Prevalence of resurgence of destructive behavior when thinning reinforcement schedules during functional communication training

Functional communication training is a well‐established treatment for socially reinforced destructive behavior that typically includes differential reinforcement of the functional communication response (FCR) in combination with extinction of destructive behavior. However, when the schedule of reinforcement for the FCR is thinned, destructive behavior may resurge (e.g., Greer, Fisher, Saini, Owen, & Jones, 2016). Currently, data are unavailable on the prevalence and characteristics of resurgence during reinforcement schedule thinning. In this study, we evaluated the prevalence of resurgence during reinforcement schedule thinning on a per‐case and per‐schedule‐step basis and also evaluated the magnitude of resurgence in relation to the functions of destructive behavior. We observed resurgence in 19 of the 25 (76%) applications of reinforcement schedule thinning. In some cases, the magnitude of resurgence exceeded the mean levels of destructive behavior observed in baseline. We discuss these results relative to prior translational and applied research on resurgence.     

Achieving socially significant reductions in problem behavior following the interview‐informed synthesized contingency analysis: A summary of 25 outpatient applications

Jessel, Hanley, and Ghaemmaghami (2016) reported the results of 30 interview‐informed, synthesized contingency analyses (IISCAs) and found the IISCAs to be an effective tool for identifying the functions of problem behavior across a variety of topographies, participants, and settings. Jessel et al. did not, however, include data on the effectiveness of the corresponding treatments. In the current study, we collected and summarized 25 additional applications, from analysis to treatment, in which the IISCA was applied in an outpatient clinic. The IISCA identified various social functions of problem behavior, which informed personalized treatments of functional communication training with contingency‐based reinforcement thinning. A 90% or greater reduction in problem behavior was obtained for every participant by the end of the treatment evaluation. The assessment and treatment process was socially validated by caregivers who rated the procedures highly acceptable and helpful, and the improvement in their child's behavior highly satisfactory.     

Comparison of naturalistic and arbitrary discriminative stimuli during schedule thinning following functional communication training

We replicated and extended research on incorporating naturalistic discriminative stimuli into schedule thinning following functional communication training with three boys with autism spectrum disorder who engaged in severe behavior. Comparing naturalistic to arbitrary discriminative stimuli, two participants demonstrated differentiated communication in fewer sessions when arbitrary stimuli were used, while the third participant mastered the discriminations in a comparable number of sessions. Although previous research has demonstrated success in rapidly thinning the schedule with arbitrary stimuli, we extended this line of research by evaluating the extent to which differentiated communication would maintain during rapid schedule thinning in both naturalistic and arbitrary conditions. Two participants' communication remained differentiated, and in both conditions, during rapid schedule thinning. However, neither discrimination maintained for the third participant. Results are discussed in terms of the existing literature and directions for future research.     

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.     

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.     

The role of adventitious reinforcement during differential reinforcement of other behavior: A systematic replication

Differential reinforcement of other behavior (DRO) is commonly used to decrease problem behavior by presenting reinforcers contingent upon the absence of a target response. Although it is well demonstrated that DROs decrease response rates, the processes producing these decreases are not well understood. The present study systematically replicated previous research assessing whether adventitious reinforcement of alternative behavior contributes to the effectiveness of DRO. We presented university students with two options on a computer and reinforced target responding on a variable-ratio schedule. Next, we compared decreases in target-response rates and any increases in alternative responding during DRO schedules versus yoked variable-time schedules or extinction probes. DRO schedules resulted in the lowest target-response rate and highest alternative-response rate. These findings generally provide some support for the adventitious reinforcement of “other” 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.     

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.     

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.     

On the predictive validity of behavioral momentum theory for mitigating resurgence of problem behavior

We summarize the results of four recent translational studies from our lab that used the predictions of behavioral momentum theory to inform the development of more durable treatments for destructive behavior. Treatments informed by behavioral momentum theory generally showed better suppression of target responding during an extinction challenge than did a comparison treatment. We reanalyze data from each of the four studies to show that this general finding is apparent both at the aggregate (i.e., proportion of baseline response rates averaged across participants) and within participant (i.e., percentage reduction in proportion of baseline response rates, difference in raw response rates during the extinction challenge). Interestingly, participants who experienced multiple cycles of the extinction challenge generally showed less differentiation in target responding between the treatment informed by behavioral momentum theory and the comparison treatment. Overall results suggest that applications of behavioral momentum theory can substantially improve the durability of common treatments for destructive behavior.     

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.     

An evaluation of delay to reinforcement and mand variability during functional communication training

Children with autism spectrum disorder and other developmental disabilities often exhibit invariant responding (i.e., restricted behavioral repertoires), deficits in communication, and challenging behavior. Approaches demonstrated in the basic and applied literature to increase response variability include extinction, lag schedules of reinforcement, and percentile schedules of reinforcement. Results of basic studies have also indicated that delays to reinforcement often produce increases in response variability. The purpose of the current study was to evaluate the effects of a delay to reinforcement on the variability of communication responses during functional communication training with individuals with developmental disabilities and histories of engaging in challenging behavior. Results indicated that delays to reinforcement increased mand variability with all four participants with variable effects on challenging behavior across participants.     

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.     

Further evaluation of treatment duration on the resurgence of destructive behavior

Translation of promising procedures for mitigating treatment relapse has received considerable attention recently from researchers across the basic–applied continuum. One procedure that has demonstrated mixed support involves increasing the duration of treatment as a strategy for blunting resurgence. In a recent translational study, Greer et al. (2020) failed to detect a mitigation effect of increased treatment duration on the resurgence of destructive behavior. However, design limitations may have been responsible. The present study corrected these limitations by (a) employing a sequential design to decrease the possibility of multiple-treatment interference, (b) evaluating more treatment durations, (c) arranging treatments of fixed durations, and (d) conducting treatments of more extreme duration in a different clinical sample. Despite these improvements in experimental rigor and the testing of more extreme boundary conditions, the present study also failed to detect a mitigation effect of increased treatment duration. Likely explanations are discussed.     

Multiple schedules of conjugate reinforcement and extinction: A translational model for assessing automatically reinforced behavior

This study evaluated the extent to which a conjugate reinforcement schedule (CONJ) involving a contingency between pedaling a stationary bike and viewing a preferred movie could serve as a translational preparation for the analysis of automatically reinforced behavior. In part, researchers examined whether providing participants with either an accurate or an inaccurate rule about the extinction (EXT) component of a multiple schedule (MULT) contributed to the development of control by the MULT (CONJ EXT) schedule. Results show schedule control emerged for four of five participants who received the accurate rule and none of the five participants who received the inaccurate rule. In addition, participants who received accurate rules typically increased pedaling during CONJ components that followed two consecutive EXT components, suggesting that they experienced deprivation for audio and visual stimulation generated by pedaling. These preliminary findings suggest that researchers could use this translational preparation to identify matched interventions for some automatically reinforced behavior.     

A preliminary evaluation of treatment duration on the resurgence of destructive behavior

Quantitative models of resurgence (e.g., Behavioral Momentum Theory, Resurgence as Choice) suggest that resurgence is partly a function of the duration of extinction exposure, with longer histories of extinction producing less resurgence. This prediction is supported by some laboratory research and has been partially supported by clinical translations that did not isolate the effects of extinction exposure prior to testing for resurgence. The degree to which different histories of extinction impact the likelihood of treatment relapse in therapeutic applications of differential reinforcement is of great interest to the clinical community, including insurance carriers and other financial providers. In the present study, we isolated the effects of extinction history for severe destructive behavior across 6 participants referred for treatment services and examined resurgence of destructive behavior when alternative reinforcement terminated. Our within-subject evaluation showed no difference in the level of resurgence or persistence of destructive behavior following short and long exposures to differential reinforcement with extinction. We discuss our failure to replicate in relation to experimental-design considerations for investigating this and other relapse phenomena in future research with clinical populations.