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.     

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 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.     

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.     

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.     

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.     

Use of an Antecedent Intervention to Decrease Vocal Stereotypy of a Student With Autism in the General Education Classroom

This study examined the use of an antecedent-based intervention to reduce the vocal stereotypy of a student diagnosed with Autism within the general education classroom. The student displayed frequent nonfunctional speech and disruptive vocal sounds. An antecedent-based intervention, involving the use of qualitatively different cards—to cue the student when it was appropriate or inappropriate to engage in vocal stereotypy—was designed and implemented. An adaptive alternating treatment design was utilized and conditions were randomized and counterbalanced across treatment sessions. Data on vocal stereotypy were collected using partial interval recording. The results indicated the participant was successful in discriminating between cues and decreased stereotypy during intervention compared to baseline conditions. Similar findings were found when the intervention was implemented across a second school setting.     

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.     

Effects of music on vocal stereotypy in children with autism

We examined the effects of manipulating the intensity (i.e., volume) of music on engagement in vocal stereotypy in 2 children with autism. Noncontingent access to music decreased immediate engagement in vocal stereotypy for each participant, but it produced only marginal effects on subsequent engagement in the behavior (i.e., after withdrawal). Manipulating the intensity of music did not produce differential effects on immediate engagement in vocal stereotypy. The implications of the results and applications for future research are discussed.     

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.     

EFFECTS OF VERBAL REPRIMANDS ON TARGETED AND UNTARGETED STEREOTYPY

Results of brief functional analyses indicated that motor and vocal stereotypy persisted in the absence of social consequences for five participants diagnosed with autism spectrum disorder (ASD). Subsequently, effects of a stimulus control procedure involving contingent reprimands for each participant's higher probability (targeted) stereotypy were evaluated. Results indicated that contingent verbal reprimands (i) decreased the targeted stereotypy for all five participants, (ii) decreased the untargeted stereotypy for two of five participants, and (iii) increased the untargeted stereotypy for one of five participants. Although response suppression was not achieved for any participant, three participants maintained low levels of the target stereotypy with one or two reprimands during 5‐min sessions. Furthermore, two of those participants maintained near‐zero levels of motor and vocal stereotypy during 10‐min sessions. These findings suggest that signaled verbal reprimands may be a practical intervention for reducing stereotypy in some children with ASD. Some limitations of the findings and areas of future research are briefly discussed. Copyright © 2014 John Wiley & Sons, Ltd.     

Effects of three types of noncontingent auditory stimulation on vocal stereotypy in children with autism

We evaluated the effects of 3 types of noncontingent auditory stimulation (music, white noise, recordings of vocal stereotypy) on 2 children with autism who engaged in high rates of vocal stereotypy. For both participants, the music condition was the most effective in decreasing vocal stereotypy to near-zero levels, resulted in the highest parent social validity ratings, and was selected as most preferred in treatment preference evaluations.     

Differential reinforcement to decrease stereotypy exhibited by an adult with autism spectrum disorder

Motor and vocal stereotypies are behaviors commonly exhibited by individuals with autism spectrum disorder (ASD). Stereotypy may impede and interfere with learning new skills and decrease work performance in employment settings. Previous research has evaluated effective interventions for stereotypy; however, they have typically focused on treating stereotypy exhibited by children in structured settings. We evaluated the practicality of implementing a simple differential reinforcement of other behavior procedure with an adult with ASD in multiple, naturalistic environments. Results showed rapid decreases in motor and vocal stereotypies upon implementation of the intervention and maintenance of low levels of behavior. These data highlighted the successful treatment of stereotypy exhibited by an adult with a long history of exhibiting these behaviors. Treatment effects were replicated across multiple, naturalistic environments.     

THE UTILITY OF ASSESSING MUSICAL PREFERENCE BEFORE IMPLEMENTATION OF NONCONTINGENT MUSIC TO REDUCE VOCAL STEREOTYPY

We conducted a modified paired‐choice preference assessment and used a multielement design to examine the effects of noncontingent access to high‐ and low‐preference music on vocal stereotypy exhibited by children with autism. For 3 of the 4 participants, high‐preference music (a) produced lower levels of vocal stereotypy than low‐preference music and (b) reduced vocal stereotypy when compared to a no‐interaction condition. Results underscore the potential importance of assessing musical preference prior to using noncontingent music to reduce vocal stereotypy.     

THE EFFECTS OF MATCHED STIMULATION AND RESPONSE INTERRUPTION AND REDIRECTION ON VOCAL STEREOTYPY

Stereotypy has been classified as repetitive behavior that does not serve any apparent function. Two procedures that have been found to reduce rates of vocal stereotypy effectively are response interruption and redirection (RIRD) and noncontingent access to matched stimulation (MS). The purpose of the current study was to evaluate the effects of RIRD alone, MS alone, and MS combined with RIRD. One participant's results suggested similar suppressive effects on vocal stereotypy across treatment conditions. For the second participant, a slightly greater suppression of stereotypy was associated with MS + RIRD. In addition, both participants emitted a greater frequency of appropriate vocalizations in conditions with RIRD. Data suggest that the addition of MS might facilitate the implementation of RIRD in applied settings.     

Further evaluation of methods to identify matched stimulation

The effects of preferred stimulation on the vocal stereotypy of 2 individuals were evaluated in two experiments. The results of Experiment 1 showed that (a) the vocal stereotypy of both participants persisted in the absence of social consequences, (b) 1 participant manipulated toys that did and did not produce auditory stimulation, but only sound-producing toys decreased his vocal stereotypy, and (c) only noncontingent music decreased vocal stereotypy for the other participant, but sterotypy paradoxically increased when toys were presented with music. Using a three-component multiple schedule, the results of Experiment 2 showed that the vocal stereotypy of both participants remained below preintervention levels following the removal of auditory stimulation and that 1 participant's vocal stereotypy increased following the removal of contingent reprimands. These patterns suggest that auditory stimulation functioned as an abolishing operation for vocal stereotypy and reprimands functioned as an establishing operation for vocal stereotypy. Together, the two experiments provide a method for identifying alternative stimulation that may substitute for automatically reinforced behavior.     

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.     

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.     

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.     

Acoustic parameters of infant-directed singing in mothers with depressive symptoms

The purpose of this study was to explore the relationship between mothers’ depressive symptoms and the acoustic parameters of infant-directed (ID) singing. Participants included 80 mothers and their 3- to 9-month-old infants. A digital recording was made of each mother's voice while singing to her infant. Extraction and analyses of vocal data revealed a main effect of tempo, meaning that as mothers reported more depressive symptoms, they tended to sing faster to their infants. Additionally, an interaction effect indicated that mothers with depressive symptoms were more likely to sing with tonal key clarity to their male infants. These findings suggest that as mothers experience depressive symptoms, their ID singing may lack the sensitivity and emotional expression that infants need for affect regulation. An intervention that combines interaction coaching and ID singing may help mothers with depressive symptoms to engage in sensitive and emotionally synchronized interactions with their infants.