NONCONTINGENT PRESENTATION OF ATTENTION AND ALTERNATIVE STIMULI IN THE TREATMENT OF ATTENTION-MAINTAINED DESTRUCTIVE BEHAVIOR

Previous research has demonstrated that destructive behavior may be reduced through noncontingent presentation of attention when attention is identified as the stimulus responsible for behavioral maintenance. Because it may not always be possible to deliver attention in all situations, we examined the extent to which alternative stimuli that have been identified through a choice assessment would substitute for attention (the functional analysis—based reinforcer) in a noncontingent reinforcement procedure. Prior to treatment, functional analyses demonstrated that the destructive behavior of 2 clients with mental retardation was maintained by adult attention. Next, a stimulus choice assessment identified highly preferred tangible items for the 2 clients. Finally, we compared the effectiveness of two noncontingent reinforcement procedures: continuous noncontingent access to attention and continuous noncontingent access to the tangible item identified in the choice assessment. For both clients, these noncontingent reinforcement procedures reduced destructive behavior. The results are discussed in terms of the clinical implications for the treatment of destructive behavior using functional and alternative stimuli.     

ON THE EFFECTS OF NONCONTINGENT DELIVERY OF DIFFERING MAGNITUDES OF REINFORCEMENT

We conducted a parametric analysis of response suppression associated with different magnitudes of noncontingent reinforcement (NCR). Participants were 5 adults with severe or profound mental retardation who engaged in a manual response that was reinforced on variable-ratio schedules during baseline. Participants were then exposed to NCR via multielement and reversal designs. The fixed-time schedules were kept constant while the magnitude of the reinforcing stimulus was varied across three levels (low, medium, and high). Results showed that high-magnitude NCR schedules produced large and consistent reductions in response rates, medium-magnitude schedules produced less consistent and smaller reductions, and low-magnitude schedules produced little or no effect on responding. These results suggest that (a) NCR affects responding by altering an establishing operation (i.e., attenuating a deprivation state) rather than through extinction, and (b) magnitude of reinforcement is an important variable in determining the effectiveness of NCR.     

THE ROLE OF ATTENTION IN THE TREATMENT OF ATTENTION-MAINTAINED SELF-INJURIOUS BEHAVIOR: NONCONTINGENT REINFORCEMENT AND DIFFERENTIAL REINFORCEMENT OF OTHER BEHAVIOR

Because there are potentially serious limitations to differential reinforcement of other behavior (DRO) (which is probably the most widely used treatment procedure for behavior problems), we examined an alternative procedure—noncontingent reinforcement (NCR). Three females with developmental disabilities, all of whom engaged in severe self-injurious behavior, participated. During a pretreatment functional analysis, each subject's self-injury was shown to be differentially sensitive to social attention as a maintaining consequence. Next, each subject was exposed to a DRO treatment and an NCR treatment. During DRO, attention was delivered contingent on the absence of self-injury for prespecified intervals. During NCR, attention was delivered on a fixed-time schedule that was not influenced by the subject's behavior. Results showed that both procedures were highly effective in reducing self-injury, probably because the functional reinforcer for self-injury was used during treatment. Furthermore, there was evidence that NCR attenuated several of the limitations of DRO. These results are particularly interesting in light of the long experimental history of NCR as a control rather than as a therapeutic procedure.     

NONCONTINGENT REINFORCEMENT: A FURTHER EXAMINATION OF SCHEDULE EFFECTS DURING TREATMENT

We conducted 2 studies to determine whether dense and thin NCR schedules exert different influences over behavior and whether these influences change as dense schedules are thinned. In Study 1, we observed that thin as well as dense NCR schedules effectively decreased problem behavior exhibited by 3 individuals. In Study 2, we compared the effects of 2 NCR schedules in multielement designs, one with and the other without an extinction (EXT) component, while both schedules were thinned. Problem behavior remained low as the NCR schedule with EXT was thinned, but either (a) did not decrease initially or (b) subsequently increased as the NCR schedule without EXT was thinned. These results suggest that dense schedules of NCR decrease behavior by altering its motivating operation but that extinction occurs as the NCR schedule is thinned. The benefits and limitations of using dense or thin NCR schedules are discussed.     

A COMPARISON OF NONCONTINGENT REINFORCEMENT AND SENSORY EXTINCTION AS TREATMENTS FOR SELF-INJURIOUS BEHAVIOR

We compared the effects of two treatments, noncontingent reinforcement (NCR) and sensory extinction (EXT), on the self-injurious behavior (SIB) exhibited by 3 individuals with developmental disabilities. Results of a functional analysis indicated that their SIB was not maintained by social reinforcement, as indicated by undifferentiated responding across assessment conditions or higher rates of responding in the alone condition. Prior to treatment, leisure probes were conducted to identify highly preferred items for use in the NCR condition, and equipment probes were conducted to identify devices that produced the greatest behavioral suppression for use in the EXT condition. Following baseline, treatment was implemented in a multiple baseline across subjects design, and the effects of NCR and EXT were compared in a multielement format. During NCR sessions, participants had continuous access to a highly preferred item. During EXT sessions, participants wore equipment (gloves or protective sleeves) that seemed to attenuate stimulation directly produced by their SIB, while still allowing the behavior to occur. Results indicated that both procedures were effective in reducing SIB, although NCR was associated with either more rapid or greater overall response suppression.     

NEGATIVE SIDE EFFECTS OF NONCONTINGENT REINFORCEMENT

Noncontingent reinforcement (NCR) has emerged as a treatment package for severe behavior problems. Although concerns about potential side effects (such as incidental reinforcement) have been raised, there have been few reported negative side effects in published studies to date. In this article, we report an NCR treatment evaluation for severe aggression that produced (a) an extinction burst and (b) incidental reinforcement. These side effects were evaluated by examining within-session response patterns and response distributions. As a solution, a brief omission contingency was added to the reinforcement schedule. The omission contingency resulted in decreased aggression rates.     

NONCONTINGENT REINFORCEMENT AS TREATMENT FOR SEVERE PROBLEM BEHAVIOR: SOME PROCEDURAL VARIATIONS

Noncontingent reinforcement (NCR) as a treatment for problem behavior has typically included (a) continuous access to reinforcers at the onset of treatment and (b) extinction. We extended research on NCR by conducting a three-phase preliminary investigation of these components. In Phase 1, a functional analysis showed that the problem behavior of 3 participants with developmental disabilities was maintained by tangible positive reinforcement. In Phase 2, treatment started with the initial NCR interval based on the latency to the first problem behavior during baseline. In Phase 3, treatment consisted of NCR without extinction to determine whether extinction was an essential treatment component. Results showed that the initial NCR schedule based on latency (Phase 2) and NCR without extinction (Phase 3) were effective for reducing rates of problem behavior compared with baseline. Findings are discussed regarding the initial schedule of reinforcement and extinction as components of NCR.     

NONCONTINGENT DELIVERY OF ARBITRARY REINFORCERS AS TREATMENT FOR SELF-INJURIOUS BEHAVIOR

Results of recent research have shown that noncontingent reinforcement (NCR) can be effective in reducing the frequency of behavior problems. In typical NCR applications, the reinforcer that is responsible for behavioral maintenance (as demonstrated through a functional analysis) no longer follows occurrences of the target behavior but instead is delivered according to a time-based schedule. Thus, it is unclear if NCR would be effective if the target behavior continued to be reinforced or if arbitrary reinforcers (i.e., those irrelevant to behavioral maintenance) were substituted for the maintaining reinforcers in the NCR procedure. In this study, 2 individuals whose self-injurious behavior (SIB) was maintained by positive reinforcement were exposed to conditions in which arbitrary and maintaining reinforcers were withheld and were delivered either contingently or noncontingently. Results indicated that noncontingent delivery of arbitrary reinforcers was effective in reducing SIB even though occurrences of SIB produced access to the maintaining reinforcer. These results suggest that (a) arbitrary reinforcers may sometimes be substituted for maintaining reinforcers, (b) an important component of NCR procedures is alteration of a behavior's establishing operation, and (c) NCR with arbitrary reinforcers might therefore be effective when maintaining reinforcers cannot be identified or withheld during the course of treatment.     

NONCONTINGENT ESCAPE AS TREATMENT FOR SELF-INJURIOUS BEHAVIOR MAINTAINED BY NEGATIVE REINFORCEMENT

We extended research on the role of noncontingent positive reinforcement following a functional analysis of attention-maintained self-injurious behavior to self-injury maintained by negative reinforcement in 2 young males with developmental disabilities. During a pretreatment functional analysis, each participant's self-injury was shown to be differentially sensitive to escape from instructional activities as negative reinforcement. During noncontingent escape, escape from learning activities was provided on a fixed-time schedule that was not influenced by the participant's behavior. One participant was also exposed to differential negative reinforcement of other behavior. During this condition, escape from instructional activities was provided contingent on the omission of self-injury for prespecified intervals. Results showed that the provision of escape, even when noncontingent, resulted in significant reductions in self-injury. These results are particularly interesting in light of the experimental history of noncontingent reinforcement as a control rather than as a therapeutic procedure. Noncontingent escape is discussed as a form of extinction that may be less likely than other forms of extinction to produce severe side effects.     

FIXED-TIME SCHEDULES ATTENUATE EXTINCTION-INDUCED PHENOMENA IN THE TREATMENT OF SEVERE ABERRANT BEHAVIOR

We compared the effects of extinction (EXT) and fixed-time (FT) schedules as treatment for severe problem behavior displayed by 3 individuals with developmental disabilities. First, functional analyses identified the reinforcers maintaining aberrant behavior for all 3 individuals. Next, EXT and FT schedules were compared using a multielement design. During EXT, the reinforcer maintaining problem behavior was withheld. During FT, the reinforcers were presented response independently at preset intervals. Results showed that FT schedules were generally more effective than EXT schedules in reducing aberrant behavior. FT schedules may be used in situations when extinction-induced phenomena are problematic.     

A COMPARISON OF DIFFERENTIAL REINFORCEMENT AND NONCONTINGENT REINFORCEMENT TO TREAT FOOD SELECTIVITY IN A CHILD WITH AUTISM

We compared differential reinforcement plus escape extinction to noncontingent reinforcement plus escape extinction to treat food selectivity exhibited by a young child with autism. The interventions were equally effective for increasing bite acceptance and decreasing problem behaviors. However, a social validity measure suggested that noncontingent reinforcement was preferred by the child's caregiver.     

COMBINING NONCONTINGENT REINFORCEMENT AND DIFFERENTIAL REINFORCEMENT SCHEDULES AS TREATMENT FOR ABERRANT BEHAVIOR

Research has shown that noncontingent reinforcement (NCR) can be an effective behavior-reduction procedure when based on a functional analysis. The effects of NCR may be a result of elimination of the contingency between aberrant behavior and reinforcing consequences (extinction) or frequent and free access to reinforcers that may reduce the participant's motivation to engage in aberrant behaviors or mands. If motivation is momentarily reduced, behavior such as mands may not be sensitive to positive reinforcement. In this study, for 3 children with aberrant behavior maintained by tangible positive reinforcement, differential-reinforcement-of-alternative-behavior schedules were superimposed on NCR schedules to determine if mands could be strengthened. Results for the participants indicated that NCR did not preclude reinforcement of mands.     

THE EFFECTS OF CONTINGENT AND NONCONTINGENT ATTENTION ON SELF-INJURY AND SELF-RESTRAINT

Self-restraint and self-injurious behavior (SIB) are two responses that can sometimes be members of the same functional response class (i.e., maintained by the same contingency). In such cases, a single treatment should be effective for both responses. In this investigation, we examined the effects of providing attention (the presumed reinforcer) both noncontingently and contingent upon either SIB or self-restraint. Results were consistent with our hypothesis that both responses were maintained by attention and suggested that noncontingent reinforcement was a potentially effective treatment.     

DIFFERENTIAL REINFORCEMENT OF OTHER BEHAVIOR AND NONCONTINGENT REINFORCEMENT AS CONTROL PROCEDURES DURING THE MODIFICATION OF A PRESCHOOLER'S COMPLIANCE1

Differential reinforcement of other behavior (DRO) and noncontingent reinforcement were compared as control procedures during the modification of a 3-yr-old preschooler's compliance. The recorded reinforcer was teacher proximity (within 3 ft (0.9 m) of the subject for at least 5 sec) which was often accompanied by positive verbal comments that varied in content across experimental conditions. The verbal content during contingent reinforcement might have been: “Thank you for picking up the blocks”; during noncontingent reinforcement: “You're wearing a pretty dress”; and during DRO: “I don't blame you for not picking up because it isn't any fun”. Contingent reinforcement increased compliance in all manipulation conditions. Noncontingent reinforcement decreased compliance during two reversal conditions. However, the behavior was variable and did not decrease to the low levels reached during the two DRO reversals.     

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.     

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.     

DIFFERENTIAL REINFORCEMENT OF ALTERNATIVE BEHAVIOR AND DEMAND FADING IN THE TREATMENT OF ESCAPE-MAINTAINED DESTRUCTIVE BEHAVIOR

The escape-maintained destructive behavior of a boy with autism was reduced during instructional sequences with differential reinforcement of compliance (DRA), escape extinction without physical guidance, and demand fading. The procedure decreased destructive behaviors to near-zero levels and greatly increased compliance.     

THE EFFECTS OF MEAL SCHEDULE AND QUANTITY ON PROBLEMATIC BEHAVIOR

We present 2 case examples that illustrate the effects of meal schedule and quantity on displays of problematic behavior. In the first example, self-injury displayed by a toddler with severe developmental delays was maintained by parent attention, but only when he was satiated for food. When he was food deprived, self-injury decreased but did not appear to be differentiated across low or high social conditions. In the second example, crying and self-injury displayed by an elementary-aged girl with severe disabilities were correlated: Both behaviors were associated with food quantity, and neither behavior was responsive to social stimuli. These results replicate and extend previous findings demonstrating that meal schedule or food quantity can affect problematic behavior. In the present studies, brief functional analyses of aberrant behavior provided useful information for interpreting distinct patterns of behavior displayed by each child. We discuss these results in terms of the concept of establishing operations.     

USE OF NEGATIVE REINFORCEMENT IN THE TREATMENT OF SELF-INJURIOUS BEHAVIOR

Behavioral assessment procedures were used to determine the maintaining conditions of self-injury exhibited by 2 children with severe multiple handicaps. For both children, negative reinforcement (escape from grooming activities) was determined to be the maintaining reinforcer for self-injury (hand/arm biting) within an alternating treatments design. The treatment packages involved the use of negative reinforcement (brief escape from grooming activities) contingent upon a behavior that was incompatible with self-injury (reaching and pressing a microswitch that activated a prerecorded message of “stop”). Treatment was evaluated with a reversal design for 1 child and with a multiple baseline across grooming activities for the 2nd child. The treatment led to a marked decrease in self-injury for both children. At follow-up, high rates of self-injury were reported for the 1st child, but low rates of self-injury and an increase in task-related appropriate behavior were observed for the 2nd child.