THE FUNCTIONS OF SELF-INJURIOUS BEHAVIOR: AN EXPERIMENTAL-EPIDEMIOLOGICAL ANALYSIS

Data are summarized from 152 single-subject analyses of the reinforcing functions of self-injurious behavior (SIB). Individuals with developmental disabilities referred for assessment and/or treatment over an 11-year period were exposed to a series of conditions in which the effects of antecedent and consequent events on SIB were examined systematically by way of multielement, reversal, or combined designs. Data were collected during approximately 4,000 experimental sessions (1,000 hr), with the length of assessment for individuals ranging from 8 to 66 sessions (M = 26.2) conducted over 2 to 16.5 hr (M = 6.5). Differential or uniformly high responding was observed in 145 (95.4%) of the cases. Social-negative reinforcement (escape from task demands or other sources of aversive stimulation) accounted for 58 cases, which was the largest proportion of the sample (38.1%). Social-positive reinforcement (either attention or access to food or materials) accounted for 40 (26.3%) of the cases, automatic (sensory) reinforcement accounted for 39 (25.7%), and multiple controlling variables accounted for 8 (5.3%). Seven sets of data (4.6%) showed either cyclical or inconsistent patterns of responding that were uninterpretable. Overall results indicated that functional analysis methodologies are extremely effective in identifying the environmental determinants of SIB on an individual basis and, subsequently, in guiding the process of treatment selection. Furthermore, an accumulation of assessment data from such analyses across a large number of individuals provides perhaps the most rigorous approach to an epidemiological study of behavioral function.     

Improvable,yes; insoluble,no: A reply to Flock

The relationship between apparent size and apparent depth in certain forms of the Müller-Lyer illusion is explored both Experimentally and theoretically. The Experimental results show that the apparent Sizes and apparent distances of the Müller-Lyer shafts in the normal and in the “reverse” illusions are related to each other. They also contradict specific predictions About the apparent depth location of Müller-Lyer shafts derived from the Misapplied size-constancy theory and Emmert’s Law. These results are interpreted In terms of the operation of the size-distance Principle, and this interpretation is supported by observations of other illusions.     

EFFECTS OF INTERMITTENT PUNISHMENT ON SELF-INJURIOUS BEHAVIOR: AN EVALUATION OF SCHEDULE THINNING

Although the use of punishment often raises ethical issues, such procedures may be needed when the reinforcers that maintain behavior cannot be identified or controlled, or when competing reinforcers cannot be found. Results of several studies on the effects of intermittent schedules of punishment suggest that therapists must use fairly rich schedules of punishment to suppress problem behavior. However, residential caretakers, teachers, and parents often have difficulty implementing programs that require constant monitoring of the client's behavior. In this study, we examined the feasibility of gradually thinning the delivery of punishment from a continuous schedule to an intermittent schedule during the course of treatment for self-injurious behavior (SIB). Results of functional analyses for 5 individuals who had been diagnosed with profound mental retardation indicated that their SIB was not maintained by social consequences. Treatment with continuous schedules of time-out (for 1 participant) or contingent restraint (for the other 4 participants) produced substantial reductions in SIB. When they were exposed to intermittent schedules of punishment (fixed-interval [FI] 120 s or FI 300 s), SIB for all but 1 of the participants increased to levels similar to those observed during baseline. For these 4 participants, the schedule of punishment was gradually thinned from continuous to FI 120 s or FI 300 s. For 2 participants, SIB remained low across the schedule changes, demonstrating the utility of thinning from continuous to intermittent schedules of punishment. Results for the other 2 participants showed that intermittent punishment was ineffective, despite repeated attempts to thin the schedule.     

Discrete‐trial training performance of behavior interventionists with autism spectrum disorder: A systematic replication and extension

Further research is needed on strategies to improve employment outcomes for individuals with autism spectrum disorder (ASD). We replicated and extended prior research by examining the acquisition, maintenance, and generalization of discrete‐trial training (DTT) performance of adults with ASD who were interested in careers as behavior technicians. Three participants received training on how to implement DTT with children and we assessed the maintenance and generalization of DTT performance in the absence of feedback. Results indicated that procedural integrity generalized across children and targets and maintained for 6 to 17 session days without feedback. Results have implications for the successful employment of individuals with ASD as behavior technicians and for future research on strategies to enhance their performance on the job.     

Inserting mastered targets during error correction when teaching skills to children with autism

Research has identified a variety of effective approaches for responding to errors during discrete‐trial training. In one commonly used method, the therapist delivers a prompt contingent on the occurrence of an incorrect response and then re‐presents the trial so that the learner has an opportunity to perform the correct response independently. Some authors recommend inserting trials with previously mastered targets between the prompted response and opportunities to respond independently, but no studies have directly examined the benefits of this approach. In this study, we manipulated the placement of trials with mastered targets during discrete‐trial training to compare the effectiveness of error correction with and without this recommended insertion procedure. Four children with autism participated, and each was taught 18 targets across 3 target sets. Results indicated that embedding trials with mastered targets into error correction may not confer benefits for most children and that doing so may lead to less efficient instruction.     

Behavior analytic contributions to public health and telehealth

The Journal of Applied Behavior Analysis is launching a special series on the topics of public health and telehealth. The special series begins with the articles in this issue and will continue for the next 2 to 3 issues with an open submission window until September 1, 2020. Behavior analysis has much to offer with respect to public health and much to gain from continued and expanded use of telehealth. This paper outlines the importance of these topics in the current crisis and in our ongoing evolution as a field. The historical literature in behavior analysis is reviewed for each topic along with suggestions for future research. The articles from the special series will be combined with historical contributions from JABA into a virtual issue. We encourage continued submissions on these topics even after the special series is completed as future papers will also be incorporated into the special issue.     

Transfer of treatment effects from combined to isolated conditions during functional communication training for multiply controlled problem behavior

Functional communication training (FCT) is highly effective for treating socially maintained problem behavior when based on the results of functional analyses (FA). Research suggests that combining relevant antecedents and consequences of problem behavior during FCT can be an efficient approach to treatment for behavior that is multiply controlled. However, no studies have evaluated whether treatment effects under combined conditions would transfer to single, or isolated, conditions. Participants were 5 children with autism, aged 3 years to 6 years, who engaged in problem behavior maintained by both escape from demands and access to tangibles. An experimenter coached their caregivers via video conferencing to implement FA and FCT in their homes. All participants received FCT under a combined condition, followed by brief exposure to sessions with isolated antecedents and consequences. Treatment effects for just 1 of the 5 participants immediately persisted under isolated conditions. These results suggest that, when caregivers combine variables relevant to multiple functions during FCT, exposure to isolated conditions may at least temporarily produce treatment failures.     

Theologia Prima—Liturgical Theology as an Ecumenical Challenge to Lutheran Worship Practice

Abstract : The doctrine of justification is of highest importance for Lutheran theology. But regarding their worship practice Lutheran churches seem to be less aware of this priority than Orthodox, Roman‐Catholic and Anglican churches. David Fagerberg, building on Alexander Schmemann, claims the worship service experience is theologia prima, God's action upon God's people. At the same time Andrea Grillo calls the human being an animal ceremoniale stating that liturgy always reminds us that God's action comes first. Can Lutherans building upon this ecumenical liturgical theology find in the worship service the ‘place of justification’?     

Association of Depression with Complications of Diabetic Pregnancy: A Retrospective Analysis

The goal of this study was to determine whether an association between histories of depression and adverse pregnancy outcome could be established using a retrospective analysis. Participants were a convenience sample of 152 pregnant diabetic women for whom prior pregnancy data were available. Prior pregnancy outcome, depression history, and other clinical characteristics were determined from chart review and medical history questionnaires. Logistic regression was used to determine which of the measured clinical factors, including history of depression, had a significant association with history of pregnancy complications. Thirty-nine patients (26%) had a past history of depression. Three pregnancy complications (preterm labor, pre-eclampsia, fetal prematurity) were more common in the group having a history of depression as was the proportion of participants requiring Caesarean section p( < .05 for each comparison). A history of depression was associated with prior pregnancy complications independent of the effects of parity, prepregnancy BMI, tobacco use history, diabetes type, and presence of diabetes complications (OR = 3.6; 95% CI = 1.5–9.0, p = .006). These retrospective data indicate that depression is linked to complications of diabetic pregnancy and support the need for prospective studies to clarify the effects of depression and its treatment on diabetic pregnancy.     

Assessing and teaching job‐related social skills to adults with autism spectrum disorder

Few studies have evaluated interventions to improve the job‐related social skills of adults with autism spectrum disorder. In this study, we examined the efficacy of a treatment package for teaching several social skills that are critical to job success, such as responding appropriately to feedback and asking for a task model from the supervisor. Three adults, aged 19 to 27 years, participated. Initial training of each skill consisted of verbal explanations, modeling, and role‐play with feedback, along with stimulus prompts to promote generalization to a different setting. The trainer introduced additional intervention components as needed. We also evaluated generalization across different social skills and evocative situations. Results indicated that the treatment package was generally effective in improving the targeted social skills, and that stimulus prompts may be necessary for generalization to a job setting. However, generalized responding across social skills rarely emerged. These findings have important implications for preparing individuals with autism to function successfully on the job.