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.     

Differential reinforcement-of-low-rate procedures: A systematic replication with students with autism spectrum disorder

Becraft, Borrero, Davis, Mendres-Smith, and Castillo (2018) studied the effects of two different types of DRL schedules (full session and spaced responding) under 2 sets of stimulus conditions (with and without signals). Reduced rates of responding maintained under both types of DRL schedules, when signals were included. The present study represents a replication of procedures by Becraft et al. involving learners with autism spectrum disorder (ASD). The results replicated those of Becraft et al. in that responding in both full-session and spaced-responding DRL schedules was low, but not eliminated. These results provide preliminary evidence to suggest that children with ASD are responsive to signals in DRL arrangements, which may set the stage for evaluation of signaled DRL arrangements for socially significant response forms.     

An extension of commonly used toilet-training procedures to children with autism spectrum disorder

The current study evaluated a toilet-training treatment package described by Greer et al. (2016) with children diagnosed with autism spectrum disorder (ASD). Most of the current research on toilet-training interventions for children with ASD are replications and modifications of Azrin and Foxx (1971) or (more recently) LeBlanc et al. (2005). However, these procedures are composed of components that are not included in studies with typically developing (TD) children. For example, Greer et al. evaluated the effectiveness of three typical components within a toilet-training package, mostly with TD participants: a 30-min sit schedule, placing participants in underwear, and differential reinforcement. The primary purpose of the current study was to replicate and extend the treatment package described by Greer et al. to children with ASD. A secondary purpose was to evaluate modifications necessary for individualized toilet training when the commonly used components were ineffective. The results of Greer et al. were replicated for 11 participants with ASD in the current study, suggesting that intensive toileting interventions (e.g., interventions requiring overcorrection, reprimands, and dense sit schedules) may only be necessary for a subset of individuals with ASD.     

Implementing a differential reinforcement of low rates schedule to alter vocal stereotypy and task engagement in two adolescents with autism spectrum disorder

Vocal stereotypy (VS) is often observed in individuals with autism spectrum disorder (ASD) which at high rates can interfere with socialization or functioning in structured settings. There are multiple effective interventions available; yet, many procedures target the complete omission of the behavior or are only assessed at short intervals, making it unclear how they will generalize in applied settings. One intervention yet to be assessed as an individual intervention for automatically reinforced VS is differential reinforcement of low rates of behavior (DRL). In the present study, a functional analysis determined that the VS of two female adolescents with ASD was maintained by automatic reinforcement. A DRL procedure was implemented which incorporated: (a) a specified interval for reinforcement; (b) the behavioral expectations; (c) the permissible instances of VS within the interval; (d) learner feedback; and (e) the reset/non-reset aspect of the schedule. As the targeted behavior decreased across sessions, the DRL interval was systematically increased in order to thin out the schedule of reinforcement. The intervention reduced VS and increased untargeted task engagement for both participants. Applied and theoretical implications of the study as well as social validity, limitations, and future research are discussed.     

Caregiver-implemented toilet training procedures for children with autism spectrum disorder

Children with Autism Spectrum Disorder often exhibit deficits in daily living skills, including toileting skills. Previous studies have evaluated components of common toilet training practices, including differential reinforcement, sit schedules, fluid loading, underwear, and wet alarms. The purpose of this study was to replicate and extend previous work by delivering all coaching remotely. Three caregiver-child dyads participated in this study. A researcher coached caregivers on the implementation of the protocol using a modified behavioral skills training approach via telehealth. Caregivers submitted daily toileting data and weekly audio recordings for treatment integrity checks. The sit schedule fading was individualized to meet the needs and preferences of each family. All caregivers implemented the protocol with high integrity. Two participants met the mastery criteria at the 90-min sit schedule and maintained performance at the 1- and 6-week maintenance follow up probes. The third participant, despite an interruption of treatment, also reached mastery.     

Temporal regulation of children with autism spectrum disorder exposed to a differential-reinforcement-of low-rates schedule

This study investigated temporal adjustment of children with autism spectrum disorder under a differential-reinforcement-of-low-rates (DRL) schedule. Sixteen participants, aged 3.2 to 7 years, were exposed to two conditions, DRL 5 s and DRL 20 s. Children participated in 7 sessions in each condition, except for 1 participant who attained the adjustment criteria in the DRL 5-s schedule. Temporal adjustment was measured with the proportion of reinforced interresponse times (IRTs) and the mean IRT. The operant response was a press on a touch screen and the reinforcers were cartoons. IQ and receptive language were measured prior to the DRL sessions. Results showed that the mean proportion of reinforced IRTs was slightly higher in the DRL 5-s schedule. The mean IRT was above the IRT requirement in both conditions. However, substantial individual variability was observed. Children with higher IQ and receptive language scores presented a greater proportion of reinforced IRTs in both conditions. Moreover, participants who adjusted their responses to the DRL 5-s schedule were more likely to adjust responding to the DRL 20-s schedule. This suggests that some children might be more sensitive to reinforcement contingencies than others. This study points at future research in the field of timing in children.     

Effects of a problem-solving strategy on the independent completion of vocational tasks by adolescents with autism spectrum disorder

Individuals with autism spectrum disorder (ASD) often have few employment opportunities and a lower job quality than individuals of typical development. Social deficits and lack of independence may contribute to underemployment and unemployment of individuals with ASD. The ability to solve problems might ameliorate some of these barriers. We taught four adolescents with ASD a problem-solving strategy (i.e., use of a textual activity schedule) to assist with independent completion of vocational tasks in the face of three types of problems (e.g., missing or broken items) and nonproblem situations. Following introduction of the problem-solving strategy, all four participants independently completed the tasks when a problem was presented and responding generalized to untaught vocational tasks.     

A comparison of fixed momentary differential reinforcement of other behavior to variable momentary differential reinforcement of other behavior to reduce challenging behavior

Differential reinforcement of other behavior (DRO) is commonly used to reduce behavioral excesses. Momentary DRO schedules involve delivery of reinforcement contingent upon the absence of the target behavior at a given moment. Two variations of momentary DRO exist: fixed-momentary (FM) DRO and variable-momentary (VM) DRO. In the current study, we directly compared FM-DRO and VM-DRO schedules to reduce challenging behavior maintained by automatic reinforcement exhibited by four children with autism spectrum disorder. The results suggest that both the DRO schedules were equally effective to reduce challenging behavior. A social validity measure showed that most caregivers rated the VM-DRO as a preferred schedule and noted the potential for FM-DRO schedule to become more discriminable over time, which could reduce its effectiveness. However, most caregivers also commented that the FM-DRO schedule was easier to implement.     

An evaluation of a multi-component intervention for loud speech among children with autism spectrum disorder

Idiosyncratic patterns of speech are common among individuals with autism spectrum disorder (ASD) and can greatly affect their ability to participate successfully in various social and educational settings. We evaluated a treatment package with three children with ASD and a history of loud speech. A multiple baseline across participants design and a decibel meter application were used to evaluate whether the multi-component intervention (i.e., a rule, differential reinforcement, and in vivo feedback) would effectively reduce participants' rates of loud speech. The results showed that the intervention decreased rates of loud speech for all participants. Results are discussed in terms of (a) their extension of the literature regarding speech prosody in ASD by demonstrating an effective intervention for loud speech, (b) clinical implications, and (c) potential future research regarding this nuanced, yet crucial aspect of social communication, including appropriate methods for addressing loud speech in individuals with ASD.     

An alternative method of thinning reinforcer delivery during differential reinforcement

Differential reinforcement of alternative behavior (DRA) may result in rates of reinforcement that are impractical for caregivers to implement; therefore, recent research has examined methods for thinning reinforcer delivery during DRA. In this study, reinforcer delivery was thinned during DRA by restricting access to the participant's alternative response materials.     

Choice for reinforced behavioral variability in children with autism spectrum disorder

Although individuals with autism spectrum disorder (ASD) tend to behave repetitively, certain reinforcement contingencies (e.g., lag schedules) can be used to increase behavioral variability. In a lag schedule, reinforcers only follow responses that differ from recent responses. The present study was designed to promote variable play behavior in preschoolers with ASD interacting with playsets and figurines and to assess preference for variability and repetition contingencies. Data have shown a preference for variability in pigeons and college students, but this effect has not been explored in clinical populations. In this experiment, preschoolers with ASD were taught to discriminate between variability and repetition contingencies. Only play behaviors that met a lag schedule were reinforced in the presence of one color, and only repetitive behaviors were reinforced in the presence of another. After differential performance was established, participants experienced a concurrent chains schedule. Participants chose between the colors taught in training and then completed a play session with the selected contingency. One participant selected variability and repetition equally. The other participants showed a slight preference for variability. These results indicate that some individuals with ASD may play repetitively, not because they prefer repetition, but because they require additional teaching to play variably.     

Teaching children with autism spectrum disorder to tact olfactory stimuli

Research on tact acquisition by children with autism spectrum disorder (ASD) has often focused on teaching participants to tact visual stimuli. It is important to evaluate procedures for teaching tacts of nonvisual stimuli (e.g., olfactory, tactile). The purpose of the current study was to extend the literature on secondary target instruction and tact training by evaluating the effects of a discrete‐trial instruction procedure involving (a) echoic prompts, a constant prompt delay, and error correction for primary targets; (b) inclusion of secondary target stimuli in the consequent portion of learning trials; and (c) multiple exemplar training on the acquisition of item tacts of olfactory stimuli, emergence of category tacts of olfactory stimuli, generalization of category tacts, and emergence of category matching, with three children diagnosed with ASD. Results showed that all participants learned the item and category tacts following teaching, participants demonstrated generalization across category tacts, and category matching emerged for all participants.     

Comparing skill acquisition under varying onsets of differential reinforcement: A preliminary analysis

The purpose of the current study was to evaluate the effect of implementing differential reinforcement at different times relative to the onset of teaching new skills to learners with autism spectrum disorder. Specifically, we first determined the most efficient differential reinforcement arrangement for each participant. Using the most efficient arrangement, we evaluated if differential reinforcement from the immediate onset, early onset, or late onset is the most efficient for learners to acquire a new skill. Three children diagnosed with autism spectrum disorder who have a history of receiving intervention based on the principles of applied behavior analysis participated in this study. The immediate onset of differential reinforcement resulted in the most efficient instruction in 6 of 7 comparisons. The results are discussed in light of previous studies and suggestions for future research are provided.     

Use of non-directive therapy for adolescents with autism spectrum disorder: A systematic review

In this review, we systematically explored research on the use of non-directive therapies with adolescents (aged 11–18 years) with autism spectrum disorder (ASD). N = 12 studies were eligible for inclusion. The findings suggested four therapeutic components which were consistently present across all non-directive interventions and held similarities with play therapy principles: (a) collaboration between adolescent and therapist; (b) adolescent-led discussions; (c) reflection and reframing; and (d) encouragement and acceptance of the adolescent as they were. Therapeutic outcomes improved when the therapists had an understanding of ASD in order to tailor the intervention to the individual. Future primary research investigating the applicability of play therapy principles and limitations is discussed.     

Emergent control for play responses following instructive feedback for children with autism spectrum disorder

Play provides children learning opportunities in the natural environment to acquire communication skills. While working to establish skills that may lead to additional leisure and social opportunities of children with autism spectrum disorder (ASD), procedures need to be both effective and efficient. One way to increase efficiency of teaching is through the use of instructive feedback (IF). Therefore, the purpose of the current study is to systematically replicate and extend previous research by examining if play behaviors emerge when using IF to teach conceptually related primary (i.e., tacts) and secondary targets (i.e., play skills). The results of the present study extend previous research by demonstrating the effectiveness of teaching tacts to individuals with ASD, and that using IF during tact training can help promote the acquisition of play skills.     

An evaluation of two differential reinforcement procedures with escape extinction to treat food refusal

Consumption of solids and liquids occurs as a chain of behaviors that may include accepting, swallowing, and retaining the food or drink. In the current investigation, we evaluated the relative effectiveness of differential reinforcement of the first behavior in the chain (acceptance) versus differential reinforcement for the terminal behavior in the chain (mouth clean). Three children who had been diagnosed with a feeding disorder participated. Acceptance remained at zero when differential reinforcement contingencies were implemented for acceptance or mouth clean. Acceptance and mouth clean increased for all 3 participants once escape extinction was added to the differential reinforcement procedures, independent of whether reinforcement was provided for acceptance or for mouth clean. Maintenance was observed in 2 children when escape extinction was removed from the treatment package. The mechanism by which consumption increased is discussed in relation to positive and negative reinforcement contingencies.