An experimental demonstration of AAB renewal in children with autism spectrum disorder

Operant renewal is a return of extinguished behavior due to changes in contextual stimuli that control the occurrence or nonoccurrence of a response. Well‐established in classical conditioning and operant research, renewal presents itself in three forms—ABA, ABC, and AAB—and poses threats to treatment maintenance where extinction procedures are utilized. As AAB renewal may be less likely to occur than ABA or ABC renewal, the current study sought to determine if AAB renewal would occur with three participants with Autism Spectrum Disorder who were taught a simple lever pull response. Results showed that lever pulls increased for two of three participants when we introduced novel stimuli (i.e., a light and a buzzer) to alter the contextual environment after extinction. These findings suggest that AAB renewal may account for some instances of response recovery after extinction and that the procedure of this study may be beneficial to the further study of renewal and the variables that affect its occurrence within a translational model.     

A translational evaluation of renewal of inappropriate mealtime behavior

The term renewal describes the recurrence of previously extinguished behavior that occurs when the intervention context changes. Renewal has important clinical relevance as a paradigm for studying treatment relapse because context changes are necessary for generalization and maintenance of most intervention outcomes. The effects of context changes are particularly important during intervention for pediatric feeding disorders because children eat in a variety of contexts, and extinction is an empirically supported and often necessary intervention. Therefore, we used an ABA arrangement to test for renewal during intervention with 3 children diagnosed with a feeding disorder. The A phase was functional reinforcement of inappropriate mealtime behavior in a simulated home setting with the child's caregiver as feeder, B was function‐based extinction in a standard clinic setting with a therapist as feeder, and the return to the A phase was function‐based extinction in a simulated home setting with caregiver as feeder. Returning to Context A resulted in renewal of inappropriate mealtime behavior across children, despite the caregivers' continued implementation of function‐based extinction with high levels of integrity.     

Further evaluation of a nonsequential approach to studying operant renewal

Basic‐laboratory assessments of renewal may inform clinical efforts to maintain reduction of severe destructive behavior when clients transition between contexts. The contextual changes arranged during standard renewal procedures, however, do not necessarily align with those that clients experience during outpatient therapy. More specifically, clients transition between clinical (associated with extinction for target behavior) and home/community (associated with reinforcement for target behavior) contexts during outpatient treatment. Standard renewal assessments do not incorporate these contextual alternations during treatment. The present experiment aimed to directly compare renewal of rats' lever pressing following a standard (“sequential”) ABA renewal procedure (i.e., baseline in Context A, extinction in Context B, renewal test in Context A) and a “nonsequential” renewal assessment wherein treatment consisted of daily alternation between Context A (associated with reinforcement for lever pressing) and Context B (associated with extinction). Lever pressing renewed to a greater extent for rats in the Nonsequential group than for rats in the Sequential group, suggesting the contextual changes that clients experience during outpatient treatment for severe destructive behavior may be a variable that is important to consider in translational research on renewal. Potential implications of these findings for basic and clinical research on renewal are discussed.     

Renewal during functional communication training

Functional communication training (FCT) is one of the most commonly prescribed interventions for the treatment of severe destructive behavior exhibited by individuals with intellectual disabilities. Although highly effective, FCT has been shown to fail in some cases when treatment is introduced into the child's typical environment. Basic and translational research on renewal provides a model for studying the relapse of destructive behavior following successful response to treatment in clinic settings using FCT. In the present study, we evaluated whether relapse of destructive behavior could be attributed to the discriminative control of the home context, which was historically correlated with reinforcement for destructive behavior. We implemented baseline contingencies in the home setting with caregivers acting as interventionists (i.e., Context A). We then implemented FCT in a treatment clinic with trained therapists (i.e., Context B). Finally, we introduced FCT in the home setting with caregivers implementing the treatment procedures (i.e., return to Context A). For three of four participants we observed the relapse of destructive behavior consistent with operant renewal. We discuss the implications of these findings with respect to strategies designed to promote generalization of FCT across settings during the treatment of severe destructive behavior.     

Operant renewal of desirable behavior in a simulated workplace: A translational model

Organizational settings are replete with changing stimulus contexts and contingencies, which makes relapse a particularly relevant framework for understanding the ways in which controlling stimuli influence employee responding. The purpose of the current study was to develop a translational model to assess renewal of desirable behavior in a simulated workplace with neurotypical adults. Experiment 1 assessed renewal of desirable behavior using a computerized check processing task. Experiment 2 extended the findings and the translational utility of the experimental arrangement to implementation of a behavior-analytic teaching procedure. Results across both experiments demonstrated renewal of desirable behavior. Overall, the current methodology and findings extend the human operant literature on renewal and demonstrate a translational model that brings together operant renewal and organizational behavior management.     

Investigations of operant ABA renewal during differential reinforcement

Operant renewal is a form of relapse in which a previously extinguished response recurs due to a change in context. We designed two experiments to examine the impact of differential reinforcement of alternative behavior on ABA renewal in a translational model of relapse with 12 children. We compared levels of renewal in two 3-phase arrangements. In one arrangement, we reinforced target responding in Context A, extinguished responding in Context B, and returned to Context A while continuing to implement extinction. In a second arrangement, an alternative response produced reinforcement in Context B and during the return to Context A. Results across the 2 experiments indicated 3 general findings. First, extinction plus differential reinforcement disrupted target behavior more consistently in Context B relative to extinction alone. Second, renewal tended to be greater and more persistent during extinction alone relative to extinction plus differential reinforcement. Third, the renewal effect appeared to depend on whether the alternative response had a history of extinction in Context A. We discuss methodological implications for the treatment of severe destructive behavior.     

In Pursuit of Generalization: An Updated Review

Stokes and Osnes (1989) outlined three principles to facilitate the generalization and maintenance of therapeutic gains. Use of functional contingencies, training diversely, and incorporating functional mediators were recommended. Our review, with most illustrations from studies of youth, updates Stokes and Osnes’s original paper with a focus on evidence-based strategies to increase generalization of therapeutic gains across settings, stimuli, and time. Research since 1989 indicates that training for generalization by increasing the frequency of naturally occurring reinforcers for positive behaviors, and altering maladaptive contingencies that inadvertently reinforce problem behaviors, are associated with favorable treatment outcomes. Training diversely by practicing therapy skills across contexts and in response to varying stimuli is also implicated in clinical outcomes for internalizing, externalizing, and neurodevelopmental disorders. Preliminary research recommends the use of internal (e.g., emotion identification) and external (e.g., coping cards) functional mediators to prompt effective coping in session and at home. Strategies for increasing generalization, including the use of technology, are examined and future research directions are identified.     

Conducting extinction in multiple contexts does not necessarily attenuate the renewal of shock expectancy in a fear-conditioning procedure with humans

The renewal of Pavlovian-conditioned responses may provide a model for the relapse of fear following extinction-based treatments for anxiety disorders. Renewal can be observed if conditional stimulus (CS) and unconditional stimulus (US) pairings are given in one context, extinction trials of CS presentations in a second context, prior to test trials of CS presentations in the original acquisition context (ABA renewal). We examined ABA renewal in humans by using a fear-conditioning procedure with an unpleasant shock US. A renewal of rated shock expectancy was demonstrated with this procedure. Conducting extinction treatment in multiple contexts was expected to attenuate the renewal effect. However, the renewal of shock expectancy persisted when extinction treatment was given across three or five different contexts. With the current renewal design, learning task, and measure of conditioned behaviour, extinction treatment does not appear to readily generalise to the test context. The use of multiple extinction treatments in a clinical setting may not necessarily reduce the likelihood of relapse via a renewal effect.     

Unpaired shocks during extinction weaken the contextual renewal of a conditioned discrimination

Extinction is generally more fragile than conditioning, as illustrated by the contextual renewal effect. The traditional extinction procedure entails isolated presentations of the conditioned stimulus. Extinction may be boosted by adding isolated presentations of the unconditioned stimulus, as this should augment breaking the contingency between the two stimuli. In a human conditioning experiment with on-line expectancy ratings and electrodermal responding as dependent variables, 32 participants were differentially conditioned to two neutral figures using electric shock. After a change of context, one group received normal extinction treatment whereas another group received explicitly unpaired presentations of the figures and shock. At test, the two figures were presented in the original context again. For both measures, only the group that received normal extinction showed renewal of the conditioned discrimination. These results suggest that unpaired shocks during extinction strengthen the extinction learning.     

Contextual-specificity of short-delay extinction in humans: renewal of fear-potentiated startle in a virtual environment

A recent fear-potentiated startle study in rodents suggested that extinction was not context dependent when extinction was conducted after a short delay following acquisition, suggesting that extinction can lead to erasure of fear learning in some circumstances. The main objective of this study was to attempt to replicate these findings in humans by examining the context specificity of short-delay extinction in an ABA renewal procedure using virtual reality environments. A second objective was to examine whether renewal, if any, would be influenced by context conditioning. Subjects underwent differential aversive conditioning in virtual context A, which was immediately followed by extinction in virtual context B. Extinction was followed by tests of renewal in context A and B, with the order counterbalanced across subjects. Results showed that extinction was context dependent. Evidence for renewal was established using fear-potentiated startle as well as skin conductance and fear ratings. In addition, although contextual anxiety was greater in the acquisition context than in the extinction context during renewal, as assessed with startle, context conditioning did not influence the renewal effect. These data do not support the view that extinction conducted shortly after acquisition is context independent. Hence, they do not provide evidence that extinction can lead to erasure of a fear memory established via Pavlovian conditioning.     

Behavioral contrast and generalization across settings in the treatment of autistic children

Previous research on the generalization of treatment gains across settings has typically focused on the question of whether generalization occurs or does not occur. However, the experimental literature suggests another possibility: that behavioral contrast may occur in extra-therapy settings if the reinforcement procedures in the therapy setting are highly discriminable from those in other settings. Therefore, this investigation was designed to systematically assess whether: (1) a highly discriminable treatment procedure in one setting would produce a behavioral contrast effect in other unmanipulated settings; and (2) such contrast-like trends could be eliminated if initially different reinforcement procedures in two settings were subsequently made similar. The results for the eight autistic children who participated in this investigation showed that: (1) When very different reinforcement procedures (primary rewards or punishment in therapy settings, and no rewards or punishment in extra-therapy settings) were in effect, the children showed contrast-like behavior changes in the untreated extra-therapy settings; and (2) such trends in responding could be eliminated, resulting in generalization of treatment gains, if the reinforcement procedures were subsequently made relatively similar in the two settings, even if the procedures consisted essentially of noncontingent reinforcement.     

All we need is a cue to remember: the effect of an extinction cue on renewal

In the present study, it was investigated by employing a human fear conditioning paradigm whether an extinction retrieval cue can attenuate renewal of conditioned responding after an extinction treatment procedure, and if so, what the precise role of such an extinction cue comprises. It was hypothesized that such a cue can attenuate renewal and would function as a safety signal capable of directly inhibiting the expectancy of an aversive outcome and conditioned skin conductance responding to a conditioned stimulus. The results demonstrated that the extinguished expectancy of an aversive outcome was renewed when the CS was presented outside the extinction context and that an extinction cue attenuated this effect. This extinction cue, however, only transferred its inhibitory properties to other, non-extinguished stimuli when there was no contextual switch. This safety signal function was not observed after a switch in context. Possible functions of the extinction cue and its application in extinction-based exposure treatments are discussed.     

Learning and memory in conditioned fear extinction: effects of D-cycloserine

This review addresses the effects of the cognitive enhancer D-cycloserine (DCS) on the memory processes that occur in conditioned fear extinction, which is the experimental model for exposure techniques to reduce clinical anxiety. All reported rat studies show an enhanced fear extinction effect when DCS is administered acutely before or shortly after extinction training. DCS also promotes the generalization of this fear extinction effect. In addition, DCS reduces some forms of relapse (reduced reinstatement, reduced spontaneous recovery), but not others (contextual renewal, rapid reacquisition). It is argued that this pattern of results is best explained by assuming that DCS promotes extinction learning to the background context, resulting in enhanced contextual inhibition. Four human studies have produced mixed results, but some methodological issues complicate the reported failures. It is concluded that DCS is a promising tool as an adjunct to extinction techniques in exposure treatment, but that more pre-clinical and clinical research is needed to fully characterize its behavioral consequences.     

Extensive extinction in multiple contexts eliminates the renewal of conditioned fear in rats

Two studies examined whether nonreinforcement of a stimulus in multiple contexts, instead of a single context, would decrease renewal of conditioned fear in rats (as assessed by conditioned suppression of lever pressing). In Experiment 1, renewal was measured after 36 nonreinforced CS trials delivered during six extinction sessions in a single context or two extinction sessions in each of three different contexts. The number of extinction contexts did not have an effect on renewal. In Experiment 2, groups received either 36 or 144 nonreinforced CS trials during six or twenty-four extinction sessions in a single context or three different contexts. Again, renewal was not influenced by the number of extinction contexts when only 36 trials were given. However, when 144 trials were used, renewal was completely eliminated when extinction was divided between 3 contexts, but was not weakened when the sessions took place in a single context. The results suggest that the use of multiple treatment settings in exposure-based therapies is only likely to reduce relapse if a sufficient number of sessions are provided in each of the treatment settings.     

Electrolytic lesions of the dorsal hippocampus disrupt renewal of conditional fear after extinction

There is a growing body of evidence that the hippocampus is critical for context-dependent memory retrieval. In the present study, we used Pavlovian fear conditioning in rats to examine the role of the dorsal hippocampus (DH) in the context-specific expression of fear memory after extinction (i.e., renewal). Pre-training electrolytic lesions of the DH blunted the expression of conditional freezing to an auditory conditional stimulus (CS), but did not affect the acquisition of extinction to that CS. In contrast, DH lesions impaired the context-specific expression of extinction, eliminating the renewal of fear normally observed to a CS presented outside of the extinction context. Post-extinction DH lesions also eliminated the context dependence of fear extinction. These results are consistent with those using pharmacological inactivation of the DH and suggest that the DH is required for using contextual stimuli to regulate the expression of fear to a Pavlovian CS after extinction.     

Factors regulating the effects of hippocampal inactivation on renewal of conditional fear after extinction

After extinction of fear to a Pavlovian conditional stimulus (CS), contextual stimuli come to regulate the expression of fear to that CS. There is growing evidence that the context dependence of memory retrieval after extinction involves the hippocampus. In the present experiment, we examine whether hippocampal involvement in memory retrieval after extinction is related to the history of CS presentations in the context used for retrieval testing. We used infusions of muscimol to inactivate the dorsal hippocampus (DH) during postextinction retrieval tests that were conducted in contexts that differed in their history of CS presentations in that context. We found that DH inactivation affected the context-dependent retrieval of extinction (i.e., renewal) when testing occurred in a context that had no history of CS exposure, but not in a context that reliably predicted the CS. These results are discussed in terms of theories regarding the role of the hippocampus in contextual memory retrieval.     

Constraints on enhanced extinction resulting from extinction treatment in the presence of an added excitor

Three Pavlovian fear conditioning experiments with rats as subjects explored the effect of extinction in the presence of a concurrent excitor. Our aim was to explore this particular treatment, documented in previous studies to deepen extinction, with novel control groups to shed light on the processes involved in extinction. Relative to subjects extinguished on the target CS alone, Experiments 1 and 2 found across a range of parameters that any appreciable effect of facilitated extinction due to the concurrent excitor was submerged by generalization decrement going from extinction to testing. In Experiment 3 we used different durations for the target and concurrent stimuli in order to discourage configuring and an ABC renewal design to increase sensitivity, and observed diminished renewal resulting from extinction in the presence of a second excitor. Our findings suggest that there are distinct limits to the observation of enhanced extinction in the presence of an excitor and identifies some of the sources of these limitations.     

Re-exposure to reinforcement in Context A during treatment in Context B reduces ABC renewal

Previous work from our laboratory showed that intermittently re-exposing rats to reinforcement for lever pressing in a training (A) context, while eliminating lever pressing in a second (B) context, increased ABA renewal of lever pressing relative to rats that experienced only Context B during response elimination. In the current study, we replicated these procedures while assessing renewal in the presence of a novel context (i.e., ABC renewal). Unlike the findings described above, renewal was reduced in the group that experienced re-exposure to Context A during lever-press elimination relative to rats that experienced only Context B. These findings suggest that alternating between contexts associated with reinforcement and extinction during treatment reduces the probability that organisms will respond in novel contexts. These outcomes may be the result of discrimination and/or generalization processes. Moreover, this training procedure may offer a potential mitigation strategy for ABC renewal.     

GENERALIZATION AND MANTENANCE OF TREATMENT GAINS OF BEHAVIORALLY HANDICAPPED STUDENTS FROM RESOURCE ROOMS TO REGULAR CLASSROOMS USING SELF-EVALUATION PROCEDURES

This study provided six behaviorally handicapped elementary school students with a short-term resource treatment to bring their behavior under the control of a combination of treatment procedures emphasizing self-evaluation. Once acceptable levels of appropriate behavior were maintained with only minimal external reinforcement and students were accurately self-evaluating their own work and behavior, generalization and maintenance of behavior gains were sought by introducing a reduced form of the self-evaluation procedures in the students' regular classrooms. A multiple baseline across pairs of subjects design was used to examine individual student's behavior. Analysis of the results of the study indicated that students transferred and maintained high levels of appropriate classroom behavior in their regular classrooms, once self-evaluation procedures were extended into those settings. For four of the six students, all extra-training components were faded. Only two students required a modified form of the original intervention to maintain behavior gains in their regular classrooms.     

ASSESSING AND PROGRAMMING GENERALIZED BEHAVIORAL REDUCTION ACROSS MULTIPLE STIMULUS PARAMETERS

Generalization across three stimulus parameters was examined for 5 individuals whose self-injurious behavior was maintained by escape from task demands. Prior to treatment, three stimulus parameters (therapist, setting, and demands) were systematically varied across baseline sessions. These variables were held constant during treatment, which consisted of escape extinction. When treatment was completed, three novel stimulus parameters were probed. If the rate of self-injury was high during this probe, treatment was reimplemented with one new stimulus parameter (the other two were the same as in the original treatment condition). Following this second treatment, another probe with three novel stimuli was conducted. If the rate of self-injury was again high, treatment was implemented again while a second stimulus parameter was changed. This sequence continued until generalization was observed across the three parameters. Results showed idiosyncratic differences in generalization. The behavior of 2 subjects showed complete generalization during the first novel probe. A 3rd subject's behavior showed generalization following treatment across two stimulus parameters (setting and therapist). The behavior of the 2 remaining subjects showed a complete lack of generalization across the three parameters; both subjects required training for novelty by randomly varying the stimulus parameters for a substantial number of sessions.