be feasible because elopement often occurs when supervision is low or the behavior cannot be prevented. The present study evaluated the use of blocking in the treatment of elopement by using differential reinforcement of other behavior with and without blocking. In this case, results suggested that blocking may be an essential component for differential reinforcement-based treatments of elopement.     

Treatment of elopement following a latency‐based interview‐informed,synthesized contingency analysis

Using a latency measure during a functional analysis of problem behavior increases the brevity of the assessment period and decreases risks resulting from exposure to contexts intended to evoke problem behavior. In addition, latency‐based functional analyses may be especially suitable for discrete behaviors such as elopement, which require resetting the environment after each instance of the response. We evaluated a comprehensive assessment and treatment package for the elopement of two children diagnosed with autism. We observed short latencies to elopement during the test condition of the analysis and no elopement during the control condition. We then taught the participants multiple forms of functional communication responses of increasing complexity while elopement was blocked. This was followed by the thinning of reinforcement to a terminal goal, creating a treatment package that nearly eliminated elopement and was socially validated by caregivers.     

Evaluation of a break-to-choice chained-schedule intervention for multiply maintained problem behavior

Interventions for multiply maintained problem behavior often involve developing separate treatment conditions to address each function. Although isolating treatment conditions lead to positive outcomes, developing individual treatments for each identified function may be time-consuming. Alternatively, synthesizing treatment procedures may allow for more efficient treatment effects. We extended previous research by evaluating functional communication training (FCT) and chained schedules of reinforcement to treat multiply maintained problem behavior in children diagnosed with autism spectrum disorder. First, we conducted a functional analysis that concluded problem behavior was multiply maintained. Next, we taught functional communication responses (FCRs) and implemented a chained schedule of reinforcement. During the initial link, FCRs for a break resulted in the presentation of a choice menu with the other putative reinforcers in the terminal link. The relevant reinforcer was delivered contingent on the emission of subsequent FCRs. Finally, we systematically schedule thinned to caregiver-informed terminal schedules for each participant. The results of our study demonstrated that FCT, in combination with a sequential compound schedule of reinforcement, effectively decreased multiply maintained problem behavior and increased appropriate alternative responses (FCRs and compliance) even at terminal schedules of reinforcement.     

The evaluation and treatment of aggression maintained by attention and automatic reinforcement.

In the current investigation, we used direct and indirect methods to assess and treat several topographies of aggression that were hypothesized to have separate operant functions in a young boy with severe mental retardation and pervasive developmental disorder. First, a functional analysis of aggression, using the methods described by Iwata, Dorsey, Slifer, Bauman, and Richman (1982/1994), was conducted and produced inconclusive results. Next, indirect methods were used to develop a second functional analysis, which showed that chin grinding (firmly pressing and grinding his chin against the skin and bones of others) persisted independent of social contingencies and that the other topographies of aggression (e.g., hitting, kicking) were maintained by social positive reinforcement (attention). A treatment designed to decrease aggression maintained by attention—functional communication training with extinction—reduced all forms of aggression except chin grinding. This latter topography of aggression, which we hypothesized was maintained by automatic reinforcement, was reduced when the response-reinforcer relation was interrupted through response blocking and the child was provided with an alternative form of chin stimulation.     

Assessment and treatment of problem behavior maintained by mand compliance

We modified functional analysis procedures to include a condition in which we reinforced problem behavior by complying with a child's mands. After identifying compliance with mands as a reinforcer, we evaluated the efficacy of a token system with a response‐cost contingency and incorporated discriminative stimuli to signal when mands would be reinforced. The token system with response cost effectively reduced problem behavior. Similar procedures may be beneficial when continuous adult compliance is not possible, when adults want to control when they will comply with the child's mands, or to build a child's tolerance for adult‐directed situations.     

Developing a treatment for hand‐clapping maintained by automatic reinforcement using sensory analysis,noncontingent reinforcement,and thinning

Two subjects diagnosed with autism spectrum disorder and related disabilities who engaged in hand‐clapping maintained by automatic reinforcement participated in this study. We conducted a sensory analysis to evaluate matched stimuli that functioned as an abolishing operation or extinction for different sources of sensory reinforcement. Finally, we implemented noncontingent reinforcement (NCR) using the stimuli found to compete in the assessment to reduce the target behavior, and we thinned item availability. Results showed a decrease in hand‐clapping, and hand‐clapping remained low when we thinned the schedule of reinforcement. This research further elucidates how NCR can treat problem behavior maintained by automatic reinforcement.     

Functional analysis and treatment of verbal perseverations displayed by an adult with autism

The function of perseverative speech for an adult man who had been diagnosed with autism and mental retardation was examined. Results showed that verbal perseverations were maintained by social attention. An intervention consisting of differential reinforcement of appropriate verbal responses and extinction of perseverative verbal responding was effective in decreasing verbal perseverations.     

Functional analysis and treatment of aggression maintained by preferred conversational topics

After an initial functional analysis of a participant's aggression showed unclear outcomes, we conducted preference and reinforcer assessments to identify preferred forms of attention that may maintain problem behavior. Next, we conducted an extended functional analysis that included a modified attention condition. Results showed that the participant's aggression was maintained by access to preferred conversational topics. A function-based intervention decreased aggression and increased an appropriate communicative response.     

Functional analysis and treatment of breath holding maintained by nonsocial reinforcement.

A functional analysis showed that breath holding exhibited by a 16‐year‐old boy with mental retardation occurred independent of social consequences. Assessment results of the existing treatment procedure—a verbal reprimand—were used to design a treatment package that reduced the behavior to low levels across 7 months.     

Varying response effort in the treatment of pica maintained by automatic reinforcement

Pica is a life-threatening behavior displayed by many individuals with developmental disabilities. In the current study, automatic reinforcement maintained the pica of 3 participants. Following functional analyses of pica, response-effort manipulations were conducted in which the effort to obtain pica or alternative items was varied systematically. Several general relations emerged as a result of the study. First, levels of pica were reduced relative to baseline when alternative items were available independent of the effort required to obtain alternative items or pica. Second, increasing the effort for alternative items resulted in increases in pica relative to when effort for alternative items was low. Third, increasing response effort for pica produced reductions in pica relative to baseline when alternative items were unavailable. Fourth, the highest levels of pica occurred when the effort to engage in pica was low or medium and no alternative items were available. These findings are discussed in terms of the relative effects of quality of reinforcement and response effort on behavior.