TREATING STEREOTYPY IN ADOLESCENTS DIAGNOSED WITH AUTISM BY REFINING THE TACTIC OF “USING STEREOTYPY AS REINFORCEMENT”

Problems with "problem behavior": A secondary systematic review of intervention research on transition-age autistic youth

LAY ABSTRACT

In a previous study, we looked at research done on strategies to support autistic people who were between 14 and 22 years old. For this study, we looked at all of the studies in our previous study that tried to decrease or stop autistic people from doing certain things-many researchers call these things "problem behavior." There were 48 studies that tried to reduce problem behavior, and most of them used strategies like prompting and reinforcement to try get autistic people to change their behavior. We found many things wrong with these studies. Most of them did not define the group of behaviors they were trying to stop autistic people from doing. None of the studies looked at whether any side effects happened when they tried the strategy they were studying. Also, most of the studies tried to stop autistic people from doing behaviors that probably were not harmful, like stereotypic behavior. Most of the studies did not say how they decided that the behaviors they tried to stop were a problem for the autistic people in the study, and most studies did not try to figure out why the autistic people in the study did the behaviors the researchers were trying to stop them from doing.

A systematic review of social-validity assessments in the Journal of Applied Behavior Analysis: 2010-2020

We conducted a systematic review of studies published in the Journal of Applied Behavior Analysis between 2010 and 2020 to identify reports of social validity. A total of 160 studies (17.60%) published during this time included a measure of social validity. For each study, we extracted data on (a) the dimensions of social validity, (b) the methods used for collecting social-validity data, (c) the respondents, and (d) when social-validity data were collected. Most social-validity assessments measured the acceptability of intervention procedures and outcomes, with fewer evaluating goals. The most common method for collecting social validity data was Likert-type rating scales, followed by non-Likert-type questionnaires. In most studies, the direct recipients of the intervention provided feedback on social validity. Social-validity assessment data were often collected at the conclusion of the study. We provide examples of social-validity measurement methods, discuss their strengths and limitations, and provide recommendations for improving the future collection and reporting of social-validity data.

Environmental enrichment accelerates the acquisition of schedule-induced drinking in rats

Environmental enrichment (EE) provides an improvement in the housing conditions of experimental animals, such as laboratory rats, with greater physical and social stimulation through toys and company in the home cages. Its use is known to influence performance of experimental protocols, but these effects have not been well determined in the schedule-induced drinking (SID) procedure. The main goal of this study was to investigate the effects of EE on the acquisition of SID in 24 12-week-old male Wistar rats, divided into two groups, a group with EE housed with toys and companions, and a group without enrichment in individual housing conditions without toys (social isolation and no environmental enrichment, INEE). A total of 25 sessions, under a fixed time 30 s food reinforcement schedule and with access to water in the experimental chambers were carried out. Sessions lasted 30 min. The results showed that the EE group developed faster the excessive drinking pattern of SID, and drank to higher levels, than the INEE group. The greater development of SID in the EE group contradicts the view of schedule-induced behavior as linked to stress reduction and better suits with the conception of induction related to positive reinforcement.

Cultural responsiveness in applied behavior analysis: Research and practice

The new Ethics Code for Behavior Analysts requires that certificants engage in training related to culturally responsive service delivery (BACB, 2020). There is limited work in the area of culturally responsive evidence-based practice within our field. Therefore, it is incumbent on researchers and practitioners to identify best practices for working with diverse populations. Hence, the purpose of this paper is three-fold: a) to review research within and outside the field of ABA related to culturally responsive assessment and treatment and provide practice recommendations, b) to examine the extent to which current practices in behavior assessment and treatment align with aspects of culturally responsive practices, and c) to inspire research in the areas of behavior assessment and treatment to identify best practices with regard to culturally responsive behavior analytic practices. The content of this paper is grounded in the framework described by Beaulieu and Jimenez-Gomez (2022).

On the generality of preference for contingent reinforcement

Reinforcers can be delivered dependent on or independent of responding. Both human and nonhuman animals have shown a preference for contexts involving contingent reinforcement, but the generality of this phenomenon to humans and its implications have not yet been described. We present an integrative summary of studies evaluating preference for contingent versus noncontingent reinforcement, including (a) study participants, reinforcer types, response topographies, and contexts; (b) outcomes; (c) potential variables influencing preference outcomes; and (d) suggestions regarding research to expand behavior analysts' ability to design preferred contexts.

Toward trauma-informed applications of behavior analysis

Despite a growing acknowledgement of the importance of understanding the impacts of trauma on therapeutic approaches across human service disciplines, discussions of trauma have been relatively infrequent in the behavior analytic literature. In this paper, we delineate some of the barriers to discussing and investigating trauma in applied behavior analysis (ABA) and describe how the core commitments of trauma-informed care could be applied to behavior analysis. We then provide some examples of how trauma-informed care might be incorporated into ABA practice. We conclude by suggesting opportunities to approach trauma as a viable avenue for behavior analytic research and argue that omitting trauma-informed care from ABA could be detrimental not only to the public perception of ABA, but to the effectiveness of our assessment and treatment procedures.

The Effects of a Procedure to Decrease Motor Stereotypy on Social Interactions in a Child With Autism Spectrum Disorder

Repetitive and stereotypic motor movements and vocal behavior are among the diagnostic characteristics of autism spectrum disorder (American Psychiatric Association, 2013, Diagnostic and Statistical Manual of Mental Disorders [5th ed.]. Washington, DC: Author). Motor stereotypy can interfere with the acquisition and demonstration of many adaptive skills and may socially stigmatize individuals, limiting the development and maintenance of peer relationships. The current study evaluated the effects of a differential reinforcement procedure used to establish discriminative stimulus control over the rate of motor stereotypy. In the second experimental phase, the child was taught a multistep self-management program using the differential reinforcement procedure. The data indicate that the procedure was effective in decreasing the rate of motor stereotypy across all evaluated settings for an increased duration. Although motor stereotypy was not completely eliminated by the procedure, a large reduction in rate was observed, as well as a large increase in the initiation of and response to social interactions. The findings are discussed in terms of social validity and the establishment and transfer of stimulus control.

Assessment of children's and caregivers' preferences for treatments for escape-maintained problem behavior

This study assessed children's and caregivers' preferences for various arrangements of negative reinforcement, including differential negative reinforcement of an alternative behavior (DNRA), noncontingent escape (NCE), and escape extinction. In the first treatment comparison, the DNRA and NCE treatments similarly decreased problem behavior, but all 3 children preferred DNRA. By contrast, 3 of 4 caregivers preferred escape extinction, likely due to increased compliance in this condition. In a second treatment comparision with 1 child, a multiple schedule and then a chained schedule were introduced to increase the practically of the initial DNRA treatment. The child continued to prefer the treatment with contingent reinforcement in both comparisons, and his caregivers preferred the chained schedule. Results further support the selection of treatments that include contingent reinforcement, and the evaluation serves as a model for progressing through treatment options until child and caregiver preferences align.

A comparison of intervention for problematic speech using reinforcement with and without preferred topics

Previous research has shown that responding to the appropriate and problematic speech of individuals diagnosed with developmental disabilities with interested and uninterested listener responses, respectively, can promote more appropriate conversational engagement. However, Fisher et al. (2013) also responded to appropriate speech with access to preferred conversational topics. This study examined the influence of listener interest on the problematic speech of 8 participants and tested the additive effects of (Study 1) and participant preference for (Study 2) delivering preferred topics as reinforcement for appropriate speech. Interventions were equally effective with or without arranging access to preferred topics, but a majority of participants demonstrated a preference for intervention with contingent access to preferred topics. Caregivers and speech-language pathologists rated the intervention procedures as acceptable and changes in participants' speech satisfactory.

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 differential reinforcement procedures for treating automatically reinforced behavior

Children diagnosed with autism spectrum disorder (ASD) often exhibit stereotypy, which can be socially stigmatizing, interfere with daily living skills, and affect skill acquisition. We compared differential reinforcement of alternative behavior (DRA) and differential reinforcement of other behavior (DRO) when neither procedure included response blocking or interruption for (a) reducing stereotypy, (b) increasing task engagement, and (c) increasing task completion. DRA contingencies yielded superior outcomes across each measure when evaluated with 3 individuals with autism spectrum disorder.

A review of environmental enrichment as treatment for problem behavior maintained by automatic reinforcement

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.

An evaluation of a punisher assessment for decreasing automatically reinforced problem behavior

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.

Experimental analysis of stereotypy with applications of nonparametric statistical tests for alternating treatments designs

INTRODUCTION

Stereotypy is common in individuals with developmental disabilities and may become disruptive in the context of instruction.

PURPOSE

The purpose of this study was to embed brief experimental analyses in the context of reading instruction to evaluate effects of antecedent and consequent variables on latencies to and durations of stereotypy.

METHOD

We trained a reading instructor to implement a trial-based functional analysis and a subsequent antecedent analysis of stimulus features for an adolescent with autism in a reading clinic. We used alternating treatments designs with applications of nonparametric statistical analyses to control Type I error rates.

RESULTS

Results of the experimental analyses suggested stereotypy was maintained by non-social reinforcement and informed the extent to which features of academic materials influenced levels of stereotypy. Results of nonparametric statistical analyses were consistent with conclusions based on visual analysis.

CONCLUSION

Brief experimental analyses may be embedded in academic instruction to inform the stimulus conditions that influence stereotypy.

Differential Reinforcement of Other Behaviors to Treat Challenging Behaviors Among Children With Autism: A Systematic and Quality Review

This review summarizes the literature regarding differential reinforcement of other behaviors (DRO) to treat challenging behavior among children with autism spectrum disorder (ASD) and determines the quality of studies among the current literature according to the 2014 Council for Exceptional Children (CEC): Standards for Evidence-Based Practices in Special Education. Studies that focused on the use of DRO in the treatment of challenging behavior for individuals with ASD were included for systematic analysis. Forty-five studies were identified for inclusion in this review and were evaluated using the eight quality indicators described by the CEC. To the authors’ knowledge, this is the only systematic review of the literature that evaluates DRO as an intervention for individuals diagnosed with ASD. Principle findings, practical recommendations, and areas of future research are discussed.

An Assessment of Three Procedures to Teach Echoic Responding

The research literature has revealed mixed outcomes on various procedures for increasing vocalizations and echoic responding in persons with disabilities (Miguel, Carr, & Michael The Analysis of Verbal Behavior, 18, 3-13, 2002; Stock, Schulze, & Mirenda The Analysis of Verbal Behavior, 24, 123-133, 2008). We examined the efficacy of an assessment procedure for identifying the most effective echoic teaching procedure to six students diagnosed autism spectrum disorder (ASD) and other developmental delays. The assessment procedure included a within-participant comparison of vocal imitation training (VIT), stimulus-stimulus pairing (SSP), and a mand-model procedure (MM). A functional analysis of the responses was conducted to determine whether responding was functionally an echoic or a mand. The results indicated that the assessment was effective in identifying a teaching procedure for five out of the six participants and that responding was established under echoic control. These outcomes support the efficacy of this assessment procedure for identifying effective echoic teaching procedures.

Increasing Functional Leisure Engagement for Children With Autism Using Backward Chaining

Research with individuals with disabilities has demonstrated the utility of intervention approaches to address toy play, also referred to as functional leisure engagement (FLE). Examples include prompting FLE, blocking stereotypy, and differentially reinforcing appropriate FLE with social or automatic (i.e., access to stereotypy) reinforcers. Backward chaining has yet to be evaluated, but may be useful for establishing more complex FLE. The current study employed a treatment package consisting of these components with three school-aged children with autism in a therapeutic classroom. Effects were evaluated during pretest and posttest sessions, which consisted of free access to toys in a novel setting. The percentage of session with FLE was evaluated using a multiple probe design across participants. Results showed all participants demonstrated an increase in FLE and two participants showed decreased stereotypy. Feasibility for classroom implementation is discussed.

Restricted Interests and Autism: Further Assessment of Preferences for a Variety of Leisure Items

Researchers have yet to identify the conditions under which people diagnosed with autism spectrum disorder demonstrate restricted interests; it is possible that the impression of restricted interests is strengthened when a limited variety of items are included in a client's preference assessments. This study will extend past research on preferences of children with autism by (a) examining participants' preferences for unreplenished (familiar) play or leisure items versus items that are replenished frequently, (b) assessing if participants who prefer replenished items select items with properties that are matched or unmatched to their most preferred unreplenished item, and (c) assessing if participants who show an exclusive preference for unreplenished items will select replenished items during response-restriction and enhanced-replenished pool manipulations. Participants were four adolescents with autism and a caregiver-reported history of restricted interests. One participant selected both unreplenished (familiar) items and replenished (novel) items without further manipulations. The remaining three participants only selected replenished-matched leisure items after additional manipulations. Results are discussed in terms of the ethical and practical importance of assessing a range of potential reinforcers, particularly with clients who demonstrate restricted interests.

The primatologist as a behavioral engineer

The field of primate behavior management has had only limited success in preventing and treating abnormal behaviors, such as stereotypy and self-injury, in captive non-human primates (NHP). In contrast, applied behavior analysts have had great success in treating similar topographies of behavior in human clinical settings. By adapting and adopting the behavioral principles and methodologies commonly used by applied behavior analysts, primatologists may be able to develop more effective ways to analyze, reduce, and prevent these aberrant behaviors in NHP. This article reviews studies that have used behavior analytic techniques to successfully address problem behaviors in NHP. Additionally, relevant literature from the field of applied behavior analysis is reviewed to illustrate how adopting a theoretical framework that emphasizes the determination of the underlying operant functions of behavior could lead to new behavioral technologies and advance the field of captive primate management. Am. J. Primatol. 79:e22500, 2017. © 2015 Wiley Periodicals, Inc.