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Thakore A, Kelly A, Petursdottir AI, Stockdale M. Evaluation of a Treatment Package for Chronic, Stereotypic Hand Mouthing of a Child Diagnosed with Autism. Behav Anal Pract 2024; 17:915-920. [PMID: 39391199 PMCID: PMC11461378 DOI: 10.1007/s40617-024-00956-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2024] [Indexed: 10/12/2024] Open
Abstract
We describe the clinical treatment of repetitive, stereotypic hand mouthing in a 7-year old child with severe developmental delay, conducted in the context of center-based autism service. The client's history included use of mechanical restraint to prevent tissue damage and infection. Prior antecedent- and reinforcement-based interventions were ineffective. Functional analysis results suggested hand mouthing was maintained by automatic reinforcement. Response interruption and redirection (RIRD) initially did not decrease hand mouthing, but the addition of contingent protective equipment, together with modified RIRD, was followed by reduction to near-zero level, which was maintained following withdrawal of the intervention. • Repetitive hand mouthing may require treatment due to tissue damage and other health consequences. • Repetitive hand mouthing is typically maintained in the absence of social contingencies and may be resistant to treatment. • When reinforcement-based interventions are not sufficient, contingent application of nonrestraining protective equipment may produce lasting reduction in hand mouthing. • Successful intervention in this case freed the client from mechanical (arm band) restraint and was followed by gains in skill acquisition. Supplementary Information The online version contains supplementary material available at 10.1007/s40617-024-00956-8.
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Affiliation(s)
- Aarti Thakore
- Central Texas Autism Center, 3006 Bee Caves Road, Austin, TX 78746 USA
| | - Andrea Kelly
- Central Texas Autism Center, 3006 Bee Caves Road, Austin, TX 78746 USA
| | | | - Morgan Stockdale
- Central Texas Autism Center, 3006 Bee Caves Road, Austin, TX 78746 USA
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Chezan LC, McCammon MN, Wolfe K, Drasgow E, Tabacu LM. Teachers' Familiarity, Confidence, Training, and Use of Problem Behavior Interventions for Learners with Autism Spectrum Disorder in School Settings. JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES 2022; 35:1-25. [PMID: 36373127 PMCID: PMC9638298 DOI: 10.1007/s10882-022-09885-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
Our main purpose in this study was to investigate the levels of and the relationship between familiarity, confidence, training, and use of problem behavior interventions by special education teachers working with learners with autism spectrum disorder (ASD) in school settings. A total of 80 special education teachers in South Carolina and Virginia completed an online survey. Results indicate a positive correlation between teachers' familiarity, confidence, training, and use of problem behavior interventions. Across all intervention categories, providing choices, prompting, modeling, and direct instruction received the highest rankings for familiarity, confidence, and use. In addition, our results reveal that familiarity and confidence in implementing these interventions differs across groups of special education teachers based on years of experience. The most frequently reported factors that limit the use of problem behavior interventions in school settings were competing responsibilities, the need to involve multiple people, the amount of time required, and the difficulty using interventions during typical routines. Implications for research and practice are discussed. Supplementary Information The online version contains supplementary material available at 10.1007/s10882-022-09885-2.
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Affiliation(s)
- Laura C. Chezan
- Old Dominion University, 110 Child Study Center, 4501 Hampton Blvd., Norfolk, VA 23529 US
| | - Meka N. McCammon
- Department of Child and Family Studies, University of South Florida, 4202 Fowler Ave, Tampa, FL 33620 US
| | - Katie Wolfe
- University of South Carolina, 820 Main St, Columbia, SC 29208 US
| | - Erik Drasgow
- University of South Carolina, 820 Main St, Columbia, SC 29208 US
| | - Lucia M. Tabacu
- Old Dominion University, 2300 Engineering and Computational Sciences Building, Norfolk, VA 23529 US
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3
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Parents Are People Too: Implementing Empirically Based Strategies During Daily Interactions. Behav Anal Pract 2022; 15:986-1000. [PMID: 35342509 PMCID: PMC8935904 DOI: 10.1007/s40617-022-00686-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2022] [Indexed: 01/05/2023] Open
Abstract
The outcomes of the COVID-19 pandemic have resulted in decision-making related to in-person versus remote behavior-analytic service delivery. For those service providers who shifted from delivering in-person therapy to remote consultation, parents have presumably, at least at times, assumed a role similar to a registered behavior technician (RBT). We suggest that behavior analysts recommend two empirically based strategies to parents that they could incorporate into their daily lives during service disruptions: environmental enrichment and differential reinforcement of alternative behavior. We provide examples of naturally occurring contexts during which parents could integrate these procedures: (1) self-care or daily living activities, (2) physical activity, and (3) preferred learning activities. We support selecting these strategies and their application during exemplar contexts under the premise that they do not result in additional time expenditure, afford parents opportunities to complete essential (household, work-related, or personal) tasks, and still result in therapeutic gains.
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Llinas M, Wilder DA, Walz R. A comparison of continuous, dense, and lean schedules of noncontingent access to matched competing stimuli to reduce stereotypy. BEHAVIORAL INTERVENTIONS 2022. [DOI: 10.1002/bin.1867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Mary Llinas
- School of Behavior Analysis and the Scott Center for Autism Treatment Florida Institute of Technology Melbourne Florida USA
| | - David A. Wilder
- School of Behavior Analysis and the Scott Center for Autism Treatment Florida Institute of Technology Melbourne Florida USA
| | - Ryan Walz
- School of Behavior Analysis and the Scott Center for Autism Treatment Florida Institute of Technology Melbourne Florida USA
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Virues‐Ortega J, Clayton K, Pérez‐Bustamante A, Gaerlan BFS, Fahmie TA. Functional analysis patterns of automatic reinforcement: A review and component analysis of treatment effects. J Appl Behav Anal 2022; 55:481-512. [DOI: 10.1002/jaba.900] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/03/2021] [Accepted: 12/03/2021] [Indexed: 11/08/2022]
Affiliation(s)
- Javier Virues‐Ortega
- Universidad Autónoma de Madrid Madrid Spain
- The University of Auckland Auckland New Zealand
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Slocum SK, Yatros N, Scheithauer M. Developing a treatment for hand‐clapping maintained by automatic reinforcement using sensory analysis, noncontingent reinforcement, and thinning. BEHAVIORAL INTERVENTIONS 2020. [DOI: 10.1002/bin.1749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Sarah K. Slocum
- Department of Severe Behavior Marcus Autism Center Atlanta Georgia USA
- Department of Pediatrics Emory University School of Medicine Atlanta Georgia USA
| | - Nicolette Yatros
- Department of Health Professions Rollins College Winter Park Colorado USA
| | - Mindy Scheithauer
- Department of Severe Behavior Marcus Autism Center Atlanta Georgia USA
- Department of Pediatrics Emory University School of Medicine Atlanta Georgia USA
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Leif ES, Roscoe EM, Ahearn WH, Rogalski JP, Morrison H. Increasing item engagement and decreasing automatically reinforced problem behavior within a modified competing stimulus assessment. J Appl Behav Anal 2020; 53:1638-1659. [PMID: 32166743 DOI: 10.1002/jaba.695] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 12/08/2019] [Indexed: 11/09/2022]
Abstract
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.
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Affiliation(s)
- Erin S Leif
- The New England Center for Children and Northeastern University
| | - Eileen M Roscoe
- The New England Center for Children and Northeastern University
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Meindl JN, Ivy JW, Glodowski KR, Noordin K. Applying Standards of Effectiveness to Noncontingent Reinforcement: A Systematic Literature Review. Behav Modif 2019; 45:619-640. [PMID: 31452379 DOI: 10.1177/0145445519865073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Noncontingent reinforcement is a time-based schedule of reinforcement that has been shown to decrease problem behavior. Although the intervention is considered well established, there exist concerns that much of the supporting research has been conducted under highly controlled experimental conditions that may lack ecological validity. That is, although the efficacy has been demonstrated, the effectiveness in less controlled settings has not. To evaluate this concern, we analyzed research on noncontingent reinforcement between 1993 and 2017. Standards of evidence for effectiveness were adapted from prevention science and applied to noncontingent reinforcement literature. We specifically focused on generalizability across populations and settings, the conditions under which the intervention was applied, specific treatment parameters, opportunity cost, and social validity. Our results indicate several areas where evidence of noncontingent reinforcement effectiveness in applied settings is limited. We identify these limitations and provide a range of recommendations for future research to promote more widespread dissemination of the procedure.
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Affiliation(s)
| | - Jonathan W Ivy
- The Pennsylvania State University-Harrisburg, Middletown, PA, USA
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Wunderlich KL, Vollmer TR, Mehrkam LR, Feuerbacher EN, Slocum SK, Kronfli FR, Pizarro E. The stability of function of automatically reinforced vocal stereotypy over time. J Appl Behav Anal 2019; 53:678-689. [PMID: 31378941 DOI: 10.1002/jaba.620] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 07/02/2019] [Indexed: 11/11/2022]
Abstract
Although prior research has suggested the function of socially reinforced problem behavior can change across time, the stability of the function of automatically reinforced behavior is largely unknown. Further, some authors have suggested automatically reinforced behavior is likely to enter into socially mediated contingencies. The present study compared 2 functional analyses conducted on the same target behavior at least 1 year apart. Participants were 6 individuals diagnosed with an intellectual or developmental disability displaying automatically reinforced vocal stereotypy. Results indicated the function of each participant's vocal stereotypy remained stable over time (i.e., no new functions were acquired); however, future research on functional stability for automatically reinforced behavior of other topographies is needed.
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Gover HC, Fahmie TA, McKeown CA. A review of environmental enrichment as treatment for problem behavior maintained by automatic reinforcement. J Appl Behav Anal 2018; 52:299-314. [PMID: 30242793 DOI: 10.1002/jaba.508] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 10/26/2017] [Indexed: 11/11/2022]
Abstract
We reviewed studies that used environmental enrichment as treatment for problem behavior maintained by automatic reinforcement. A search of behavior analytic journals produced 71 publications with a total of 265 applications of environmental enrichment used alone or in conjunction with alternative behavior manipulations (e.g., prompting, reinforcement) and problem behavior manipulations (e.g., blocking, restraint). Environmental enrichment, as a sole intervention, was efficacious in 41% of the sample. Alternative behavior manipulations, problem behavior manipulations, and a combination of both improved the overall efficacy of environmental enrichment. We discuss factors that may influence the efficacy of environmental enrichment, current trends in research on this topic, and implications for both practitioners and researchers.
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Verriden AL, Roscoe EM. An evaluation of a punisher assessment for decreasing automatically reinforced problem behavior. J Appl Behav Anal 2018; 52:205-226. [PMID: 30238452 DOI: 10.1002/jaba.509] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 10/26/2017] [Indexed: 11/11/2022]
Abstract
We extended research on the identification and evaluation of potential punishers for decreasing automatically reinforced problem behavior in four individuals with autism spectrum disorder. A punisher selection interview was conducted with lead clinicians to identify socially acceptable punishers. During the treatment evaluation, treatment phases were introduced sequentially and included noncontingent reinforcement (NCR), NCR and differential reinforcement of alternative behavior (DRA), and NCR-and-DRA with punishment. During the NCR-and-DRA with punishment phase, four to five potential punishers were evaluated using a multielement design. Dependent measures included the target problem behavior, appropriate item engagement, and emotional responding. For all participants, NCR-and-DRA was not effective and punishment was necessary. However, the most effective punisher identified in the context of NCR-and-DRA differed across participants.
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Affiliation(s)
| | - Eileen M Roscoe
- Western New England University.,The New England Center for Children
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12
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Rooker GW, Bonner AC, Dillon CM, Zarcone JR. Behavioral treatment of automatically reinforced SIB: 1982 - 2015. J Appl Behav Anal 2018; 51:974-997. [PMID: 29989153 DOI: 10.1002/jaba.492] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 10/19/2017] [Indexed: 01/06/2023]
Abstract
Some individuals diagnosed with intellectual and developmental disabilities engage in automatically reinforced self-injurious behavior (SIB). For these individuals, identifying effective treatments may be difficult due to the nature of the reinforcement contingency. The purpose of this study was to review the literature on the treatment of automatically reinforced SIB to determine commonalities in procedures that produced effective and ineffective treatment outcomes, as well as historical trends in the treatment of this class of SIB. Results of this review indicated that there were many high-quality studies on this topic, but also a wide range in the quality of studies. As for effective treatments, noncontingent reinforcement (the most common treatment component) was found to be more effective when informed by a competing stimulus assessment rather than a preference assessment. Suggestions to improve the quality of the published record and areas in which additional research is needed are discussed.
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Affiliation(s)
- Griffin W Rooker
- Johns Hopkins University School of Medicine.,The Kennedy Krieger Institute
| | | | | | - Jennifer R Zarcone
- Johns Hopkins University School of Medicine.,The Kennedy Krieger Institute
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Rispoli M, Brodhead M, Wolfe K, Gregori E. Trial-Based Functional Analysis Informs Treatment for Vocal Scripting. Behav Modif 2017; 42:441-465. [PMID: 29188725 DOI: 10.1177/0145445517742882] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Research on trial-based functional analysis has primarily focused on socially maintained challenging behaviors. However, procedural modifications may be necessary to clarify ambiguous assessment results. The purposes of this study were to evaluate the utility of iterative modifications to trial-based functional analysis on the identification of putative reinforcement and subsequent treatment for vocal scripting. For all participants, modifications to the trial-based functional analysis identified a primary function of automatic reinforcement. The structure of the trial-based format led to identification of social attention as an abolishing operation for vocal scripting. A noncontingent attention treatment was evaluated using withdrawal designs for each participant. This noncontingent attention treatment resulted in near zero levels of vocal scripting for all participants. Implications for research and practice are presented.
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Affiliation(s)
| | | | - Katie Wolfe
- University of South Carolina, Columbia, SC, USA
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Kelley ME, Nadler CB, Rey C, Cowie S, Podlesnik CA. Noncontingent reinforcement competes with response performance. J Exp Anal Behav 2017; 107:343-353. [DOI: 10.1002/jeab.255] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 04/12/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Michael E. Kelley
- The Scott Center for Autism Treatment and Florida Institute of Technology
| | - Cy B. Nadler
- Division of Developmental and Behavioral Sciences, Children's Mercy Kansas City
| | - Catalina Rey
- The Scott Center for Autism Treatment and Florida Institute of Technology
| | | | - Christopher A. Podlesnik
- The Scott Center for Autism Treatment and Florida Institute of Technology
- The University of Auckland
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Berg WK, Wacker DP, Ringdahl JE, Stricker J, Vinquist K, Salil Kumar Dutt A, Dolezal D, Luke J, Kemmerer L, Mews J. An integrated model for guiding the selection of treatment components for problem behavior maintained by automatic reinforcement. J Appl Behav Anal 2016; 49:617-38. [PMID: 26990962 DOI: 10.1002/jaba.303] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 01/08/2016] [Indexed: 11/12/2022]
Abstract
We evaluated the usefulness of 2 assessments to guide treatment selection for individuals whose prior functional analysis indicated that automatic reinforcement maintained their problem behavior. In the 1st assessment, we compared levels of problem behavior during a noncontingent play condition and an alone or ignore condition. In the 2nd, we assessed participants' relative preferences for automatic reinforcement and social reinforcers in a concurrent-operants arrangement. We used the results of these 2 assessments to assign 5 participants to a treatment based on noncontingent access to social reinforcers or to a treatment based on differential access to social reinforcers. We conducted monthly probes with the participants over 10 to 12 months to evaluate the effects of the treatment procedures. All participants showed reductions in problem behavior over this period.
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Delgado-Casas C, Navarro JI, Garcia-Gonzalez-Gordon R, Marchena E. Functional analysis of challenging behavior in people with severe intellectual disabilities. Psychol Rep 2014; 115:655-69. [PMID: 25375028 DOI: 10.2466/15.pr0.115c26z4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Challenging behaviors exhibited by individuals with developmental disabilities often hinder the acquisition of academic, social, and life skills. Functional analysis has been useful for assessing challenging behavior in various settings. The purpose of this study was to implement an operant methodology for recognizing the functional properties of challenging behavior in people with intellectual disabilities. Four adults diagnosed with profound intellectual disability received assessment under several experimental conditions using a functional analysis methodology: social attention as positive reinforcement, negative reinforcement such as the termination of demands, positive tangible reinforcements, absence of social contingencies, and escape from noisy stimuli. Results showed that different types of reinforcement or avoiding contingencies affected the rate of aggression, self-injury, disruption, stereotypy, or socially offensive behaviors, and functional analysis may potentially be a viable alternative for identifying challenging behaviors.
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Beavers GA, Iwata BA, Lerman DC. Thirty years of research on the functional analysis of problem behavior. J Appl Behav Anal 2014; 46:1-21. [PMID: 24114081 DOI: 10.1002/jaba.30] [Citation(s) in RCA: 268] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Accepted: 11/13/2012] [Indexed: 11/08/2022]
Abstract
Hanley, Iwata, and McCord (2003) reviewed studies published through 2000 on the functional analysis (FA) of problem behavior. We update that review for 2001 through 2012, including 158 more recent studies that reported data from 445 FAs. Combined with data obtained from Hanley et al., 435 FA studies, with line graphs for 981 FAs, have been published since 1961. We comment on recent trends in FA research and introduce the studies in the 2013 special issue of the Journal of Applied Behavior Analysis.
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Querim AC, Iwata BA, Roscoe EM, Schlichenmeyer KJ, Ortega JV, Hurl KE. Functional analysis screening for problem behavior maintained by automatic reinforcement. J Appl Behav Anal 2014; 46:47-60. [PMID: 24114084 DOI: 10.1002/jaba.26] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Accepted: 11/27/2012] [Indexed: 11/07/2022]
Abstract
A common finding in previous research is that problem behavior maintained by automatic reinforcement continues to occur in the alone condition of a functional analysis (FA), whereas behavior maintained by social reinforcement typically is extinguished. Thus, the alone condition may represent an efficient screening procedure when maintenance by automatic reinforcement is suspected. We conducted a series of 5-min alone (or no-interaction) probes for 30 cases of problem behavior and compared initial predictions of maintenance or extinction to outcomes obtained in subsequent FAs. Results indicated that data from the screening procedure accurately predicted that problem behavior was maintained by automatic reinforcement in 21 of 22 cases and by social reinforcement in 7 of 8 cases. Thus, results of the screening accurately predicted the function of problem behavior (social vs. automatic reinforcement) in 28 of 30 cases.
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