Treatment of self-injury and hand mouthing following inconclusive functional analyses

Evaluation of a multicomponent intervention for diurnal bruxism in a young child with autism

Bruxism, forceful grinding of one's teeth together, can produce destructive outcomes such as wear on the teeth and damaged gums and bone structures. The current study implemented a multicomponent intervention that consisted of vocal and physical cues to decrease rates of bruxism. A partial component analysis suggested that the vocal cue was only effective at decreasing levels of bruxism when paired with a simultaneous physical cue.

Progressing from brief assessments to extended experimental analyses in the evaluation of aberrant behavior

The role of experimental analyses in guiding treatment is well established. However, not all experimental analyses yield conclusive results. Outcomes may be inconclusive due to time limitations that preclude extended observation and detailed experimental manipulations, or may result from interactions across experimental conditions, multiple control, or other unknown factors. In this study, we describe an assessment sequence that moves through four phases beginning with relatively brief (1 to 2 hr) analyses and culminating in extended analyses that may control for experimental confounding effects (e.g., interaction effects). Data illustrating the model are presented for 20 individuals referred for severe behavior problems including self-injury, aggression, stereotypy, and tantrums. Analyses were considered to be complete only when clear and replicable response patterns emerged. Results showed that clear and replicable response patterns emerged for 85% of the participants.

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.

Identifying Stimuli that Alter Immediate and Subsequent Levels of Vocal Stereotypy

We used a three-component multiple-schedule with a brief reversal design to evaluate the effects of structurally unmatched and matched stimuli on immediate and subsequent vocal stereotypy that was displayed by three children with autism spectrum disorders. For 2 of the 3 participants, access to matched stimuli, unmatched stimuli, and music decreased immediate levels of vocal stereotypy; however, with the exception of matched stimuli for one participant, none of the stimuli produced a clear abolishing operation for subsequent vocal stereotypy. That is, vocal stereotypy typically increased to baseline levels shortly after alternative stimulation was removed. Detection of motivating operations for each participant’s vocal stereotypy was aided by the analysis of component distributions. The results are discussed in terms of immediate and subsequent effects of preferred stimuli on automatically reinforced problem behavior.

Progressing from initially ambiguous functional analyses: three case examples

Most often functional analyses are initiated using a standard set of test conditions, similar to those described by Iwata, Dorsey, Slifer, Bauman, and Richman [Iwata, B. A., Dorsey, M. F., Slifer, K. J., Bauman, K. E., & Richman, G. S. (1994). Toward a functional analysis of self-injury. Journal of Applied Behavior Analysis, 27, 197-209 (Reprinted from Analysis and Intervention in Developmental Disabilities, 2, 3-20, 1982)]. These test conditions involve the careful manipulation of motivating operations, discriminative stimuli, and reinforcement contingencies to determine the events related to the occurrence and maintenance of problem behavior. Some individuals display problem behavior that is occasioned and reinforced by idiosyncratic or otherwise unique combinations of environmental antecedents and consequences of behavior, which are unlikely to be detected using these standard assessment conditions. For these individuals, modifications to the standard test conditions or the inclusion of novel test conditions may result in clearer assessment outcomes. The current study provides three case examples of individuals whose functional analyses were initially undifferentiated; however, modifications to the standard conditions resulted in the identification of behavioral functions and the implementation of effective function-based treatments.

Comparing preference assessments: selection- versus duration-based preference assessment procedures

In the current investigation, the results of a selection- and a duration-based preference assessment procedure were compared. A Multiple Stimulus With Replacement (MSW) preference assessment [Windsor, J., Piché, L. M., & Locke, P. A. (1994). Preference testing: A comparison of two presentation methods. Research in Developmental Disabilities, 15, 439-455] and a variation of a Free-Operant (FO) preference assessment procedure [Roane, H. S., Vollmer, T. R., Ringdahl, J. E., & Marcus, B. A. (1998). Evaluation of a brief stimulus preference assessment. Journal of Applied Behavior Analysis, 31, 605-620] were conducted with four participants. A reinforcer assessment was conducted to determine which preference assessment procedure identified the item that produced the highest rates of responding. The items identified as most highly preferred were different across preference assessment procedures for all participants. Results of the reinforcer assessment showed that the MSW identified the item that functioned as the most effective reinforcer for two participants.

A review of behavioral treatments for self-injurious behaviors of persons with autism spectrum disorders

Autism spectrum disorders (ASD) are considered to be among the most serious of the mental health conditions. Concomitant with many cases of ASD is intellectual disability. Further compounding the disability is the fact that both conditions are known risk factors for self-injurious behavior (SIB). To date, the most effective intervention methods, based on the available data, appear to be variants of behavior modification. This article provides an overview of the current status of learning-based interventions for SIB in ASD and provides a review of specific studies. Although most studies describe some combination of reinforcement and punishment procedures, efforts are under way to develop more positively oriented strategies, such as functional assessment, to decrease the use of punishment. However, almost all the treatment studies employ single case designs, thus preventing a comparison of treatment efficacy. These issues are discussed along with other strengths, weaknesses, and future directions for clinical practice and treatment.

Positive behavioral intervention in children who were wards of the court attending a mainstream school

This report looked at the effects of treatment using contingency contracts and token economy procedures in three children, two 14 yr. and one 8 yr., who were wards of the court and attending a mainstream school. Students presented problems of adaptation to school, such as making constant noises with the mouth, hands, or pencil on the desk; frequently emitted raucous cries in the classroom; destruction of school resource materials; verbal aggression to classmates and teachers; verbal rejection of all academic work, refusing to do it, making negative comments prior to starting any school activity, in addition to lack of motivation for undertaking school activities. A 4-mo. individual treatment using contingency contracts and token economy behavioral procedures was implemented, with several follow-up sessions. The results indicated an adaptation of behavior to the school environment, confirmed by teachers, significantly reducing the incidence of insults, the destruction of school materials, and indolence during class sessions. These students are at high risk for social exclusion. Interventions have potential social importance in possible prevention of adult criminality, increasing academic achievement, and decreasing social exclusion.

A method for describing preschoolers' activity preferences

We designed a series of analyses to develop a measurement system capable of simultaneously recording the free-play patterns of 20 children in a preschool classroom. Study 1 determined the intermittency with which the location and engagement of each child could be momentarily observed before the accuracy of the measurement was compromised. Results showed that intervals up to 120 s introduced less than 10% measurement error. Study 2 determined the extent of agreement between two observers who simultaneously collected data for 20 children using 30-, 60-, 90-, and 120-s momentary time sampling (MTS) intervals. The three larger intervals resulted in high levels of interobserver agreement (above 90%), whereas the 30-s interval resulted in unacceptably low levels of agreement (less than 80%). By allowing observers to select from among the different MTS intervals via a datasheet array and then collect data with the chosen system, Study 3 determined observers' preferences for the remaining MTS intervals. Both data collectors preferred the 90-s MTS procedure. The sensitivity of the 90-s MTS procedure, which was shown to be accurate, reliable, and preferred, was then demonstrated by its use to describe activity preferences of a classroom of children in Study 4. This system identified high- and low-preference activities for individual children and revealed interesting patterns of response allocation by the group.

Practical implications of data reliability and treatment integrity monitoring

Data reliability and treatment integrity have important implications for clinical practice because they can affect clinicians' abilities to accurately judge the efficacy of behavioral interventions. Reliability and integrity data also allow clinicians to provide feedback to caregivers and to adjust interventions as needed. We present reasons why reliability and integrity measures are paramount in clinical work, discuss events that may result in decreased reliability or integrity, and provide several efficient means for collecting data and calculating reliability and integrity measures.

Assessing and treating vocal stereotypy in children with autism

Previous research implies that stereotypic behavior tends to be maintained by the sensory consequences produced by engaging in the response. Few investigations, however, have focused on vocal stereotypy. The current study examined the noncommunicative vocalizations of 4 children with an autism spectrum disorder. First, functional analyses were conducted in an attempt to identify the function of each child's behavior. For each of the participants, it was found that vocal stereotypy was likely not maintained by the social consequences. Following assessment, response interruption and redirection (RIRD) was implemented in an ABAB design to determine whether vocal stereotypy could be successfully redirected. RIRD involved a teacher issuing a series of vocal demands the child readily complied with during regular academic programming. Vocal demands were presented contingent on the occurrence of vocal stereotypy and were continuously presented until the child complied with three consecutively issued demands without emitting vocal stereotypy. For each child, RIRD produced levels of vocal stereotypy substantially lower than those observed in baseline. For 3 of the children, an increase in appropriate communication was also observed. The children's teachers were trained to implement RIRD. Brief follow-up probes and anecdotal information implied that the treatment had a positive impact in the natural environment.

Leisure items as controls in the attention condition of functional analyses

Leisure items (e.g., games, toys) are commonly made available as controls during attention conditions of functional analyses (Ringdahl, Winborn, Andelman, & Kitsukawa, 2002). However, Ringdahl et al. raised questions about this practice. This paper reviews research that supports and conflicts with the inclusion of leisure items as controls, including a quantitative analysis of relevant articles published in the Journal of Applied Behavior Analysis over a 10-year period. Data reviewed suggest that practitioners may consider omitting leisure items as controls or including such items strategically based on the accumulation of assessment information.

Stereotypy I: a review of behavioral assessment and treatment

In this paper, we review definitional issues related to stereotypy, behavioral interpretations of stereotypy, procedures for determining operant function(s) of stereotypy, and behavioral interventions for stereotypy. In general, a preponderance of the assessment literature suggests that most forms of stereotypy are maintained by automatic reinforcement. Review of the treatment literature suggests that antecedent (e.g., environmental enrichment) and consequent (e.g., differential reinforcement of alternative behavior) interventions produce at least short-term reductions in stereotypy. Suggestions for further assessment and treatment of stereotypy are provided.

Stereotypy II: a review of neurobiological interpretations and suggestions for an integration with behavioral methods

Stereotypy is a relatively common behavioral disorder displayed by individuals with developmental disabilities, including autism. In this paper, we review selected studies on neurobiological interpretations of stereotypy and pharmacological interventions for stereotypy. Specifically, we review studies that evaluated the effects of serotonin uptake inhibitors (e.g., clomipramine) or opioid antagonists (e.g., naltrexone) on stereotypy displayed by humans. Throughout, suggestions are made for the incorporation of behavioral methods into this area of research.

On the role of preference in response competition

A duration-based preference assessment identified items that matched and did not match the sensory consequences hypothesized to maintain stereotypy. When evaluated in treatment, these items effectively competed with the occurrence of stereotypy, regardless of their sensory properties. It is suggested that relative preference, as measured in duration-based assessment, can be as significant as type of stimulation produced in interventions that reduce automatically reinforced problem behavior.

Individualized sampling parameters for behavioral observations: enhancing the predictive validity of competing stimulus assessments

Recent studies have used pretreatment analyses, termed competing stimulus assessments, to identify items that most effectively displace the aberrant behavior of individuals with developmental disabilities. In most studies, there appeared to have been no systematic basis for selecting the sampling period (ranging from 30 s to 10 min) in which items were assessed. Unfortunately, estimates based on brief samples of behavior do not always predict the extent to which items will displace aberrant behavior over longer periods. This study first examined a method for determining an accurate individualized sample length for competing stimulus assessments, based on statistical measures of correspondence with extended effects, using a small number of items. The effects of a larger number of items were then assessed using the determined sample length. Finally, the method was validated by comparing its predictions, in terms of the reduction of problem behavior over more extended periods, to predictions based on sample durations typically used in previous investigations. For two participants, predictions based on individualized determination of sample lengths were more accurate than predictions based on typical sample lengths. These results are discussed in terms of the exchange between expediency and accuracy during competing stimulus assessments.

Considering student choice when selecting instructional strategies: a comparison of three prompting systems

Three secondary age students with moderate intellectual disabilities learned to use the system of least prompts, a self-operated picture prompting system, and a self-operated auditory prompting system to use a copy machine and a debit machine. Both the effectiveness and efficiency of these prompting systems were compared. Additionally, student preference of instructional method was examined. The results demonstrated that each prompting system was effective and efficient with varying students when skill acquisition and duration of task performance were measured. All students demonstrated increased independence in completing both tasks. This study found that the preferred prompting systems were more effective in terms of both skill acquisition and duration for completing tasks for students.

Analysis of response allocation in individuals with multiple forms of stereotyped behavior

Three experiments were conducted to evaluate response allocation of stereotypy during free-operant and restricted-operant conditions. Five children with autism or related developmental disabilities participated in at least one and up to three of the experiments. In Experiment 1, the stereotypic response that emerged as most probable during a free-operant phase was restricted, and response allocation was again evaluated. The results for 3 participants showed that restricting the high-probability response was correlated with covarying reductions in a nontargeted stereotypy. In Experiment 2, the effect of environmental enrichment on response allocation was evaluated. One participant reallocated behavior to appropriate object manipulation, 1 participant showed no change in behavior, and a 3rd participant reallocated behavior to object manipulation only when the putative stimulus products of the object manipulation matched those of stereotypy. In Experiment 3, additional interventions were implemented to promote response reallocation. Results showed that both response restriction and reinforcement for object manipulation decreased stereotypy and increased object manipulation. Collectively, the results of these experiments point to a need for complex evaluations of interventions for stereotypy.

Increasing toy play among toddlers with multiple disabilities in an inclusive classroom: a more-to-less, child-directed intervention continuum

We evaluated a more-to-less, child-directed continuum of interventions to increase toy play among toddlers with multiple disabilities in an inclusive classroom. In keeping with recommended practices in early intervention, all procedures were conducted within the toddlers' classroom. Following initial observations of three toddlers (under 3 years of age) that indicated toy play was less frequent than that of their typically developing peers, preference assessments were conducted of selected toys. The toddlers were then provided with repeated choices of preferred toys in a child-directed manner. Two of the toddlers subsequently received staff prompts and praise for toy play, representing a less child-directed (i.e., more staff-directed) intervention component, in addition to choices of preferred toys. Overall, toy play as well as nonprompted toy play increased for one toddler during the former condition and for two toddlers during the latter condition. For two of the toddlers, toy play increased to a level commensurate with that of their classmates who did not have disabilities. Small increases also occurred in the number of toys played with by each toddler. Results are discussed in terms of how intervention procedures can be applied along a more- to less-child-directed continuum based on individual child responsiveness to respective procedures. Areas for future research discussed include applying the continuum with other child behaviors, including more advanced toy play.

Observational assessment of toy preferences among young children with disabilities in inclusive settings. Efficiency analysis and comparison with staff opinion

Numerous investigations have demonstrated means of assessing preferences among students and adults with disabilities. In contrast, there has been little attention on preference identification among young children. We evaluated a preference assessment with 7 toddlers and preschoolers with disabilities in inclusive programs. First, identification of toy-play preferences was compared across three assessments that varied in amount of toy-play behavior sampled and time required for implementation (5-, 10-, and 15-session assessments). Second, results of the assessments were compared to staff opinion. Results indicated the most efficient assessment identified preferences that generally were consistent with preferences identified with the less time-efficient assessments. Results also indicated staff reports did not consistently indicate which toys were played with most frequently. Overall, results demonstrate an efficient means of determining preferences among young children with disabilities in inclusive settings. Results also suggest that staff opinion should not be relied on exclusively to determine preferences.

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.

Assessment and treatment of vocal tics associated with Tourette's syndrome

A functional analysis suggested that a young man's vocal tics were maintained by automatic reinforcement. A preference assessment was conducted to identify stimuli that effectively competed with the occurrence of vocal tics. When used as components of a reinforcement-based intervention, however, these stimuli were ineffective at reducing the occurrence of vocal tics. Observations conducted in a naturalistic context led to the hypothesis that variations in tics were associated with body positioning. Thus, an additional analysis was conducted to determine if vocal tics occurred less when the participant was lying down versus when he was seated upright. Results suggested that a combination of procedures might be useful in developing idiosyncratic interventions for automatically reinforced problem behavior, such as vocal tics.

Functional analysis of problem behavior in children with mental retardation

Pediatric nurses are frequently asked to give advice on behavior management. This can become considerably more difficult when the child in question has limited cognitive abilities and communication skills. It is especially complex when the behavior in question involves self-injury or aggression. Frequently used behavior modification strategies such as time-out may actually reinforce the inappropriate behavior in these children by allowing them to escape from an aversive task. Likewise, other common behavior management strategies such as discussion, saying "no," or yelling at the child, may reinforce the inappropriate behavior by providing attention for it. It is sometimes difficult to identify the antecedents of self-injurious or aggressive behavior, making appropriate behavior management plans elusive. However, functional analysis can be used to identify the functions that serve to maintain a child's inappropriate behavior, and may provide a basis for developing and implementing an individualized behavior management plan. The possibility that discomfort from an untreated or undertreated physiologic problem is exacerbating the behavior should not be overlooked.

Assessing reinforcers under progressive schedule requirements

Recent research findings suggest that reinforcing stimuli may be differentially effective as response requirements increase. We extended this line of research by evaluating responding under increasing schedule requirements via progressive-ratio schedules and behavioral economic analyses. The differential effectiveness of preferred stimuli in treating destructive behavior maintained by automatic reinforcement also was examined. Results showed that one of two stimuli was associated with more responding under increasing schedule requirements for the 4 participants. Furthermore, stimuli associated with more responding under increasing schedule requirements generally were more effective in treating destructive behavior than stimuli associated with less responding. These data suggest that progressive-ratio schedules and behavioral economic analyses may be useful for developing a new technology for reinforcer identification. From a clinical perspective, these results suggest that two reinforcers may be similarly effective for low-effort tasks and differentially effective for high-effort tasks.

Effects of a fixed-time schedule on aberrant and adaptive behavior

Fixed-time (FT) schedules of reinforcement have been used to decrease destructive behavior. However, the effects of FT schedules on acquisition and maintenance of appropriate behavior remain unclear. In this study, we present a case in which an FT schedule produced an increase in adaptive behavior and resulted in a significant decrease in destructive behavior.

Parametric analysis of overcorrection duration effects. Is longer really better than shorter?

Positive practice overcorrection (PPOC) has long played a significant role in the behavioral treatment of serious self-stimulatory behavior. Three experiments comparing the effectiveness of 30-second, 2-minute, and 8-minute PPOC on reduction of stereotypic hand behavior of adults with severe to profound developmental disabilities were conducted to resolve inconsistencies in previously reported findings concerning the role of PPOC duration in response suppression. Experiment 1, which used an alternating treatments--multiple baseline design, suggested that the different durations were equally effective in reducing the stereotypic behaviors to near-zero levels. Experiment 2, which used a reversal design, supported the findings of Experiment 1. Experiment 3, which used a reversal design to test the shortest and longest durations, generally confirmed the results of the first two experiments. This study therefore failed to support the oft-claimed superiority of long-duration PPOC. The possible factors underlying these findings and their implications for future research and practice are discussed.

Recent advances in the assessment of aberrant behavior maintained by automatic reinforcement in individuals with developmental disabilities

Many aberrant behaviors exhibited by individuals with developmental disabilities are maintained by "automatic reinforcement". These behaviors are often difficult to treat, with the most effective behavioral interventions often resulting in only moderate success. However, a series of recent studies has advanced our ability to understand and treat these behaviors through the innovative use of behavioral assessment. We review the recent development of three categories of assessments: (a) nonhypothesis-based stimulus preference assessments, (b) hypothesis-based stimulus preference assessments, and (c) hypothesis-based assessments incorporating noncontingent reinforcement and sensory extinction procedures. We consider each category's contribution to both our ability to prescribe effective behavioral interventions and our ability to more fully understand the concept of automatic reinforcement.

An evaluation of the effects of matched stimuli on behaviors maintained by automatic reinforcement

The purpose of the current investigation was to extend the literature on matched stimuli to three dissimilar forms of aberrant behavior (dangerous climbing and jumping, saliva manipulation, and hand mouthing). The results of functional analyses suggested that each behavior was automatically reinforced. Preference assessments were used to identify two classes of stimuli: items that matched the hypothesized sensory consequences of aberrant behavior (matched stimuli) and items that produced sensory consequences that were not similar to those produced by the aberrant behavior (unmatched stimuli). The effects of providing continuous and noncontingent access to either the most highly preferred matched or the most highly preferred unmatched stimuli were assessed relative to a condition in which no stimuli were available. Overall results suggested that providing access to items that matched the hypothesized sensory consequences of aberrant behavior may be more effective than simply selecting stimuli either arbitrarily or based on the results of preference assessments alone.

Integrating basic and applied research and the utility of Lattal and Perone's Handbook of research methods in human operant behavior

Lattal and Perone's Handbook of methods used in human operant research on behavioral processes will be a valuable resource for researchers who want to bridge laboratory developments with applied study. As a supplemental resource, investigators are also encouraged to examine the series of papers in the Journal of Applied Behavior Analysis that discuss basic research and its potential for application. Increased knowledge of behavioral processes in laboratory research could lead to innovative solutions to practical problems addressed by applied behavior analysts in the home, classroom, clinic, and community.

Experimental functional analyses for challenging behavior: a study of validity and reliability

The convergent validity of an experimental (analog) functional analysis was investigated by a comparison of three separate ways of interpreting the data derived from such an assessment: two previously published methods and the criterion Z method derived by the authors. Data from the experimental functional analysis of the challenging behavior(s) of 27 individuals with intellectual disabilities were analyzed to assess agreement between the three forms of interpretation. The test-retest reliability of all three methods over periods of 2 weeks, 1 month, and 3 months was also calculated. The results suggest that the methods of interpreting function from experimental assessments can give different results and that the test-retest reliability of the experimental functional analyses is poor. The implications of these findings are discussed in relation to clinical practice.

A validity study on the Questions About Behavioral Function (QABF) Scale: predicting treatment success for self-injury, aggression, and stereotypies

We investigated the validity of the Questions About Behavioral Function (QABF), a checklist designed to assess antecedent behavior, using a sample of 398 persons with mental retardation and a targeted maladaptive behavior of self-injurious behavior, aggression, or stereotypies. The QABF was used successfully to derive clear behavioral functions for most individuals (84%) across all three target behaviors. Further, subjects with treatments developed from functional assessment (QABF results) improved significantly when compared to controls receiving standard treatments not based on functional analysis. Implications of the present findings for assessing and treating maladaptive behaviors are discussed.

On the relation between object manipulation and stereotypic self-injurious behavior

Results from a number of studies have shown an inverse relationship between stereotypic behavior and object manipulation. The purposes of this study were to determine whether techniques similar to those used previously (prompting and reinforcement) would be effective in increasing object manipulation under both prompted and unprompted conditions, and to ascertain whether increases in object manipulation would result in decreases in stereotypic self-injurious behavior (SIB). Two individuals with developmental disabilities who engaged in SIB maintained by automatic reinforcement participated. Results showed that object manipulation increased from baseline levels when experimenters prompted participants to manipulate leisure items, but that object manipulation was not maintained under unprompted conditions, and rates of SIB stayed within baseline levels. We then attempted to increase object manipulation further by (a) reinforcing object manipulation, (b) blocking SIB while reinforcing manipulation, and (c) preventing SIB by applying protective equipment while reinforcing object manipulation. Reinforcing object manipulation alone did not affect levels of object manipulation. Blocking effectively reduced attempts to engage in SIB for 1 participant but produced no increase in object manipulation. When the 2nd participant was prevented from engaging in SIB through the use of protective equipment, rates of object manipulation increased dramatically but were not maintained when the equipment was removed. These results suggest that stimulation derived from object manipulation, even when supplemented with arbitrary reinforcement, may not compete with stimulation produced by stereotypic SIB; therefore, direct interventions to reduce SIB are required.

Effects of reinforcement for alternative behavior during punishment of self-injury

A number of variables influence the effectiveness of punishment and may determine the extent to which less intrusive forms of punishment may be used as alternatives to more intrusive interventions. For example, it has been suggested that response suppression during punishment may be facilitated if reinforcement is concurrently available for an alternative response. However, results of basic research demonstrating this finding have not been replicated with interventions more commonly prescribed as treatments for problem behavior. We evaluated the effects of relatively benign punishment procedures (reprimands or brief manual restraint) on the self-injurious behavior of 4 individuals who had been diagnosed with mental retardation, when access to reinforcement for alternative behavior (manipulation of leisure materials) was and was not available. In all cases, punishment produced greater response suppression when reinforcement for an alternative response was available.

Further analysis of problem behavior in response class hierarchies

A functional analysis identified the reinforcers for 3 participants' problem behavior, but only relatively mild problem behaviors (e.g., screaming, disruption) were observed when all topographies produced tested consequences. We then conducted an extinction analysis in which specific topographies produced a reinforcer while all other topographies were on extinction. The extinction analysis confirmed that the same reinforcer identified in the initial functional analysis maintained more severe topographies of problem behavior (e.g., aggression). In addition, results of the extinction analysis indicated that 2 of the participants displayed patterns of responding consistent with a response class hierarchy hypothesis, in which less severe problem behavior frequently occurred prior to more severe topographies. The 3rd participant displayed a response pattern indicative of differential reinforcement effects.

Decreasing signs of negative affect and correlated self-injury in an individual with mental retardation and mood disturbances

We evaluated the effects of an enriched environment, based on a paired-choice preference assessment, on both rates of self-injurious behavior (SIB) and percentage of session intervals during which signs of negative affect were displayed by a woman with mental retardation and a mood disorder. Results suggested that SIB and signs of negative affect were highly correlated and that the enriched environment effectively reduced both.

The evaluation and treatment of aggression maintained by attention and automatic reinforcement

In the current investigation, we used direct and indirect methods to assess and treat several topographies of aggression that were hypothesized to have separate operant functions in a young boy with severe mental ratardation and pervasive developmental disorder. First, a functional analysis of aggression, using the methods described by Iwata, Dorsey, Slifer, Bauman, and Richman (1982/1994), was conducted and produced inconclusive results. Next, indirect methods were used to develop a second functional analysis, which showed that chin grinding (firmly pressing and grinding his chin against the skin and bones of others) persisted independent of social contingencies and that the other topographies of aggression (e.g., hitting, kicking) were maintained by social positive reinforcement (attention). A treatment designed to decrease aggression maintained by attention--functional communication training with extinction--reduced all forms of aggression except chin grinding. This latter topography of aggression, which we hypothesized was maintained by automatic reinforcement, was reduced when the response--reinforcer relation was interrupted through response blocking and the child was provided with an alternative form of chin stimulation.

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 complete 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.

Evaluation of a brief stimulus preference assessment

We evaluated the utility of a brief (5-min) stimulus preference assessment for individuals with developmental disabilities. Participants had noncontingent (free) access to an array of stimuli and could interact with any of the stimuli at any time. Stimuli were never withdrawn or withheld from the participants during a 5-min session. In Experiment 1, the brief preference assessment was conducted for 10 participants to identify differentially preferred stimuli, and reinforcer assessments were conducted to test the reinforcing efficacy of those stimuli identified as highly preferred. In Experiment 2, a comparison was conducted between the brief preference assessment and a commonly used paired-stimulus preference assessment. Collectively, results demonstrated that the brief preference assessment identified stimuli that functioned as reinforcers for a simple operant response, identified preferred stimuli that were differentially effective as reinforcers compared to nonpreferred stimuli, was associated with fewer problem behaviors, and required less time to complete than a commonly used paired-stimulus preference assessment.

Assessment and treatment of destructive behavior maintained by stereotypic object manipulation

In the current investigation, 2 participants with mental retardation displayed property destruction and stereotypy, and both responses involved the same materials (e.g., breaking and tapping plastic objects). Three experiments were conducted (a) to indirectly assess the functions of these two responses, (b) to determine their relation to one another, and (c) to develop a treatment to reduce the more serious behavior, property destruction. In Experiment 1, previously destroyed materials were either present or absent, and their presence reduced property destruction but not stereotypy. In Experiment 2, matched toys (ones that produced sensory stimulation similar to stereotypy) were either present or absent, or were replaced by unmatched toys (for 1 participant). Matched toys produced large reductions and unmatched toys produced small reductions in property destruction and stereotypy. In Experiment 3, attempts to pick up undestroyed objects were either blocked or not blocked while matched toys were continuously available. Response blocking reduced property destruction (and attempts), prevented stereotypy, and increased manipulation of matched toys. These results suggest that the two aberrant responses formed a chain (e.g., breaking and then tapping the object), which was maintained by the sensory consequences (e.g., auditory stimulation) of the terminal response, and that previously destroyed material or matched toys made the initial response (property destruction) unnecessary.

A comparison of noncontingent reinforcement and sensory extinction as treatments for self-injurious behavior

We compared the effects of two treatments, noncontingent reinforcement (NCR) and sensory extinction (EXT), on the self-injurious behavior (SIB) exhibited by 3 individuals with developmental disabilities. Results of a functional analysis indicated that their SIB was not maintained by social reinforcement, as indicated by undifferentiated responding across assessment conditions or higher rates of responding in the along condition. Prior to treatment, leisure probes were conducted to identify highly preferred items for use in the NCR condition, and equipment probes were conducted to identify devices that produced the greatest behavioral suppression for use in the EXT condition. Following baseline, treatment was implemented in a multiple baseline across subjects design, and the effects of NCR and EXT were compared in a multielement format. During NCR sessions, participants had continuous access to a highly preferred item. During EXT sessions, participants wore equipment (gloves or protective sleeves) that seemed to attenuate stimulation directly produced by their SIB, while still allowing the behavior to occur. Results indicated that both procedures were effective in reducing SIB, although NCR was associated with either more rapid or greater overall response suppression.

The effect of noncontingent sensory reinforcement, contingent sensory reinforcement, and response interruption on stereotypical and self-injurious behavior

Three analyses were conducted to assess the effects of different consequent stimuli on the rate of stereotypical and self-injurious behavior performed by two individuals with severe developmental disabilities and dual sensory impairments. An analogue functional analysis documented an undifferentiated pattern of problem behavior across all conditions for Participant 1. Data for Participant 2 indicated an undifferentiated pattern with lower frequencies in the demand condition. Stimuli chosen to compete with the type of sensory stimulation produced by the stereotypy and self-injurious behavior were presented noncontingently during play conditions. Noncontingent presentation of the specially selected stimuli resulted in reductions in stereotypy and self-injurious behavior. Finally, contingent presentation of the same stimuli with and without response interruption was assessed in a demand context. Contingent presentation of the specially selected stimuli plus response interruption resulted in more suppression than contingent sensory stimulus presentation alone. Results are discussed as to competing and concurrent schedules of reinforcement.

Noncontingent presentation of attention and alternative stimuli in the treatment of attention-maintained destructive behavior

Previous research has demonstrated that destructive behavior may be reduced through noncontingent presentation of attention when attention is identified as the stimulus responsible for behavioral maintenance. Because it may not always be possible to deliver attention in all situations, we examined the extent to which alternative stimuli that have been identified through a choice assessment would substitute for attention (the functional analysis-based reinforcer) in a noncontingent reinforcement procedure. Prior to treatment, functional analyses demonstrated that the destructive behavior of 2 clients with mental retardation was maintained by adult attention. Next, a stimulus choice assessment identified highly preferred tangible items for the 2 clients. Finally, we compared the effectiveness of two noncontingent reinforcement procedures: continuous noncontingent access to attention and continuous noncontingent access to the tangible item identified in the choice assessment. For both clients, these noncontingent reinforcement procedures reduced destructive behavior. The results are discussed in terms of the clinical implications for the treatment of destructive behavior using functional and alternative stimuli.

Basic and applied research on choice responding

Choice responding refers to the manner in which individuals allocate their time or responding among available response options. In this article, we first review basic investigations that have identified and examined variables that influence choice responding, such as response effort and reinforcement rate, immediacy, and quality. We then describe recent bridge and applied studies that illustrate how the results of basic research on choice responding can help to account for human behavior in natural environments and improve clinical assessments and interventions.

Noncontingent reinforcement as treatment for severe problem behavior: some procedural variations

Noncontingent reinforcement (NCR) as a treatment for problem behavior has typically included (a) continuous access to reinforcers at the onset of treatment and (b) extinction. We extended research on NCR by conducting a three-phase preliminary investigation of these components. In Phase 1, a functional analysis showed that the problem behavior of 3 participants with developmental disabilities was maintained by tangible positive reinforcement. In Phase 2, treatment started with the initial NCR interval based on the latency to the first problem behavior during baseline. In Phase 3, treatment consisted of NCR without extinction to determine whether extinction was an essential treatment component. Results showed that the initial NCR schedule based on latency (Phase 2) and NCR without extinction (Phase 3) were effective for reducing rates of problem behavior compared with baseline. Findings are discussed regarding the initial schedule of reinforcement and extinction as components of NCR.

Noncontingent delivery of arbitrary reinforcers as treatment for self-injurious behavior

Results of recent research have shown that noncontingent reinforcement (NCR) can be effective in reducing the frequency of behavior problems. In typical NCR applications, the reinforcer that is responsible for behavioral maintenance (as demonstrated through a functional analysis) no longer follows occurrences of the target behavior but instead is delivered according to a time-based schedule. Thus, it is unclear if NCR would be effective if the target behavior continued to be reinforced or if arbitrary reinforcers (i.e., those irrelevant to behavioral maintenance) were substituted for the maintaining reinforcers in the NCR procedure. In this study, 2 individuals whose self-injurious behavior (SIB) was maintained by positive reinforcement were exposed to conditions in which arbitrary and maintaining reinforcers were withheld and were delivered either contingently or noncontingently. Results indicated that noncontingent delivery of arbitrary reinforcers was effective in reducing SIB even though occurrences of SIB produced access to the maintaining reinforcer. These results suggest that (a) arbitrary reinforcers may sometimes be substituted for maintaining reinforcers, (b) an important component of NCR procedures is alteration of a behavior's establishing operation, and (c) NCR with arbitrary reinforcers might therefore be effective when maintaining reinforcers cannot be identified or withheld during the course of treatment.