Vibration as a reinforcer with a profoundly retarded child

Emerging Evidence from Single-Subject Research in the Field of Deaf-Blindness

Professionals in the field of deaf-blindness are challenged to use instructional practices that have been tested using experimental methodology. Single-subject design has been examined as a form of research that assists in substantiating practice. In a review of the literature, the authors identified 54 single-subject studies from 1969 to 2006 that provided emerging evidence for practitioners.

Reducing Disruptive Behavior in the Classroom Using Contingent-Interrupted Auditory Stimulation

The present study evaluated a positive behavior therapy approach to managing disruptive screaming and crying in a classroom setting. A 10-year-old female with severe mental retardation, visual impairment, physical disabilities, and behavior problems served as the subject. Two events (tactile and auditory stimulation) were presented to the child in a contingent-interrupted stimulation paradigm. Specifically, stimuli were withdrawn contingent on targeted inappropriate behaviors. A withdrawal design was employed to assess the efficacy of tactile stimulation (using a back massager). Results indicated that tactile stimulation was ineffective in managing disruptive behavior during a discrimination task. However, application of auditory stimulation (using a tape recording of various environmental sounds) decreased disruptive behavior to zero levels. Experimental control in the latter case was documented in a multiple baseline design across settings (sitting while performing a discrimination task, kneeling, and standing). In addition, auditory stimulation was successfully faded by reducing the volume. Follow-up probes demonstrated maintenance of treatment gains up to 5 months.

Good Vibrations

This article is a personal account of experience in the use of therapeutic vibration techniques with mentally and physically handicapped people. The equipment is described and case studies provided. The author has found the techniques to be of practical use for many people with a combination of problems.

Reducing Self-Injurious Behavior of Severely Retarded Individuals through Withdrawal of Reinforcement Procedures

Self-injurious behavior is a serious problem among some of the profoundly and severely retarded. In Experiment I a retarded male was exposed to a contingent withdrawal of reinforcement procedure in an attempt to suppress his self-abusive behavior. Vibratory stimulation was used as the reinforcer. In Experiment II differential reinforcement of other behavior and contingent withdrawal of vibration were used to decrease the self-injurious behavior of a retarded girl. The results of both experiments indicated that vibratory stimulation can serve as an effective reinforcer for severely retarded individuals, and the contingent withdrawal of reinforcement can produce response suppression similar to that found under an application of aversive stimulus procedure.

Sensory Reinforcement with Autistic Children

Three non-verbal, autistic boys of 9, 12 and 16 years served as subjects in two experiments and a nurse play-therapist acted as the agent. The first experiment compared the effects upon a motor coordination task of each subject's preferred sensory reinforcer with those of the sensory reinforcer preferred by the other two subjects. On-task performances were maintained by prompting and by contingent presentation of each reinforcer in a multiple-baseline design across subjects. All subjects showed higher levels of on-task performance for their preferred sensory activity. In the second experiment a multielement-baseline design compared the effects of the preferred sensory reinforcer with those of a preferred edible reinforcer. All subjects showed higher levels of on-task performance for their preferred sensory activity. Inter-observer reliability remained above 90%. A role for sensory reinforcement in training autistic children is suggested.

Assessment of aberrant behavior maintained by wheelchair movement in a child with developmental disabilities

A child that used a wheelchair was anecdotally observed to display little aggressive behavior when being pushed in his wheelchair, but higher rates of aggressive behavior when movement was terminated. A functional analysis was conducted to systematically assess the relationship between aggression and wheelchair movement. The functional analysis results revealed elevated rates of aggression when it resulted in being briefly pushed in the wheelchair. This functional hypothesis was subsequently validated by teaching the child to request movement through appropriate means and demonstrating that aggression decreased under treatment conditions. These results extend prior research on functional analysis by demonstrating a previously unreported behavioral function particular to individuals with motor deficits.

Functional analysis and intervention to reduce self-injurious and agitated behavior when removing protective equipment for brief time periods

The authors conducted studies that were designed to maintain low levels of hand-to-head self-injury when protective equipment was removed (i.e., rigid arm sleeves and a protective helmet) for brief time periods with an individual with profound intellectual disabilities. A series of assessments was first conducted of a topographically similar form of behavior to self-injury when the person was wearing protective equipment (i.e., hitting helmet with rigid arm sleeves). Results of these assessments indicated that head hitting (with equipment) was not sensitive to social consequences (Study 1) but that it was reduced substantially when the individual had access to items that produced vibration or vibration and sound (Study 2). A treatment protocol that included items that produced vibration and vibration with sound produced substantial reductions in attempts at self-injury and agitation when protective equipment was removed for brief time periods (Study 3).

The concept of automatic reinforcement: implications for behavioral research in developmental disabilities

Automatic reinforcement refers to situations in which behavior is maintained by operant mechanisms independent of the social environment. A number of difficulties exist in conducting an adequate functional analysis of automatically reinforced aberrant behavior. For example, sources of reinforcement are often difficult or impossible to identify, manipulate, or control. Further, the development of treatments is often difficult because many behavioral interventions, such as timeout, involve manipulation of the social environment--an approach that may be functionally irrelevant in the case of automatic reinforcement. This article discusses the problems inherent in the analysis of automatically reinforced behavior and reviews four classes of treatment that are compatible with that behavioral function. The four types of intervention reviewed include manipulations of establishing operations, sensory extinction, differential reinforcement, and punishment. Suggestions for future research are discussed.

Teaching choice making during social interactions to students with profound multiple disabilities

We taught 4 students with profound multiple disabilities to use a microswitch communication system to request a change in recreational stimuli during social interactions with nondisabled peers. In Study 1, we conducted a preference assessment across a range of stimuli for each student. The most and least preferred stimuli were incorporated into microswitch communication system training in Study 2. During the second study, 3 of the 4 students (a) learned to use the microswitch communication system to control stimulus presentation, (b) more clearly differentiated their time among stimuli, and (c) increased their level of general alertness. Study 3 extended the use of the microswitch communication system to social interactions with nondisabled peers. Two students were more engaged in interactions when they chose when to change stimuli; 1 student was more alert when a peer chose when to change activities; a 4th student showed an undifferentiated pattern. The outcomes of the investigation are discussed in terms of the effects of controlling stimulus presentation on the behavior of students with profound multiple disabilities and the stability of preference hierarchies over time.

Use of reinforcement to increase independence in physical fitness performance of profoundly mentally retarded youth

The purpose of this study was to examine the influence of verbal praise and verbal praise plus music or vibratory reinforcement on the level of independent performance on abdominal strength and endurance, lower back and hip flexibility, and upper body strength/endurance exercises of 12 profoundly mentally retarded, ambulatory youth, ages 10 to 18 years. A single-subject AB design with a control group was used to assess the difference in performance of physical fitness under the baseline condition of no reinforcement and under the two experimental conditions of verbal praise and verbal praise plus music or vibratory reinforcement. In contrast to previous results reported in the literature, verbal praise and verbal praise plus music or vibratory reinforcement were not effective in increasing the level of independence in performing selected physical fitness tasks.

A comprehensive evaluation of reinforcer identification processes for persons with profound multiple handicaps

We evaluated comprehensively a preference assessment for identifying reinforcers for persons with profound multiple handicaps. Four experiments were conducted involving 18 individuals. Results of Experiment 1 replicated previous findings in that the assessment identified student preferences for respective stimuli, and caregiver opinion of preferences did not coincide with the systematic assessment. Results of Experiment 2 indicated highly preferred stimuli were likely to function as reinforcers in training programs, whereas stimuli not highly preferred did not function as reinforcers. Results of Experiment 3 suggested the 12 stimuli used in the assessment represented a comprehensive stimulus set for identifying preferences, although the utility of the set sometimes could be enhanced by caregiver opinion. Results of Experiment 4 indicated the assessment identified preferences likely to be maintained over time. Overall, results are discussed in terms of identifying limits and alternatives to a behavioral teaching technology when applied to persons with profound multiple handicaps.

Establishing operations and reinforcement effects

Positive reinforcement procedures have had a major impact on educational programs for the developmentally disabled; nevertheless, variation in reinforcer effectiveness both within and across individuals is a common phenomenon. This study examined one class of variables--establishing operations--that might influence the effectiveness of reinforcers. Five developmentally disabled adult males participated. Responding on one of two motor tasks--switch closure or block placement--was assessed during baseline, satiation, and deprivation conditions with respect to three classes of consequences: small food items, music, and social praise. Deprivation and satiation conditions were constructed so as not to alter significantly the normal course of events in a subject's day. For example, food deprivation entailed scheduling sessions just prior to a subject's regular lunch, and social deprivation involved limiting a subject's access to social interaction for 15 minutes, during which time the subject had access to an assortment of other activities. Results showed that each stimulus class functioned as reinforcement with different degrees of effectiveness during satiation versus deprivation conditions. These results are discussed in light of previous research on enhancement of reinforcer efficacy as well as the assessment and identification of functional reinforcers, and implications are presented for future research and client habilitation.

Teaching persons with profound multiple handicaps: a review of the effects of behavioral research

The behavioral research on teaching individuals who have profound multiple handicaps is reviewed. The primary focus is on determining the degree to which behavioral research has demonstrated the teaching of meaningful skills to this population. Results of the review indicate that investigations have demonstrated, albeit inconsistently, that behavior change has resulted from contingency management interventions with persons who have profound multiple handicaps. However, there is little evidence that such interventions have resulted in meaningful behavior change according to currently accepted criteria for beneficially affecting the quality of life of persons with serious handicaps. Potential explanations for the lack of such evidence are offered, including the relative lack of research attention given to this issue, the possible ineffectiveness of the components of the technology applied, and possible ineffective application of the potentially effective technology. Suggestions for future research are discussed in terms of developing more effective educational and habilitative services for persons with profound multiple handicaps. In particular, we suggest research on a wider variety of behavioral teaching procedures, providing more comprehensive evaluations of the applications of procedures and developing treatment programs that do not focus solely on traditional skill acquisition.

A practical strategy for ongoing reinforcer assessment

There is a need for practical methods of reinforcer assessment that systematically track ongoing changes in clients' preferences. In this study, the effects of a time-efficient reinforcer assessment package were evaluated in a multiple baseline across 3 preschoolers with autism, comparing individualized item selections by experienced teachers with children's presession preferences for items of various sensory qualities. Systematic assessment of children's reinforcers for correct responding virtually eliminated nontargeted maladaptive behaviors, as well as yielding expected improvements in accuracy. The powerful side-effects of potent reinforcers underline the importance of increased attention to reinforcer assessment in research and practice.

Identifying reinforcers for persons with profound handicaps: staff opinion versus systematic assessment of preferences

We evaluated a systematic means of determining stimulus preferences among seven profoundly handicapped persons. Preferences were determined by observing student approach responses to individual stimuli. Results indicated that there were differential stimulus preferences across the multiply handicapped participants. However, results of the systematic assessment did not coincide with the results of a more traditional, caregiver-opinion method of assessing student preferences. A second experiment was then conducted with five participants to evaluate whether stimuli that were assessed to consistently represent preferences would function as reinforcers in skill training programs. Results indicated that stimuli that were systematically assessed to represent student preferences typically functioned as reinforcers when applied contingently. However, preferred stimuli as reflected by caregiver opinion did not function as reinforcers unless those stimuli were also preferred on the systematic assessment. Results are discussed in terms of assisting profoundly handicapped persons by (a) improving the effectiveness of training programs by increasing the likelihood of using stimuli that have reinforcing value and (b) increasing the overall quality of life by providing preferred stimuli in the routine living environment.

Training and generalization of reach-grasp behavior in blind, retarded young children

The effects of a graduated prompting treatment procedure were analyzed in three phases of an experiment on the training and generalization of reaching-grasp responding in 2- to 4-year-old blind, severely or profoundly retarded children. In Phase 1, we used a multiple-baseline across-subjects design to investigate the effectiveness of the treatment on midline reach-grasp responding. In Phase 2, we used a reversal design to investigate the effects of repeated implementations and withdrawals of the treatment. In both phases, generalization to right and left positions was measured. In Phase 3, in a multiple-baseline across-responses design, the treatment was implemented in right and left positions. Also in Phase 3, shift of stimulus control from toy-sound to verbal instructions was measured. The results showed that the graduated prompting procedure was effective in training reach-grasp responding in all three children; for one child, the effects were durable over repeated applications of the treatment procedure, but were not maintained during withdrawals; for another child, the treatment procedure was effective in teaching reach-grasp responding in all three positions; and for the same child, training of reach-grasp responding generalized to toys presented without sound, given only the verbal instruction.

Sensory reinforcement in the mentally handicapped and autistic child: a review

Sensory reinforcement was first studied by learning theorists working with animals in the 1950s. Attempts to examine the phenomenon with children followed in the 1960s, and the studies demonstrated that sensory stimuli could act like any other reinforcers with normal young children. Similar work with the autistic and mentally handicapped child arose in relation to both the study of receptor development and more treatment-oriented research. It now seems that even profoundly handicapped children can learn to operate simple levers when reinforced by sensory stimuli, and some handicapped children have learned quite complex skills through sensory reinforcement. There also appears to be a close relationship between stereotyped behavior and sensory reinforcement. The clinical implications of the studies reviewed are discussed.