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.     

THE USE OF POSITIVE AND NEGATIVE REINFORCEMENT IN THE TREATMENT OF ESCAPE-MAINTAINED DESTRUCTIVE BEHAVIOR

We identified 3 clients whose destructive behavior was sensitive to negative reinforcement (break from tasks) and positive reinforcement (access to tangible items, attention, or both). In an instructional context, we then evaluated the effects of reinforcing compliance with one, two, or all of these consequences (a break, tangible items, attention) when destructive behavior produced a break and when it did not (escape extinction). For 2 clients, destructive behavior decreased and compliance increased when compliance produced access to tangible items, even though destructive behavior resulted in a break. For 1 client, extinction was necessary to reduce destructive behavior and to increase compliance. Subsequently, when the schedule of reinforcement for compliance was faded for all clients, destructive behavior was lower and fading proceeded more rapidly when compliance produced multiple functional reinforcers (i.e., a break plus tangible items or attention) and destructive behavior was on extinction. The results are discussed in terms of the effects of relative reinforcement value and extinction on concurrent operants.     

False-positive tangible outcomes of functional analyses

Functional analysis (FA) methodology is the most precise method for identifying variables that maintain problem behavior. Occasionally, however, results of an FA may be influenced by idiosyncratic sensitivity to aspects of the assessment conditions. For example, data from several studies suggest that inclusion of a tangible condition during an FA may be prone to a false-positive outcome, although the extent to which tangible reinforcement routinely produces such outcomes is unknown. We examined susceptibility to tangible reinforcement by determining whether a new response was acquired more readily when exposed to a tangible contingency relative to others commonly used in an FA (Study 1), and whether problem behavior known not to have a social function nevertheless emerged when exposed to tangible reinforcement (Study 2). Results indicated that inclusion of items in the tangible condition should be done with care and that selection should be based on those items typically found in the individual's environment.     

Brief assessment and treatment of multiple challenging behaviors

We conducted a brief assessment of multiple challenging behaviors in a 19‐year‐old man with developmental disabilities. The results of the brief assessment suggested that spitting and aggression were attention maintained, whereas property destruction was related to escape and tangibles. Spitting also appeared to have a sensory component. Based on the results of the brief assessment, three treatments were evaluated. For attention, treatment involved noncontingent attention and teaching an alternative attention‐gaining gesture. For the escape and tangible functions, opportunities to request tangibles were made contingent on task participation. The third treatment involved provision of leisure materials to provide an alternative source of sensory stimulation. All three treatments were associated with reduced challenging behavior and increased alternative behaviors. These findings suggest that a combination of brief assessment and treatment evaluation may be a useful component in the provision of behavioral support to individuals with developmental disabilities who present with multiple forms of challenging behaviors. Copyright © 2000 John Wiley & Sons, Ltd.     

Developing positive social-emotional behaviors: a study of training and generalization effects

Four handicapped children were taught four positive social-emotional behaviors: smiling, sharing, positive physical contacting, and verbal complimenting, using instructions, modelling, and praise. Rates of these behaviors were shown to increase in four trained subjects using a within-subject multiple-baseline experimental design. The generality of the behavior change was investigated by integrating three untrained subjects with the trained subjects in a setting free of adult-imposed contingencies and through a series of follow-up observations. Three trained subjects evidenced collateral increases in the generalization setting on at least one other behavior when training in smiling was conducted. One trained subject showed generalization session increases for each behavior when training was conducted to increase that behavior. All three untrained subjects demonstrated increased rates of smiling and sharing when interventions were conducted to increase those behaviors with the trained subjects. There was no appreciable generalization of verbal complimenting by either the trained or the untrained subjects. Both trained and untrained subjects generally maintained their increased rates of smiling, sharing, and positive physical contacting across four weeks of follow-up observations.     

A descriptive analysis of social consequences following problem behavior.

The social consequences delivered for problem behavior during functional analyses are presumed to represent common sources of reinforcement; Final acceptance however, the extent to which these consequences actually follow problem behavior in natural settings remains unclear. The purpose of this study was to determine whether access to attention, escape, or tangible items is frequently observed as a consequence of problem behavior under naturalistic conditions. Twenty‐seven adults who lived in a state residential facility and who exhibited self‐injurious behavior, aggression, or disruption participated. Observers recorded the occurrence of problem behavior by participants as well as a variety of consequences delivered by caregivers. Results indicated that attention was the most common consequence for problem behavior and that aggression was more likely to produce social consequences than were other forms of problem behavior.     

Evaluation of the rate of problem behavior maintained by different reinforcers across preference assessments

The rates of problem behavior maintained by different reinforcers were evaluated across 3 preference assessment formats (i.e., paired stimulus, multiple-stimulus without replacement, and free operant). The experimenter administered each assessment format 5 times in a random order for 7 children with developmental disabilities whose problem behavior was maintained by attention, tangible items, or escape. Results demonstrated different effects related to the occurrence of problem behavior, suggesting an interaction between function of problem behavior and assessment format. Implications for practitioners are discussed with respect to assessing preferences of individuals with developmental disabilities who exhibit problem behavior.     

Examining patterns suggestive of acquisition during functional analyses: A consecutive controlled series of 116 cases

The functional analysis approach described by Iwata et al. (1982/1994) has been used widely to determine the variables evoking and maintaining challenging behavior. However, one potential concern with conducting functional analyses is that repeated exposure to contingencies may induce a novel functional relation. To examine the likelihood of these potential iatrogenic effects, we evaluated social test conditions of the functional analysis for 116 participants and searched for patterns of responding indicative of acquisition. Patterns suggestive of acquisition occurred in 13.70% of tangible reinforcement conditions; however, the prevalence was only slightly lower in the attention condition (8.75%). Much lower prevalence was observed for the escape condition (2.13%). When grouped by quotient score, a pattern of acquisition was just as likely to be observed in the attention condition as in the tangible condition. Additionally, patterns indicative of acquisition were no more likely to be observed with participants who emitted automatically reinforced challenging behavior.     

A SELF-INSTRUCTIONAL PACKAGE FOR INCREASING ATTENDING BEHAVIOR IN EDUCABLE MENTALLY RETARDED CHILDREN

The purpose of this study was to develop a self-instructional package that would aid highly distractible retarded children in increasing their attending behavior in a training and two generalization (a one-to-one and a classroom) situations. Three untrained subjects were monitored for general comparison and social validation purposes. One of these control subjects was distractible and the other two (criterion comparison) were evaluated as not having attentional problems. A multiple baseline design was employed in which training was sequentially introduced across subjects. During training, the experimental subjects were taught through self-instruction to focus their attention and to cope with two tasks, math and printing. After learning the self-instructions the subjects were systematically and sequentially exposed to photo-slides of distracting situations, to audio-distractors composed of noisy lunchroom verbal peer interactions, and to in vivo distractors provided by kindergarten children playing with wooden blocks in the training setting. The entire training procedure was handled in a game-like context to maintain subject interest and to facilitate generalization. The results suggested that the training package produced direct and generalized changes in self-instructional behavior. In addition, a decrease in off-task behavior occurred during math, printing, and also during a phonics program in the one-to-one and classroom situations. However, reliable changes in academic task performance were not observed. Finally, no systematic changes on any of the dependent measures occurred for the three untrained subjects.     

Experimental analysis and treatment of multiply controlled problem behavior: a systematic replication and extension

We evaluated interventions designed to reduce multiply controlled problem behavior exhibited by a young boy with developmental disabilities, using a multiple baseline design. Each intervention was designed to address a specific social function of problem behavior. Results showed that the separate interventions were useful in reducing problem behavior, and terminal schedules were reached by way of schedule thinning (attention condition) and delays to reinforcement (tangible and escape conditions).     

A comparison of differential reinforcement and noncontingent reinforcement for the treatment of a child's multiply controlled problem behavior

Noncontingent reinforcement (NCR) and differential reinforcement of other behavior (DRO) with escape as the reinforcer were evaluated after an initial functional analysis indicated the problem behaviors exhibited by a 7 year old child were maintained by escape. When NCR and DRO did not decrease the problem behaviors, a second functional analysis was conducted and showed that the behaviors were maintained by attention and escape. DRO with attention and escape as reinforcers was compared to NCR with attention and escape as reinforcers for the treatment of the child's multiply controlled behavior problems. Results showed that DRO and NCR were both effective at reducing the problem behavior to low levels and increasing compliance. Copyright © 2003 John Wiley & Sons, Ltd.     

Some effects of praise during the escape condition of the functional analysis

Many researchers provide praise for complying with demands during the escape condition of the functional analysis (FA). However, praise may function as a reinforcer for some individuals which may reduce the aversiveness of task presentation or increase behavior that competes with problem behavior (e.g., compliance with demands). In general, this may result in lower or less stable levels of problem behavior and decrease the efficiency of the FA. Thus, the purpose of the current study was to evaluate some effects of praise on the rate of problem behavior and compliance during the escape condition of the FA in children diagnosed with autism spectrum disorder. We found that praise did not affect the rate of problem behavior but did increase compliance in three of five subjects. The results of the study and implications for the assessment of problem behavior are discussed.     

Enhancing the effects of extinction on attention-maintained behavior through noncontingent delivery of attention or stimuli identified via a competing stimulus assessment

Recent research has shown that the noncontingent delivery of competing stimuli can effectively reduce rates of destructive behavior maintained by social-positive reinforcement, even when the contingency for destructive behavior remains intact. It may be useful, therefore, to have a systematic means for predicting which reinforcers do and do not compete successfully with the reinforcer that is maintaining destructive behavior. In the present study, we conducted a brief competing stimulus assessment in which noncontingent access to a variety of tangible stimuli (one toy per trial) was superimposed on a fixed-ratio 1 schedule of attention for destructive behavior for individuals whose behavior was found to be reinforced by attention during a functional analysis. Tangible stimuli that resulted in the lowest rates of destructive behavior and highest percentages of engagement during the competing stimulus assessment were subsequently used in a noncontingent tangible items plus extinction treatment package and were compared to noncontingent attention plus extinction and extinction alone. Results indicated that both treatments resulted in greater reductions in the target behavior than did extinction alone and suggested that the competing stimulus assessment may be helpful in predicting stimuli that can enhance the effects of extinction when noncontingent attention is unavailable. DESCRIPTORS: Attention-maintained problem behavior, competing stimuli, extinction, functional analysis, noncontingent reinforcement     

EXPERIMENTAL ANALYSIS AND EXTINCTION OF SELF-INJURIOUS ESCAPE BEHAVIOR

Three studies are presented in which environmental correlates of self-injurious behavior were systematically examined and later used as the basis for treatment. In Study 1, 7 developmentally disabled subjects were exposed to a series of conditions designed to identify factors that maintain self-injurious behavior: attention contingent on self-injurious behavior (positive reinforcement), escape from or avoidance of demands contingent on self-injurious behavior (negative reinforcement), alone (automatic reinforcement), and play (control). Results of a multielement design showed that each subject's self-injurious behavior occurred more frequently in the demand condition, suggesting that the behavior served an avoidance or escape function. Six of the 7 subjects participated in Study 2. During educational sessions, “escape extinction” was applied as treatment for their self-injurious behavior in a multiple baseline across subjects design. Results showed noticeable reduction or elimination of self-injurious behavior for each subject and an increase in compliance with instructions in all subjects for whom compliance data were taken. The 7th subject, whose self-injurious behavior during Study 1 occurred in response to medical demands (i.e., physical examinations), participated in Study 3. Treatment was comprised of extinction, as in Study 2, plus reinforcement for tolerance of the examination procedure, and was evaluated in a multiple baseline across settings design. Results showed that the treatment was successful in eliminating self-injurious behavior and that its effects transferred across eight new therapists and three physicians. General implications for the design, interpretation, and uses of assessment studies are discussed.     

Functional analysis and intervention of perseverative speech in students with high-functioning autism and related neurodevelopmental disabilities

Although perseverative speech is a common characteristic of individuals with high-functioning neurodevelopmental disabilities, little is known about the operant functions of these verbalizations. We conducted analogue functional analyses of perseverative speech for 2 students using reinforcement contingencies that included alone, attention, control, escape, and tangible conditions. Results showed the following patterns: attention only (Charlotte) or multiply determined including an attention function (Paul). We then tested an intervention for perseverative speech maintained by social positive reinforcement that included differential reinforcement of alternative behavior and extinction of perseverative speech for 1 participant. The intervention reduced perseverative speech, but did not increase appropriate speech until we added a prompting component. We then replicated this three-component intervention with Paul. The results showed moderate to high decreases in levels of perseverative speech and increased appropriate verbalizations in both cases. The results systematically replicated the interventions of previous studies by adding a prompting component to the intervention.     

Comparisons of synthesized and individual reinforcement contingencies during functional analysis

Researchers typically modify individual functional analysis (FA) conditions after results are inconclusive (Hanley, Iwata, & McCord, 2003). Hanley, Jin, Vanselow, and Hanratty (2014) introduced a marked departure from this practice, using an interview‐informed synthesized contingency analysis (IISCA). In the test condition, they delivered multiple contingencies simultaneously (e.g., attention and escape) after each occurrence of problem behavior; in the control condition, they delivered those same reinforcers noncontingently and continuously. In the current investigation, we compared the results of the IISCA with a more traditional FA in which we evaluated each putative reinforcer individually. Four of 5 participants displayed destructive behavior that was sensitive to the individual contingencies evaluated in the traditional FA. By contrast, none of the participants showed a response pattern consistent with the assumption of the IISCA. We discuss the implications of these findings on the development of accurate and efficient functional analyses.     

The influence of therapist attention on self-injury during a tangible condition

This study investigated the effects of therapist attention on the self-injurious behavior (SIB) of a 6-year-old girl with developmental disabilities. After results of a functional analysis indicated that SIB was maintained by attention and tangible reinforcement, tangible conditions with and without contingent verbal attention were compared. Results suggested that the inclusion of verbal attention in a tangible condition may confound functional analysis outcomes for behavior that is maintained by attention.