Analyzing the multiple functions of stereotypical behavior for students with autism: implications for assessment and treatment

We studied behavioral functions associated with stereotypical responses for students with autism. In Study 1, analogue functional analyses (attention, demand, no-attention, and recreation conditions) were conducted for 5 students. Results suggested that stereotypy was multiply determined or occurred across all assessment conditions. For 2 students, stereotypy was associated with positive and negative reinforcement and the absence of environmental stimulation. For 2 other students, stereotypy occurred at high levels across all experimental conditions. For the 5th student, stereotypy was associated with negative reinforcement and the absence of environmental stimulation. In Study 2, the stereotypy of 1 student was further analyzed on a function-by-function basis. Within a concurrent-schedules procedure, alternative responses were taught to the student using functional communication training. The results of Study 2 showed that similar topographies of stereotypy, based on qualitatively different reinforcers, were reduced only when differential reinforcement contingencies for alternative forms of communication were implemented for specific response-reinforcer relations. Our results suggest that the causes of stereotypy for students with autism are complex and that the presumed association between response topography and behavioral function may be less important than previously realized.     

Effects of parent training on parent and child behavior using procedures based on functional analyses

We evaluated the effects of parent training for four children whose aberrant behaviors were maintained by social positive or negative reinforcement. Interventions were based on the behavioral function of the problem behavior. Child participants were four children (ages 3 to 5 years) who had developmental delays and exhibited significant aberrant behaviors (tantrums and aggression). The children's mothers were the parent participants. The children's behavior improved as a function of the parents' performance. Copyright © 2001 John Wiley & Sons, Ltd.     

Brief functional analysis and treatment of tantrums associated with transitions in preschool children

A brief functional analysis was used to examine the influence of termination of prechange activities and initiation of postchange activitieson tantrums exhibited by 2 preschool children. For 1 participant, tantrums were maintained by access to certain (pretransition) activities. For a 2nd participant, tantrums were maintained by avoidance of certain task initiations. Although advance notice of an upcoming transition was ineffective, differential reinforcement of other behavior plus extinction reduced tantrums for both participants.     

Use of a paired-stimulus demand analysis to evaluate demands for inclusion in functional analyses

Clinicians regularly use both indirect and direct assessments to identify preferred stimuli to include in control conditions and positive reinforcement test conditions in a functional analysis (FA). However, clinicians often rely on indirect assessment alone (e.g., caregiver report) to identify aversive stimuli to include in negative reinforcement test conditions. In this study, we evaluate a paired-stimulus demand analysis and validate assessment results via FA. Results indicate that, for all 4 participants, the demands selected least often evoked higher rates of destructive behavior than more frequently selected demands. We identified an escape function for all 4 participants in the escape–least selected (LS) condition (true positive finding) and for only 1 participant in the escape–most selected (MS) condition (false negative finding for 3 of 4 participants). These results support the utility of empirically deriving stimuli for inclusion in the negative reinforcement test condition of an FA to decrease the likelihood of false negative findings.     

A Preliminary Investigation of the Assessment and Treatment of Tantrums With Two Post-Institutionalized Romanian Adoptees

A functional analysis of tantrums was carried out with 2 children who were adopted from state-run Romanian orphanages. Tantrums included such behaviours as screaming, property destruction, self-injury and aggression. The functional analysis was conducted in an outpatient treatment unit and consisted of exposing the child and mother to a number of specific social contexts that were designed to identify social consequences maintaining tantrums. These social contexts were alternated rapidly in a multi-element design fashion during the outpatient assessment to demonstrate experimental control. Results indicated that tantrums were maintained by attention from the mother when the mother's attention was diverted away from the child (i.e. when the mother was interacting with another person). A treatment plan, which consisted of the mother delivering frequent but brief attention statements to the child during diverted attention contexts eliminated tantrums during the assessment. Follow-up evaluations for up to 6 months indicated that parents used the treatment plan and that tantrums were no longer a difficulty with these children.     

THE RELATIVE INFLUENCE OF MOTIVATING OPERATIONS FOR POSITIVE AND NEGATIVE REINFORCEMENT ON PROBLEM BEHAVIOR DURING DEMANDS

Research has demonstrated the feasibility of using positive reinforcement to treat problem behavior maintained by negative reinforcement. This line of research was extended in the current study. A functional analysis (FA) was conducted that suggested problem behavior was maintained by positive and negative reinforcement. Following the FA, a demand analysis was conducted with three demand conditions: one that replicated the demand condition from the FA, one that included presession exposure to a preferred item, and another that included presession exposure to preferred items and access to those items during breaks from demands. Although problem behavior occurred in all three demand conditions, within session analyses showed that problem behavior ceased during breaks from demands only when they included access to preferred items. This finding suggests that the motivating operation responsible for evoking problem behavior did not decrease when only a break was provided. Subsequent functional communication training and treatment analysis showed that treatments based on positive reinforcement were effective at reducing problem behavior, but those based on a negative reinforcement hypothesis were not. Copyright © 2013 John Wiley & Sons, Ltd.     

Reduction of dangerously aggressive behavior in a severely retarded resident through a combination of positive reinforcement procedures

A severely retarded resident was released from a timeout chair only occasionally for brief periods of time. Under the timeout contingency alone, the subject made a choke response within minutes of being released. Attention, such as hugs, smiles, and candy was then increased, first by providing it non-contingently and continuously as long as there were no aggressive responses and then, by making it contingent upon incompatible responses. Under conditions of timeout plus increased attention, choking decreased aburptly. Grabbing responses, which increased when choking was reduced, were also reduced under conditions of timeout plus attention. Unrestrained time was gradually increased and all extra attention, i.e., more scheduled attention than provided other residents, was gradually withdrawn. When the resident was unrestrained all day and all extra attention was withdrawn, grabs and, to a lesser extent, chokes increased. Both were again reduced to a manageable level by scheduling several brief periods of attention each day. Hence, the program resulted in quick reductions that endured when the program was largely withdrawn. The changes in aggressive responding as a function of the presence and absence of extra attention suggest the importance of extra "positive reinforcement" in programs based upon positive reinforcement procedures and dealing with retarded residents for whom positive reinforcers may be scarce.     

THE DIFFERENTIAL EFFECTS OF TEACHER AND PEER ATTENTION ON THE DISRUPTIVE CLASSROOM BEHAVIOR OF THREE CHILDREN WITH A DIAGNOSIS OF ATTENTION DEFICIT HYPERACTIVITY DISORDER

We conducted functional analyses of classroom disruption during contingent teacher and peer attention conditions for 3 children with attention deficit hyperactivity disorder. Attention provided by peer confederates appeared to function as a distinct form of positive reinforcement for all 3 children.     

AN EVALUATION OF THE INTERACTION BETWEEN QUALITY OF ATTENTION AND NEGATIVE REINFORCEMENT WITH CHILDREN WHO DISPLAY ESCAPE‐MAINTAINED PROBLEM BEHAVIOR

The choice‐making behavior of 2 typically developing children who engaged in problem behavior maintained by negative reinforcement was evaluated within a concurrent‐operants assessment that varied the quality of attention across free‐play and demand conditions. The results demonstrated that it was possible to bias responding towards academic demands for both participants by providing high‐quality attention, despite the continuous availability of negative reinforcement. The current study extended brief clinical methods with typically developing children and demonstrated how different qualities of attention provided across concurrent schedules could bias responding.     

REDUCING BEHAVIOR PROBLEMS THROUGH FUNCTIONAL COMMUNICATION TRAINING

It is generally agreed that serious misbehavior in children should be replaced with socially appropriate behaviors, but few guidelines exist with respect to choosing replacement behaviors. We address this issue in two experiments. In Experiment 1, we developed an assessment method for identifying situations in which behavior problems, including aggression, tantrums, and self-injury, were most likely to occur. Results demonstrated that both low level of adult attention and high level of task difficulty were discriminative for misbehavior. In Experiment 2, the assessment data were used to select replacements for misbehavior. Specifically, children were taught to solicit attention or assistance or both verbally from adults. This treatment, which involvedthe differential reinforcement of functional communication, produced replicable suppression of behavior problems across four developmentally disabled children. The results were consistent with an hypothesis stating that some child behavior problems may be viewed as a nonverbal means of communication. According to this hypothesis, behavior problems and verbal communicative acts, though differing in form, may be equivalent in function. Therefore, strengtheningthe latter should weakenthe former.     

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.     

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.     

Preliminary comparison of two negative reinforcement schedules to reduce self-injury

This study compared the effectiveness of differential negative reinforcement of other behavior (DNRO) and alternative behavior (DNRA) for reducing self-injurious tantrums maintained by escape from demands in a 4-year-old girl with severe retardation. Both DNRA and DNRO reduced self-injury and increased independent performance of two tasks (tooth brushing and bathing); however, improvement on both measures was greater with the DNRA intervention.     

Recent advances in the modification of establishing operations to reduce aberrant behavior

The term establishing operation (EO) refers to an event that alters the reinforcement effects of a particular stimulus. Although EOs have received more attention in the basic, non-human literature, reports of EO manipulations in the treatment of aberrant behavior are increasingly appearing. We discuss EO interventions for behaviors maintained by social positive reinforcement (e.g., noncontingent reinforcement), social negative reinforcement (e.g., noncontingent escape, curricular revision, demand fading), and automatic reinforcement (e.g., environmental enrichment, noncontingent stimulation, reduced aversive stimulation). Suggestions for future research concerning both specific EO interventions and the general manipulation of EOs as a behavior-change technique are provided. © 1998 John Wiley & Sons, Ltd.     

Concurrent schedules of positive and negative reinforcement: differential-impact and differential-outcomes hypotheses

Considerable evidence from outside of operant psychology suggests that aversive events exert greater influence over behavior than equal-sized positive-reinforcement events. Operant theory is largely moot on this point, and most operant research is uninformative because of a scaling problem that prevents aversive events and those based on positive reinforcement from being directly compared. In the present investigation, humans' mouse-click responses were maintained on similarly structured, concurrent schedules of positive (money gain) and negative (avoidance of money loss) reinforcement. Because gains and losses were of equal magnitude, according to the analytical conventions of the generalized matching law, bias (log b (double dagger) 0) would indicate differential impact by one type of consequence; however, no systematic bias was observed. Further research is needed to reconcile this outcome with apparently robust findings in other literatures of superior behavior control by aversive events. In an incidental finding, the linear function relating log behavior ratio and log reinforcement ratio was steeper for concurrent negative and positive reinforcement than for control conditions involving concurrent positive reinforcement. This may represent the first empirical confirmation of a free-operant differential-outcomes effect predicted by contingency-discriminability theories of choice.     

EFFECTS OF PRESESSION ATTENTION ON THE FREQUENCY OF ATTENTION-MAINTAINED BEHAVIOR

The effect of prior attention was systematically manipulated to study its influence on rates of yelling and head hitting, both maintained by positive reinforcement in the form of attention. Higher levels of head hitting occurred in analogue attention conditions when the person was deprived of attention (no social interactions for 1 hr) prior to the analysis in comparison to when the person received high levels of attention (attention delivered on a fixed-time 30-s schedule for 1 hr) prior to the analysis.     

An examination of response covariation in the behavioral treatment of identical twin boys with multiple behavioral disorders

This study examined the response covariation phenomenon in the behavioral treatment of a noncompliant, nonattentive child with autism in a school setting. The treatment consisted of reinforcement for compliance and attention. Results showed that the reinforcement of compliance was associated with increased levels of compliance, attending, and directed verbalizations. Sequential scatterplot data analysis suggested that compliance and attending directly covaried as a function of the reinforcement for compliance contingency. The results of this multiple treatment study suggests that reinforcement of compliance had the broadest positive effect for the subject since positive collateral changes were observed in attending and directed verbalizations when compliance was reinforced.     

The effect of reinforcement and verbal rehearsal on selective attention in learning-disabled children

A central-incidental task of selective attention was administered to 100 learning-disabled boys — 48 younger children (81/2–101/2 years) and 52 older children (101/2–121/2 years). Subjects at both age levels were assigned to one of four conditions: (a) a standard condition; (b) a rehearsal condition, in which subjects were taught a verbal rehearsal strategy; (c) a reinforcement condition, in which correct responses were rewarded; and (d) a combined rehearsal-reinforcement condition. Older subjects recalled more central task but not more incidental task information than younger subjects. A measure of selective attention efficiency was also greater for older than for younger subjects. Central recall in the rehearsal-reinforcement condition was greater than in any other condition. Central recall was greater in the rehearsal condition than in the standard and reinforcement conditions. Selective attention efficiency was greater for both rehearsal conditions than for both nonrehearsal conditions. Incidental recall was higher for reinforcement subjects than for rehearsal subjects. Results suggest that induced verbal rehearsal improves central recall and selective attention in learning-disabled children. Reinforcement alone does not improve central recall but may when paired with rehearsal.This article is based on a Ph.D. dissertation completed by the senior author at the University of Virginia. Preparation of this article was supported in part by a contract (300-77-0495) from the Bureau of Education for the Handicapped, Office of Education, for the University of Virginia Learning Disabilities Research Institute.     

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.     

Functional analysis of self‐injury maintained by automatic reinforcement: exposing masked social functions

Two functional analyses for self‐injurious behavior (SIB) exhibited by a child diagnosed with mental retardation and autism were conducted. Responding was high and undifferentiated in the first functional analysis, indicating that SIB was maintained by automatic reinforcement. During the second functional analysis, the client wore a padded helmet and all SIB was blocked. SIB decreased in all conditions except attention, suggesting that SIB was multiply controlled (social positive and automatic reinforcement). Copyright © 2001 John Wiley & Sons, Ltd.