Further evaluation of response interruption and redirection as treatment for stereotypy

The effects of 2 forms of response interruption and redirection (RIRD)-motor RIRD and vocal RIRD-were examined with 4 boys with autism to evaluate further the effects of this intervention and its potential underlying mechanisms. In Experiment 1, the effects of motor RIRD and vocal RIRD on vocal stereotypy and appropriate vocalizations were compared for 2 participants. In Experiment 2, the effects of both RIRD procedures on both vocal and motor stereotypy and appropriate vocalizations were compared with 2 additional participants. Results suggested that RIRD was effective regardless of the procedural variation or topography of stereotypy and that vocal RIRD functioned as a punisher. This mechanism was further explored with 1 participant by manipulating the schedule of RIRD in Experiment 3. Results were consistent with the punishment interpretation.     

A comparison of response interruption and redirection and competing items on vocal stereotypy and appropriate vocalizations

The current study compared the reductive effects of response interruption and redirection (RIRD) and competing items (including sound-producing and nonsound-producing toys) on the vocal stereotypy exhibited by two children diagnosed with Autism Spectrum Disorder. Sound-producing toys reduced vocal stereotypy relative to nonsound-producing toys and RIRD reduced stereotypy and increased rates of appropriate vocalizations to a greater extent than providing competing items. These findings replicate and extend previous literature suggesting that RIRD and sound-producing competing items are effective methods to treat vocal stereotypy.     

Assessing and treating vocal stereotypy in children with autism

Previous research implies that stereotypic behavior tends to be maintained by the sensory consequences produced by engaging in the response. Few investigations, however, have focused on vocal stereotypy. The current study examined the noncommunicative vocalizations of 4 children with an autism spectrum disorder. First, functional analyses were conducted in an attempt to identify the function of each child's behavior. For each of the participants, it was found that vocal stereotypy was likely not maintained by the social consequences. Following assessment, response interruption and redirection (RIRD) was implemented in an ABAB design to determine whether vocal stereotypy could be successfully redirected. RIRD involved a teacher issuing a series of vocal demands the child readily complied with during regular academic programming. Vocal demands were presented contingent on the occurrence of vocal stereotypy and were continuously presented until the child complied with three consecutively issued demands without emitting vocal stereotypy. For each child, RIRD produced levels of vocal stereotypy substantially lower than those observed in baseline. For 3 of the children, an increase in appropriate communication was also observed. The children's teachers were trained to implement RIRD. Brief follow-up probes and anecdotal information implied that the treatment had a positive impact in the natural environment.     

THE EFFECTS OF MATCHED STIMULATION AND RESPONSE INTERRUPTION AND REDIRECTION ON VOCAL STEREOTYPY

Stereotypy has been classified as repetitive behavior that does not serve any apparent function. Two procedures that have been found to reduce rates of vocal stereotypy effectively are response interruption and redirection (RIRD) and noncontingent access to matched stimulation (MS). The purpose of the current study was to evaluate the effects of RIRD alone, MS alone, and MS combined with RIRD. One participant's results suggested similar suppressive effects on vocal stereotypy across treatment conditions. For the second participant, a slightly greater suppression of stereotypy was associated with MS + RIRD. In addition, both participants emitted a greater frequency of appropriate vocalizations in conditions with RIRD. Data suggest that the addition of MS might facilitate the implementation of RIRD in applied settings.     

An evaluation of the effects of response interruption redirection and matched stimulation on vocal stereotypy

Stereotypy is one of the core diagnostic features of autism spectrum disorder and warrants behavioral intervention when it negatively impacts the person's life. The aim of this study was to evaluate the effectiveness of noncontingent matched stimulation (NCR‐M) compared with response interruption redirection (RIRD) on reducing levels of vocal stereotypy in the natural environment. Interventions were compared using an alternating treatments design followed by generalization and maintenance phases, which utilized lay people as instructors. Results showed that both RIRD and NCR‐M resulted in a reduction in vocal stereotypy for three out of four participants within an educational setting. An increase in appropriate vocalizations was found for two out of four participants for both interventions. These results suggest that both NCR‐M and RIRD were effective in reducing levels of vocal stereotypy, yet their effects on appropriate communication remain undetermined. Social validity scores were obtained following the study, which demonstrated that both interventions were met with approval across a variety of measures.     

The Effects of Motor and Vocal Response Interruption and Redirection on Vocal Stereotypy and Appropriate Vocalizations

Stereotypy has been defined as repetitive vocal or motor behaviors that are noncontextual with invariant topographies. One intervention to reduce vocal stereotypy and increase appropriate vocalizations is response interruption and redirection (RIRD). Previous research has suggested that RIRD's behavioral mechanism consists of punishment. The purpose of this study was to extend this research by comparing two procedures, namely, vocal and motor RIRD contingent upon the occurrence of vocal stereotypy and to evaluate concomitant increases in appropriate vocalizations. A multiple treatment reversal design was used to compare the effectiveness of both interventions on five children diagnosed with an Autism Spectrum Disorder. Results suggested that both demand topographies were equally effective in reducing vocal stereotypy and increasing appropriate vocalizations. This research replicates previous findings that have suggested that RIRD is a punishment procedure. Copyright © 2015 John Wiley & Sons, Ltd.     

Evaluation of the immediate and subsequent effects of response interruption and redirection on vocal stereotypy

We evaluated 2 3-component multiple-schedule sequences-a response interruption and redirection (RIRD) treatment sequence and a no-interaction control sequence-using a multielement design. With this design, we were able to evaluate the immediate and subsequent effects of RIRD on 2 participants' vocal stereotypy. For both participants, RIRD produced an immediate decrease in vocal stereotypy and did not result in a subsequent increase.     

The role of task preference in the effectiveness of response interruption and redirection

Response interruption and redirection (RIRD) is a common treatment for automatically reinforced vocal stereotypy; it involves the contingent presentation of task instructions. Tasks that are included in RIRD are typically selected based on caregiver report, which may affect the efficacy of RIRD. The purpose of the current study was to evaluate the role of task preference in the efficacy of RIRD for four participants who engaged in vocal stereotypy. We conducted task-preference assessments and selected tasks of varying preferences to include in RIRD. For three out of four participants, the results showed that RIRD with higher preference tasks was not effective at reducing vocal stereotypy, whereas RIRD with lower preference tasks was effective for all participants.     

Response interruption and redirection for vocal stereotypy in children with autism: a systematic replication

This study systematically replicated and extended previous research on response interruption and redirection (RIRD) by assessing instructed responses of a different topography than the target behavior, percentage of session spent in treatment, generalization of behavior reduction, and social validity of the intervention. Results showed that RIRD produced substantial decreases in vocal stereotypy. Limitations of this study were that behavior reduction did not generalize to novel settings or with novel instructors and that appropriate vocalizations did not improve.     

THE EFFECTS OF RESPONSE INTERRUPTION AND REDIRECTION AND SERTRALINE ON VOCAL STEREOTYPY

Although response interruption and redirection (RIRD) has been shown to be successful in reducing vocal stereotypy, recent reports have suggested that selective serotonin reuptake inhibitors (SSRIs) may also reduce these behaviors. The purpose of the current investigation was to examine the effects of RIRD with and without sertraline on automatically maintained vocal stereotypy of a 4‐year‐old boy with autism. Results suggested that vocal stereotypy decreased when RIRD was implemented and that sertraline did not affect the participant's vocal stereotypy.     

THE EFFECTS OF RESPONSE INTERRUPTION AND REDIRECTION (RIRD) AND DIFFERENTIAL REINFORCEMENT ON VOCAL STEREOTYPY AND APPROPRIATE VOCALIZATIONS

The relation between contextually appropriate vocalizations (AV) and vocal stereotypy (VS) has yet to be established within the response interruption and redirection (RIRD) literature. RIRD may promote AV by suppressing VS and/or by functioning as incompatible responses. The occurrence of VS and AV was assessed during baseline, RIRD alone, and RIRD combined with a differential reinforcement system for AV (RIRD + DRI) for a 5‐year‐old child with autism. Results showed an increase in AV once RIRD was implemented and further increases in AV and decreases in stereotypy when the token system of reinforcement for AV was implemented. Copyright © 2012 John Wiley & Sons, Ltd.     

Further evaluation of treatments for vocal stereotypy: Response interruption and redirection and response cost

The purpose of this study was to expand on research on treatments for stereotypy by evaluating the effects of response interruption and redirection (RIRD) and response cost (RC) alone and as a treatment package on vocal stereotypy. Treatment phases included RIRD, RC, and response interruption and redirection plus response cost (RIRD + RC). The efficacy of these treatments was determined by measuring duration of stereotypy in session and during treatment intervals. Vocal stereotypy decreased in all three treatment conditions; however, when data analysis included stereotypy occurring during treatment intervals, stereotypy during the RC condition occurred at similar levels as baseline for one treatment evaluation phase for Karl and both treatment evaluations phases for Jon. We discuss implications of these findings, limitations of the current study, and areas for future research.     

EFFECTS OF VERBAL REPRIMANDS ON TARGETED AND UNTARGETED STEREOTYPY

Results of brief functional analyses indicated that motor and vocal stereotypy persisted in the absence of social consequences for five participants diagnosed with autism spectrum disorder (ASD). Subsequently, effects of a stimulus control procedure involving contingent reprimands for each participant's higher probability (targeted) stereotypy were evaluated. Results indicated that contingent verbal reprimands (i) decreased the targeted stereotypy for all five participants, (ii) decreased the untargeted stereotypy for two of five participants, and (iii) increased the untargeted stereotypy for one of five participants. Although response suppression was not achieved for any participant, three participants maintained low levels of the target stereotypy with one or two reprimands during 5‐min sessions. Furthermore, two of those participants maintained near‐zero levels of motor and vocal stereotypy during 10‐min sessions. These findings suggest that signaled verbal reprimands may be a practical intervention for reducing stereotypy in some children with ASD. Some limitations of the findings and areas of future research are briefly discussed. Copyright © 2014 John Wiley & Sons, Ltd.     

Effects of socially appropriate singing on the vocal stereotypy of children with autism spectrum disorder

This study evaluated the effects of children with autism spectrum disorder engaging in socially acceptable singing on their vocal stereotypy. A multiple‐baseline across four participants with embedded multielement designs was used to assess the effects of the singing intervention upon later occurrence of vocal stereotypy for each participant. Results showed that fewer instances of vocal stereotypy occurred during and after singing intervention sessions. Additionally, two children began to emit appropriate singing after intervention, which suggests that the topography of their vocal stereotypy (e.g., monosyllabic or screeching sounds) was altered to some extent. Overall, results suggest positive implications for teaching appropriate vocal behaviors as functional replacements for vocal stereotypy.     

King,C. A., Foster,C. E., & Rogalski,K. M. (2013). Teen Suicide Risk: A Practitioner Guide to Screening,Assessment, and Management.

ABSTRACT

The purpose of this study was to investigate the use of response interruption and redirection (RIRD) to reduce vocal stereotypy in a student with Autism Spectrum Disorder in a special education classroom during group instruction. This study extends the literature on the use of RIRD, examining effectiveness with an adolescent with intellectual disability and limited functional language in a naturalistic setting. Results indicated that RIRD was effective in decreasing vocal stereotypy in this student.     

A replication of the RIRD strategy to decrease vocal stereotypy in a student with autism

This study was conducted to decrease vocal stereotypy in a student with autism. Results of functional analysis indicated that vocal stereotypy was maintained by automatic reinforcement. We used the Response Interruption and Redirection (RIRD; Ahearn, Clark, & McDonald, 2007 ) strategy to decrease the vocal behavior. An ABAB design was used. Results indicated that the RIRD intervention successfully reduced the target behavior. Results are discussed and implications for practice are provided. Copyright © 2009 John Wiley & Sons, Ltd.     

The emergence of untrained mands and tacts in children with autism

Despite Skinner's (1957) assertion that verbal operants are initially functionally independent, recent studies have suggested that in some cases the acquisition of one verbal operant (e.g., mand) gives rise to the other (e.g., tact) without explicit training. The present study aimed to evaluate the functional independence of mands and tacts during instruction with children with autism. Four boys with autism (3 to 6 years old) were taught to construct two 4‐piece structures. Two participants were taught directly to mand, whereas the other 2 were taught to tact the names of the pieces. The effects of training were evaluated in a multiple probe design across verbal operants and tasks. Three of the 4 participants demonstrated an immediate transfer of control from 1 verbal operant to the other. These results were consistent with previous research with typically developing young children.     

EFFECTS OF NONCONTINGENT MUSIC ON VOCAL STEREOTYPY AND TOY MANIPULATION IN CHILDREN WITH AUTISM SPECTRUM DISORDERS

Noncontingent music has been shown to reduce engagement in vocal stereotypy in children with autism spectrum disorders, but its effects on appropriate collateral behavior remain unknown. Given that noncontingent music is typically implemented during periods of free play, clinicians may be concerned with the effects of the intervention on toy manipulation. Thus, we examined the immediate and subsequent effects of noncontingent music on engagement in vocal stereotypy and toy manipulation in four children with autism spectrum disorders by using a three‐component multiple schedule combined with a multi‐element design. The results suggest that noncontingent music (i) reduced immediate engagement in vocal stereotypy for three of four participants, (ii) never increased subsequent engagement in vocal stereotypy, and (iii) produced idiosyncratic effects on immediate and subsequent engagement in toy manipulation for two participants. The clinical implications of the results are discussed in terms of improving the treatment of vocal stereotypy using noncontingent music. Copyright © 2012 John Wiley & Sons, Ltd.     

Abatement of intractable vocal stereotypy using an overcorrection procedure

We conducted a series of reversals to compare the effects of four different treatments on vocal stereotypy emitted by a 7‐year‐old boy with autism. The results showed that (1) the level of vocal stereotypy decreased during exposure to matched stimulation but returned to high levels immediately upon its removal; (2) stereotypy did not significantly decrease during differential reinforcement of other behavior; and (3) contingent withdrawal of movies and music (i.e., response cost) was only moderately effective. However, positive practice overcorrection decreased vocal stereotypy by clinically significant levels. Further, when differential reinforcement of engagement in a Lego^® building task was implemented, the level of engagement was significantly higher when positive practice overcorrection was in place than when overcorrection was withdrawn. Copyright © 2011 John Wiley & Sons, Ltd.     

Multiple schedules with response interruption and redirection to reduce stereotypy in children with autism spectrum disorder: Generalization and social validity

Although response interruption and redirection (RIRD) and multiple schedule arrangements have sometimes been shown to be effective in reducing stereotypy for individuals with autism spectrum disorder (ASD), important questions remain about optimal methods for facilitating generalization and social validity. In the current study, we sought to extend the literature on stereotypy treatment and MSAs in several ways. First, we programmed for generalization by conducting sessions with two exemplars of two different categories of activities (i.e., school work, toy play) and assessing generalization with novel exemplars and activities and during the participant's typical instructional program. Second, we used RIRD instructions that were contextual models of appropriate behavior relevant to each activity. Third, during the free access component of the multiple schedule, we used a child's play tent as a first step toward teaching participants to engage in stereotypy during private free time. For all three participants with ASD, stereotypy decreased quickly and substantially, with reductions generalizing to novel activities and contexts. An extensive social validity assessment with board-certified behavior analysts indicated high social acceptability of the goals, procedures, and outcomes.