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Kimball RT, Greer BD, Fuhrman AM, Lambert JM. Relapse and its mitigation: Toward behavioral inoculation. J Appl Behav Anal 2023; 56:282-301. [PMID: 36715533 PMCID: PMC10121865 DOI: 10.1002/jaba.971] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 12/03/2022] [Indexed: 01/31/2023]
Abstract
Relapse following the successful treatment of problem behavior can increase the likelihood of injury and the need for more intensive care. Current research offers some predictions of how treatment procedures may contribute to relapse, and conversely, how the risk of relapse can be mitigated. This review describes relapse-mitigation procedures with varying levels of support, the quantitative models that have influenced the research on relapse mitigation, different experimental methods for measuring relapse mitigation, and directions for future research. We propose that by viewing the implementation of relapse-mitigation procedures as a means of producing behavioral inoculation, clinicians are placed in the proactive and intentional role of exposing their client's behavior to an array of reinforcement and stimulus conditions during treatment with the goal of decreasing the detrimental impact of future treatment challenges.
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Affiliation(s)
- Ryan T. Kimball
- Department of Counseling and Applied Behavioral Studies, University of Saint Joseph
| | - Brian D. Greer
- Rutgers Brain Health Institute
- Severe Behavior Program, Children’s Specialized Hospital–Rutgers University Center for Autism Research, Education, and Services (CSH–RUCARES)
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School
| | - Ashley M. Fuhrman
- Severe Behavior Program, Children’s Specialized Hospital–Rutgers University Center for Autism Research, Education, and Services (CSH–RUCARES)
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School
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2
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Parilla S, Gussin R, Moss‐Lourenco P, Fienup DM. Lag schedules to increase variability in responding in a home setting. BEHAVIORAL INTERVENTIONS 2022. [DOI: 10.1002/bin.1923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Affiliation(s)
- Stephanie Parilla
- Queens College City University of New York New York New York USA
- Bridge Kids and Manhattan Psychological Group New York New York USA
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3
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Houck EJ, Dracobly JD, Baak SA. A Practitioner’s Guide for Selecting Functional Communication Responses. Behav Anal Pract 2022; 16:65-75. [PMID: 37006421 PMCID: PMC10050301 DOI: 10.1007/s40617-022-00705-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2022] [Indexed: 11/25/2022] Open
Abstract
Functional communication training (FCT) is an effective and widely used procedure to reduce problem behaviors. The purpose of FCT is to replace a problem behavior with a socially appropriate and communicative behavior - the functional communication response (FCR), which produces the same reinforcer as the problem behavior. Recent reviews of FCT have focused on providing overall recommendations for how the procedure should be implemented. A relatively small body of literature has been devoted to the selection of the FCR. The purpose of this article is to propose a set of considerations for practitioners in selecting FCRs.
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Affiliation(s)
- Elizabeth J. Houck
- Department of Behavior Analysis, University of North Texas, 1155 Union Circle #3311070, Denton, TX 76201 USA
| | - Joseph D. Dracobly
- Department of Behavior Analysis, University of North Texas, 1155 Union Circle #3311070, Denton, TX 76201 USA
| | - Sara A. Baak
- Department of Behavior Analysis, University of North Texas, 1155 Union Circle #3311070, Denton, TX 76201 USA
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4
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Banerjee I, Lambert JM, Copeland BA, Paranczak JL, Bailey KM, Standish CM. Extending functional communication training to multiple language contexts in bilingual learners with challenging behavior. J Appl Behav Anal 2021; 55:80-100. [PMID: 34569621 DOI: 10.1002/jaba.883] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 09/09/2021] [Accepted: 09/09/2021] [Indexed: 11/09/2022]
Abstract
Little research has highlighted how evidence-based practices (e.g., functional communication training [FCT]) might be adapted for bilingual learners with disabilities. In the current study, we served 2 children with autism spectrum disorder (ASD) and challenging behavior whose parents primarily spoke Spanish at home, and whose teachers primarily spoke English at school. Following traditional FCT (i.e., 1 language only), we systematically replicated the findings of Neely, Graber et al. (2020) by demonstrating that mands in the untrained language (i.e., English) did not emerge when trained mands (i.e., Spanish) contacted extinction in alternative-language contexts. Simultaneously, challenging behavior consistently resurged. After children received explicit training with both languages and were taught to change the language of request when initial attempts were unsuccessful (i.e., "repair the message" training), these same children successfully obtained high rates of reinforcement in both language contexts, and challenging behavior rarely occurred.
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5
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Silbaugh BC. Some Dimensions of Mand Variability and Implications for Research and Practice. Anal Verbal Behav 2021; 37:123-145. [PMID: 34395169 PMCID: PMC8295427 DOI: 10.1007/s40616-021-00144-7] [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: 01/28/2021] [Indexed: 10/21/2022] Open
Abstract
Since Skinner's conceptualization of the mand, applied behavior analysis researchers have used the concept to develop stimulus control transfer procedures effective for addressing manding deficits. More recently, researchers have explored the clinical utility of reinforcing mand variability during mand training and functional communication training. However, limitations in the conceptual analysis of mand variability may have limited the kinds of questions addressed in this research and our understanding of the findings. The current article reconceptualizes mand variability as consisting of eight distinct dimensions and provides operational definitions of the dimensions that may be useful for more precisely characterizing the effects of reinforcement on mand variability in future research. The article concludes with a brief discussion of potential clinical and research implications.
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O'Brien MJ, Pelzel KE, Hendrix NM, Schieltz KM, Miller K, Call NA, Tsami L, Lerman DC, Berg WK, Kopelman TG, Wacker DP, Lindgren SD. Parent Ratings of Generalized and Indirect Effects of Functional Communication Training for Children with Autism Spectrum Disorder. Behav Modif 2021; 46:971-1001. [PMID: 34041956 DOI: 10.1177/01454455211018815] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Functional communication training (FCT) is a behavioral treatment that has been shown to reduce problem behavior and increase appropriate communication in young children with autism spectrum disorder (ASD). In this study, we assessed the effects of FCT on targeted and nontargeted problem behaviors outside of the training context, as well as parent stress, for 30 young children with ASD and their parents. Indirect measures of generalization treatment effects were administered prior to and following FCT treatment delivered via telehealth. Children demonstrated significant improvement on both targeted (measured via observation) and nontargeted (measured via checklist) problem behaviors, both within and outside of the training context, and parent stress was significantly reduced following treatment. These results suggest that the impact of FCT may extend beyond the training context for both the children being treated and the parents delivering treatment, even when generalization is not specifically programmed for during treatment.
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Affiliation(s)
- Matthew J O'Brien
- The University of Iowa, Iowa City, IA, USA.,The University of Iowa Stead Family Children's Hospital, Iowa City, IA, USA
| | - Kelly E Pelzel
- The University of Iowa, Iowa City, IA, USA.,The University of Iowa Stead Family Children's Hospital, Iowa City, IA, USA
| | - Nicole M Hendrix
- Marcus Autism Center, Atlanta, GA, USA.,Children's Healthcare of Atlanta and Emory University, Atlanta, GA, USA
| | - Kelly M Schieltz
- The University of Iowa, Iowa City, IA, USA.,The University of Iowa Stead Family Children's Hospital, Iowa City, IA, USA
| | - Kenzie Miller
- The University of Iowa, Iowa City, IA, USA.,The University of Iowa Stead Family Children's Hospital, Iowa City, IA, USA
| | - Nathan A Call
- Marcus Autism Center, Atlanta, GA, USA.,Children's Healthcare of Atlanta and Emory University, Atlanta, GA, USA
| | - Loukia Tsami
- The University of Houston - Clear Lake, Houston, TX, USA
| | | | - Wendy K Berg
- The University of Iowa, Iowa City, IA, USA.,The University of Iowa Stead Family Children's Hospital, Iowa City, IA, USA
| | - Todd G Kopelman
- The University of Iowa, Iowa City, IA, USA.,The University of Iowa Stead Family Children's Hospital, Iowa City, IA, USA
| | - David P Wacker
- The University of Iowa, Iowa City, IA, USA.,The University of Iowa Stead Family Children's Hospital, Iowa City, IA, USA
| | - Scott D Lindgren
- The University of Iowa, Iowa City, IA, USA.,The University of Iowa Stead Family Children's Hospital, Iowa City, IA, USA
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7
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Fuhrman AM, Fisher WW, Greer BD, Shahan TA, Craig AR. Resurgence Following Traditional and Interdependent Differential Reinforcement of Alternative Behavior. BEHAVIORAL DEVELOPMENT BULLETIN 2021; 26:29-42. [PMID: 34594471 PMCID: PMC8478277 DOI: 10.1037/bdb0000101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Clinicians frequently prescribe functional communication training (FCT) as a treatment for severe destructive behavior. Recent research has shown that FCT treatments are susceptible to treatment relapse in the form of resurgence of destructive behavior when individuals contact periods in which reinforcers are unavailable. Results of preliminary studies suggest that teaching multiple response alternatives can mitigate the resurgence of target behavior. The current evaluation serves as a preliminary study in which we used a laboratory arrangement to evaluate the effects of a novel approach to training multiple alternative responses on the resurgence of target behavior. Findings showed that multiple-response training did not decrease resurgence of target responding consistently; however, it increased the total amount of target and alternative responding observed during the resurgence phase and decreased the overall probability of the target response.
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Affiliation(s)
- Ashley M. Fuhrman
- Children’s Specialized Hospital–Rutgers University Center for Autism Research, Education, and Services (CSH–RUCARES)
- Rutgers Robert Wood Johnson Medical School
| | - Wayne W. Fisher
- Children’s Specialized Hospital–Rutgers University Center for Autism Research, Education, and Services (CSH–RUCARES)
- Rutgers Robert Wood Johnson Medical School
| | - Brian D. Greer
- Children’s Specialized Hospital–Rutgers University Center for Autism Research, Education, and Services (CSH–RUCARES)
- Rutgers Robert Wood Johnson Medical School
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8
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Fuhrman AM, Lambert JM, Greer BD. A Brief Review of Expanded-Operant Treatments for Mitigating Resurgence. PSYCHOLOGICAL RECORD 2021; 72:319-323. [DOI: 10.1007/s40732-021-00456-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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9
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Ousley CL, Raulston TJ, Gregori EV, McNaughton D, Bhana N, Mantzoros T. A comparison of single-case evaluation tools applied to functional communication training with augmentative and alternative communication supports for students with developmental disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 107:103803. [PMID: 33129038 DOI: 10.1016/j.ridd.2020.103803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 09/18/2020] [Accepted: 10/15/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Students with developmental disabilities frequently present with both limited vocal speech and challenging behavior. Functional communication training (FCT) with augmentative and alternative communication (AAC) supports, is a commonly recommended intervention to reduce challenging behavior for these students, while also increasing appropriate communication. AIMS Current research on this topic has not applied multiple evaluation tools, despite the recent suggestion to do so. Further, there are limited studies in the field of special education that have (a) applied multiple evaluation tools and (b) compared the results of the tools. METHOD In the current review, we applied three evaluation tools to intervention studies examining the use of FCT with AAC supports in school-based settings to determine the current level of scientific support for this intervention. We identified 38 studies, which contained 59 single-case designs (SCDs). Next, we compared the methodological rigor and/or quality, outcome scores, and Evidence-Based Practice (EBP) ratings provided by the three evaluation tools. RESULTS AND CONCLUSION Our results yielded inconsistent methodological rigor and/or quality, participant outcome measures, and EBP classifications between the evaluation tools. No two evaluation tools completely aligned. Limitations and future research are discussed.
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Affiliation(s)
- Ciara L Ousley
- The Pennsylvania State University, Cedar Building, University Park, PA, 16801, USA.
| | - Tracy J Raulston
- The Pennsylvania State University, Cedar Building, University Park, PA, 16801, USA
| | - Emily V Gregori
- The University of Illinois at Chicago, 1040 W Harrison St., Chicago, IL, 60607, USA
| | - David McNaughton
- The Pennsylvania State University, Cedar Building, University Park, PA, 16801, USA
| | - Naima Bhana
- The Pennsylvania State University, Cedar Building, University Park, PA, 16801, USA
| | - Theoni Mantzoros
- The Pennsylvania State University, Cedar Building, University Park, PA, 16801, USA
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10
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Silbaugh BC, Swinnea S, Falcomata TS. Replication and Extension of the Effects of Lag Schedules on Mand Variability and Challenging Behavior During Functional Communication Training. Anal Verbal Behav 2020; 36:49-73. [PMID: 32699738 PMCID: PMC7343690 DOI: 10.1007/s40616-020-00126-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
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.
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Affiliation(s)
- Bryant C. Silbaugh
- Department of Interdisciplinary Learning and Teaching, College of Education and Human Development, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249 USA
| | - Samantha Swinnea
- Department of Special Education, The University of Texas at Austin, San Antonio, TX USA
| | - Terry S. Falcomata
- Department of Special Education, The University of Texas at Austin, San Antonio, TX USA
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11
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A Systematic Synthesis of Lag Schedule Research in Individuals with Autism and Other Populations. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2020. [DOI: 10.1007/s40489-020-00202-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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12
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Fisher WW, Fuhrman AM, Greer BD, Mitteer DR, Piazza CC. Mitigating resurgence of destructive behavior using the discriminative stimuli of a multiple schedule. J Exp Anal Behav 2019; 113:263-277. [PMID: 31621919 DOI: 10.1002/jeab.552] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 10/01/2019] [Indexed: 01/10/2023]
Abstract
Results of several recent translational studies have suggested that correlating contextual or discriminative stimuli with the delivery and withholding of reinforcement for the functional communication response (FCR) may mitigate resurgence of destructive behavior, but few, if any, have isolated the effects of those stimuli. In the present study, we first trained the FCR, brought it under stimulus control of a multiple schedule, and thinned its reinforcement schedule in one stimulus context. Next, we conducted resurgence evaluations (i.e., baseline, functional communication training [FCT], extinction challenge) in two novel contexts to test the effects of the discriminative stimuli on resurgence. We programmed one context to include the (a) SD during the FCT phase to signal the availability of reinforcement for the FCR and (b) SΔ during a subsequent extinction challenge to signal the unavailability of reinforcement for the FCR. The other context did not include the SD during the FCT phase, nor the SΔ during the extinction challenge. We expected to see greater persistence of the FCR in the context that included the SD during FCT and less persistence of the FCR and less resurgence of destructive behavior in the context that included the SΔ during the extinction challenge. Obtained results confirmed this latter prediction, but we observed no reliable difference when the SD was present or absent during the FCT phase. Our results have relevance for practitioners in that they provide further empirical support for the use of discriminative stimuli when treating destructive behavior.
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Affiliation(s)
- Wayne W Fisher
- University of Nebraska Medical Center's Munroe-Meyer Institute
| | | | - Brian D Greer
- University of Nebraska Medical Center's Munroe-Meyer Institute
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13
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Seaver JP, Bourret JC. Producing mands in concurrent operant environments. J Appl Behav Anal 2019; 53:366-384. [PMID: 31219193 DOI: 10.1002/jaba.592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 04/02/2019] [Indexed: 11/11/2022]
Abstract
This study examined strategies designed to increase the rate of targeted, low-probability mands in a concurrent operant environment. We examined the effects of schedule manipulations, prompt manipulations, motivating operation manipulations, and combined behavioral process manipulations. Increases in target mands were produced for all 8 participants. Schedule manipulations were effective in producing increased rates of targeted mands for 3 of 8 participants, whereas prompt manipulations were effective for 4 of 8 participants. Motivating operation manipulations were effective in producing increased rates of targeted mands for 2 of 8 participants and combined behavioral process manipulations were effective for the single participant exposed to the combination.
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Affiliation(s)
- Jonathan P Seaver
- Western New England University and the New England Center for Children
| | - Jason C Bourret
- Western New England University and the New England Center for Children
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14
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Ferguson RH, Falcomata TS, Ramirez-Cristoforo A, Vargas Londono F. An Evaluation of the Effects of Varying Magnitudes of Reinforcement on Variable Responding Exhibited by Individuals With Autism. Behav Modif 2019; 43:774-789. [PMID: 31216864 DOI: 10.1177/0145445519855615] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Interventions aimed at increasing communicative response variability hold particular importance for individuals with autism spectrum disorders (ASD). Several procedures have been demonstrated in the applied and translational literature to increase response variability. However, little is known about the relationship between reinforcer magnitude and response variability. In the basic literature, Doughty, Giorno, and Miller evaluated the effects of reinforcer magnitude on behavioral variability by manipulating reinforcer magnitude across alternating relative frequency threshold contingencies, with results suggesting that larger reinforcers induced repetitive responding. The purpose of this study was to translate Doughty et al.'s findings to evaluate the relative effects of different magnitudes of reinforcement on communicative response variability in children with ASD. A Lag 1 schedule of reinforcement was in place during each condition within an alternating treatments design. Magnitudes of reinforcement contingent on variable communicative responding were manipulated across the two conditions. Inconsistent with basic findings, the results showed higher levels of variable communicative responding associated with the larger magnitude of reinforcement. These outcomes may have potential implications for interventions aimed at increasing response variability in individuals with ASD, as well as future research in this area.
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Davis TN, Rispoli M. Introduction to the Special Issue: Interventions to Reduce Challenging Behavior Among Individuals With Autism Spectrum Disorder. Behav Modif 2019; 42:307-313. [PMID: 29621899 DOI: 10.1177/0145445518763851] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The prevalence of autism spectrum disorder (ASD) is on the rise. In addition to the social communication skill deficits and restrictive repetitive behaviors and interests, many individuals with ASD engage in challenging behavior. Challenging behavior is associated with a multitude of negative outcomes. Challenging behavior may cause harm to the individual with ASD as well as limit opportunities for educational, vocational, and social participation and development. In addition, caregivers experience high stress and low quality of mental health. As a result, challenging behavior warrants intervention that is specifically tailored to the unique characteristics of individuals with ASD. The purpose of this Special Issue is to showcase recent research in the treatment of challenging behavior for individuals with ASD. This two-part Special Issue contains 12 studies that range from systematic and quality reviews of the intervention literature, to innovative treatment approaches, to studies that develop and evaluate treatments for restrictive and repetitive behaviors and interests.
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Wiskow KM, Matter AL, Donaldson JM. An evaluation of lag schedules and prompting methods to increase variability of naming category items in children with autism spectrum disorder. Anal Verbal Behav 2018; 34:100-123. [PMID: 31976217 PMCID: PMC6702487 DOI: 10.1007/s40616-018-0102-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
A lag schedule of reinforcement is one way to increase response variability; however, previous research has been mixed with regard to the necessary parameters to increase variability. For some individuals, low schedule requirements (e.g., Lag 1) are sufficient to increase variability. For other individuals, higher lag schedules (e.g., Lag 3) or a lag schedule in combination with prompting is needed to increase variability. We evaluated the efficiency of different within-session progressive lag schedules to increase response variability with 2 children with autism. Results showed that increasing the lag criterion across sessions increased variability to levels similar to beginning with a high lag schedule for one participant. When lag schedules did not increase variability for the second participant, we compared a variety of prompting procedures. Results of the prompting evaluation showed that a tact-priming procedure was effective to increase varied responding.
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Affiliation(s)
- Katie M. Wiskow
- Department of Psychology and Child Development, College of Science, California State University, Stanislaus, One University Circle, Turlock, CA 95382 USA
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