Using negative reinforcement to increase self-feeding in a child with food selectivity

We examined the effects of a negative reinforcement-based treatment on the self-feeding of 1 child with food selectivity by type and texture. Self-feeding increased when the child could choose to either self-feed 1 bite of a target food or be fed 1 bite of the target food and 5 bites of another food. Possible mechanisms that underlie the effectiveness of the intervention and implications for future research are discussed.     

Issues in the treatment of depressed children

Basic research into the cognitive, behavioral, familial, and physiological disturbances associated with depressive disorders during childhood is reviewed. Implications for the development of a treatment program are discussed and a comprehensive treatment model is proposed. The proposed model includes intervention strategies for the child, parents, family, and school. The child component consists of intervention strategies for the affective, cognitive, behavioral, and physiological disturbances that are evident from the existing research. The parent training component is designed to address disturbances in parenting due to cognitive disturbances and skills deficits. The family therapy component emphasizes changing interaction patterns that communicate schema-consistent maladaptive interactions. A school consultation component is proposed in which school personnel support the skills training through prompting use of the skills and reinforcement of the use of the coping skills.     

Increasing item engagement and decreasing automatically reinforced problem behavior within a modified competing stimulus assessment

A competing stimulus assessment (CSA) is commonly used to identify leisure items for use in treatments designed to decrease automatically reinforced problem behavior. However, this type of assessment may not yield useful information if participants do not readily engage with leisure items. The purpose of this study was to evaluate a modified CSA that included additional treatment components (i.e., prompting, prompting plus differential reinforcement of alternative behavior). The modified CSA identified the treatment components and leisure items that were most effective for increasing leisure-item engagement and decreasing problem behavior for each participant. Modified CSA outcomes maintained during an extended treatment analysis in a natural setting and when intervention components were faded.     

Nondirective prompting and noncontingent reinforcement in the treatment of destructive behavior during hygiene routines.

The escape-maintained destructive behavior of a girl with mental retardation persisted during hygiene routines with directive prompting, differential reinforcement for compliance, and extinction as treatment. Using nondirective prompting and noncontingent reinforcement, destructive behavior was reduced to near-zero levels during the hygiene routine.     

Auditory hallucinations and delusional thinking: A review and critique of outcome studies

This paper reviews the literature in which behavioral interventions were applied in an attempt to reduce hallucinatory and delusional verbalizations in psychiatric patients. Subject characteristics, dependent variables and treatment variations, as well as generalization of effects, are considered. It is concluded that even though operant procedures, such as extinction, aversive stimulation, and token reinforcement, have been successful in decreasing hallucinatory-delusional verbalizations, further research examining generalization is needed. Methodological issues influencing interpretation are discussed and suggestions for further research are offered.     

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.     

Further evaluation of prompt density,rate of reinforcement,and the persistence of manding

Previous research has evaluated the effects of prompt rates on the rate of communicative behavior. More recent research has suggested that dense prompting can result in communicative behavior that is more resistant to change. However, existing research has not considered the impact that higher response rates had on reinforcement rate, a variable known to impact response persistence. The current study systematically replicated previous research by evaluating communicative responding in contexts associated with dense- and lean-prompt schedules and extended existing research by (a) holding reinforcement rates similar across the two prompting schedules (lean and dense), and (b) evaluating the persistence of communicative responding in the contexts associated with each prompting schedule. The results for Experiment 1 clearly replicated and extended previous research. The results for Experiment 2 were equivocal and suggested that previous reinforcement history and response class size impacted outcomes.     

Treating obsessive compulsive behavior and enhancing peer engagement in a preschooler with intellectual disability

Intellectual disability (ID) is a neurodevelopmental disorder characterized by impairments in cognitive and adaptive functioning in social, practical, or conceptual domains. Individuals with ID present with higher‐order repetitive behaviors such as a need for sameness, ritualistic, and compulsive behaviors. Often referred to as obsessive compulsive behaviors (OCBs), these behaviors increase in prevalence between 2 and 5 years of age. The present study evaluated an exposure‐based behavioral intervention for decreasing OCBs and concomitantly increasing play skills in a 4‐year‐old boy with mild ID in an inclusive preschool setting. Using a multiple baseline across behaviors design, the intervention was associated with a decrease in target behaviors and an increase in the duration of peer social engagement, with results maintained at 3‐week follow‐up. The intervention consisted of exposure and response prevention with function‐based components. Procedures including prompting and reinforcement were generalized to parent and teacher mediators. This study provides preliminary support for the use of an exposure‐based behavioral intervention to treat OCBs in children of preschool age with ID.     

AUGMENTING SIMPLIFIED HABIT REVERSAL IN THE TREATMENT OF ORAL-DIGITAL HABITS EXHIBITED BY INDIVIDUALS WITH MENTAL RETARDATION

We investigated whether a simplified habit reversal treatment eliminates fingernail biting and related oral-digital habits exhibited by individuals with mild to moderate mental retardation. Although simplified habit reversal did little to decrease the target behaviors for 3 of 4 participants, simplified habit reversal plus additional treatment procedures decreased the behavior to near-zero levels for all participants. These procedures included remote prompting, remote contingencies involving differential reinforcement plus response cost, and differential reinforcement of nail growth. Limitations of habit reversal for individuals with mental retardation along with directions for future research involving therapist-mediated treatment procedures, particularly those involving remote prompting and remote contingencies, are discussed.     

Establishing motion control in children with autism and intellectual disability: Applications for anatomical and functional MRI

Excessive motion makes magnetic resonance imaging (MRI) extremely challenging among children with autism spectrum disorder (ASD). The medical risks of sedation establish the need for behavioral interventions to promote motion control among children with ASD undergoing MRI scans. We present a series of experiments aimed at establishing both tolerance of the MRI environment and a level of motion control that would be compatible with a successful MRI. During Study 1, we evaluated the effects of prompting and contingent reinforcement on compliance with a sequence of successive approximations to an MRI using a mock MRI. During Study 2, we used prompting and progressive differential reinforcement of other behaviors (DRO) to promote motion control in a mock MRI for increasing periods of time. Finally, during Study 3, some of the participants underwent a real MRI scan while a detailed in‐session motion analysis informed the quality of the images captured.     

AN EXPERIMENTAL ANALYSIS OF “SPILLOVER” EFFECTS ON THE SOCIAL INTERACTION OF BEHAVIORALLY HANDICAPPED PRESCHOOL CHILDRENsp1

The effects of prompting and social reinforcement directed to target subjects on their social behavior and that of peers who never received prompting and reinforcement for positive social behavior, were examined. In a combined reversal and multiple-baseline design, three behaviorally handicapped preschool boys who exhibited divergent social behavior repertoires and varied histories with social reinforcement events, were sequentially exposed to intervention conditions in order to investigate “spillover” of treatment effects. Prompting and reinforcement increased positive social behavior and decreased negative social behavior emitted by all target subjects. The results also demonstrated a “spillover” effect on two target subjects, who at various times were not under intervention, and on the peers as well. The findings suggest that: (a) the direct and indirect effects of intervention procedures may be enhanced by designing treatment based on the social repertoire and reinforcement histories of the subjects; and (b) the treatment “spillover” effect may be increased by applying procedures to two children at once, rather than to one at a time.     

Generalization of the disruptive effects of alternative stimuli when combined with target stimuli in extinction

Differential‐reinforcement treatments reduce target problem behavior in the short term but at the expense of making it more persistent long term. Basic and translational research based on behavioral momentum theory suggests that combining features of stimuli governing an alternative response with the stimuli governing target responding could make target responding less persistent. However, changes to the alternative stimulus context when combining alternative and target stimuli could diminish the effectiveness of the alternative stimulus in reducing target responding. In an animal model with pigeons, the present study reinforced responding in the presence of target and alternative stimuli. When combining the alternative and target stimuli during extinction, we altered the alternative stimulus through changes in line orientation. We found that (1) combining alternative and target stimuli in extinction more effectively decreased target responding than presenting the target stimulus on its own; (2) combining these stimuli was more effective in decreasing target responding trained with lower reinforcement rates; and (3) changing the alternative stimulus reduced its effectiveness when it was combined with the target stimulus. Therefore, changing alternative stimuli (e.g., therapist, clinical setting) during behavioral treatments that combine alternative and target stimuli could reduce the effectiveness of those treatments in disrupting problem behavior.     

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.     

Food reinforcement and eating: a multilevel analysis

Eating represents a choice among many alternative behaviors. The purpose of this review is to provide an overview of how food reinforcement and behavioral choice theory are related to eating and to show how this theoretical approach may help organize research on eating from molecular genetics through treatment and prevention of obesity. Special emphasis is placed on how food reinforcement and behavioral choice theory are relevant to understanding excess energy intake and obesity and how they provide a framework for examining factors that may influence eating and are outside of those that may regulate energy homeostasis. Methods to measure food reinforcement are reviewed, along with factors that influence the reinforcing value of eating. Contributions of neuroscience and genetics to the study of food reinforcement are illustrated by using the example of dopamine. Implications of food reinforcement for obesity and positive energy balance are explored, with suggestions for novel approaches to obesity treatment based on the synthesis of behavioral and pharmacological approaches to food reinforcement.     

Pyramidal parent training using behavioral skills training: Training caregivers in the use of a differential reinforcement procedure

Six caregivers participated in a research study in which behavioral skills training (BST) was used within a pyramidal training model to train a differential reinforcement of an alternative behavior (DRA) procedure. Physical prompting was utilized to obtain correct responses across the identified alternative behavior. The caregivers were split into two tiers, comprised of three caregivers each. The experimenter trained tier‐one caregivers, who then trained tier‐two caregivers after meeting a predetermined mastery criterion. A multiple baseline design across participants research design was used to evaluate the effectiveness of correct implementation of the DRA procedure, demonstrating experimental control across participants. During baseline, caregivers did not implement DRA correctly. Following training, tier‐one and tier‐two caregivers demonstrated correct implementation of the DRA and prompting procedure. Intervention score was (M = 96%), from a baseline score of (M = 34.6%), for tier‐one participants. Intervention score was (M = 96.6%), from a baseline score of (M = 33%), for tier‐two participants. A follow‐up maintenance probe demonstrated correct implementation of the DRA procedure with prompting across both tiers of trained caregivers.     

TRAINING AND GENERALIZATION OF AFFECTIVE BEHAVIOR DISPLAYED BY YOUTH WITH AUTISM

The purpose of this study was to teach contextually appropriate affective behavior to 4 youths with autism. Treatment consisted of modeling, prompting, and reinforcement introduced in a multiple baseline design across response categories of affective behavior. During treatment, verbal praise and tokens were delivered contingent on appropriate affective responding during training trials. Modeling and verbal prompting were used as correction procedures. Each youth received treatment in either three or four response categories. Treatment systematically increased responding within the response categories for all 4 participants, with effects being specific to the affective response categories under treatment. Treatment effects occurred across untrained scenarios, therapists, time, and settings, suggesting that generalization had occurred.     

A review of environmental enrichment as treatment for problem behavior maintained by automatic reinforcement

We reviewed studies that used environmental enrichment as treatment for problem behavior maintained by automatic reinforcement. A search of behavior analytic journals produced 71 publications with a total of 265 applications of environmental enrichment used alone or in conjunction with alternative behavior manipulations (e.g., prompting, reinforcement) and problem behavior manipulations (e.g., blocking, restraint). Environmental enrichment, as a sole intervention, was efficacious in 41% of the sample. Alternative behavior manipulations, problem behavior manipulations, and a combination of both improved the overall efficacy of environmental enrichment. We discuss factors that may influence the efficacy of environmental enrichment, current trends in research on this topic, and implications for both practitioners and researchers.     

Eliminating the battering of women by men: Some considerations for behavior analysis

Based on review of representative literature, history and current research indicate that battering by male partners is a major health problem for women. Use of physical aggression and verbal coercion can be described by three-term contingencies involving escape, avoidance, punishment, and positive reinforcement. These contingencies occur within societal practices, rules, and models that involve oppression of women and insubstantial consequences for men who batter. The difficulties in directly observing a couple's interactions and their aggression have been a methodological barrier to the involvement of behavior analysts in treatment of and research on domestic violence. Recommendations are made for behavior analysts to contribute to reducing battering through development and analysis of program components and application of contingency management and behavioral training technology.     

Improving adherence to fluid restrictions in male hemodialysis patients: a comparison of cognitive and behavioral approaches.

A cognitive intervention and a behavioral intervention were compared to determine their relative effectiveness in reducing interdialytic weight gain (IWG) among eight adult male hemodialysis patients. The behavioral model consisted of positive reinforcement, shaping, and self-monitoring. The cognitive model consisted of a counseling intervention designed to modify health beliefs. Three small-sample experimental studies showed that both interventions produced immediate reductions in IWG. However, the behavioral intervention was superior to the cognitive intervention in producing maintenance of reduced weight gain. Combining the interventions resulted in no improvement over the behavioral intervention alone. Continuation of self-monitoring procedures produced maintenance of improvements up to 2 months posttreatment. Repeated-measures analysis of variance showed changes for only the "barriers" dimension of the health belief model (Hartman & Becker, 1978) (p < .001), and this occurred only following or concurrent with adherence behavior change. Suggestions for treatment and future research are offered.