A preliminary investigation on improving functional communication training by mitigating resurgence of destructive behavior

Despite the effectiveness and widespread use of functional communication training (FCT), resurgence of destructive behavior can occur if the functional communication response (FCR) contacts a challenge, such as lapses in treatment integrity. We evaluated a method to mitigate resurgence by conducting FCT using a multiple schedule of reinforcement prior to extinction. After functional analyses of 2 boys’ destructive behavior and treatment with FCT (Study 1), we compared levels of resurgence during an extinction challenge either after a typical FCT sequence or after exposure to schedule thinning in the context of a multiple‐schedule arrangement (Study 2). Results for both participants suggested that schedule thinning using discriminative stimuli in a multiple schedule mitigated the resurgence of destructive behavior.     

Destructive behavior increases as a function of reductions in alternative reinforcement during schedule thinning: A retrospective quantitative analysis

The behavioral processes determining the magnitude of the resurgence of destructive behavior during reinforcement schedule thinning have yet to be described, despite an uptick in prevalence research on the topic. As predicted by Resurgence as Choice theory, recent animal research has found that resurgence increases with the magnitude of a downshift in alternative reinforcement. Here we reanalyze the data from 2 recent prevalence studies to determine whether the size of the decrease in alternative reinforcement availability predicts the magnitude of resurgence in the clinic. Results from this retrospective analysis suggest that resurgence of destructive behavior increases significantly with decreases in the availability of alternative reinforcement. Implications for future research and translations of theoretical analyses to the clinic are discussed.     

Mitigating resurgence of destructive behavior using the discriminative stimuli of a multiple schedule

Results of several recent translational studies have suggested that correlating contextual or discriminative stimuli with the delivery and withholding of reinforcement for the functional communication response (FCR) may mitigate resurgence of destructive behavior, but few, if any, have isolated the effects of those stimuli. In the present study, we first trained the FCR, brought it under stimulus control of a multiple schedule, and thinned its reinforcement schedule in one stimulus context. Next, we conducted resurgence evaluations (i.e., baseline, functional communication training [FCT], extinction challenge) in two novel contexts to test the effects of the discriminative stimuli on resurgence. We programmed one context to include the (a) S^D during the FCT phase to signal the availability of reinforcement for the FCR and (b) S^Δ during a subsequent extinction challenge to signal the unavailability of reinforcement for the FCR. The other context did not include the S^D during the FCT phase, nor the S^Δ during the extinction challenge. We expected to see greater persistence of the FCR in the context that included the S^D during FCT and less persistence of the FCR and less resurgence of destructive behavior in the context that included the S^Δ during the extinction challenge. Obtained results confirmed this latter prediction, but we observed no reliable difference when the S^D was present or absent during the FCT phase. Our results have relevance for practitioners in that they provide further empirical support for the use of discriminative stimuli when treating destructive behavior.     

Baseline reinforcement rate and resurgence of destructive behavior

Concepts from behavioral momentum theory, along with some empirical findings, suggest that the rate of baseline reinforcement may contribute to the relapse of severe destructive behavior. With seven children who engaged in destructive behavior, we tested this hypothesis in the context of functional communication training by comparing the effects of different baseline reinforcement rates on resurgence during a treatment challenge (i.e., extinction). We observed convincing resurgence of destructive behavior in four of seven participants, and we observed more resurgence in the condition associated with high‐rate baseline reinforcement (i.e., variable‐interval 2 s in Experiment 1 or fixed‐ratio 1 in Experiment 2) compared to a low‐rate baseline reinforcement condition. We discuss the implications of these results relative to schedules of reinforcement in the treatment of destructive behavior and strategies to mitigate resurgence in clinical settings.     

Resurgence and repeated within-session progressive-interval thinning of alternative reinforcement

Resurgence of a previously suppressed target behavior is common when reinforcement for a more recently reinforced alternative behavior is thinned. To better characterize such resurgence, these experiments examined repeated within-session alternative reinforcement thinning using a progressive-interval (PI) schedule with rats. In Experiment 1, a transition from a high rate of alternative reinforcement to a within-session PI schedule generated robust resurgence, but subsequent complete removal of alternative reinforcement produced no additional resurgence. Experiment 2 replicated these findings and showed similar effects with a fixed-interval (FI) schedule arranging similarly reduced session-wide rates of alternative reinforcement. Thus, the lack of additional resurgence following repeated exposure to the PI schedule was likely due to the low overall obtained rate of alternative reinforcement provided by the PI schedule, rather than to exposure to within-session reinforcement thinning per se. In both experiments, target responding increased at some point in the session during schedule thinning and continued across the rest of the session. Rats exposed to a PI schedule showed resurgence later in the session and after more cumulative alternative reinforcers than those exposed to an FI schedule. The results suggest the potential importance of further exploring how timing and change-detection mechanisms might be involved in resurgence.     

Noncontingent reinforcement without extinction plus differential reinforcement of alternative behavior during treatment of problem behavior

The effects of noncontingent reinforcement (NCR) without extinction during treatment of problem behavior maintained by social positive reinforcement were evaluated for five individuals diagnosed with autism spectrum disorder. A continuous NCR schedule was gradually thinned to a fixed‐time 5‐min schedule. If problem behavior increased during NCR schedule thinning, a continuous NCR schedule was reinstated and NCR schedule thinning was repeated with differential reinforcement of alternative behavior (DRA) included. Results showed an immediate decrease in all participants’ problem behavior during continuous NCR, and problem behavior maintained at low levels during NCR schedule thinning for three participants. Problem behavior increased and maintained at higher rates during NCR schedule thinning for two other participants; however, the addition of DRA to the intervention resulted in decreased problem behavior and increased mands.     

Resurgence following differential reinforcement of alternative behavior implemented with and without extinction

In the clinic, differential reinforcement of alternative behavior (DRA) often involves programming extinction for destructive behavior while reinforcing an alternative form of communication (e.g., a functional communication response); however, implementing extinction can be unsafe or impractical under some circumstances. Quantitative theories of resurgence (i.e., Behavioral Momentum Theory and Resurgence as Choice) predict differences in the efficacy of treatments that do and do not involve extinction of target responding when reinforcement conditions maintaining alternative responding worsen. We tested these predictions by examining resurgence following two DRA conditions in which we equated rates of reinforcement. In DRA without extinction, target and alternative behavior produced reinforcement. In DRA with extinction plus noncontingent reinforcement, only alternative behavior produced reinforcement. We conducted this study in a reverse-translation sequence, first with participants who engaged in destructive behavior (Experiment 1) and then in a laboratory setting with rats (Experiment 2). Across both experiments, we observed proportionally lower levels of target responding during and following the DRA condition that arranged extinction for the target response. However, levels of resurgence were similar following both arrangements.     

Reinforcement schedule thinning following treatment with functional communication training

We evaluated four methods for increasing the practicality of functional communication training (FCT) by decreasing the frequency of reinforcement for alternative behavior. Three participants whose problem behaviors were maintained by positive reinforcement were treated successfully with FCT in which reinforcement for alternative behavior was initially delivered on fixed-ratio (FR) 1 schedules. One participant was then exposed to increasing delays to reinforcement under FR 1, a graduated fixed-interval (FI) schedule, and a graduated multiple-schedule arrangement in which signaled periods of reinforcement and extinction were alternated. Results showed that (a) increasing delays resulted in extinction of the alternative behavior, (b) the FI schedule produced undesirably high rates of the alternative behavior, and (c) the multiple schedule resulted in moderate and stable levels of the alternative behavior as the duration of the extinction component was increased. The other 2 participants were exposed to graduated mixed-schedule (unsignaled alternation between reinforcement and extinction components) and multiple-schedule (signaled alternation between reinforcement and extinction components) arrangements in which the durations of the reinforcement and extinction components were modified. Results obtained for these 2 participants indicated that the use of discriminative stimuli in the multiple schedule facilitated reinforcement schedule thinning. Upon completion of treatment, problem behavior remained low (or at zero), whereas alternative behavior was maintained as well as differentiated during a multiple-schedule arrangement consisting of a 4-min extinction period followed by a 1-min reinforcement period.     

Persistence during and resurgence following noncontingent reinforcement implemented with and without extinction

Noncontingent reinforcement (NCR) is typically implemented with extinction (EXT) for destructive behavior reinforced by social consequences and without EXT for destructive behavior reinforced by sensory consequences. Behavioral momentum theory (BMT) predicts that responding will be more persistent, and treatment relapse in the form of response resurgence more likely, when NCR is implemented without EXT due to the greater overall rate of reinforcement associated with this intervention. We used an analogue arrangement to test these predictions of BMT by comparing NCR implemented with and without EXT. For two of three participants, we observed more immediate reductions in responding during NCR without EXT. However, for all participants, NCR without EXT produced greater resurgence than NCR with EXT when we discontinued all reinforcers during an EXT Only phase, although there was variability in response patterns across and within participants. Implications for treatment of destructive behavior using NCR are discussed.     

Effects of thinning the rate at which the alternative behavior is reinforced on resurgence of an extinguished instrumental response

Three experiments with rats examined the effects of thinning the rate of reinforcement for the alternative behavior in the resurgence paradigm. In all experiments, pressing one lever (L1) was first reinforced and then extinguished while pressing a second alternative lever (L2) was then reinforced. When L2 responding was then extinguished, L1 responses "resurged." Resurgence was always observed when L2 was reinforced on an unchanging reinforcement schedule during Phase 2. However, other rats received systematic decreases in the rate of L2 reinforcement before extinction of L2 began. Such a "thinning" procedure was predicted to reduce final resurgence by associating L1 extinction with longer and longer periods without a reinforcer. The procedure did reduce the resurgence effect observed when L2 was put on extinction (Experiment 3). However, in each experiment, thinned groups also returned to L1 responding, and continued to make L1 responses, while the reinforcement schedule for L2 was being thinned. Fine-grained analysis of behavior in time suggested that this early resurgence was not due to adventitious reinforcement of L1, occasion setting of L1 by reinforcer presentation, or the entrainment of L1 as a schedule-induced interim behavior. The results are overall consistent with the hypothesis that resurgence is a renewal effect in which extinguished L1 responding recovers when the context provided by the L2 reinforcement schedule is changed. Challenges for this view are also discussed.     

Schedule thinning following communication training: using competing stimuli to enhance tolerance to decrements in reinforcer density

Functional communication training (FCT) is a widely used treatment for individuals with developmental disabilities who exhibit severe behavior problems. One inherent challenge of employing FCT as a treatment in the community is that reinforcement for appropriate communication cannot always be immediate or even possible in some circumstances. Of the few studies that have incorporated some form of schedule thinning for communication, most have reported disruption of communication or increases in problem behavior when the schedule of reinforcement is thinned. In the current study, we compared FCT with extinction to FCT with extinction and access to competing stimuli. After conducting a functional analysis, a competing stimulus assessment was performed to identify stimuli that produce reinforcement that ostensibly competes with reinforcement that maintains problem behavior. It was hypothesized that FCT with competing stimuli would result in more stable reductions in problem behavior during schedule thinning, which would ultimately result in quicker achievement of the treatment goal (low levels of problem behavior under the terminal reinforcement schedule for communication) than FCT without competing stimuli. Results confirmed this hypothesis.     

Behavioral momentum theory fails to account for the effects of reinforcement rate on resurgence

The behavioral‐momentum model of resurgence predicts reinforcer rates within a resurgence preparation should have three effects on target behavior. First, higher reinforcer rates in baseline (Phase 1) produce more persistent target behavior during extinction plus alternative reinforcement. Second, higher rate alternative reinforcement during Phase 2 generates greater disruption of target responding during extinction. Finally, higher rates of either reinforcement source should produce greater responding when alternative reinforcement is suspended in Phase 3. Recent empirical reports have produced mixed results in terms of these predictions. Thus, the present experiment further examined reinforcer‐rate effects on persistence and resurgence. Rats pressed target levers for high‐rate or low‐rate variable‐interval food during Phase 1. In Phase 2, target‐lever pressing was extinguished, an alternative nose‐poke became available, and nose‐poking produced either high‐rate variable‐interval, low‐rate variable‐interval, or no (an extinction control) alternative reinforcement. Alternative reinforcement was suspended in Phase 3. For groups that received no alternative reinforcement, target‐lever pressing was less persistent following high‐rate than low‐rate Phase‐1 reinforcement. Target behavior was more persistent with low‐rate alternative reinforcement than with high‐rate alternative reinforcement or extinction alone. Finally, no differences in Phase‐3 responding were observed for groups that received either high‐rate or low‐rate alternative reinforcement, and resurgence occurred only following high‐rate alternative reinforcement. These findings are inconsistent with the momentum‐based model of resurgence. We conclude this model mischaracterizes the effects of reinforcer rates on persistence and resurgence of operant behavior.     

Further investigation of differential reinforcement of alternative behavior without extinction for escape‐maintained destructive behavior

Previous research indicates that manipulating dimensions of reinforcement during differential reinforcement of alternative behavior (DRA) for situations in which extinction cannot be implemented is a potential approach for treating destructive behavior. Therefore, we replicated and extended previous research by determining (a) the conditions under which DRA without extinction decreased and maintained low levels of destructive behavior and (b) whether intervention effects maintained during reinforcement schedule thinning for the alternative response (i.e., compliance). Results showed that effective treatments were developed in the absence of extinction by manipulating the quality of reinforcement for compliance for 2 participants and by combining manipulations of the magnitude and quality of reinforcement for compliance for the other 2 participants. However, maintaining treatment effects during reinforcement schedule thinning required combining the magnitude and quality of reinforcement for 3 of the 4 participants. We discuss the clinical utility of this approach, review limitations of the study, and suggest directions for future research.     

Evaluating the effects of discriminability on behavioral persistence during and following time‐based reinforcement

With four children with autism we evaluated a refinement to time‐based reinforcement designed to reduce response persistence when we simultaneously introduced time‐based reinforcement and extinction. We further evaluated whether this refinement mitigated response recurrence when all reinforcer deliveries ceased during an extinction‐only disruptor phase. The refinement involved increasing the saliency of the contingency change from contingent reinforcement (during baseline) to time‐based reinforcement by delivering different colored reinforcers during time‐based reinforcement. Behavioral momentum theory predicts that increasing the discriminability of the change from variable‐interval to variable‐time reinforcement should lead to faster reductions in responding. We present data on four participants, three of whom displayed response patterns consistent with the predictions of behavioral momentum theory during time‐based reinforcement. However, the participants showed more varied patterns of recurrent behavior during extinction. We discuss these results within a translational research framework focusing on strategies used to mitigate treatment relapse for severe destructive behavior, as time‐based reinforcement is one of the most commonly prescribed interventions for destructive behavior displayed by individuals with intellectual and developmental disabilities.     

EVALUATION OF CLIENT PREFERENCE FOR FUNCTION-BASED TREATMENT PACKAGES

Functional communication training (FCT) and noncontingent reinforcement (NCR) are commonly prescribed treatments that are based on the results of a functional analysis. Both treatments involve delivery of the reinforcer that is responsible for the maintenance of destructive behavior. One major difference between the two treatment procedures is that client responding determines reinforcement delivery with FCT (e.g., reinforcement of communication is delivered on a fixed-ratio 1 schedule) but not with NCR (e.g., reinforcement is delivered on a fixed-time 30-s schedule). In the current investigation, FCT and NCR were equally effective in reducing 2 participants' destructive behavior that was sensitive to attention as reinforcement. After the treatment analysis, the participants' relative preference for each treatment was evaluated using a modified concurrent-chains procedure. Both participants demonstrated a preference for the FCT procedure. The results are discussed in terms of treatment efficacy and preference for control over when reinforcement is delivered. In addition, a method is demonstrated in which clients with developmental disabilities can participate in selecting treatments that are designed to reduce their destructive behavior.     

A comparison of dense-to-lean and fixed lean schedules of alternative reinforcement and extinction

Behavior-reduction interventions typically employ dense schedules of alternative reinforcement in conjunction with operant extinction for problem behavior. After problem behavior is reduced in the initial treatment stages, schedule thinning is routinely conducted to make the intervention more practical in natural environments. In the current investigation, two methods for thinning alternative reinforcement schedules were compared for 3 clients who exhibited severe problem behavior. In the dense-to-lean (DTL) condition, reinforcement was delivered on relatively dense schedules (using noncontingent reinforcement for 1 participant and functional communication training for 2 participants), followed by systematic schedule thinning to progressively leaner schedules. During the fixed lean (FL) condition, reinforcement was delivered on lean schedules (equivalent to the terminal schedule of the DTL condition). The FL condition produced a quicker attainment of individual treatment goals for 2 of the 3 participants. The results are discussed in terms of the potential utility of using relatively lean schedules at treatment outset.     

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.     

Evaluation of multiple schedules with naturally occurring and therapist‐arranged discriminative stimuli following functional communication training

Many studies have shown that (a) functional communication training (FCT) is effective for reducing problem behavior, and (b) multiple schedules can facilitate reinforcer schedule thinning during FCT. Most studies tha have used multiple schedules with FCT have included therapist‐arranged stimuli (e.g., colored cards) as the discriminative stimuli (S^Ds), but recently, researchers have evaluated similar multiple‐schedule training procedures with naturally occurring S^Ds (e.g., overt therapist behavior). The purposes of the current study were to compare the effects of arranged and naturally occurring S^Ds directly during (a) acquisition of discriminated functional communication responses (FCRs) and (b) generalization of discriminated FCRs when we introduced the multiple schedules in novel contexts in which the naturally occurring stimuli were either relatively easy or difficult to discriminate. Results showed that (a) 2 of 3 participants acquired discriminated responding of the FCR more rapidly with arranged than with naturally occurring stimuli, (b) 2 of 3 participants showed resurgence of problem behavior , and (c) 2 of 3 participants showed greater generalization of discriminated responding to novel contexts with arranged stimuli than with naturally occurring stimuli. We discuss these results relative to the conditions under which naturally occurring and arranged S^Ds may promote rapid and generalized treatment gains.     

DRA contingencies promote improved tolerance to delayed reinforcement during FCT compared to DRO and fixed-time schedules

Following Functional Communication Training (FCT), clinicians often gradually expose newly taught communicative responses to delayed reinforcement contingencies to prepare clients for the normative environment in which requests are frequently reinforced after a delay. The introduction of delays may result in the resurgence and maintenance of problem behavior and the weakening of the newly trained communicative response. The current study compared delay tolerance with three individuals diagnosed with intellectual and developmental disabilities when reinforcement for the functional communication response (FCR) was delivered following (a) the passage of time, (b) the omission of problem behavior, or (c) the occurrence of an alternative behavior. We measured delay tolerance in terms of minimizing problem behavior and maintaining efficient FCRs. Outcomes support requiring alternative responding during delays to attain optimal treatment results.     

Punishment of an alternative behavior generates resurgence of a previously extinguished target behavior

Resurgence is often defined as the recurrence of an extinguished behavior when a more recently reinforced alternative behavior is also extinguished. Resurgence has also been observed when the alternative behavior is devalued by other means (e.g., reinforcement rate or magnitude reductions). The present study investigated whether punishment of an alternative behavior would generate resurgence. A target response was reinforced during Phase 1 and then extinguished in Phase 2 while an alternative response was reinforced. During Phase 3, response‐dependent foot shocks were superimposed on the schedule of reinforcement for the alternative response and shock intensity was escalated gradually across sessions. Resurgence of the target response was reliably observed, mostly at higher intensities. The effect was replicated in two subsequent exposures to the sequence of conditions, with resurgence tending to occur at the lowest foot shock intensity. These results suggest that devaluation of an alternative behavior via punishment can generate resurgence. Although it is difficult to reconcile the overall pattern of results with Bouton's context account, these findings are consistent with the suggestion that resurgence results from a “worsening of conditions” for the alternative behavior and with the formalization of that suggestion in terms of a choice‐based matching‐law account (i.e., Resurgence as Choice).