FUNCTIONAL ANALYSIS AND TREATMENT OF CIGARETTE PICA

A series of analyses was conducted to assess and treat the pica of cigarette butts by a young man with mental retardation and autism. First, we demonstrated that pica was maintained in a condition with no social consequences when the available cigarettes contained nicotine but not when the cigarettes contained herbs without nicotine. Second, a choice assessment (Fisher et al., 1992) confirmed that tobacco was preferred over the other components of the cigarette (e.g., paper, filter, etc.). Third, an analogue functional analysis (Iwata, Dorsey, Slifer, Bauman, & Richman, 1982/1994) demonstrated that cigarette pica was maintained independent of social consequences. Fourth, a treatment designed to interrupt the hypothesized response—reinforcer relationship reduced consumption of cigarettes to zero. Finally, because cigarette pica occurred primarily when the individual was alone or under minimal supervision, a procedure based on stimulus control was developed to improve the effectiveness of the intervention in these situations.     

Varying response effort in the treatment of pica maintained by automatic reinforcement

Pica is a life-threatening behavior displayed by many individuals with developmental disabilities. In the current study, automatic reinforcement maintained the pica of 3 participants. Following functional analyses of pica, response-effort manipulations were conducted in which the effort to obtain pica or alternative items was varied systematically. Several general relations emerged as a result of the study. First, levels of pica were reduced relative to baseline when alternative items were available independent of the effort required to obtain alternative items or pica. Second, increasing the effort for alternative items resulted in increases in pica relative to when effort for alternative items was low. Third, increasing response effort for pica produced reductions in pica relative to baseline when alternative items were unavailable. Fourth, the highest levels of pica occurred when the effort to engage in pica was low or medium and no alternative items were available. These findings are discussed in terms of the relative effects of quality of reinforcement and response effort on behavior.     

THE EFFECTS OF RESPONSE EFFICIENCY ON FUNCTIONALLY EQUIVALENT COMPETING BEHAVIORS

Three experiments addressed the role of response efficiency in the application of functional equivalence training. Functional equivalence training includes conducting a functional assessment of the problem behavior. Variables that predict and maintain the problem behavior are defined, and socially appropriate, functionally equivalent skills are identified and taught. The logic is that if the learner has a socially appropriate way to achieve the same function, he or she will be less likely to use problem behaviors. This study examined the role of response efficiency in functional equivalence training. Response efficiency was examined in terms of three variables: (a) physical effort, (b) schedule of reinforcement, and (c) the time delay between presentation of the discriminative stimulus and reinforcer delivery. Each of the three experiments involved a person who performed a set of problem behaviors and a functional assessment of the problem behaviors. A socially appropriate alternative response was taught, but this new response was less efficient than the problem behavior on one of the efficiency variables (effort, schedule, delay in time). The new behaviors did not compete successfully with the problem behaviors until a new, more efficient, alternative behavior was taught. These results are discussed in terms of our understanding of response covariation and the need in applied contexts to include response efficiency in any functional analysis assessment.     

COVARIATION WITHIN FUNCTIONAL RESPONSE CLASSES: IMPLICATIONS FOR TREATMENT OF SEVERE PROBLEM BEHAVIOR

Two studies examined the effects of a reductive treatment versus instruction-based treatments on the generalized reduction of problem behaviors. Each study involved a detailed analysis of multiple problem behaviors performed by school-aged youth with severe intellectual disabilities. The analysis examined the contrasting effects of one of two different positive intervention procedures (teaching a positive alternative behavior or providing additional teacher assistance during instruction) versus blocking and/or verbally reprimanding a problem behavior. The focus of each analysis was on the covariation of multiple problem behaviors within functional response classes. Results of the investigation indicated that when only one member of the response class was blocked, a collateral increase was observed in one or more different problem behaviors from the same response class. Alternatively, when 1 participant was taught a functionally equivalent mand response, all problem behaviors in the response class were reduced. Problem behaviors also were reduced for the remaining participant by presenting antecedent teacher assistance. Implications of the research extend to analysis of covariation within response classes and to procedures that result in generalized reduction of problem behaviors within a response class.     

FUNCTIONAL ANALYSIS AND TREATMENT OF SEVERE PICA

A two-phase functional analysis of a profoundly retarded 19-year-old male's pica facilitated the design of an effective intervention containing no aversive components. In the first analysis, frequent staff-client interaction resulted in 25% and 66% less pica than limited and no interaction, respectively. Paradoxical effects were obtained in the second analysis, where no protective helmet resulted in 38% and 26% less pica than the helmet with face shield and helmet without face shield, respectively. On the basis of these analyses, limited interaction and no helmet conditions were combined in an effective, staff-implemented treatment at a medium-sized institution.     

ASSESSING STIMULUS CONTROL IN NATURAL SETTINGS: AN ANALYSIS OF STIMULI THAT ACQUIRE CONTROL DURING TRAINING

When a learner is taught a new response, the stimuli that influence its display are often unknown. The presence or absence of these stimuli alters the probability of occurrence of the response. By identifying the stimuli influencing the probability of newly acquired responses, interventionists may program for their generalization more effectively and efficiently. This investigation describes the application of an operant methodology to assess functional relationships between responses and specific stimulus variables. Four young adults with moderate mental retardation were taught to include “please” as part of requests they made in school. Four environmental stimuli, present during training, were assessed for the controlling properties they acquired. Each of the four was assessed prior to and after training by presenting it in isolation (i.e., the other three were varied). If the presence of a single stimulus associated with training did not occasion “please,” then pairs of stimuli were probed. The results revealed that single-stimulus probing occasioned responding by only 1 learner; paired-stimulus probing set the occasion for including “please” by 2 others. Control of the 4th learner's responding was lost before training was introduced, because he began including “please” in his requests during baseline. The implications of these results are discussed in terms of analyzing stimulus control and promoting stimulus generalization.     

The effects of response cost in the treatment of aberrant behavior maintained by negative reinforcement

Positive reinforcement contingencies can sometimes be used to decrease problem behavior maintained by negative reinforcement (e.g., escape). In the current study, we evaluated the extent to which response cost (i.e., contingent removal of a preferred stimulus) would compete with the negative reinforcer maintaining destructive behavior. The response cost contingency reduced destructive behavior by 87% from baseline levels even though the negative reinforcement contingency (i.e., escape) remained in place.     

ESTABLISHING DISCRIMINATIVE CONTROL OF RESPONDING USING FUNCTIONAL AND ALTERNATIVE REINFORCERS DURING FUNCTIONAL COMMUNICATION TRAINING

Functional communication training (FCT) is a popular treatment for problem behaviors, but its effectiveness may be compromised when the client emits the target communication response and reinforcement is either delayed or denied. In the current investigation, we trained 2 individuals to emit different communication responses to request (a) the reinforcer for destructive behavior in a given situation (e.g., contingent attention in the attention condition of a functional analysis) and (b) an alternative reinforcer (e.g., toys in the attention condition of a functional analysis). Next, we taught the participants to request each reinforcer in the presence of a different discriminative stimulus (S^D). Then, we evaluated the effects of differential reinforcement of communication (DRC) using the functional and alternative reinforcers and correlated S^Ds, with and without extinction of destructive behavior. During all applications, DRC (in combination with S^Ds that signaled available reinforcers) rapidly reduced destructive behavior to low levels regardless of whether the functional reinforcer or an alternative reinforcer was available or whether reinforcement for destructive behavior was discontinued (i.e., extinction).     

Promoting safety belt use among state employees: the effects of prompting and a stimulus-control intervention.

This study assessed the effects of dashboard stickers and signature sheets on safety belt use among occupants of state-owned vehicles in three Florida agencies. The stickers and signature sheets contained information regarding a regulation requiring safety belt use and a consequence of a 25% reduction in benefits for noncompliance if the driver were to become involved in an accident. Safety belt use significantly increased during the intervention phase in all three agencies and maintained variable but high levels for 5 months. In Agency 1 and Agency 2 (stickers plus signature sheets) safety belt use increased from averages of 10.8% and 9.4% during baseline to 57.4% and 47.0%, respectively, during intervention. In Agency 3 (stickers only) the rates of safety belt use averaged 9.7% during baseline and 38.0% during intervention. Some increases in private vehicle use were observed. A substantial reduction in workers'' compensation claim costs was shown for the target agencies with some reductions also shown in the nontarget agencies.     

TREATMENT OF PICA THROUGH MULTIPLE ANALYSES OF ITS REINFORCING FUNCTIONS

We conducted functional analyses of the pica of 3 participants. The pica of 1 participant appeared to be maintained by automatic reinforcement; that of the other 2 participants appeared to be multiply controlled by social and automatic reinforcement. Subsequent preference and treatment analyses were used to identify stimuli that would compete with the automatic function of pica for the 3 participants. These analyses also identified the specific aspect of oral stimulation that served as automatic reinforcement for 2 of the participants. In addition, functional analysis-based treatments were used to address the socially motivated components of 2 of the participants' pica. Results are discussed in terms of (a) the importance of using the results of functional analyses to develop treatments for pica and (b) the advantages of developing indirect analyses to identify specific sources of reinforcement for automatically reinforced behavior.     

Effects of idiosyncratic stimulus variables on functional analysis outcomes.

As the methods for the functional analysis of problem behavior have continued to develop, there has been a greater focus on the specificity of controlling variables, both antecedents and consequences. Accelerating research interest in the role of antecedents reveals that a large array of stimulus variables can influence the rate of problem behavior. Indeed, the variety of these stimuli is so great that it is sometimes possible to overlook specific stimulus variables during initial assessment. The present study shows that a failure to identify these very specific (idiosyncratic) stimulus variables is serious because their presence can systematically alter the outcomes of functional analyses that are designed to assess the motivation of problem behavior. Guidelines are therefore discussed concerning when to suspect that idiosyncratic stimuli might be acting to influence assessment data, thereby promoting a search for additional stimulus variables whose identification can aid in improving the design of functional analysis conditions.     

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.     

The treatment of muscle tics with dissimilar competing response practice

Prior research has shown that muscle tics can be suppressed by the performance of a competing response contingent on the occurrence of the muscle tics. In an effort to determine whether the topography of the competing response was important to the muscle tic suppressing effects of contingent competing response practice, we evaluated the effects of a competing response that was topographically dissimilar to the muscle tic. Three subjects engaged in dissimilar competing responses contingent on the occurrence of a muscle tic; 2 of these subjects subsequently engaged in similar competing response practice. The results showed a decrease in objective measures of muscle tic frequency with the introduction of dissimilar competing response practice for each subject; subsequent exposure to similar competing response practice for 2 subjects resulted in no additional decrement in the level of muscle tics. These results suggest that the topography of the competing response may not be crucial for the suppression of muscle tics. Discrepancies between the objective measures of muscle tics and self-recorded measures are noted and discussed.