EFFECTS OF STIMULANT MEDICATION UNDER VARIED MOTIVATIONAL OPERATIONS

We evaluated the evocative effects of four conditions (high‐ and low‐preference activities, low and divided attention) and stimulant medication on the behavior of a 16‐year‐old boy with attention deficit hyperactivity disorder and moderate mental retardation. All behavior (activity engagement, activity changes, inappropriate touching, rude behaviors, and physical aggression) improved with stimulant medication in most conditions, but undesirable behaviors were not reduced to acceptable levels in all conditions. This finding suggests that stimulant medication may be a valuable adjunct to function‐based interventions.     

Differential reinforcement of alternative behavior increases resistance to extinction: clinical demonstration, animal modeling, and clinical test of one solution

Basic research with pigeons on behavioral momentum suggests that differential reinforcement of alternative behavior (DRA) can increase the resistance of target behavior to change. This finding suggests that clinical applications of DRA may inadvertently increase the persistence of target behavior even as it decreases its frequency. We conducted three coordinated experiments to test whether DRA has persistence-strengthening effects on clinically significant target behavior and then tested the effectiveness of a possible solution to this problem in both a nonhuman and clinical study. Experiment 1 compared resistance to extinction following baseline rates of reinforcement versus higher DRA rates of reinforcement in a clinical study. Resistance to extinction was substantially greater following DRA. Experiment 2 tested a rat model of a possible solution to this problem. Training an alternative response in a context without reinforcement of the target response circumvented the persistence-strengthening effects of DRA. Experiment 3 translated the rat model into a novel clinical application of DRA. Training an alternative response with DRA in a separate context resulted in lower resistance to extinction than employing DRA in the context correlated with reinforcement of target behavior. The value of coordinated bidirectional translational research is discussed.     

The effects of constant versus varied reinforcers on preference and resistance to change

Previous research has demonstrated that factors such as reinforcer frequency, amount, and delay have similar effects on resistance to change and preference. In the present study, 4 boys with autism made choices between a constant reinforcer (one that was the same food item every trial) and a varied food reinforcer (one that varied randomly between three possible food items). For all 4 boys, varied reinforcers were preferred over constant reinforcers, and they maintained higher response rates than constant reinforcers. In addition, when a distraction (a video clip) was introduced, responding maintained by varied reinforcers was more resistant to distraction than responding maintained by constant reinforcers. Thus, the present experiment extended the generality of the relation between preference and resistance to change to variation in reinforcer quality.     

An evaluation of three methods of saying "no" to avoid an escalating response class hierarchy

We evaluated the effects of three different methods of denying access to requested high-preference activities on escalating problem behavior. Functional analysis and response class hierarchy (RCH) assessment results indicated that 4 topographies of problem behaviors displayed by a 13-year-old boy with high-functioning autism constituted an RCH maintained by positive (tangible) reinforcement. Identification of the RCH comprised the baseline phase, during which computer access was denied by saying "no" and providing an explanation for the restriction. Two alternative methods of saying "no" were then evaluated. These methods included (a) denying computer access while providing an opportunity to engage in an alternative preferred activity and (b) denying immediate computer access by arranging a contingency between completion of a low-preference task and subsequent computer access. Results indicated that a hierarchy of problem behavior may be identified in the context of denying access to a preferred activity and that it may be possible to prevent occurrences of escalating problem behavior by either presenting alternative options or arranging contingencies when saying "no" to a child's requests.     

European developments

The British National Health Service is 50 years old. The provision of many services has changed considerably through this time in ways that reflect shifts in organization and philosophy. The provision of psychotherapy has been particularly sensitive to these changes in ways that have made it more widely available but also shaped its content. As the pace of change continues to accelerate, some implications of the most recent shifts in philosophy for clinical practice are considered.     

A computerized test of self-control predicts classroom behavior

We assessed choices on a computerized test of self-control (CTSC) for a group of children with features of attention deficit hyperactivity disorder (ADHD) and a group of controls. Thirty boys participated in the study. Fifteen of the children had been rated by their parents as hyperactive and inattentive, and 15 were age- and gender-matched controls in the same classroom. The children were observed in the classroom for three consecutive mornings, and data were collected on their activity levels and attention. The CTSC consisted of two tasks. In the delay condition, children chose to receive three rewards after a delay of 60 s or one reward immediately. In the task-difficulty condition, the children chose to complete a difficult math problem and receive three rewards or complete an easier problem for one reward. The children with ADHD features made more impulsive choices than their peers during both conditions, and these choices correlated with measures of their activity and attention in the classroom.     

EFFECTIVENESS OF BRIEF TIME-OUT WITH AND WITHOUT CONTINGENT DELAY: A COMPARATIVE ANALYSIS

We evaluated a commonly used component of brief time-out, in which release from time-out is delayed contingent on the occurrence of disruption. Data were collected for one normal and two mentally retarded children on time-out-producing behaviors (aggression and disruption) as well as delay-producing behaviors during time-out (loud vocalizations, out-of-chair, aggression, and disruption). The results of a combination ABAC reversal and multiple-baseline design indicated that, under the conditions used in this investigation, both delay and no delay variations were effective in reducing the frequency of the target behaviors. Implications for the use of time-out to reduce aberrant behaviors are discussed.     

FUNCTIONAL ANALYSIS AND INTERVENTION FOR BREATH HOLDING

We conducted a functional analysis of breath-holding episodes in a 7-year-old girl with severe mental retardation and Cornelia-de-Lange syndrome. The results showed that breath holding served an operant function, primarily to gain access to attention. The intervention, consisting of extinction, scheduled attention, and use of a picture card communication system, resulted in decreased breath holding.