THE ROLE OF ATTENTION IN THE TREATMENT OF ATTENTION-MAINTAINED SELF-INJURIOUS BEHAVIOR: NONCONTINGENT REINFORCEMENT AND DIFFERENTIAL REINFORCEMENT OF OTHER BEHAVIOR

Because there are potentially serious limitations to differential reinforcement of other behavior (DRO) (which is probably the most widely used treatment procedure for behavior problems), we examined an alternative procedure—noncontingent reinforcement (NCR). Three females with developmental disabilities, all of whom engaged in severe self-injurious behavior, participated. During a pretreatment functional analysis, each subject's self-injury was shown to be differentially sensitive to social attention as a maintaining consequence. Next, each subject was exposed to a DRO treatment and an NCR treatment. During DRO, attention was delivered contingent on the absence of self-injury for prespecified intervals. During NCR, attention was delivered on a fixed-time schedule that was not influenced by the subject's behavior. Results showed that both procedures were highly effective in reducing self-injury, probably because the functional reinforcer for self-injury was used during treatment. Furthermore, there was evidence that NCR attenuated several of the limitations of DRO. These results are particularly interesting in light of the long experimental history of NCR as a control rather than as a therapeutic procedure.     

THE CLASS SPECIFIC EFFECTS OF COMPLIANCE TRAINING WITH “DO” AND “DON'T” REQUESTS: ANALOGUE ANALYSIS AND CLASSROOM APPLICATION

Two experiments are reported in which the relationship between compliance with “do” and “don't” requests was examined with developmentally disabled children. In Experiment 1, a multiple baseline design across subjects with counterbalanced treatment conditions was used to evaluate a compliance training program composed of four phases: (a) baseline, during which no consequences were delivered for compliance, (b) reinforcement for compliance with one targeted “do” request, (c) reinforcement for compliance with one targeted “don't” request, and (d) follow-up with reinforcement on a variable ratio schedule for compliance with any “do” or “don't” request. Results of probes conducted before and after training within each condition indicated that generalized compliance occurred only with requests of the same type as the target exemplar (“do” or “don't”). In Experiment 2, these results were replicated in a classroom setting. Following collection of baseline probe data on student compliance, a teacher training program was successfully implemented to increase reinforcement of compliance first with one “do” and subsequently with one “don't” request of a target student. Results of multiple baseline probes across “do” and “don't” requests indicated that the teacher generalized and maintained reinforcement of compliance with other requests of the same type and to other students, with a resulting increase in student compliance with the type of requests reinforced. The impact of treatment on both teacher and student behavior was socially validated via consumer ratings. Implications of these findings with respect to response class formation and compliance training programs are discussed.     

THE EFFECTS OF AN ENVIRONMENTAL “ENRICHMENT” PROGRAM ON THE BEHAVIOR OF INSTITUTIONALIZED PROFOUNDLY RETARDED CHILDREN

This study determined the effects of procedures designed to “enrich” the physical and social environment of an institutional ward on the “adaptive” and “maladaptive” child, adult, self, and object-directed behaviors of five profoundly retarded ambulatory females. Behavior observed in two treatment conditions, an environment “enriched” with toys and objects and an “enriched” environment coupled with differential reinforcement of adaptive behavior, was compared to behavior occurring in corresponding baseline or “austere” conditions and during a period of noncontingent reinforcement. The results generally revealed: (1) little change in adaptive and maladaptive child and adult-directed behavior across conditions, (2) an overall higher incidence of adaptive object-directed behavior and reduced self-directed maladaptive behavior in each treatment condition from that observed in corresponding control conditions, and (3) the use of an “enriched” environment and differential reinforcement of adaptive behavior resulted in maladaptive self-directed behavior being reduced and adaptive object-directed behavior being increased beyond that observed in the “enriched” environment alone. These behavioral gains were largely maintained during a follow-up condition by continuing the “enriched” environment and transferring the responsibility for differential reinforcement to direct-care staff.     

ANALYSIS OF THE REINFORCEMENT AND EXTINCTION COMPONENTS IN DRO CONTINGENCIES WITH SELF-INJURY

Previous research has shown that self-injurious behavior (SIB) maintained by positive reinforcement may be reduced under differential-reinforcement-of-other-behavior (DRO) contingencies. In this study, we conducted an analysis of the reinforcement and extinction components of DRO while treating the self-injury of 3 women with developmental disabilities. A functional analysis revealed that each subject's SIB was maintained by positive reinforcement in the form of attention. Subsequent reinforcer assessments identified preferred and nonpreferred stimuli for later use in conjunction with DRO. Results showed high rates of SIB for all 3 subjects during baseline, which persisted when DRO was implemented without the relevant extinction component (withholding of attention for SIB) for 2 of the subjects. Low rates of SIB were observed for all subjects when DRO plus extinction was implemented or when extinction was implemented alone, suggesting that extinction may be a critical component of DRO schedules.     

AN INVESTIGATION OF THE EFFECTS OF TOKEN REINFORCEMENT ON DIVERGENT VERBAL RESPONDING1

The effect of token reinforcement on three classes of divergent verbal responding to verbal stimulus items from three measures of the Wallach-Kogan Creativity test was examined. The subjects consisted of two “gifted”, two “average”, and two “learning disabled” children from a public-school setting. The design utilized both an intra-subject and inter-subject multiple-baseline design with a reversal design added. Tokens were dispensed contingent upon the number of appropriate verbal responses to each stimulus item, i.e., a continuous schedule of reinforcement was used—one token per appropriate response. Interobserver agreement on “appropiateness” was 993%. The tokens could be used to “purchase” items listed in a “menu” format (e.g., ball and jacks—100 tokens). Consistently large effects of token reinforcement were observed, without generalization of effect across the three classes of behaviors, or conditions. These results support the works of Goetz and Baer (Journal of Applied Behavior Analysis, 1973, 6 , 209–217), Goetz and Salmonson (Behavior Analysis and Education, G. Semb, (Ed.), University of Kansas, 1972, 53–61), and Maloney and Hopkins (Journal of Applied Behavior Analysis, 1973, 6 , 425–434). Implications lie in continued experimental analysis of behavior approach to the concept called “creativity”. Additionally, implications are made in classroom application of assessing and intervening in the area of divergent responding for children with deficits in those areas.     

INSTRUCTIONS,FEEDBACK, AND REINFORCEMENT IN REDUCING ACTIVITY LEVELS IN THE CLASSROOM

The biomotometer, an electronic device which simultaneously measures motor activity and provides auditory feedback, was used in combination with material reinforcers in an experiment to reduce children's activity level in a classroom setting. Subjects were nine boys and two girls, aged 9–13, from a day hospital program for emotionally disturbed children. After five baseline trials, each child had five contingent reinforcement trials in which he/she received feedback “beeps” from the biomotometer and was given toy or candy rewards after each trial in which activity fell at least 20% below mean baseline level. Then five noncontingent reinforcement trials were run in which children received rewards for wearing the apparatus without the feedback attachment. Results indicated that the intervention “package,” including instructions, feedback, and contingent reinforcement, was successful in all five trials for 8 of 11 children. Activity levels increased during the final noncontingent phase.     

REDUCING AGGRESSIVE AND SELF-INJURIOUS BEHAVIOR OF INSTITUTIONALIZED RETARDED CHILDREN THROUGH REINFORCEMENT OF OTHER BEHAVIORS1

Aggressive and self-injurious behaviors of four retarded children were reduced by combining various techniques with the differential reinforcement of other behaviors (DRO). In one study, aggressive responses of a severely retarded child were reduced when DRO was combined with a 30-sec timeout. In a second study, various aggressive classroom behaviors were reduced when the child was told “no” for an inappropriate response but earned puzzle pieces for periods of time when inappropriate responses did not occur. Exchangeable tokens were given to a third subject for every 15 min in which aggressive responding did not occur, while each inappropriate response resulted in the loss of all tokens accrued. Responding was decreased to a level far below baseline. For a fourth child, self-injurious responses were followed by “no”, and intervals of time in which no self-injurious responding occurred earned candy. The rate of this behavior reduced significantly. In each case, the DRO procedure combined with the other techniques proved to be manageable for the teacher and successful in reducing the inappropriate behavior.     

EFFECTS OF DIRECT,INTERMITTENT, AND VICARIOUS REINFORCEMENT PROCEDURES ON THE DEVELOPMENT AND MAINTENANCE OF INSTRUCTION-FOLLOWING BEHAVIORS IN A GROUP OF YOUNG CHILDREN1

A group of young children (mean age: 2.5 yr) were instructed to follow different requests by a teacher in a day-care setting. Experiment I verified that mean group instruction following was low (10%) despite the opportunity for “observational learning”, i.e., the group of 12 children could watch a nonreinforced adult comply with the teacher's request. In Experiment II, when positive consequences were provided contingent on the adult model's behavior, mean group instruction following was relatively unaffected (14%). When direct reinforcement was given to four peer models, each for several sessions, the individual performances of three of the four peer models was elevated (from 50% to 80%); however, the mean performance of the remaining nonreinforced children (N = 7) was only moderately affected (21%). When reinforcement contingencies were again changed, so that each group member was provided direct, but intermittent reinforcement, mean group performance increased substantially to levels of over 70%. Once instruction following was high, presentation of reinforcement only to one peer model sufficed to maintain performance whereas earlier, this same vicarious reinforcement procedure had failed to establish group compliance. The maintenance of instruction-following behavior when reinforcement was applied solely to one child was interpreted mainly in terms of a high resistance to extinction following a history of intermittent reinforcement rather than a “vicarious”- or “self”-reinforcement mechanism. Finally, removal and re-introduction of group intermittent reinforcement, respectively, lowered performance (to levels of 40%) and elevated (to levels of 65%) the group's performance.     

THERAPIST‐ AND SELF‐MONITORED DRO CONTINGENCIES AS A TREATMENT FOR THE SELF‐INJURIOUS SKIN PICKING OF A YOUNG MAN WITH ASPERGER SYNDROME

The use of differential reinforcement of other behavior (DRO) has decreased, at least partially due to the development of less effortful alternative behavioral interventions (e.g., noncontingent reinforcement; Vollmer, Iwata, Zarcone, Smith, & Mazaleski, 1993). The effort associated with DRO contingencies may be lessened by incorporating self‐monitoring components in which clients are responsible for the delivery of reinforcers for their own behavior. The current study evaluates the effectiveness of DRO in the treatment of self‐injury when implemented first by the therapist and subsequently by the client.     

TOKEN REINFORCEMENT DURING THE INSTATEMENT AND SHAPING OF FLUENCY IN THE TREATMENT OF STUTTERING

The value of token reinforcement in the instatement and shaping of fluency was examined in an intensive treatment program for adult stutterers. Experiment 1 examined the effect of removing the tangible back-up reinforcers for the token system and found that clients' performance in the program was equally good with or without these back-up reinforcers, suggesting that a strict token economy may not be crucial to rapid progress through treatment. Experiment 2 compared contingent and noncontingent token reinforcement, while controlling for some variables that may have confounded the results of earlier research, and found no difference in clients' performance. Experiment 3 examined the effect of the entire removal of token reinforcement. Performance was found to be no worse under a “no tokens” system than under a system of tokens with back-up reinforcers. It is argued that in a highly structured treatment program where many other reinforcers are operating, token reinforcement may be largely redundant. Clinical and theoretical implications of the findings are discussed.     

NONCONTINGENT ESCAPE AS TREATMENT FOR SELF-INJURIOUS BEHAVIOR MAINTAINED BY NEGATIVE REINFORCEMENT

We extended research on the role of noncontingent positive reinforcement following a functional analysis of attention-maintained self-injurious behavior to self-injury maintained by negative reinforcement in 2 young males with developmental disabilities. During a pretreatment functional analysis, each participant's self-injury was shown to be differentially sensitive to escape from instructional activities as negative reinforcement. During noncontingent escape, escape from learning activities was provided on a fixed-time schedule that was not influenced by the participant's behavior. One participant was also exposed to differential negative reinforcement of other behavior. During this condition, escape from instructional activities was provided contingent on the omission of self-injury for prespecified intervals. Results showed that the provision of escape, even when noncontingent, resulted in significant reductions in self-injury. These results are particularly interesting in light of the experimental history of noncontingent reinforcement as a control rather than as a therapeutic procedure. Noncontingent escape is discussed as a form of extinction that may be less likely than other forms of extinction to produce severe side effects.     

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.     

MAINTENANCE OF THERAPEUTIC CHANGE BY MOMENTARY DRO

Differential reinforcement of other behavior (DRO) involves delivery of reinforcement at the end of an interval during which the target behavior has not occurred. Momentary DRO, however, is a procedure in which reinforcement is delivered if a response did not occur at the end of an interval. We examined the extent to which momentary DRO maintained suppression, following initial treatment with whole-interval DRO, of nine retarded students' maladaptive behavior. Results indicate that momentary DRO maintained response suppression comparable to that obtained by whole-interval DRO.     

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.     

A COMPARISON OF TWO PROCEDURES FOR PROGRAMMING THE DIFFERENTIAL REINFORCEMENT OF OTHER BEHAVIORS

The relative effectiveness of two methods of programming DRO schedules of reinforcement was examined in two experiments. In these two methods, reinforcement is delivered if inappropriate responding is not occurring (a) at the end of an interval (momentary DRO), or (b) throughout the entire interval (whole-interval DRO). In Experiment 1, the effects of these schedules on disruptive responding of three retarded students were assessed in a multiple-baseline design. For two students, the momentary schedule occurred first and was ineffective, whereas the whole interval that followed was effective; for the third student, the whole-interval schedule occurred first and was effective, and reduced responding was maintained under the momentary schedule. In Experiment 2, baseline and the two DRO schedules were each presented in random order each day to one student in an alternating treatments design. The momentary DRO schedule reduced responding, but the whole-interval schedule was more effective.     

COMBINING NONCONTINGENT REINFORCEMENT AND DIFFERENTIAL REINFORCEMENT SCHEDULES AS TREATMENT FOR ABERRANT BEHAVIOR

Research has shown that noncontingent reinforcement (NCR) can be an effective behavior-reduction procedure when based on a functional analysis. The effects of NCR may be a result of elimination of the contingency between aberrant behavior and reinforcing consequences (extinction) or frequent and free access to reinforcers that may reduce the participant's motivation to engage in aberrant behaviors or mands. If motivation is momentarily reduced, behavior such as mands may not be sensitive to positive reinforcement. In this study, for 3 children with aberrant behavior maintained by tangible positive reinforcement, differential-reinforcement-of-alternative-behavior schedules were superimposed on NCR schedules to determine if mands could be strengthened. Results for the participants indicated that NCR did not preclude reinforcement of mands.     

COMPETITION BETWEEN POSITIVE AND NEGATIVE REINFORCEMENT IN THE TREATMENT OF ESCAPE BEHAVIOR

We compared the effects of reinforcing compliance with either positive reinforcement (edible items) or negative reinforcement (a break) on 5 participants' escape-maintained problem behavior. Both procedures were assessed with or without extinction. Results showed that compliance was higher and problem behavior was lower for all participants when compliance produced an edible item rather than a break. Treatment gains were achieved without the use of extinction. Results are discussed regarding the use of positive reinforcement to treat escape behavior.     

A comparison of differential reinforcement and noncontingent reinforcement for the treatment of a child's multiply controlled problem behavior

Noncontingent reinforcement (NCR) and differential reinforcement of other behavior (DRO) with escape as the reinforcer were evaluated after an initial functional analysis indicated the problem behaviors exhibited by a 7 year old child were maintained by escape. When NCR and DRO did not decrease the problem behaviors, a second functional analysis was conducted and showed that the behaviors were maintained by attention and escape. DRO with attention and escape as reinforcers was compared to NCR with attention and escape as reinforcers for the treatment of the child's multiply controlled behavior problems. Results showed that DRO and NCR were both effective at reducing the problem behavior to low levels and increasing compliance. Copyright © 2003 John Wiley & Sons, Ltd.     

REDUCING WANDERING BY PERSONS WITH DEMENTIA USING DIFFERENTIAL REINFORCEMENT

Wandering behavior of 4 geriatric patients with dementia residing in a long-term care facility was assessed using direct behavioral observations. The consequences identified during the observations as maintaining wandering for each patient were then applied for the absence of wandering using differential reinforcement of other behavior (DRO). The effectiveness of the DRO procedure was evaluated using an ABAB design. Results indicated significant reductions in wandering during treatment.     

“Other” behavior and the DRO: The roles of extinction and reinforcement

Jessel et al. (2015) provided some evidence to suggest that “other” behavior is strengthened in the differential reinforcement of other behavior (DRO). The present study is a systematic replication of the Jessel et al. procedures. The effects of DRO and extinction on target responding, target-other responding (a response with an established history of reinforcement), and nontarget-other responding emitted by children with intellectual and developmental disabilities and children with no known diagnoses were compared. Other behavior increased in at least one DRO condition for each participant, suggesting that other behavior increases when using DRO, at least initially. Under extinction, target responding and target-other responding decreased to low rates for three of the five participants; however, rates of nontarget-other responding were elevated compared to the DRO condition. These results suggest that increased rates of target-other responding and nontarget-other responding during the DRO condition may be a result of extinction-induced variability.