A comparison of procedures for eliminating self-injurious behavior of retarded adolescents

An attempt was made to eliminate the self-injurious behaviors of four institutionalized, profoundly retarded adolescents. Some of the behaviors studied were: face-slapping, face-banging, hair-pulling, face-scratching, and finger-biting. Three remediative approaches to self-injurious behavior were compared. Elimination of all social consequences of the self-injurious behavior was not effective with the two subjects with whom it was attempted. The same two subjects were exposed to a procedure involving reinforcement of non-self-injurious behavior which was ineffective under no food deprivation and was effective with one of the two subjects under mild food deprivation. Electric-shock punishment eliminated the self-injurious behaviors of all four subjects with whom it was attempted. The results suggested that punishment was more effective than differential reinforcement of non-self-injurious behavior which, in turn, was more effective than extinction through elimination of social consequences. However, the effects of the punishment were usually specific to the setting in which it was administered. In order to eliminate the self-injurious behaviors of severely retarded children, it is apparently necessary to carry out the treatment in many of the settings in which it occurs.     

Dry bed: A rapid method of eliminating bedwetting (enuresis) of the retarded

Bedwetting has been a major and unsolved problem for the severely retarded. To solve this problem, an intensive training program was designed similar to a recently developed program for daytime toilet training of the retarded. Some distinctive features of the new procedure were frequent positive reinforcement for correct toileting, a negative reinforcer for accidents, positive practice in night time toileting, increased level of urination by forcing drinking, immediate detection of correct and incorrect toileting, and Positive Practice for accidents. Of twelve retarded adult bedwetters, the average bedwetter required only one night of intensive training. Several days of apparatus monitoring were used following the training but proved unnecessary for two-thirds of the trainees. Accidents were reduced by about 85 % during the first week after training, and almost entirely (95%) during the fifth week with no relapse during a 3 month follow-up. No reduction of accidents resulted when the same bedwetters were given a control procedure that provided no positive or negative reactions other than the sounding of an alarm upon bedwetting. The Dry-Bed procedure appears to be a very rapid solution to the problem of enuresis among the retarded and may be applicable to other difficult populations and also to normals.     

A reinforcement plus interruption method of eliminating behavioral stereotypy of profoundly retarded persons

Stereotyped responses have been shown to be eliminated by an overcorrection-reinforcement program. The present study evaluated response-interruption as an alternative to the overcorrection component with seven profoundly retarded adults. During the baseline praise condition, stereotypy occurred during 66% of the observations for the seven profoundly retarded adults but decreased to less than one response per half hour in a mean of two sessions of individual training. In the subsequent class situation, stereotypy was reduced to less than 5% on the first day of class, to less than 1% by the fourth day and less than one stereotypy per hour after the third day. The interruption method seems preferable to postural overcorrection because of its apparent and relative nonaversiveness.     

Instruction-following behavior of a retarded child and its controlling stimuli

A combination of positive reinforcement and fading of physical guidance was used to teach a profoundly retarded boy specific responses to specific verbal instructions. The design consisted of a multiple baseline of probe data across different verbal instructions. The subject started responding correctly to each verbal instruction as that item was trained in a multiple-baseline order. Generalization did not occur to items that had not yet been trained, nor did it occur to items included to assess generalization. Probes of variations in the verbal instructions, conducted after training was completed, revealed that generalization was minimal except in those cases where the variation consisted of the verb only, the noun only, the noun plus preposition, or where the verb of the instruction was presented last. Training a profoundly retarded 11-yr-old subject to respond to specific verbal instructions did not adequately facilitate the development of a generative instruction-following capability, nor did all verbal elements of the instruction control a specific response.     

Habit-reversal: A method of eliminating nervous habits and tics

No clinical treatment for nervous habits has been generally effective. The present rationale is that nervous habits persist because of response chaining, limited awareness, excessive practice and social tolerance. A new procedure was devised for counteracting these influences: the client practiced movements which were the reverse of the nervous habit, he learned to be aware of each instance of the habit and to differentiate it from its usual response chain and he was given social approval for his efforts to inhibit the habit. The treatment was given during a single session to 12 clients who had diverse nervous habits such as nail-biting, thumb-sucking, eyelash-picking, head-jerking, shoulder-jerking, tongue-pushing and lisping. The habits were virtually eliminated on the very first day for all 12 clients and did not return during the extended follow-up for the 11 clients who followed the instructions.     

A comparison of several procedures for eliminating behavior

The pecking response of pigeons was reinforced when a minimum period of time had elapsed since the last response (DRL schedule of food-reinforcement). Punishment, satiation, extinction, and stimulus change were employed separately to reduce responding. When the effects of the four procedures were compared, punishment was found capable of producing a more immediate, complete and long lasting response reduction than the others. Punishment had its maximum effect on the responses that were least relevant to reinforcement. The punishment reduced the frequency of the short inter-response times to a greater extent than did either extinction or satiation. In this way, punishment actually increased the efficiency of the DRL responding.     

A rapid method of eliminating stuttering by a regulated breathing approach

The Habit Reversal Procedure for eliminating nervous habits was applied to the problem of stuttering. In the new procedure the speaker interrupted his speech at moments of actual or anticipated stuttering and at natural pause points, and resumed speaking immediately after breathing deeply during the pause. In addition to this regularized pausing and breathing, the program included other factors such as formulation of one's thoughts prior to speaking, identification of stutter-prone situations, identification of mannerisms associated with stuttering, speaking for short durations when tense or nervous, daily breathing exercises, relaxation procedures for anxiety, immediate display of improved speaking, and enlisting family support for progress. Fourteen stutterers were given training in the program during a single counseling session of about two hours duration. The next day, the average number of stuttering episodes decreased by 94 per cent, by 97 per cent at the end of one month, and by 99 per cent during the extended follow-up. Each of the clients was improved by at least 93 per cent. The new procedure appears to be more rapid and effective than alternative procedures.     

Prevalence of maladaptive behavior in retarded children as a function of IQ and age

One hundred and twentyeight mentally retarded children, ages 6 to 14, from a special school were assessed by teachers in terms of nine maladaptive behaviors. The results indicated that the prevalence of some maladaptive behaviors changed as a function of IQ and age, and that there were splits of such changes as IQ-dependent and as age-dependent by maladaptive behavior.     

Effectiveness of the counterconditioning procedure in eliminating avoidance behavior

Data were obtained on the effectiveness of three forms of counterconditioning—each differing in the degree to which competing responses were introduced. Counterconditioning was also compared with an extinction procedure in eliminating an instrumental avoidance response. Only the counterconditioning procedure which evoked and reinforced another conditioned response during extinction of the avoidance response, was significantly more effective than a traditional extinction procedure in achieving a decrement in avoidance responding and this was only on the first session on which such procedures were in effect. When the opportunity to perform the competing response was removed, only Ss in this group evidenced a significant increase in avoidance responding.

All procedures were equally effective over sessions in eliminating avoidance behavior. A delay in effectiveness occurred to the degree to which a procedure introduced a competing response. It was in terms of the immediacy of response reduction and achievement of a very low rate of responding with very few responses being performed, that the counterconditioning procedure was superior to the extinction procedure.

The implication of these results for behavior theory and therapy were elaborated.     

Sensory Extinction: A procedure for eliminating self-stimulatory behavior in developmentally disabled children

This study was designed to investigate the role of sensory reinforcement in the motivation of self-stimulation. If self-stimulatory behavior is maintained by its sensory consequences, such as the proprioceptive, auditory, or visual stimulation it produces, then such behavior should extinguish when those sensory consequences are not permitted. The present study introduces a new procedure, Sensory Extinction, in which certain sensory consequences are masked or removed, to examine whether self-stimulation is operant behavior maintained by sensory reinforcement. The effectiveness of Sensory Extinction was assessed by a reversal design for each of three autistic children, and the results showed the following. First, self-stimulation reliably extinguished when a certain sensory consequence was removed, then increased when that consequence was permitted. This was replicable within and across children. Second, different Sensory Extinction procedures were required for different self-stimulatory behaviors, since the sensory reinforcers supporting them were idiosyncratic across children. Finally, regarding clinical gains, the data suggest that Sensory Extinction may be a relatively convenient and rapid alternative for the treatment of self-stimulation. The present findings extend the efficacy of extinction as a behavior-modification technique to instances in which the reinforcer is purely sensory. The implications of these results for the treatment of other forms of deviant behavior are discussed.