INCREASING SPONTANEOUS PLAY BY SUPPRESSING SELF-STIMULATION IN AUTISTIC CHILDREN1

Appropriate play with toys was studied in two autistic children with high occurrences of self-stimulatory behavior. Each child participated in the experimental sessions in an A-B-A design, where “A” refers to baseline sessions and “B” refers to self-stimulation suppression sessions. It was found that: (a) during the baseline sessions, the children exhibited low levels of play and high levels of self-stimulatory behavior; (b) the per cent of unreinforced, spontaneous, appropriate play increased when self-stimulatory behavior was suppressed; and (c) when the suppression of self-stimulation was discontinued, the per cent of self-stimulation and that of appropriate play approached their presuppression levels. These results seem particularly significant because they identify a set of conditions under which spontaneous appropriate behavior, uncommon in autistic children, occurs at an increased level.     

SELF-STIMULATION AND LEARNING IN AUTISTIC CHILDREN: PHYSICAL OR FUNCTIONAL INCOMPATIBILITY?1

This study investigated whether an observed inverse relationship between self-stimulation and learning in autistic children is due to a physical inability of the subject to use the same body part for self-stimulation and task responding, or whether self-stimulation “distracts” the subject from task responding. Four actively self-stimulating autistic children were taught two discrimination tasks; one required a response that physically interferred with their self-stimulation; the other did not. Results were: (a) all subjects responded similarly across both tasks; (b) the three subjects with higher mental age scores learned both tasks without external suppression of self-stimulation; and (c) none of the subjects showed an inverse relationship between self-stimulation and learning. The study demonstrated that elimination of self-stimulation is not a necessary prerequisite for the acquisition of a new behavior in all autistic children.     

SENSORY EXTINCTION AND SENSORY REINFORCEMENT PRINCIPLES FOR PROGRAMMING MULTIPLE ADAPTIVE BEHAVIOR CHANGE

The role of sensory reinforcement was examined in programming multiple treatment gains in self-stimulation and spontaneous play for developmentally disabled children. Two phases were planned. First, we attempted to identify reinforcers maintaining self-stimulation. Sensory Extinction procedures were implemented in which auditory, proprioceptive, or visual sensory consequences of self-stimulatory behavior were systematically removed and reintroduced in a reversal design. When self-stimulation was decreased or eliminated as a result of removing one of these sensory consequences, the functional sensory consequence was designated as a child's preferred sensory reinforcer. In Phase 2, we assessed whether children would play selectively with toys producing the preferred kind of sensory stimulation. The results showed the following. (1) Self-stimulatory behavior was found to be maintained by sensory reinforcement. When the sensory reinforcer was removed, self-stimulation extinguished. (2) The sensory reinforcers identified for self-stimulatory behavior also served as reinforcers for new, appropriate toy play. (3) The multiple treatment gains observed appeared to be relatively durable in the absence of external reinforcers for play or restraints on self-stimulation. These results illustrate one instance in which multiple behavior change may be programmed in a predictable, lawful fashion by using “natural communities of sensory reinforcement.”     

The elimination of autistic self-stimulatory behavior by overcorrection

No method is in general usage and of demonstrated effectiveness in eliminating the self-stimulatory behaviors of retardates and autistics. An Overcorrection rationale was used to develop such a method. The Overcorrection procedures consisted of a period of practice in the correct mode of the behavior contingent upon self-stimulatory behavior. The procedures were applied in a behavioral day-care program to three retarded children and one autistic child who exhibited object-mouthing, hand-mouthing, head-weaving and hand-clapping. For some behaviors, comparisons were made between the Overcorrection procedure and several alternative procedures, such as physical punishment by a slap, reinforcement for nonself-stimulatory behavior, a distasteful solution painted on the hand of a hand-mouther, and free reinforcement. The Overcorrection procedures eliminated the self-stimulatory behaviors of all four children in tutorial sessions and during the entire school day and were more effective than the alternative procedures in eliminating self-stimulation. The Overcorrection procedures appear to be rapid, enduring, and effective methods of eliminating self-stimulatory behavior.     

Imitation of Self-Stimulation:

Three autistic children participated in single subject, reversal designs to compare the impact of over correction and adult imitation on self-stimulation. In addition to continuous 10-second observations of frequency of self-stimulation during 10 minute sessions, experimenter and observer also rated the child's mood, attention to the experimenter and quality of attention paid. The order of interventions was randomized fro each subject with baseline preceding each intervention. Although each child's response pattern was unique, the data showed systematic changes in rates of self-stimulation across conditions for two of the children with mean levels of self-stimulation declining during the over correction procedure and increasing during imitation. There were parallel changes in mood and attention with all three children appearing “happiest” and most attentive when their self-stimulatory behavior was imitated by the adult. These results raise interesting possibilities for using adult imitation as a vehicle for establishing a reinforcing relationship with the autistic child.     

TEACHING CHILDREN WITH AUTISM APPROPRIATE PLAY IN UNSUPERVISED ENVIRONMENTS USING A SELF-MANAGEMENT TREATMENT PACKAGE

The present study used a self-management treatment package to teach 3 children with autism, who exhibited inappropriate play behaviors, to play appropriately in the absence of a treatment provider. After self-management training, generalization and maintenance of the behavior change were assessed. Because of the detrimental effects of self-stimulation (arm flapping, spinning toys, twirling, etc.) on learning, the relationship between self-stimulatory behaviors and appropriate play was measured. Results indicated that the children learned to exhibit appropriate play skills in unsupervised settings, appropriate play skills generalized to new settings, and 2 of the children maintained their gains at 1-month follow-up. In addition, self-stimulatory behaviors decreased as appropriate play increased. Treatment implications of these findings are discussed.     

SUPPRESSION OF SELF-STIMULATION: THREE ALTERNATIVE STRATEGIES

Four boys with autistic-like behavior were treated for self-stimulatory behavior with three different treatment procedures—time-out, differential reinforcement of other behavior (DRO), and overcorrection. All four boys showed a rapid response to the overcorrection procedure. Three boys demonstrated some evidence of decrement in responding with time-out. During the DRO procedure, one showed a modest decrease, two showed no change, but one exhibited a consistent increase in responding under this condition. A multiple baseline applied to one of the subjects failed to reveal any generalization of suppression from one setting to another. A strong but not perfect relationship was found between a frequency and a duration measure of self-stimulation. There was some evidence of negative side effects for one boy during overcorrection and for another during time-out. None of these negative side effects was enduring. There was also some indirect evidence that overcorrection facilitated appropriate play.     

Sensory Extinction: A procedure for eliminating self-stimulatory behavior in developmentally disabled children

This study was designed to investigate the role of sensory reinforcement in the motivation of self-stimulation. If self-stimulatory behavior is maintained by its sensory consequences, such as the proprioceptive, auditory, or visual stimulation it produces, then such behavior should extinguish when those sensory consequences are not permitted. The present study introduces a new procedure, Sensory Extinction, in which certain sensory consequences are masked or removed, to examine whether self-stimulation is operant behavior maintained by sensory reinforcement. The effectiveness of Sensory Extinction was assessed by a reversal design for each of three autistic children, and the results showed the following. First, self-stimulation reliably extinguished when a certain sensory consequence was removed, then increased when that consequence was permitted. This was replicable within and across children. Second, different Sensory Extinction procedures were required for different self-stimulatory behaviors, since the sensory reinforcers supporting them were idiosyncratic across children. Finally, regarding clinical gains, the data suggest that Sensory Extinction may be a relatively convenient and rapid alternative for the treatment of self-stimulation. The present findings extend the efficacy of extinction as a behavior-modification technique to instances in which the reinforcer is purely sensory. The implications of these results for the treatment of other forms of deviant behavior are discussed.     

Changes in self-stimulatory behaviors with treatment

For four of six autistic children who underwent intensive behavioral treatment, the nature of their self-stimulatory behavior changed from initial lowlevel motor behaviors (such as rocking, spinning, twirling) to differing kinds of higher-level behaviors (such as lining of objects, echolalic speech, and preoccupation with spelling and numerical values). The children who changed to the highest levels of self-stimulatory behavior also showed the largest gains in treatment (as determined by IQ scores, school placement, etc.). The changes in self-stimulatory behaviors were attributed to the intense teaching of appropriate social behaviors and the explicit therapeutic suppression of low-level, self-stimulatory behaviors. The long-term therapeutic effects of changing from lower-to higher-level forms of self-stimulatory behavior were discussed.This study was supported by a grant from the National Institute of Mental Health (grant MH 11440). We want to express our thanks to the parents who allowed us to study their children. We gratefully acknowledge the assistance of Maria Audero with the design of the weighted measure, and Tracee Parker with the collection of the data.     

Self-stimulatory behavior and perceptual reinforcement.

Self-stimulatory behavior is repetitive, stereotyped, functionally autonomous behavior seen in both normal and developmentally disabled populations, yet no satisfactory theory of its development and major characteristics has previously been offered. We present here a detailed hypothesis of the acquisition and maintenance of self-stimulatory behavior, proposing that the behaviors are operant responses whose reinforcers are automatically produced interoceptive and exteroceptive perceptual consequences. The concept of perceptual stimuli and reinforcers, the durability of self-stimulatory behaviors, the sensory extinction effect, the inverse relationship between self-stimulatory and other behaviors, the blocking effect of self-stimulatory behavior on new learning, and response substitution effects are discussed in terms of the hypothesis. Support for the hypothesis from the areas of sensory reinforcement and sensory deprivation is also reviewed. Limitations of major alternative theories are discussed, along with implications of the perceptual reinforcement hypothesis for the treatment of excessive self-stimulatory behavior and for theoretical conceptualizations of functionally related normal and pathological behaviors.     

The Use of an Aversive Smell to Eliminate Autistic Self-Stimulatory Behavior

Commercially available smelling salts were used to provide an aversive smell which was compared with a time-out procedure in the modification of self-stimulation in an autistic child. The aversive smell was much more effective that time out whether applied on an FR 1 or VR 3 schedule. The FR 1 schedule of the aversive smell was also associated with a marked decline in self-stimulation in non-experimental environments. The effectiveness, ease of application, and acceptability of smellin salts all indicate the value of continued research with this stimulus in the elimination of self-stimulatory and other autistic responses.     

The Treatment of Self-stimulation of a Serverely Mentally Retarded and Deaf-blind Client by Brief Physical Interruption — A Case Report

Abstract

The subject's self-stimulation consisted of high frequent shouting and varied finger, hand and arm stereotypies. The target self-simulatory behavior was shouting.

The first part of the treatment was designed to strengthen alternatives to shouting by using hand/arm stereotypies as reinforcers. The subject could self-stimulate by use of hands and arms when he did not shout. Contingent on shouting, the hand/arm stereotypies were briefly interrupted. This treatment did not reduce the frequency of shouting. The brief physical interruptions, however, seemed to reduce the hand and arm stereotypies.

In the second part of the treatment, the treatment design included brief interruptions of the target behavior. Contingent on shouting, the shouting behavior and the hand and arm stereotypies were briefly interrupted. The frequency of shouting was considerably reduced. In this treatment, the reduction of stereotypies seemed to be related to brief physical interruptions of the self-stimulatory behaviors.     

Intracranial self-stimulation improves memory consolidation in rats with little training

Post-training intracranial electrical self-stimulation can improve learning and memory consolidation in rats. However, the molecular mechanisms involved are not known yet. Since previous paradigms of this kind of facilitation are relatively unsuitable to try a molecular approach, here we develop a single and short model of learning and memory facilitation by post-training self-stimulation that could make easier the research of its neural and molecular basis. Thus, three consecutive experiments were carried out to ascertain whether post-training self-stimulation is able to facilitate memory when learning consists of only a brief (5 trials) two-way active avoidance conditioning session. The results of Experiment 1 showed that it is actually possible, and that 48 h after the acquisition session is a very good time to observe the memory improvement. As a way to probe the retroactive effect of self-stimulation, in Experiment 2 we observed that the same self-stimulation treatment given to the subjects not post-training but 48 h before a single two-way active avoidance session does not improve the acquisition of conditioning. In Experiment 3, we showed that the SS facilitative effect observed 48 h after the acquisition session in Experiment 1 was still maintained one week later. We concluded that post-training intracranial self-stimulation can consistently improve memory consolidation even when little acquisition training is given to the animals in a single training session.     

MOVEMENT SUPPRESSION TIME-OUT FOR UNDESIRABLE BEHAVIOR IN PSYCHOTIC AND SEVERELY DEVELOP MENTALLY DELAYED CHILDREN

The effects of a movement suppression time-out, which involved punishing any movement or verbalization while a client is in the time-out area, were evaluated in four experiments. The first experiment examined the effects of a DRO procedure and movement suppression plus DRO in suppressing self-injurious behavior in a psychotic child in three different situations. In Experiment 2, the results of the previous experiment were replicated with two dangerous behaviors in a second psychotic child. In a third experiment, movement suppression plus DRO was compared with contingent restraint in reducing inappropriate poking behavior in two settings. The movement suppression procedure eliminated poking whereas contingent restraint had little effect. In the final experiment, movement suppression time-out alone was compared with exclusionary time-out alone and simple corner time-out alone. Self-stimulation occurred at high levels during the exclusionary and simple corner time-out procedures. Self-stimulation was either suppressed or reduced during movement suppression time-out. The movement suppression time-out procedure produced a larger reduction in the target behavior in all three children. The effectiveness of the movement suppression procedure was explained in terms of the suppression of self-stimulation while the time-out procedure was being applied.     

The ecological assessment of an autistic child

The behavior of an autistic child was observed in his natural environment. Observations were made in three settings, over approximately 6 months. Sixteen behaviors of the child and six behaviors of adults and peers were recorded. A cluster analysis was performed to identify response classes within the behavioral structure of the child and to see if correlations existed between response and stimulus events. To examine intra- and intersetting changes, Spearman rank correlations and ttests were also computed. This autistic child exhibited a diversity of behavior over time in a given setting and across settings. He persistently ignored other nonautistic children, although he was responsive to adults. Response classes reflected an inverse correlation between the child's selfstimulatory behaviors and his attentiveness to the environment. Elevated levels of adult attention were consistently related to reduced levels in most self-stimulatory behaviors. Two response classes showed inverse relationships between self-stimulatory behaviors. Reducing the frequency of some self-stimulatory behaviors might cause increases in others.This study is based on a dissertation submitted by the first author to The University of Tennessee in partial fulfillment of the requirements for the Ph.D. degree. The research was conducted under the chairmanship of the second author. The authors wish to express their appreciation to Dr. Edward E. Cureton for his help with the statistical analyses.     

Effects of ageing on visual discrimination learning in Drosophila melanogaster

Two experiments examined conditioned suppression of the Proboscis Extension Response (PER), unconditionally released by sucrose stimulation of gustatory tarsal receptors, in young (7-day-old), middle-aged (30-day-old) and old (50-day-old) Drosophila melanogaster males, reared at 25°C. Individual flies were trained in a differential conditioning procedure in which a white stimulus signalled a quinine reinforcer, whereas a black stimulus was non-reinforced. When trained from the outset with the discriminative procedure, flies of all ages acquired the discrimination, although the acquisition of PER suppression to the white stimulus was retarded in middle-aged and old flies. The retardation of the acquisition of PER suppression in middle-aged and old flies was replicated in a second study in which the flies received simple conditioning to the white stimulus prior to discrimination training.     

SOCIAL INFLUENCES ON “SELF-STIMULATORY” BEHAVIOR: ANALYSIS AND TREATMENT APPLICATION

We tested the hypothesis that the “self-stimulatory” behaviors exhibited by some individuals may be socially mediated. Four developmentally disabled children who exhibited hand flapping and body rocking participated in a series of three experiments conducted to assess the influence of social variables on stereotyped behavior and to develop a treatment based on the assessment. Experiment 1 used an assessment procedure to determine the relative influences of social attention and task demands on stereotyped behavior. For all four children, hand flapping and body rocking increased when difficult academic tasks were introduced. Experiment 2 involved the use of a procedural time-out and demonstrated that removing task demands contingent on stereotyped behavior resulted in increased rates of hand flapping and body rocking. In Experiment 3, these results were used to develop a communication treatment that consisted of teaching the children to request assistance on the difficult tasks. This treatment resulted in significant reductions in self-stimulatory behavior. These results are consistent with the hypothesis that some forms of repetitive stereotyped behavior may come to serve social functions (e.g., escape from aversive situations). Teaching a functionally equivalent communicative alternative to escape-motivated stereotyped behavior can be an effective form of intervention for this problem.     

Some social contexts of self-destructive behavior

This study investigated the social context of self-injurious behavior in autistic, schizophrenic, and mentally retarded children residing in a state hospital. Social interactions between subjects and staff were recorded along with subjects' self-destructive behavior. The results showed a substantial increase in self-destructive behavior following the staff's presentation of demands, denials, and punishments in 19 of the 20 subjects. These results are consistent with the hypothesis that self-injurious behavior is a social behavior, which is determined by persons in the environment. In addition, the self-destructive behavior of one subject may have been largely self-stimulatory in nature.     

EFFECTS OF A PROCEDURE DERIVED FROM THE OVERCORRECTION PRINCIPLE ON MANIPULATED AND NONMANIPULATED BEHAVIORS

Positive practice overcorrection has been shown to be effective in reducing stereotypic self-stimulatory behaviors displayed by retarded and autistic individuals. In addition, the procedure also may increase the occurrence of appropriate behavior through intensive practice. In the present study, several stereotypic and one appropriate behavior (appropriate toy play) displayed by two autistic children were measured before and during treatment by a positive practice in appropriate toy play overcorrection procedure. Overcorrection was introduced for each of the targeted inappropriate behaviors in succession for both children. Results showed that overcorrection reduced all stereotypic behaviors displayed by both children. In addition, one subject displayed marked increases in the behavior practised during overcorrection, appropriate toy play, relative to its baseline rate of occurrence. The results indicate that for some individuals, overcorrection may be effective in teaching and motivating appropriate forms of behavior as well as in reducing stereotypy.     

The effects of dopamine D(1) receptor blockade in the prelimbic-infralimbic areas on behavioral flexibility

This study examined the effects of a dopamine D₁ antagonist, SCH23390, infused into the prelimbic–infralimbic areas on the acquisition of a response and visual-cue discrimination task, as well as a shift from a response to a visual-cue discrimination and vice versa. Each test was carried out in a cross-maze. The response discrimination required learning to always turn in the same direction (right or left) for a cereal reinforcement. The visual-cue discrimination required learning to always enter the arm with the visual cue. In experiment 1, rats were tested on the response discrimination task, followed by the visual-cue discrimination task. In experiment 2, the testing order was reversed. Bilateral infusions of SCH23390 (0.1 or 1 μg/0.5 μL) into the prelimbic–infralimbic areas did not impair acquisition of the response or visual-cue discrimination tasks. SCH23390 injections at 1 μg, but not 0.1 μg impaired performance when shifting from a response to a visual-cue discrimination, and vice versa. Analysis of the errors revealed that the deficit was due to perseveration of the previously learned strategy. These results suggest that activation of dopamine D₁ receptors in the prelimbic–infralimbic areas may be critical for the suppression of a previously relevant strategy and/or generating new strategies.