Toward a functional analysis of self-injury

Collateral Effects of Behavioral Treatment for Problem Behavior on Caregiver Stress

When individuals with autism and intellectual and developmental disabilities exhibit severe problem behavior, assessment and treatment are often warranted. Parents of such individuals are at high risk for developing parenting stress. In this study, 194 parents completed the Parenting Stress Index-Short Form at their child's time of admission to and discharge from inpatient or outpatient treatment for severe problem behavior. Parent stress was examined in relation to rate and function of child problem behavior as determined via functional analysis. Repeated measures analyses of variance were conducted, and differential effects were observed when child participants exhibited an attention, automatic, or mands function for problem behavior. These findings highlight the importance of considering function of problem behavior in relation to parenting stress.

Mand compliance as a contingency controlling problem behavior: A systematic review

Bowman et al. (1997) described a dynamic contingency in which severe problem behavior was evoked by adult noncompliance with a variety of child mands, which occurred at high rates, and was reinforced by adult compliance with subsequent mands. They discovered this phenomenon with 2 children for whom standard functional analyses were inconclusive. In recent years, similar contingencies have been shown to influence problem behavior, but the manner in which they have been arranged and described has varied across studies. The purpose of this literature review is to (a) describe contingencies involving mand compliance and the circumstances under which they have been evaluated, (b) summarize procedural variations in analysis and treatment, and (c) discuss what is known and yet to be discovered about the contingency as it relates to problem behavior. Future research focused on improving technology for analyzing and treating problem behavior suspected to be sensitive to mand compliance is discussed.

A Systematic Review of Caregiver-Implemented Functional Analyses

The purpose of this systematic review was to systematically locate and analyze the research on caregiver-implemented functional analyses and subsequent function-based interventions. We included 36 studies and examined multiple features of the studies, including participant demographics, functional analysis characteristics, intervention characteristics, procedural fidelity, risks of bias, and social validity. Overall, the studies showed that caregivers were able to implement functional analyses that yielded differential responding, although few studies reported procedural fidelity data. Caregivers were also able to implement function-based interventions that led to socially significant changes in challenging behavior. Implications for practice and future research are discussed.

Underdiagnosis of psychiatric disorders in people with intellectual disabilities: Differences between psychiatric disorders and challenging behaviour

BACKGROUND AND PURPOSE

The purpose of this study was to assess the level of mental disorders and challenging behaviour in individuals with intellectual disability (ID) supported by specialized services, but without a prior psychiatric diagnosis, and to compare the levels of different disorders depending on the severity of ID.

METHODS

This is a cross-sectional study (N = 142) of population with ID. Inclusion criteria were the following: adult patients with ID and with no previous psychiatric diagnosis prior to this survey. The Wechsler Adults Intelligence Scale-II, the Psychiatric Assessment Schedule for Adults with Developmental Disability checklist and clinical interview, the Diagnostic Assessment for the Severely Handicapped scale and the Inventory for Client and Agency Planning were the assessment tools.

RESULTS

A previously undiagnosed mental disorder was found in 29.6% of the sample. The most prevalent mental disorders were major depressive and anxiety disorders. An association between psychiatric comorbidity and challenging behaviour was found only for mild/moderate ID, especially for affective disorders.

CONCLUSIONS

The presence of a psychiatric as well as a medical comorbidity is associated with severe ID, unlike challenging behaviour. Clinical limitations of the study have been discussed.

Family Accommodation and Severe Problem Behavior: Considering Family-Based Interventions to Expand Function-Based Treatment

Family involvement in routines that exacerbate and maintain child anxiety is referred to as family accommodation. Family involvement is also related to maintenance of severe problem behavior (SPB) demonstrated by children with intellectual and developmental disabilities (IDD). Family members may deliver attention, tangible items, or remove aversive task demands that produce temporary cessation, or avoidance of SPB, but long-term maintenance. This Clinical Perspectives article describes parallels between the treatment of family accommodation in child anxiety and the assessment and treatment process for SPB. Suggestions are described for borrowing the concept of family accommodation to help caregivers of children who demonstrate SPB begin to approach previously avoided contexts. A case vignette is provided to illustrate strategies for targeting family accommodation as an expansion of function-based treatments for SPB.

Functional analysis and generalized treatment of disruptive behavior during dental exams

Patient disruption during dental visits can impede treatment and may result in invasive approaches to care. The current study evaluated the efficacy of graduated exposure with and without extinction to decrease disruption during dental treatment for 4 young men with autism spectrum disorder (ASD). Modified functional analyses confirmed that disruption was maintained by escape from dental demands for all four young men. Initial treatment consisted of graduated exposure, whereby exam steps were initially removed and then gradually reintroduced as disruption remained low; throughout this phase, disruption resulted in a break from the exam. During the subsequent treatment phase, graduated exposure procedures continued and extinction for disruption was added. Graduated exposure alone did not result in sufficient treatment effects; however, the addition of extinction resulted in greater reductions in disruption and increases in exam completion for all 4 young men, and treatment effects generalized to a dental clinic setting.

Using Extinction to Increase Behavior: Capitalizing on Extinction-Induced Response Variability to Establish Mands With Autoclitic Frames

Members (behaviors) of a response class are equivalent in that they produce the same functional reinforcer. Oftentimes, some members of a response class occur at higher rates than others. This can be problematic when the members that occur at high rates are socially inappropriate (e.g., self-injury, aggression, or disruption). The participant in this study was a 16-year-old female diagnosed with autism spectrum disorder who demonstrated aggression, one-word mands, and mands with autoclitic frames. In a series of contingency reversals, we placed 2 behaviors on extinction (e.g., aggression and one-word mands), which resulted in extinction-induced variability. Capitalizing on extinction-induced variability, we reinforced a different behavior (e.g., mands with autoclitic frames). The results confirmed that (a) the rate of responding for each topography was a function of extinction-induced response variability and differential reinforcement and (b) all response topographies belonged to the same response class. These results provide empirical support for the use of extinction-induced variability to differentially increase the rate of socially appropriate behaviors while decreasing socially inappropriate behaviors that belong to the same response class.

Further examination of the treatment of multiply controlled inappropriate mealtime behavior

We systematically replicated Bachmeyer et al. (2009) by examining extinction procedures matched to each function, individually and in combination, to treat the food or liquid refusal of 4 children diagnosed with a feeding disorder whose inappropriate mealtime behavior was maintained by multiple functions (i.e., escape and attention). Previous research suggests that adding differential reinforcement to extinction procedures may result in better treatment outcomes. Therefore, we added differential reinforcement to extinction procedures matched to each function. Differential reinforcement and extinction matched only to escape or attention resulted in low rates of inappropriate mealtime behavior and high, stable levels of acceptance for only 1 child. Consistent with Bachmeyer et al., inappropriate mealtime behavior decreased, and acceptance increased for the remaining 3 children only after we matched differential reinforcement and extinction procedures to both escape and attention.

Functional assessment and function-based treatment delivered via telehealth: A brief summary

As the world navigates the COVID-19 health crisis, behavior analysts are considering how best to support families while maintaining services and ensuring the health and safety of everyone involved. Telehealth is one service delivery option that provides families with access to care in their own communities and homes. In this article, we provide a brief summary of the telehealth literature in applied behavior analysis that provided coaching and training to families for individuals who displayed challenging behavior. These studies targeted functional assessment and function-based treatment for challenging behavior. We briefly summarize what is known relative to the assessment and treatment of challenging behavior via telehealth, place these results within a descriptive context of the decisions made by the research team at the University of Iowa, and discuss what we, as behavior analysts, should consider next to advance our understanding and practice of telehealth.

The Impact of Applied Behavior Analysis to Address Mealtime Behaviors of Concern Among Individuals with Autism Spectrum Disorder

Feeding difficulties among individuals with autism spectrum disorder are common. The science of applied behavior analysis (ABA) has been employed to address these difficulties. Ample publications exist that demonstrate that ABA is consistently effective in increasing the consumption of new foods and drinks, increasing chewing and swallowing behavior, decreasing problem behavior at mealtime, and improving skills such as self-feeding. This article details the application of the basic principles of ABA, reinforcement, extinction, and punishment to treat feeding difficulties.

Examining the Specificity of Forms and Functions of Aggressive Behavior in Boys With Fragile X Syndrome

Limited information is available concerning the specificity of the forms and functions of aggressive behavior exhibited by boys with fragile X syndrome (FXS). To investigate these relationships, we conducted indirect functional assessments of aggressive behavior exhibited by 41 adolescent boys with FXS and 59 age and symptom-matched controls with intellectual and developmental disability (IDD) and compared the data between groups. Results showed that boys with FXS were more likely to exhibit specific forms of aggressive behavior (i.e., scratching others and biting others) compared to controls, but the sources of reinforcement identified for aggression were similar across groups. Boys with FXS who were prescribed psychotropic medications were more likely to be older and to exhibit more forms of aggression. The implications for the treatment of aggressive behavior during this critical developmental period in FXS are discussed.

Initial outcomes of an augmented competing stimulus assessment

Competing stimulus assessments (CSAs) are designed to identify stimuli that, when made freely available, reduce problem behavior. Although CSAs have demonstrated utility, identifying competing stimuli can be difficult for some individuals. The current study describes outcomes from an augmented CSA (A-CSA) for 6 consecutively encountered cases with treatment-resistant subtypes of automatically maintained problem behavior. When test stimuli were made freely available, only between 0 and 1 effective competing stimuli were identified for each case. Prompting and response blocking were temporarily employed in succession to promote engagement with stimuli and disrupt problem behavior. When those procedures were withdrawn and stimuli made freely available, the number of effective competing stimuli increased in all 6 cases. Findings suggest that procedures designed to promote engagement and disrupt problem behavior may allow the A-CSA to be a platform not only for identifying competing stimuli, but also for actively establishing competing stimuli.

Sensitivity to Changing Environmental Conditions across Individuals with Subtype 2 Automatically Reinforced and Socially Reinforced Self-injury

Automatically reinforced Subtype 2 self-injurious behavior (ASIB) has been characterized as showing insensitivity to competing reinforcement contingencies in the contexts of both functional analyses and in treatment using reinforcement alone (Hagopian, Rooker, &Yenokyan, 2018). One question is whether this insensitivity is specific to Subtype 2 ASIB as response class in these contexts or whether it is represents a generalized response tendency of the individual that is evident across other response classes. To examine this question, we compared responding on a single-operant task under changing reinforcement schedules for three individuals with Subtype 2 ASIB, relative to a comparison group of three individuals with socially reinforced SIB (which is characterized by sensitivity to changes in reinforcement contingencies). As hypothesized, all individuals showed sensitivity to changes in contingencies. These results provide preliminary support that the insensitivity of Subtype 2 ASIB is a property specific to that response class in these contexts rather than a generalized response tendency of the individual.

Replication and Extension of the Effects of Lag Schedules on Mand Variability and Challenging Behavior During Functional Communication Training

More is known about how to reduce challenging behavior with functional communication training (FCT) than how to mitigate its resurgence during or following a course of treatment. Research suggests reinforcing mand variability during FCT may mitigate the resurgence of challenging behavior, but validated procedures for reinforcing mand variability are limited and poorly understood. Lag schedules can reinforce variability in verbal behavior such as manding in individuals with autism, but studies have been largely limited to nonvocal mand modalities. Therefore, in the current study, we further evaluated the effects of FCT with lag schedules on vocal mand variability and challenging behavior in children with autism. The results suggest lag schedules alone or in combination with response prompt-fading strategies during FCT can increase mand variability and expand mand response classes but may fail to produce clinically significant reductions in challenging behavior.

Moving towards specificity: A systematic review of cue features associated with reward and punishment in anorexia nervosa

Models of anorexia nervosa (AN) posit that symptoms are maintained through deficient reward and enhanced punishment processing. However, theoretical and empirical inconsistencies highlight the need for a more nuanced conceptualization of this literature. Our goal was to comprehensively review the research on reward and punishment responding in AN from a cue-specific lens to determine which stimuli evoke or discourage reward and punishment responses in this population, and, ultimately, what properties these rewarding and punishing cues might share. A systematic review interrogating reward and punishment responses to specific cues yielded articles (n = 92) that examined responses to disorder relevant (e.g., food) and irrelevant (e.g., money) stimuli across self-report, behavioral, and biological indices. Overall, in most studies individuals with AN exhibited aversive responses to cues signaling higher body weights, social contexts, and monetary losses, and appetitive responses to cues for weight loss behaviors and thinness. Findings were more mixed on responses to palatable food and monetary gains. Results highlight that reward and punishment responding in AN are context specific and may be affected by varied stimulus qualities (e.g., predictability, controllability, delay, effort). Increasing specificity in future research on reward and punishment mechanisms in AN will better inform development of precisely-targeted interventions.

Functional analysis and operant treatment of food guarding in a pet dog

The present study extended functional analysis (FA) methodology to human-directed resource guarding in a dog in an in-home setting. The subject underwent four conditions including control, attention, escape, and tangible, arranged in a modified FA. The results indicated multiply controlled resource guarding (i.e., escape, attention, and tangible functions). The experimenter then conducted a treatment evaluation involving three function-based treatments in a concurrent multiple baseline design. Resource guarding decreased to zero levels in treatments for each maintaining contingency. Treatment effects were maintained when the subject was tested with an owner, with an untrained handler, a highly preferred treat, in an untrained setting, as well as after 2 weeks in the absence of training. Behavior analytic techniques may hold promise for lasting behavior change for resource guarding in domestic dogs, and should be examined in other populations and with other canine problem behavior.

Do Functional Analyses Probe Learning Histories, Or Create Them? An Exploratory Investigation

During functional analysis (FA), therapists arrange contingencies between potential reinforcers and problem behavior. It is unclear whether this fact, in and of itself, facilitates problem behavior's acquisition of new (false-positive) functions. If problem behavior can come under the control of contingencies contrived between it and known reinforcers for which there is no direct history, then outcomes of reinforcer analysis (RA) should perfectly predict FA outcomes. This study evaluated the degree to which RA outcomes corresponded with FA outcomes for eight participants referred to a university-based outpatient clinic for problem behavior. For 75% (6 of 8) of participants, correspondence was imperfect. These findings appear to support the construct validity of contemporary interpretations of FA data.

Evaluating sources of baseline data using dual-criteria and conservative dual-criteria methods: A quantitative analysis

Scheithauer et al. (2020) recently demonstrated that differences in the source of baseline data extracted from a functional analysis (FA) may not affect subsequent clinical decision-making in comparison to a standard baseline. These outcomes warrant additional quantitative examination, as correspondence of visual analysis has sometimes been reported to be unreliable. In the current study, we quantified the occurrence of false positives within a dataset of FA and baseline data using the dual-criteria (DC) and conservative dual-criteria (CDC) methods. Results of this quantitative analysis suggest that false positives were more likely when using FA data (rather than original baseline data) as the initial treatment baseline. However, both sources of baseline data may have acceptably low levels of false positives for practical use. Overall, the findings provide preliminary quantitative support for the conclusion that determinations of effective treatment may be easily obtained using different sources of baseline data.

Addressing Challenging Behavior During Hospitalizations for Children with Autism: A Pilot Applied Behavior Analysis Randomized Controlled Trial

This study evaluated the feasibility, acceptance, and potential clinical benefit of brief applied behavior analysis (ABA)-based interventions for children and adolescents with autism spectrum disorder (ASD) displaying challenging behaviors during hospitalizations. Participants included 36 children diagnosed with ASD, 6-17 years of age, who were medically or psychiatrically hospitalized. Children in the intervention group received a brief ABA intervention and were compared to children in the evaluation and monitoring-only group. Families and staff recommended the intervention, children receiving the intervention demonstrated significantly more improvement in unblinded ratings of clinical severity, data from physicians indicated a positive effect of the intervention on levels of staffing and restraints and attending medical providers universally reported satisfaction and benefit of the intervention. Improvements in challenging behaviors were not significantly different as reported by parents, and the length of hospitalization did not differ between the groups. Ultimately, the outcomes of this pilot study suggest incorporating specialized ABA-based assessment and intervention during hospitalization may be feasible and well accepted by clinicians and families. However, future research must address potent methodological challenges related to capturing meaningful data during hospitalizations in order to answer questions of ultimate pragmatic, clinical, and system-level benefits. Trial Registration ClinicalTrials.gov Identifier NCT02339935, Registered 16 January 2015, First participant consented 23 February 2015. Autism Res 2020, 13: 1072-1078. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Inpatient hospitalizations for children with autism spectrum disorder (ASD) and severe behavior are common, challenging, and costly in terms of human experience. This study evaluated the benefit of brief applied behavior analysis-based interventions to children and adolescents with ASD displaying challenging behaviors during hospitalizations. Families and staff evaluating the procedures noted perceived potential benefits of the intervention, but this initial pilot study did not document changes in hospitalization length or blinded rating of improvement.

DRA contingencies promote improved tolerance to delayed reinforcement during FCT compared to DRO and fixed-time schedules

Following Functional Communication Training (FCT), clinicians often gradually expose newly taught communicative responses to delayed reinforcement contingencies to prepare clients for the normative environment in which requests are frequently reinforced after a delay. The introduction of delays may result in the resurgence and maintenance of problem behavior and the weakening of the newly trained communicative response. The current study compared delay tolerance with three individuals diagnosed with intellectual and developmental disabilities when reinforcement for the functional communication response (FCR) was delivered following (a) the passage of time, (b) the omission of problem behavior, or (c) the occurrence of an alternative behavior. We measured delay tolerance in terms of minimizing problem behavior and maintaining efficient FCRs. Outcomes support requiring alternative responding during delays to attain optimal treatment results.

Advances in Our Understanding of Behavioral Intervention: 1980 to 2020 for Individuals Diagnosed with Autism Spectrum Disorder

There are three branches of science of behavior analysis [i.e., experimental analysis of behavior, behavior analysis, and applied behavior analysis (ABA)]. ABA can be defined as a systematic approach to understanding behavior of social interest. For the past 40 plus years, researchers have evaluated ABA and ABA based procedures (e.g., behavioral intervention) as they relate to individuals diagnosed with autism spectrum disorder (ASD) and have implemented behavioral intervention in clinical settings for individuals diagnosed with ASD. In this paper, we discuss some of the pivotal contributions in the field of ABA in research and clinical practice. Additionally, we provide recommendations for the science and clinical practice of behavioral intervention in the next 40 years.

Incorporating discriminative stimuli into functional communication training with augmentative and alternative communication devices: a tutorial

Functional communication training (FCT) is a commonly used and effective treatment for problem behavior maintained by social reinforcement (e.g., an individual engages in self-injurious behavior to gain access to adult attention). FCT involves teaching an individual to emit an appropriate communication response to access the reinforcer maintaining problem behavior (e.g., pressing a "Play, please" symbol on a device to gain the communication partner's attention) and withholding that reinforcer following problem behavior (e.g., the communication partner minimizes attention-following problem behavior and waits for a communication response). Techniques such as incorporating discriminative stimuli (e.g., differently colored cards) can make FCT more practical for caregivers by teaching individuals when reinforcement is and is not available for communication responses while simultaneously mitigating treatment relapse. Despite the effectiveness of FCT with discriminative stimuli, no studies have leveraged the capabilities of augmentative and alternative communication (AAC) devices by embedding discriminative stimuli within AAC software (e.g., by coloring communication symbols or grids). Our tutorial provides a comprehensive overview of how practitioners can incorporate FCT with discriminative stimuli into practice and includes video models of how to design these treatments on two common AAC apps.

The consecutive controlled case series: Design, data-analytics, and reporting methods supporting the study of generality

Single-case experimental designs (SCEDs) have proven invaluable in research and practice because they are optimal for asking many experimental questions relevant to the analysis of behavior. The consecutive controlled case series (CCCS) is a type of study in which a SCED is employed in a series of consecutively encountered cases that undergo a common procedure or share a common characteristic. Additional design elements, data-analytic, and reporting methods enable researchers to ask experimental questions relevant to the study of generality of procedures and processes. The current paper discusses the CCCS methodologies, including the retrospective, prospective, and randomized CCCS. These methodologies can be applied to examine the generality of clinical procedures (including their general efficacy, the limits of their generality, and variables that may mediate generality); study the epidemiology and phenomenology of clinical problems; and compare the efficacy of 2 clinical procedures within a randomized controlled trial combining SCEDs with randomized group designs.

Increasing item engagement and decreasing automatically reinforced problem behavior within a modified competing stimulus assessment

A competing stimulus assessment (CSA) is commonly used to identify leisure items for use in treatments designed to decrease automatically reinforced problem behavior. However, this type of assessment may not yield useful information if participants do not readily engage with leisure items. The purpose of this study was to evaluate a modified CSA that included additional treatment components (i.e., prompting, prompting plus differential reinforcement of alternative behavior). The modified CSA identified the treatment components and leisure items that were most effective for increasing leisure-item engagement and decreasing problem behavior for each participant. Modified CSA outcomes maintained during an extended treatment analysis in a natural setting and when intervention components were faded.

A Comparison of Demand Fading and a Dense Schedule of Reinforcement During Functional Communication Training

Ample research indicates that functional communication training (FCT) is an effective intervention to reduce challenging behavior. The purpose of this study was to evaluate the effect of demand fading on escape-maintained challenging behavior, mands, and task completion for 2 children with autism spectrum disorder. The study utilized an embedded reversal and alternating-treatments design to evaluate the efficacy of the intervention and compare the efficacy of the demand fading and dense schedule conditions. During FCT, participants were taught 2 mand topographies, one of which was associated with demand fading. FCT with and without demand fading resulted in decreases in challenging behavior for both participants. FCT with demand fading resulted in higher task completion for both participants. The effect of demand fading on the rate of mands varied by participant. Results provide further support for the use of FCT. The importance of intervention fading in the treatment of challenging behavior is discussed.

Resurgence following differential reinforcement of alternative behavior implemented with and without extinction

In the clinic, differential reinforcement of alternative behavior (DRA) often involves programming extinction for destructive behavior while reinforcing an alternative form of communication (e.g., a functional communication response); however, implementing extinction can be unsafe or impractical under some circumstances. Quantitative theories of resurgence (i.e., Behavioral Momentum Theory and Resurgence as Choice) predict differences in the efficacy of treatments that do and do not involve extinction of target responding when reinforcement conditions maintaining alternative responding worsen. We tested these predictions by examining resurgence following two DRA conditions in which we equated rates of reinforcement. In DRA without extinction, target and alternative behavior produced reinforcement. In DRA with extinction plus noncontingent reinforcement, only alternative behavior produced reinforcement. We conducted this study in a reverse-translation sequence, first with participants who engaged in destructive behavior (Experiment 1) and then in a laboratory setting with rats (Experiment 2). Across both experiments, we observed proportionally lower levels of target responding during and following the DRA condition that arranged extinction for the target response. However, levels of resurgence were similar following both arrangements.

On the Standardization of the Functional Analysis

The functional analysis procedures described in the seminal Iwata et al. (1982/1994) study are prominent in the applied behavior analytic literature, having been replicated hundreds of times over the past 30 years (Beavers, Iwata, & Lerman, 2013; Hanley, McCord, Iwata, 2003). However, the extent to which particular components of this functional analysis model have become more or less prominent over time is not clear from these literature reviews. We therefore conducted a review of the functional analysis literature between the years of 1965 and 2016 to determine the trends in the usage of particular components over time and to determine if the published literature reflects a standardization of the manner in which functional analyses of problem behavior are conducted. Furthermore, we discuss whether or not this standardization of a functional analysis model is currently necessary.

Interview-Informed Synthesized Contingency Analysis (IISCA): Novel Interpretations and Future Directions

The functional analysis (FA) methodology was developed to provide an empirical basis for understanding the reinforcers contributing to the maintenance of problem behavior. Previous research has demonstrated that multiple formats have been established to address some areas, such as practicality, efficiency, and safety. We reviewed the research on a new replication and extension of the standard FA format, the interview-informed synthesized contingency analysis (IISCA) and its subsequent treatment. We discuss the efficiency and effectiveness of the IISCA across various populations, settings, topographies of problem behaviors, and maintaining functions across 17 studies. Common treatment trends, novel developments, and other critical intervention components are also reviewed. We provide suggestions for future directions and guidelines for practitioners when considering the use of the IISCA.

Interpreting functional analysis outcomes using automated nonparametric statistical analysis

Current methods employed to interpret functional analysis data include visual analysis and post-hoc visual inspection (PHVI). However, these methods may be biased by dataset complexity, hand calculations, and rater experience. We examined whether an automated approach using nonparametric rank-based statistics could increase the accuracy and efficiency of functional analysis data interpretation. We applied Automated Nonparametric Statistical Analysis (ANSA) to a sample of 65 published functional analyses for which additional experimental evidence was available to verify behavior function. Results showed that exact behavior function agreement between ANSA and the publications authors was 83.1%, exact agreement between ANSA and PHVI was 75.4%, and exact agreement across all 3 methods was 64.6%. These preliminary findings suggest that ANSA has the potential to support the data interpretation process. A web application that incorporates the calculations and rules utilized by ANSA is accessible at https://ansa.shinyapps.io/ansa/.

Negative reinforcer magnitude manipulations for treating escape-maintained problem behavior

The purpose of the current study was to evaluate the effects of different magnitudes of escape for compliance relative to the magnitudes of escape for problem behavior in a concurrent-schedule arrangement. Three individuals who exhibited escape-maintained problem behavior participated. A large differential magnitude condition (240-s escape for compliance, 10-s escape for problem behavior) was compared to equal (30-s escape for compliance and problem behavior) and moderate differential magnitude (90-s escape for compliance, 10-s escape for problem behavior) conditions. The authors also evaluated the impact of correcting for reinforcer access time (i.e., time on escape intervals) on intervention interpretation. For all participants, problem behavior decreased during only the large differential magnitude condition, and including reinforcer access time in the overall session time did not affect interpretation of treatment outcomes. Providing larger escape magnitudes for compliance relative to problem behavior may facilitate treatment involving concurrent-reinforcement schedules for escape-maintained problem behavior.

Dog Phobia Intervention: A Case Study in Improvement of Physiological and Behavioral Symptoms in A Child with Intellectual Disability

Background: Children with intellectual disability are at risk for anxiety disorders involving intense physiological reactions and risky behavioral responses. Interventions have been identified in this field; however, assessment of underlying anxiety is limited and flawed.Method: We implemented a single-subject case study using differential reinforcement to treat dog phobia in a boy with intellectual disability. We recorded elopement and compliance with goals and measured physiological expressions of stress: galvanic skin response, heart rate variability, temperature, and latency to calm down.Results: After fifteen therapy sessions, the boy decreased elopement and noncompliance considerably and showed dramatic improvements in emotional self-regulation.Conclusions: Future research should examine the utility of including biosensing measures in clinical applications and the relationship between physiological measures of anxiety and traditional questionnaires. Children with intellectual disability at risk for anxiety disorders should be tracked longitudinally to examine the effect of interventions on social-emotional well-being and self-regulation.

Treating destructive behavior reinforced by increased caregiver compliance with the participant's mands

Functional analyses sometimes do not identify momentary fluctuations in the function of destructive behavior (Bowman, Fisher, Thompson, & Piazza, 1997). In such cases, individuals may mand for the reinforcer that is currently most preferred and display destructive behavior if that mand goes unreinforced. In this study, we conducted a mand analysis to test whether destructive behavior functioned as a precurrent response that increased reinforcement for the participant's mands. We then evaluated a treatment that matched this function of destructive behavior by providing differential or time-based reinforcement of participant mands in accordance with multiple or chained schedules with reinforcement-schedule thinning. Decreases in destructive behavior averaged 97.4% across cases. We discuss these results relative to the importance of matching treatments for destructive behavior to operant functions for both traditional and idiosyncratic functions of destructive behavior.

Comparisons of standardized and interview-informed synthesized reinforcement contingencies relative to functional analysis

We compared the functions of problem behavior identified by (a) a functional analysis (FA), (b) an interview-informed synthesized contingency analysis (IISCA) that was informed by the results of an open-ended interview and a structured observation, and (c) a standardized-synthesized contingency analysis (SSCA) in which we synthesized three common functions of problem behavior across 12 individuals in a controlled consecutive case series. We then compared outcomes across assessments. The FA was sufficient in identifying the variables maintaining problem behavior for 11 of the 12 participants, replicating the findings of Fisher, Greer, Romani, Zangrillo, and Owen (2016). Error type (i.e., false positives, false negatives) and error prevalence were similar across functions identified by the IISCA and the SSCA, calling into question the utility of the open-ended interview and the structured observation that informed the IISCA.