An evaluation of a punisher assessment for decreasing automatically reinforced problem behavior

We extended research on the identification and evaluation of potential punishers for decreasing automatically reinforced problem behavior in four individuals with autism spectrum disorder. A punisher selection interview was conducted with lead clinicians to identify socially acceptable punishers. During the treatment evaluation, treatment phases were introduced sequentially and included noncontingent reinforcement (NCR), NCR and differential reinforcement of alternative behavior (DRA), and NCR‐and‐DRA with punishment. During the NCR‐and‐DRA with punishment phase, four to five potential punishers were evaluated using a multielement design. Dependent measures included the target problem behavior, appropriate item engagement, and emotional responding. For all participants, NCR‐and‐DRA was not effective and punishment was necessary. However, the most effective punisher identified in the context of NCR‐and‐DRA differed across participants.     

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.     

Caregiver preference for reinforcement‐based interventions for problem behavior maintained by positive reinforcement

Social validity of behavioral interventions typically is assessed with indirect methods or by determining preferences of the individuals who receive treatment, and direct observation of caregiver preference rarely is described. In this study, preferences of 5 caregivers were determined via a concurrent‐chains procedure. Caregivers were neurotypical, and children had been diagnosed with developmental disabilities and engaged in problem behavior maintained by positive reinforcement. Caregivers were taught to implement noncontingent reinforcement (NCR), differential reinforcement of alternative behavior (DRA), and differential reinforcement of other behavior (DRO), and the caregivers selected interventions to implement during sessions with the child after they had demonstrated proficiency in implementing the interventions. Three caregivers preferred DRA, 1 caregiver preferred differential reinforcement procedures, and 1 caregiver did not exhibit a preference. Direct observation of implementation in concurrent‐chains procedures may allow the identification of interventions that are implemented with sufficient integrity and preferred by caregivers.     

Prevention of the development of problem behavior: A laboratory model

Few studies have isolated the preventive efficacy of common behavioral strategies like noncontingent reinforcement (NCR) and differential reinforcement of alternative behavior (DRA). The purpose of the current study was to develop and evaluate a laboratory model of these two problem behavior prevention strategies. Undergraduate students participated in a computer simulation, in which clicks to a designated area of the computer screen were analogous to the emergence of problem behavior. The responding of participants in a control group, who experienced a percentile schedule used to mimic the shaping of problem behavior, was compared to that of participants in two experimental groups, each with a history of either DRA or NCR. Between‐subjects group comparisons showed that both intervention strategies were equally effective in the prevention of our analog to problem behavior when compared to the control group. The strengths and limitations of a laboratory model for prevention are discussed in light of recent applied work in this area.     

Competition between noncontingent and contingent reinforcement schedules during response acquisition

We examined the extent to which noncontingent reinforcement (NCR), when used as treatment to reduce problem behavior, might interfere with differential reinforcement contingencies designed to strengthen alternative behavior. After conducting a functional analysis to identify the reinforcers maintaining 2 participants' self-injurious behavior (SIB), we delivered those reinforcers under dense NCR schedules. We delivered the same reinforcers concurrently under differential-reinforcement-of-alternative-behavior (DRA) contingencies in an attempt to strengthen replacement behaviors (mands). Results showed that the NCR plus DRA intervention was associated with a decrease in SIB but little or no increase in appropriate mands. In a subsequent phase, when the NCR schedule was thinned while the DRA schedule remained unchanged, SIB remained low and mands increased. These results suggest that dense NCR schedules may alter establishing operations that result in not only suppression of problem behavior but also interference with the acquisition of appropriate behavior. Thus, the strengthening of socially appropriate behaviors as replacements for problem behavior during NCR interventions might best be achieved if the NCR schedule is first thinned.     

An Evaluation of the Relative Effectiveness of Function-Based Consequent and Antecedent Interventions in a Preschool Setting

Although there is substantial functional behavioral assessment (FBA) literature suggesting that function-based interventions are effective for improving problem behavior, only a limited number of studies have examined the effectiveness of function-based antecedent versus consequent interventions. Additionally, although there has been a recent increase in the number of studies conducted in the K–12 school setting, only a limited number of studies have included children in the preschool setting. The present study extends existing literature by examining the effectiveness of function-based antecedent versus consequent interventions for reducing problem behavior and increasing appropriately engaged behavior for preschool children without cognitive disabilities. Following an FBA of 4 children, the effectiveness of a function-based antecedent (i.e., noncontingent reinforcement [NCR]) was compared with a function-based consequent (i.e., differential reinforcement of alternative behavior [DRA]) intervention using an alternating treatments design. Results indicated that both function-based NCR and DRA were effective for decreasing problem behavior and increasing appropriately engaged behavior, with function-based NCR being more effective than DRA for 2 of 4 participants.     

DO CHILDREN PREFER CONTINGENCIES? AN EVALUATION OF THE EFFICACY OF AND PREFERENCE FOR CONTINGENT VERSUS NONCONTINGENT SOCIAL REINFORCEMENT DURING PLAY

Discovering whether children prefer reinforcement via a contingency or independent of their behavior is important considering the ubiquity of these programmed schedules of reinforcement. The current study evaluated the efficacy of and preference for social interaction within differential reinforcement of alternative behavior (DRA) and noncontingent reinforcement (NCR) schedules with typically developing children. Results showed that 7 of the 8 children preferred the DRA schedule; 1 child was indifferent. We also demonstrated a high degree of procedural fidelity, which suggested that preference is influenced by the presence of a contingency under which reinforcement can be obtained. These findings are discussed in terms of (a) the selection of reinforcement schedules in practice, (b) variables that influence children's preferences for contexts, and (c) the selection of experimental control procedures when evaluating the effects of reinforcement.     

Delivering alternative reinforcement in a distinct context reduces its counter‐therapeutic effects on relapse

Delivery of alternative reinforcers in the presence of stimuli previously associated with reinforcement for target behavior increases the susceptibility of target behavior to relapse. To explore contingencies that might mitigate this counter‐therapeutic effect, we trained pigeons on a procedure that entailed extinction of previously reinforced target‐key pecking, access to a distinct stimulus context contingently on refraining from target behavior (differential‐reinforcement‐of‐other‐behavior; DRO), and reinforcement of alternative‐key pecks (differential‐reinforcement of alternative behavior; DRA) in that context. This DRO‐DRA treatment was compared with standard DRA in successive conditions, counterbalanced across pigeons. Target behavior extinguished more rapidly in the Standard‐DRA condition. When alternative reinforcement was discontinued, however, there was less resurgence after DRO‐DRA than after Standard DRA. In a third condition, the DRO contingency was suspended so that the former DRA stimuli were not presented (DRO‐NAC), and resurgence was greater than in the Standard‐DRA and DRO‐DRA conditions. Reinstatement produced by response‐independent reinforcers was small and similar across conditions. Subsequent reacquisition of target‐key pecking under baseline reinforcement conditions was faster following DRO‐NAC than Standard‐DRA or DRO‐DRA. These findings suggest that DRO‐DRA might serve as a useful method in clinical settings for reducing problem behavior while minimizing the threat of posttreatment relapse.     

Treatment of resistance to change in children with autism

“Resistance to change” represents a core symptom of autism that we conceptualized and assessed as resulting in part due to factors known to govern free‐operant choice. During a free‐choice baseline, participants chose between problematic, resistive responses and an appropriate alternative response. During the asymmetrical‐choice condition, we delivered their most highly preferred item if the participant chose the alternative response (i.e., differential reinforcement of alternative behavior [DRA]). During the guided‐ (Experiment 1) and singular‐ (Experiment 2) choice conditions, we prompted participants to choose the alternative response and then delivered their most highly preferred item (i.e., DRA with escape extinction). All participants learned to tolerate (Experiment 1) or choose (Experiment 2) the alternative response when we combined DRA with escape extinction. After exposure to escape extinction, two participants showed strong maintenance effects with DRA alone. We discuss these finding relative to the effects of DRA and escape extinction on resistance to change.     

Effects of signaled and unsignaled alternative reinforcement on persistence and relapse in children and pigeons

Three experiments explored the impact of different reinforcer rates for alternative behavior (DRA) on the suppression and post‐DRA relapse of target behavior, and the persistence of alternative behavior. All experiments arranged baseline, intervention with extinction of target behavior concurrently with DRA, and post‐treatment tests of resurgence or reinstatement, in two‐ or three‐component multiple schedules. Experiment 1, with pigeons, arranged high or low baseline reinforcer rates; both rich and lean DRA schedules reduced target behavior to low levels. When DRA was discontinued, the magnitude of relapse depended on both baseline reinforcer rate and the rate of DRA. Experiment 2, with children exhibiting problem behaviors, arranged an intermediate baseline reinforcer rate and rich or lean signaled DRA. During treatment, both rich and lean DRA rapidly reduced problem behavior to low levels, but post‐treatment relapse was generally greater in the DRA‐rich than the DRA‐lean component. Experiment 3, with pigeons, repeated the low‐baseline condition of Experiment 1 with signaled DRA as in Experiment 2. Target behavior decreased to intermediate levels in both DRA‐rich and DRA‐lean components. Relapse, when it occurred, was directly related to DRA reinforcer rate as in Experiment 2. The post‐treatment persistence of alternative behavior was greater in the DRA‐rich component in Experiment 1, whereas it was the same or greater in the signaled‐DRA‐lean component in Experiments 2 and 3. Thus, infrequent signaled DRA may be optimal for effective clinical treatment.     

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.     

Signaling stimulus presentation during treatment with noncontingent reinforcement: Visual versus vocal signals

The independent effects of two signals implemented during treatment with noncontingent reinforcement (NCR) were examined. First, functional analyses showed that problem behavior exhibited by two individuals with developmental disabilities was sensitive to social positive reinforcement. A reversal design was then used to compare the effectiveness of a timer (NCR‐visual) to a vocal statement (NCR‐vocal) indicating when the stimulus would be returned in the context of a NCR procedure. Results showed that NCR reduced problem behavior for both participants. In addition, for one participant, the NCR‐visual condition reduced problem behavior to a greater degree than the NCR‐vocal condition. Copyright © 2009 John Wiley & Sons, Ltd.     

Treatment efficacy of noncontingent reinforcement during brief and extended application

We evaluated the long-term therapeutic effects of noncontingent reinforcement (NCR). In Experiment 1, NCR effects were examined with 2 participants' arbitrary responses; in Experiment 2, NCR was used as treatment with 3 participants whose self-injurious behavior (SIB) was maintained by automatic reinforcement. In both experiments, NCR consisted of continuous access to a highly preferred leisure item and was implemented initially during 10-min and later during 120-min sessions. Varied reinforcers (leisure items) were subsequently introduced during 120-min sessions to determine if treatment effects might be extended. Finally (Experiment 2 only), NCR was implemented throughout the day in participants' homes. Results of Experiments 1 and 2 showed that reinforcers obtained through object manipulation can compete with those obtained automatically by engaging in SIB during brief NCR sessions. However, data from the 120-min sessions indicated that satiation to a specific leisure item might occur over periods of time more typical of those during which treatment would be implemented. Access to a variety of highly preferred leisure items extended the effectiveness of NCR for some individuals. When NCR was implemented throughout the day (Experiment 2), therapeutic effects were shown to be maintained for up to 1 year.     

Idiosyncratic effects of noncontingent reinforcement on problematic speech

Noncontingent reinforcement (NCR) was used to treat the attention‐maintained problematic speech of an adult male diagnosed with moderate mental retardation. A series of functional assessments was conducted that included informant interviews and a brief experimental analysis. A multiple‐baseline design was then used to assess the effects of NCR across two different therapists. Although the target behavior was substantially decreased from baseline levels, the reduction was inversely related to the density of the NCR schedule. Within‐session analyses were then used to hypothesize putative behavior‐change mechanisms responsible for the reduction. The results are discussed in relation to the active components underlying the effects of NCR. Copyright © 1999 John Wiley & Sons, Ltd.     

An alternative method of thinning reinforcer delivery during differential reinforcement

Differential reinforcement of alternative behavior (DRA) may result in rates of reinforcement that are impractical for caregivers to implement; therefore, recent research has examined methods for thinning reinforcer delivery during DRA. In this study, reinforcer delivery was thinned during DRA by restricting access to the participant's alternative response materials.     

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.     

Stimulus Fading and Response Elaboration in Differential Reinforcement for Alternative Behavior

A hallmark of applied behavior analysis is the development of function‐based interventions for problem behavior. A widely recommended function‐based intervention is differential reinforcement of alternative behavior (DRA), in which reinforcement is contingent upon socially acceptable alternatives to problem behavior (e.g., teaching communication skills). Typically, DRA is introduced under rich schedules of reinforcement. Although effective for initiating behavior change, rich schedules are often impractical in the natural setting. In this study, we evaluated the extent to which a stimulus fading program could be employed to elaborate alternative behavior (mands) in two individuals diagnosed with an autism spectrum disorder. For both participants, problem behavior was reduced substantially upon implementation of the DRA procedure. Further, problem behavior rates remained low and mand rates decreased to more practical levels as the DRA behavioral requirements increased during the fading program. The fading approach demonstrated in this paper may be a useful component of intervention packages for clinicians. Copyright © 2015 John Wiley & Sons, Ltd.     

A COMPARISON OF SENSORY INTEGRATIVE AND BEHAVIORAL THERAPIES AS TREATMENT FOR PEDIATRIC FEEDING DISORDERS

We compared the effects of escape extinction (EE) plus noncontingent reinforcement (NCR) with sensory integration therapy as treatment for the feeding problems of 2 children. Results indicated that EE plus NCR was more effective in increasing acceptance, decreasing inappropriate behavior, and increasing amount consumed relative to sensory integration for both children. The results are discussed in terms of the challenges of evaluating sensory‐integration‐based treatments, and the reasons why component analyses of multicomponent treatments like sensory integration are important.     

The Influence of Function,Topography, and Setting on Noncontingent Reinforcement Effect Sizes for Reduction in Problem Behavior: A Meta-analysis of Single-Case Experimental Design Data

Richman et al. (J Appl Behav Anal 48:131–152, 2015) completed a meta-analytic analysis of single-case experimental design data on noncontingent reinforcement (NCR) for the treatment of problem behavior exhibited by individuals with developmental disabilities. Results showed that (1) NCR produced very large effect sizes for reduction in problem behavior, (2) NCR implemented with the functional reinforcer resulted in a slightly larger effect size compared to NCR using nonfunctional reinforcers, and (3) schedule thinning for the delivery of reinforcers typically produced temporary and modest increases in levels of problem behavior. The purpose of the current study was to conduct follow-up analyses to determine whether treatment implementation setting, topography, or the function of problem behavior influenced the treatment effect size for problem behavior exhibited by individuals with developmental disabilities. Follow-up analyses showed that NCR effect sizes were very similar across inpatient and outpatient settings and across aggression and property destruction versus self-injurious behaviors. Results showed that NCR effect size for treatment of problem behavior maintained by a form of social reinforcement was slightly greater than problem behavior maintained by automatic reinforcement. Results are discussed in terms of applying NCR in school settings as an initial treatment for problem behaviors that can interfere with academic, adaptive, and vocational skill acquisition for students with developmental disabilities.     

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.