Resurgence in a discrete-trial procedure in rats

Resurgence is a transient recovery of a previously extinguished target response following a worsening of reinforcement conditions for an alternative response. Laboratory studies with nonhuman animals typically assess resurgence in free-operant situations where subjects can freely emit responses. The purpose of the current study was to investigate whether resurgence would be observed in a discrete-trial procedure where only a single response could occur in each trial, using rats as subjects. The experiment consisted of three phases, and each session ended after 200 trials. All trials began with the insertion of target and alternative levers and ended once a response was emitted. In Phase 1, both target and alternative responses were reinforced with a probability of .25. In Phase 2, the target response was extinguished while still reinforcing the alternative response with a probability of .25. Finally, resurgence was tested by placing the alternative response on extinction. All rats showed robust resurgence in this highly constrained discrete-trial situation. We also found that the latencies of resurged target responses differed from those in Phase 1. Overall, the present discrete-trial procedure could produce reliable resurgence as with typical free-operant procedures and has several potential benefits for studying resurgence.

Updated Recommendations for Reinforcement Schedule Thinning following Functional Communication Training

Schedule thinning is a necessary treatment procedure following the acquisition of a communication response during functional communication training. In this article, we update and extend the Hagopian et al. Behavior Analysis in Practice, 4, 4-16, (2011) review and recommendations on schedule-thinning procedures following functional communication training. Since their publication, substantial research has been published on the efficacy, efficiency, and social validity of schedule-thinning methods. We provide updated recommendations for schedule thinning based on contemporary literature that has been published since 2011, as well as discuss key areas for future research.

Operant ABA renewal during dense and lean schedules of differential reinforcement

Renewal is a type of relapse that occurs due to a change in context. Previous research has demonstrated that renewal of target responding may occur despite the availability of differential reinforcement for an alternative response (DRA). Nevertheless, the current literature on renewal presents mixed findings regarding the effects of dense and lean schedules of DRA on the magnitude of renewal. We used a translational approach with undergraduate college students and a task on a touchscreen tablet device to study the effects of dense and lean schedules of DRA during repeated renewal tests. All participants experienced two, three-phase ABA renewal arrangements. In the dense and lean renewal arrangements, we differentially reinforced alternative behavior in Context B and the renewal test in Context A on a VI 3-s or a VI 12-s schedule, respectively. Overall, we observed renewal in 31/36 (86%) renewal tests regardless of the density of reinforcement for the alternative response. Furthermore, the results showed that although renewal occurred in both arrangements, we found slightly higher magnitudes of renewal during DRA with lean schedules of reinforcement relative to dense schedules. We discuss the implications of these findings as they relate to the treatment of problem behavior.

A Comprehensive Systematic Review of Procedures and Analyses Used in Basic and Preclinical Studies of Resurgence, 1970-2020

Resurgence is the return of a previously reinforced response as conditions worsen for an alternative response, such as the introduction of extinction, reductions in reinforcement, or punishment. As a procedure, resurgence has been used to model behavioral treatments and understand behavioral processes contributing both to relapse of problem behavior and flexibility during problem-solving. Identifying existing procedural and analytic methods arranged in basic/preclinical research could be used by basic and preclinical researchers to develop novel approaches to study resurgence, whereas translational and clinical researchers could identify potential approaches to combating relapse during behavioral interventions. Despite the study of resurgence for over half a century, there have been no systematic reviews of the basic/preclinical research on resurgence. To characterize the procedural and analytic methods used in basic/preclinical research on resurgence, we performed a systematic review consistent with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). We identified 120 articles consisting of 200 experiments that presented novel empirical research, examined operant behavior, and included standard elements of a resurgence procedure. We reported prevalence and trends in over 60 categories, including participant characteristics (e.g., species, sample size, disability), designs (e.g., single subject, group), procedural characteristics (e.g., responses, reinforcer types, control conditions), criteria defining resurgence (e.g., single test, multiple tests, relative to control), and analytic strategies (e.g., inferential statistics, quantitative analysis, visual inspection). We make some recommendations for future basic, preclinical, and clinical research based on our findings of this expanding literature.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40614-022-00361-y.

Prevalence of relapse of automatically maintained behavior resulting from context changes

Increases in behavior due to context changes are common and are known as instances of renewal. Clinically relevant examples from the literature highlighting renewal often include socially mediated problem behaviors. This report retrospectively analyzed data during context changes for individuals who engaged in problem behavior maintained by automatic reinforcement, to evaluate the prevalence of relapse. Problem behavior reemerged during changes both in the person implementing treatment (e.g., introducing a caregiver; 36%) and in the setting (e.g., introducing treatment in the home; 26%). Most prevalence studies report greatest relapse immediately following context changes but the highest level of relapse was observed after 5 sessions following person changes and no systematic pattern with setting changes. These patterns of relapse likely reflect differences in the function of settings and people relative to automatically reinforced behavior in the present study. Implications of relapse for treatments of problem behavior maintained by automatic reinforcement are discussed.

Behavior Momentum Theory and Humans: A Review of the Literature

Behavioral Momentum Theory (BMT) is often described as analogous to Newton's (1687) laws of motion. That is to say, similar to an object in motion continuing in motion unless acted upon by a force, responses occurring in a static environment will continue to occur at the same rate, unless presented with a disruptor (Nevin, Tota, Torquato, & Shull, Journal of the Experimental Analysis of Behavior, 53, 359-379, 1990). When evaluating response rates through a behavioral momentum framework, responding continuing after a change in reinforcer conditions is said to persist. Previous research conducted with nonhuman animals indicates greater response persistence following conditions with either higher reinforcer rates or higher reinforcer magnitudes (Nevin, Journal of the Experimental Analysis of Behavior, 21(3), 389-408, 1974; Nevin et al., Journal of the Experimental Analysis of Behavior, 53, 359-379, 1990). Although BMT's implications extend across human and nonhuman species, this literature review attempts to provide practitioners and researchers information regarding response persistence across various conditions with human participants.

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.

Investigations of operant ABA renewal during differential reinforcement

Operant renewal is a form of relapse in which a previously extinguished response recurs due to a change in context. We designed two experiments to examine the impact of differential reinforcement of alternative behavior on ABA renewal in a translational model of relapse with 12 children. We compared levels of renewal in two 3-phase arrangements. In one arrangement, we reinforced target responding in Context A, extinguished responding in Context B, and returned to Context A while continuing to implement extinction. In a second arrangement, an alternative response produced reinforcement in Context B and during the return to Context A. Results across the 2 experiments indicated 3 general findings. First, extinction plus differential reinforcement disrupted target behavior more consistently in Context B relative to extinction alone. Second, renewal tended to be greater and more persistent during extinction alone relative to extinction plus differential reinforcement. Third, the renewal effect appeared to depend on whether the alternative response had a history of extinction in Context A. We discuss methodological implications for the treatment of severe destructive behavior.

Resurgence of previously taught academic responses

Resurgence is often discussed in relation to the relapse of undesirable behavior. However, resurgence may also describe the recurrence of socially appropriate behavior, including academic responding. The recurrence of academic responses following periods of extinction may aid in the solution of novel problems. The aims of this study were to evaluate the resurgence of complex, desirable behavior related to college-level instruction and to explore problem form as an aspect of environmental context. Each participant was taught 2 response chains to solve quadratic equations across experimental phases, followed by a phase in which neither chain resulted in the correct solution (extinction). During Experiment 1, the equations presented during extinction resembled those presented during reinforcement of the alternative response. Of the 8 participants in Experiment 1, 4 attempted to use the first-taught chain to solve an equation in the extinction phase. During Experiment 2, the equations presented during extinction resembled those presented during reinforcement of the target response. Of the 8 participants in Experiment 2, 6 attempted to use the first-taught chain to solve an equation in the extinction phase. Results demonstrate the resurgence of academic responses and suggest that the form of the problem may constitute a context that affects resurgence.

A preliminary evaluation of treatment duration on the resurgence of destructive behavior

Quantitative models of resurgence (e.g., Behavioral Momentum Theory, Resurgence as Choice) suggest that resurgence is partly a function of the duration of extinction exposure, with longer histories of extinction producing less resurgence. This prediction is supported by some laboratory research and has been partially supported by clinical translations that did not isolate the effects of extinction exposure prior to testing for resurgence. The degree to which different histories of extinction impact the likelihood of treatment relapse in therapeutic applications of differential reinforcement is of great interest to the clinical community, including insurance carriers and other financial providers. In the present study, we isolated the effects of extinction history for severe destructive behavior across 6 participants referred for treatment services and examined resurgence of destructive behavior when alternative reinforcement terminated. Our within-subject evaluation showed no difference in the level of resurgence or persistence of destructive behavior following short and long exposures to differential reinforcement with extinction. We discuss our failure to replicate in relation to experimental-design considerations for investigating this and other relapse phenomena in future research with clinical populations.

An evaluation of resurgence following functional communication training conducted in alternative antecedent contexts via telehealth

Treatments based on differential reinforcement may inadvertently increase the recurrence of problem behavior in the face of challenges because reinforcers for appropriate behavior occur in the same context as problem behavior. The current study evaluated one potential approach to mitigating these problems with differential reinforcement treatments based on behavioral momentum theory. Specifically, appropriate behavior was trained in contexts without a history of reinforcement prior to intervening with problem behavior. Participants were 4 children with autism spectrum disorder. Treatment used telehealth to implement functional communication training (FCT) in three alternative contexts with minimal or no history of reinforcement for problem behavior before initiating FCT in the treatment context. Evaluations of the effects of treatment and tests of resurgence were conducted intermittently during treatment to evaluate maintenance. When FCT treatment was initiated in alternative contexts, initial results were comparable to more typical implementations of FCT. Resurgence was reduced to similar levels during tests of resurgence for all participants when compared to more typical previously published implementations of FCT, but clinically significant reductions in resurgence occurred more quickly in the present study. These findings support training appropriate behavior in an alternative context to mitigate the resurgence of problem behavior during differential reinforcement treatments.

Resurgence as Choice: Implications for promoting durable behavior change

Resurgence is an increase in a previously suppressed behavior resulting from a worsening in reinforcement conditions for current behavior. Resurgence is often observed following successful treatment of problem behavior with differential reinforcement when reinforcement for an alternative behavior is subsequently omitted or reduced. The efficacy of differential reinforcement has long been conceptualized in terms of quantitative models of choice between concurrent operants (i.e., the matching law). Here, we provide an overview of a novel quantitative model of resurgence called Resurgence as Choice (RaC), which suggests that resurgence results from these same basic choice processes. We review the failures of the only other quantitative model of resurgence (i.e., Behavioral Momentum Theory) and discuss its shortcomings with respect to the limited range of circumstances about which it makes predictions in applied settings. Finally, we describe how RaC overcomes these shortcomings and discuss implications of the model for promoting durable behavior change.

Baseline reinforcement rate and resurgence of destructive behavior

Concepts from behavioral momentum theory, along with some empirical findings, suggest that the rate of baseline reinforcement may contribute to the relapse of severe destructive behavior. With seven children who engaged in destructive behavior, we tested this hypothesis in the context of functional communication training by comparing the effects of different baseline reinforcement rates on resurgence during a treatment challenge (i.e., extinction). We observed convincing resurgence of destructive behavior in four of seven participants, and we observed more resurgence in the condition associated with high-rate baseline reinforcement (i.e., variable-interval 2 s in Experiment 1 or fixed-ratio 1 in Experiment 2) compared to a low-rate baseline reinforcement condition. We discuss the implications of these results relative to schedules of reinforcement in the treatment of destructive behavior and strategies to mitigate resurgence in clinical settings.

Minimizing resurgence of destructive behavior using behavioral momentum theory

The resurgence of destructive behavior can occur during functional communication training (FCT) if the alternative response contacts a challenge (e.g., extinction). Behavioral momentum theory (BMT) suggests that refinements to FCT could mitigate resurgence of destructive behavior during periods of extinction. Following a functional analysis and treatment with FCT, we combined three refinements to FCT (i.e., the use of a lean schedule of reinforcement for destructive behavior during baseline, a lean schedule for the alternative response during FCT, and an increase in the duration of treatment) and compared the magnitude of resurgence relative to a condition in which FCT was implemented in a traditional manner. Results suggested that the combination of these three refinements to FCT was successful in decreasing the resurgence of destructive behavior during an extinction challenge. We discuss the implications of these findings, as well as areas for future research.

Stimulus contributions to operant resurgence

In two experiments, pigeons were exposed to a three-phase resurgence procedure (train Response A; extinguish Response A and train Response B; extinguish Response B). In the first experiment, the stimuli associated with phases were different, resulting in a resurgence procedure combined with an ABC renewal procedure. Presenting the novel stimulus, C, during extinction of both responses in the third phase resulted in minimal resurgence. Subsequently, substituting the original training Stimulus A for Stimulus C resulted in resurgence with all pigeons. In the second experiment, resurgence with the same stimuli present in all three phases of the resurgence procedure (AAA) was compared concurrently with a resurgence procedure in which the ABC renewal procedure used in Experiment 1 was superimposed. Substantially more resurgence occurred with the AAA procedure compared to the ABC procedure. Although ABC renewal in combination with the resurgence procedure generated some resurgence, such recurrent responding was attenuated relative to that observed when the stimulus conditions were constant across phases. Combined with earlier research showing the enhancing effects of combining resurgence and ABA renewal procedures, the present results elaborate on how stimuli correlated with certain behavioral histories affect the course of operant resurgence.

Prevalence of resurgence of destructive behavior when thinning reinforcement schedules during functional communication training

Functional communication training is a well-established treatment for socially reinforced destructive behavior that typically includes differential reinforcement of the functional communication response (FCR) in combination with extinction of destructive behavior. However, when the schedule of reinforcement for the FCR is thinned, destructive behavior may resurge (e.g., Greer, Fisher, Saini, Owen, & Jones, 2016). Currently, data are unavailable on the prevalence and characteristics of resurgence during reinforcement schedule thinning. In this study, we evaluated the prevalence of resurgence during reinforcement schedule thinning on a per-case and per-schedule-step basis and also evaluated the magnitude of resurgence in relation to the functions of destructive behavior. We observed resurgence in 19 of the 25 (76%) applications of reinforcement schedule thinning. In some cases, the magnitude of resurgence exceeded the mean levels of destructive behavior observed in baseline. We discuss these results relative to prior translational and applied research on resurgence.

Resurgence with and without an alternative response

Resurgence is the reemergence of a previously reinforced response that occurs after the elimination or reduction of reinforcement for an alternative response. Resurgence is problematic in the context of treatment because the reemergence of a previously reinforced destructive response could be detrimental to treatment gains. In the current translational study, we examined a modified resurgence procedure in which the alternative response was either present or absent during extinction. Four participants were exposed to three phases that consisted of (1) reinforcement of a target response, (2) extinction of the target response and differential reinforcement of an alternative response, and (3) extinction of both responses. Results for four out of five assessments showed greater resurgence when the alternative response was absent during Phase 3. Results suggest that more robust resurgence might occur if the alternative response is not available as opposed to the alternative response contacting extinction.

Tony nevin: The embrace of translational work by a basic scientist

Here I summarize John A. "Tony" Nevin's evolution as a translational author. All of his publications were classified by title and content as being primarily experimental analysis of behavior or translational. Translational works were subtyped as interpretative, descriptive research, or experimental research. During the first 20 years of his publication career, Tony published exclusively experimental analysis of behavior work. In 1982, he began a series of interpretative translational analyses on topics of significant social importance. These interpretative papers translated behavioral science into logical accounts of issues of war and peace, for example, and performed quantitative analyses of available data to show that social behavior, even at the level of the group or society, conforms to predictions based on established behavioral principles. Tony began experimental translational research in 1990, first to establish whether his analysis of behavioral momentum generalized to humans. Several experimental studies later addressed the persistence of clinically relevant behavior and treatment relapse. The objective descriptions of Tony's publication patterns are punctuated with anecdotes from our 32-year collaboration and friendship.

Resurgence of time allocation

The resurgence of time allocation with pigeons was studied in three experiments. In Phase 1 of each experiment, response-independent food occurred with different probabilities in the presence of two different keylights. Each peck on the key changed its color and the food probability in effect. In Phase 2, the food probabilities associated with each keylight were reversed and, in Phase 3, food was discontinued in the presence of either keylight. The food probabilities were .25 and .75, in Experiment 1, and 0.0 and 1.0 in Experiment 2. More time was allocated to the keylight correlated with more probable food in Phases 1 and 2, and in Phase 3 resurgence of time allocation occurred for two of three pigeons in Experiment 1, and for each of four pigeons in Experiment 2. Because time had to be allocated to either of the two alternatives in Experiments 1 and 2, however, it was difficult to characterize the time allocation patterns in Phase 3 as resurgence when changeover responding approached zero. In Experiment 3 this issue was addressed by providing a third alternative uncorrelated with food such that in each phase, after 30 s in the presence of either keylight correlated with food, the third alternative always was reinstated, requiring a response to access either of the two keylights correlated with food. In this experiment, the food probabilities were similar to those in Experiment 1. Resurgence of time allocation occurred for each of three pigeons under this procedure. The results of these experiments suggest that patterns of time allocation resurge similarly to discrete responses and to spatial and temporal patterns of responding.

A method to establish stimulus control and compliance with instructions

We evaluated a unique procedure to establish compliance with instructions in four young children diagnosed with autism spectrum disorder (ASD) who had low levels of compliance. Our procedure included methods to establish a novel therapist as a source of positive reinforcement, reliably evoke orienting responses to the therapist, increase the number of exposures to instruction-compliance-reinforcer contingencies, and minimize the number of exposures to instruction-noncompliance-no reinforcer contingencies. We further alternated between instructions with a high probability of compliance (high-p instructions) with instructions that had a prior low probability of compliance (low-p instructions) as soon as low-p instructions lost stimulus control. The intervention is discussed in relation to the conditions necessary for the development of stimulus control and as an example of a variation of translational research.

Basing assessment and treatment of problem behavior on behavioral momentum theory: Analyses of behavioral persistence

The connection, or bridge, between applied and basic behavior analysis has been long-established (Hake, 1982; Mace & Critchfield, 2010). In this article, we describe how clinical decisions can be based more directly on behavioral processes and how basing clinical procedures on behavioral processes can lead to improved clinical outcomes. As a case in point, we describe how applied behavior analyses of maintenance, and specifically the long-term maintenance of treatment effects related to problem behavior, can be adjusted and potentially enhanced by basing treatment on Behavioral Momentum Theory. We provide a brief review of the literature including descriptions of two translational studies that proposed changes in how differential reinforcement of alternative behavior treatments are conducted based on Behavioral Momentum Theory. We then describe current clinical examples of how these translations are continuing to impact the definitions, designs, analyses, and treatment procedures used in our clinical practice.

Renewed behavior produced by context change and its implications for treatment maintenance: A review

Behavioral treatment gains established in one setting do not always maintain in other settings. The present review examines the relevance of basic and translational research to understanding failures to maintain treatment gains across settings. Specifically, studies of the renewal effect examine how transitioning away from a treatment setting could evoke a return of undesirable behavior, rather than newly trained appropriate behavior. Studies of renewal typically arrange three phases, with a response trained and reinforced under a particular set of contextual stimuli in the first phase. Next, that response is extinguished, often under a different set of contextual stimuli. Finally, that response returns despite extinction remaining in effect upon returning to the original training context or transitioning to a novel context. Thus, removing the extinction context is sufficient to produce a recurrence of the response. The findings suggest treatment effects can become specific to the context in which the treatment was delivered. This literature offers promising methods for systematically assessing the factors contributing to treatment maintenance and improving generalization of treatment gains across contexts. Therefore, the present review suggests basic and translational research on renewal provides an empirical literature to bring greater conceptual systematization to understanding generalization and maintenance of behavioral treatment.

Persistence and resistance to extinction in the domestic dog: Basic research and applications to canine training

This review summarizes the research investigating behavioral persistence and resistance to extinction in the dog. The first part of this paper reviews Behavioral Momentum Theory and its applications to Applied Behavior Analysis and training of pet dogs with persistent behavioral problems. I also highlight how research on Behavioral Momentum Theory can be applied to the training of detection dogs in an attempt to enhance detection performance in the presence of behavioral disruptors common in operational settings. In the second part of this review, I highlight more basic research on behavioral persistence with dogs, and how breed differences and experiences with humans as alternative sources of reinforcement can influence dogs' resistance to extinction of a target behavior. Applied Behavior Analysis and Behavior Momentum Theory have important applications for behavioral treatments to reduce the persistence of problem behavior in dogs and for the development of enhanced training methods that enhance the persistence of working dogs. Dogs can also be leveraged as natural models of stereotypic behavior and for exploring individual differences in behavioral persistence by evaluating breed and environmental variables associated with differences in canine persistance.

Beyond Intervention

Individuals diagnosed with autism spectrum disorder (ASD) and other developmental disabilities are at risk of engaging in severe problem behavior, including aggression and self-injury. Severe problem behavior is an obstacle to proper education and integration into society. Therefore, eliminating severe problem behavior is key to long-term academic and social success. However, problem behavior can be persistent in the face of interventions and likely to relapse following successful intervention. This article describes basic and translational research relevant to understanding what influences the persistence and relapse of severe problem behavior in individuals diagnosed with ASD and other developmental disabilities. Investing in research to better understand persistence and relapse will pay dividends for clients, parents, clinicians, and society in general.

A preliminary investigation on improving functional communication training by mitigating resurgence of destructive behavior

Despite the effectiveness and widespread use of functional communication training (FCT), resurgence of destructive behavior can occur if the functional communication response (FCR) contacts a challenge, such as lapses in treatment integrity. We evaluated a method to mitigate resurgence by conducting FCT using a multiple schedule of reinforcement prior to extinction. After functional analyses of 2 boys' destructive behavior and treatment with FCT (Study 1), we compared levels of resurgence during an extinction challenge either after a typical FCT sequence or after exposure to schedule thinning in the context of a multiple-schedule arrangement (Study 2). Results for both participants suggested that schedule thinning using discriminative stimuli in a multiple schedule mitigated the resurgence of destructive behavior.

Multiple schedules in practical application: Research trends and implications for future investigation

Researchers began studying multiple schedules in basic laboratories, but recent advances have extended research on multiple schedules to a wide variety of socially significant applications, especially during the last decade. Applied researchers have used multiple schedules to (a) promote stimulus control over high-rate appropriate behaviors, (b) thin the schedule of reinforcement following functional communication training, and (c) obtain stimulus control over problem behaviors maintained by automatic reinforcement. In the current paper, we reviewed 31 studies with 147 applications identified through a search of the applied literature on multiple schedules. Using these studies, we (a) reviewed the empirical literature on multiple schedules, (b) recommended multiple-schedule procedures that serve as best practice guidelines for applied behavior analysts, (c) identified the generality and boundaries of current knowledge about the effectiveness of multiple schedules, and (d) critically analyzed the literature to provide directions for future multiple-schedule research.

Behavioral Momentum Theory: a Tutorial on Response Persistence

Behavioral momentum theory (BMT) provides an integrative framework for evaluating the strength of a response when it contacts a disruptor, such as the discontinuation of reinforcement (i.e., extinction). Grounded in Newtonian physics, BMT distinguishes response rate (behavioral velocity) from response strength or persistence (behavioral mass). Behavioral velocity is affected by response-reinforcer contingencies, whereas behavioral mass is affected by stimulus-reinforcer contingencies (Nevin and Wacker 2013). We describe the determiners of behavioral mass, as well as common sources of disruption that are used to measure behavioral mass. Learning activities are embedded throughout this discussion to help readers better understand BMT and its implications for practice across a range of contexts.

Training Staff to Avoid Problem Behavior Related to Restricting Access to Preferred Activities

Some training programs for staff working with individuals with intellectual disabilities fail to equip staff with the practical skills necessary to prevent behavioral episodes. The current research describes the results of a staff training program that, following traditional didactic training, used a card game followed by role-play training to increase staff competence in managing problem behavior. The card game and role-play training was based on behavioral episodes that had occurred previously in the research setting. Post-training observations showed that treatment integrity of trained staff improved.