An analysis of maintenance following functional communication training

Development and Validation of an Assessment-Driven Behavioral Intervention for Primary Complex Motor Stereotypies in Young Children

Complex motor stereotypies are rhythmic, repetitive, fixed, and non-goal directed movements (e.g., bilateral flapping/waving movements of the hands/arms). Movements typically begin in early childhood and can occur in otherwise normally developing ("primary") or autistic ("secondary") children. Stereotypies persist, occur multiple times a day, have prolonged durations, can be socially stigmatizing, and may lead to bullying and isolation. Prior behavioral treatment studies have focused on older children (ages 6-12) and report modest reductions in stereotypy (i.e., between 14% and 33%). The current study involves the functional assessment and treatment of five children with Primary Complex Motor Stereotypy using a modified awareness training procedure, differential reinforcement of other behavior, and schedule thinning in a nonconcurrent multiple baseline design. Results suggest a 99% reduction of motor stereotypy from baseline across all participants.

Relative preference for distinct reinforcers maintaining destructive behavior

The literature offers few recommendations for sequencing exposure to treatment conditions with individuals with multiply maintained destructive behavior. Identifying relative preference for the functional reinforcers maintaining destructive behavior may be one means of guiding that decision. The present study presents a preliminary attempt at developing a robust relative preference and reinforcer assessment for individuals with multiply maintained destructive behavior. Guided and free-choice trials were implemented in which participants chose between two multiple-schedule arrangements, each of which programmed signaled periods of isolated reinforcer availability and unavailability. Consistent participant choice and responding during free-choice trials was then used to thin the corresponding schedule of reinforcement. The results demonstrated a strong preference for one of the two functional reinforcers for all four participants, yet preferences differed across participants and were not well predicted by responding in prior analyses.

On the Reliability and Treatment Utility of the Practical Functional Assessment Process

Saini et al. (2019) urged caution with respect to the use of practical functional assessment (PFA) procedures to inform behavioral treatment when they found that responses to an open-ended caregiver interview were only somewhat reliable and showed moderate to weak correspondence with analog functional analyses. Because the practitioner's goal in conducting any functional assessment process is to inform the successful treatment of problem behavior, we replicated and extended Saini et al. by (a) evaluating the reliability of hypotheses gleaned from two independent PFA processes for each of four children, (b) conducting treatment informed by a randomly assigned PFA, and (c) determining the extent to which potentially different levels of reliability impacted the treatment utility of the PFA process. Results indicated that the reliability of the PFA process varied depending on the stringency with which it was evaluated. However, treatments developed from randomly determined PFA processes produced efficacious outcomes on problem behavior and targeted social skills that transferred to the context designed from the other PFA process in all evaluations, suggesting that the PFA has strong treatment utility despite parts of the process having ambiguous levels of reliability. We discuss implications for practitioners tasked with treating severe problem behavior.

Contingency-based delay to reinforcement following functional communication training for autistic individuals: A multilevel meta-analysis

LAY ABSTRACT

Functional communication training, an intervention for challenging behavior rooted in principles of applied behavior analysis, has copious empirical support dating back to the mid-1980s for autistic individuals. Recently, there has been a concerted effort to thin reinforcement delivery during functional communication training using contingency-based delays that, in turn, are designed to enhance practicality and feasibility while not compromising efficacy. In this synthesis, we meta-analyzed the literature base with the goal of investigating both combined and across type effectiveness of contingency-based delays. We also aimed to investigate moderating variables that might impact intervention outcomes. Findings showed that contingency-based delays were effective for individuals with an autism spectrum disorder diagnosis and most effective when the delay incorporated some form of positive reinforcement. In addition, differential reinforcement of alternative-based delays was overall more effective when compared to differential reinforcement of other behavior-based delays. Noteworthy moderating variables found to impact contingency-based delay efficacy included the intervention dosage and the topography of behavior. We discuss these findings and highlight directions where additional empirical research is warranted to improve our understanding about contingency-based delays for individuals diagnosed with autism spectrum disorder.

Parent Ratings of Generalized and Indirect Effects of Functional Communication Training for Children with Autism Spectrum Disorder

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.

Telehealth-enabled behavioral treatment for problem behaviors in boys with fragile X syndrome: a randomized controlled trial

Background

Children with fragile X syndrome (FXS) are at increased risk for exhibiting problem behaviors such as aggression and self-injury. However, many children with FXS have limited access to behavioral treatments that have known efficacy due to the low availability of treatment providers and the wide geographical dispersion of families with FXS across the country. Telehealth may offer a cost-effective and practical solution to overcome these significant barriers. We examined the effect of administering an established behavior analytic intervention called functional communication training (FCT) via telehealth on levels of problem behaviors exhibited by boys with FXS. We also examined treatment acceptability, as well as the effect of the treatment on levels of parenting stress.

Methods

Boys with FXS, aged 3 to 10 years, who displayed problem behaviors daily, were randomized to receive FCT via telehealth (n = 30) or treatment as usual (n = 27) over 12 weeks. Outcome measures included in-session observations of problem behavior, the Aberrant Behavior Checklist—Community (ABC-C), the Treatment Acceptability Rating Form—Revised (TARF-R), and the Parenting Stress Index, 4th edition (PSI-4).

Results

Intention-to-treat analyses indicated that scores on the irritability subscale of the ABC-C, our primary outcome measure, decreased significantly for boys who received FCT via telehealth compared to boys who received treatment as usual (p < .001, Cohen’s d = 0.65). In-session observations conducted for those who received treatment showed that levels of problem behavior decreased by 91% from baseline. Levels of parenting stress related to child behavioral problems were also lower following FCT treatment, and caregivers reported that the intervention was acceptable.

Conclusions

These findings support telehealth-enabled FCT as a framework for expanding access to behavioral treatments for problem behaviors in children with FXS. Expanded delivery of behavior analytic treatment via telehealth also has the potential to lower healthcare costs, improve child and family quality of life, and lead to advances in the treatment of problem behavior in the broader population of individuals with neurodevelopmental disorders.

Trial registration

ClinicalTrials.gov, NCT03510156. Registered 27 April 2018

Does teaching an omnibus mand preclude the development of specifying mands?

When problem behavior is controlled by a synthesized reinforcement contingency, a simple omnibus mand that yields access to all reinforcers simultaneously has been shown to effectively replace problem behavior. The question arises as to whether teaching an omnibus mand will preclude the acquisition of specifying mands for each of the combined reinforcers. In this study, after 3 students diagnosed with autism acquired an omnibus mand ("My way, please") that yielded all identified reinforcers simultaneously, specifying mands (e.g., "All done," "May I have my toys?" "Play with me") were taught to yield each individual reinforcer (e.g., escape, tangibles, attention). Problem behavior was immediately eliminated for all children, and the omnibus mand was acquired quickly. Teaching an omnibus mand did not preclude acquisition of specifying mands for any learner and instead allowed for the acquisition of specifying mands once problem behavior had been effectively reduced.

The consecutive controlled case series: Design, data-analytics, and reporting methods supporting the study of generality

Single-case experimental designs (SCEDs) have proven invaluable in research and practice because they are optimal for asking many experimental questions relevant to the analysis of behavior. The consecutive controlled case series (CCCS) is a type of study in which a SCED is employed in a series of consecutively encountered cases that undergo a common procedure or share a common characteristic. Additional design elements, data-analytic, and reporting methods enable researchers to ask experimental questions relevant to the study of generality of procedures and processes. The current paper discusses the CCCS methodologies, including the retrospective, prospective, and randomized CCCS. These methodologies can be applied to examine the generality of clinical procedures (including their general efficacy, the limits of their generality, and variables that may mediate generality); study the epidemiology and phenomenology of clinical problems; and compare the efficacy of 2 clinical procedures within a randomized controlled trial combining SCEDs with randomized group designs.

Generalization and maintenance of functional communication training for individuals with developmental disabilities: A systematic and quality review

BACKGROUND

Functional communication training (FCT) is considered an evidence-based practice for treating problem behavior in individuals with developmental disabilities (e.g. autism, intellectual disabilities, down syndrome, etc.). However, there is little known on how to sustain behavioral change following FCT interventions. This systematic and quality review synthesizes the current literature base evaluating the maintenance and generalization of behavioral effects following FCT.

METHOD

A systematic review identified 37 studies that met the pre-set inclusion criteria. Those studies were summarized in terms of: (a) generalization dimension, (b) generalization assessment design, (c) maintenance assessment design, (d) maintenance and generalization teaching strategy, and (e) latency to maintenance probes. All studies employed single-case research designs and were evaluated using the What Works Clearinghouse pilot single-case research standards (Kratochwill et al., 2013) as adapted by Maggin, Briesch, and Chafouleas (2013). Maintenance and generalization data were evaluated using a researcher-developed rubric based on the WWC standards.

RESULTS AND DISCUSSION

Results indicate that 30 studies met standards or met standards with reservations while only six studies also met all of the maintenance and generalization standards. Of the six studies, five did not implement any additional strategies beyond the contacting natural contingencies that is inherent in the FCT intervention. Implications for future research and practice are discussed.

Shaping complex functional communication responses

Response efficiency plays an important role in the initial success of functional communication training (FCT). Although low-effort functional communication responses (FCRs) have been shown to be most effective in replacing problem behavior; more developmentally advanced FCRs are favored later in the treatment process. Attempts to teach these more complex FCRs, however, often lead to the resurgence of problem behavior. In this study, we provide a detailed description of an effective shaping process applied within a changing criterion design to develop complex FCRs from simple FCRs without resurgence of problem behavior. Four children with various language and intellectual abilities participated in this study. A practical shaping procedure, suitable for typical teaching contexts, is described for two participants in Experiment 1. The necessity and efficacy of the shaping process are demonstrated with the participants in Experiment 2. Implications for practice and research are discussed.

Conducting Functional Communication Training in Home Settings: A Case Study and Recommendations for Practitioners

We coached a parent to conduct functional analysis and functional communication training (FCT) procedures in her home to reduce the destructive behavior displayed by her 2-year-old son. Descriptive assessment information and functional analysis results suggested that destructive behavior was maintained by escape from demands. After conducting a series of baseline probes, the parent implemented an FCT program to teach her son to comply with designated task requests and to mand for a break to play. Results showed that destructive behavior decreased and manding and independent task completion increased during FCT. Positive intervention outcomes were maintained for 1 year. Results are discussed with respect to developing an FCT program that is both efficient and acceptable for parents to implement in their homes.

Effects of Functional Analysis Information on Ratings of Intervention Effectiveness and Acceptability

Variables affecting ratings of intervention acceptability and effectiveness have been widely studied. In the literature, several variables have produced reliable results, such as type of intervention and severity of problem behavior. One variable that remains uninvestigated is the effect of providing functional analysis information on ratings of interventions. We analyzed the ratings of 55 teachers for both the effectiveness and acceptability of a range of interventions. We also evaluated the impact on those ratings of providing three levels of functional information about the targeted problem behavior: (a) structural (descriptive) information, (b) information describing an escape function (negative reinforcement), and (c) information describing an attention function (positive reinforcement). Sample demographics are reported, along with scores on an evaluation of knowledge of behavioral principles and causes of problem behavior. The teachers differentially rated brief interruption and differential reinforcement according to the functional information provided in the case vignettes. Severity of the problem behavior did not influence ratings. The implications of the findings are discussed in terms of teacher training and support for intervention efforts that include functional assessment strategies.

Recent Developments in Functional Assessment: Implications for School Counselors and Psychologists

New developments in the technology of behavioral assessment call for a different approach to consultation with teachers in the resolution of serious behavior problems. A "cookbook" approach based on the teacher's description of the student's actions is no longer recommended. Instead, it is necessary to conduct an individual functional assessment of the events that predict and maintain the challenging behavior, and to identify the contextual factors that are relevant to effective behavioral support. Although this approach requires more work initially than the traditional topography-only assessment, it is worthwhile because functional assessment increases the probability that the intervention will be effective.

Agreement of Function Across Methods Used in School-Based Functional Assessment With Preadolescent and Adolescent Students

As we begin to apply functional assessment procedures in mainstream educational settings, there is a need to explore options for identifying behavior function that are not only effective but efficient and practical for school personnel to employ. Attempts to simplify the functional assessment process are evidenced by the development of informant assessment measures (e.g., interviews, rating scales). In this study, the agreement (i.e., on relative rankings and primary function) across sources of information regarding behavior function was examined for 19 students in a middle school setting. These measures included teacher ratings, student ratings, student interviews, observer ratings, and conditional probabilities. In addition, for 1 student, whether information obtained through these sources was consistent with that obtained through a brief analog analysis of function was examined. Results indicated low agreement regarding rank order of behavior function and on primary function across all sources of information.

Problem Behaviour as Communication

Individuals with intellectual disabilities commonly engage in a variety of problematic behaviours such as aggression and self-injury. This paper discusses the value of using a communicative model to study these behaviour problems. First, the reciprocal nature of behaviour problems is outlined. Next, research on the use of functional communication training as a treatment for behaviour problems is reviewed in terms of its initial effectiveness, generalisation, and maintenance, as well as the mechanisms responsible for behaviour change. Finally, recommendations are made for future research and training efforts aimed at reducing severe behaviour problems.

The association between self-injurious behaviors and autism spectrum disorders

A key area of concern in children with autism spectrum disorders (ASDs) are self-injurious behaviors (SIBs). These are behaviors that an individual engages in that may cause physical harm, such as head banging, or self-biting. SIBs are more common in children with ASD than those who are typically developing or have other neurodevelopmental disabilities. Therefore, it is important that clinicians who work with children with ASD have a solid understanding of SIB. The purpose of this paper is to review the research on the epidemiology of SIB in children with ASD, factors that predict the presence of SIB in this population, and the empirically supported behavioral treatments available.

Training Teachers to Conduct Trial-Based Functional Analyses

The trial-based functional analysis (FA) is a promising approach to identification of behavioral function and is especially suited for use in educational settings. Not all studies on trial-based FA have included teachers as therapists, and those studies that have, included minimal information on teacher training. The purpose of this study was to determine whether teachers trained via an in-service training would be able to conduct trial-based FAs with high procedural integrity. We trained four teachers to conduct trial-based FAs using a combination of didactic teaching and practice with feedback. All four teachers improved performance following training. Performance remained above baseline levels during an in situ maintenance condition, but for three of four teachers, additional feedback was required to recapture performance observed immediately following training.

Functional communication training: a review and practical guide

Functional communication training (FCT) is one of the most common and effective interventions for severe behavior problems. Since the initial description of FCT by Carr and Durand (1985), various aspects of the FCT treatment process have been evaluated, and from this research, best practices have emerged. This manuscript provides a review of these practices as they arise during the development of effective FCT interventions.

A review of interventions to teach a mand repertoire

Interventions which teach developmentally disabled persons to make requests and choices are now widely recommended. Recent changes in general approaches to teaching request-making have been noted which are consistent with theory and research concerning mands. Three categories of interventions, incidental teaching, choice making, and the interrupted behavior chain are also examined with regard to theory concerning the mand and establishing operations (EOs). Several of the critical features of EOs, and in particular the momentary aspect of EOs, have not been well incorporated into interventions. Suggestions for improvement of mand interventions are therefore proposed.

An evaluation of persistence of treatment effects during long-term treatment of destructive behavior

Eight young children who displayed destructive behavior maintained, at least in part, by negative reinforcement received long-term functional communication training (FCT). During FCT, the children completed a portion of a task and then touched a communication card attached to a microswitch to obtain brief breaks. Prior to and intermittently throughout FCT, extinction probes were conducted within a withdrawal design in which task completion, manding, and destructive behavior were placed on extinction to evaluate the relative persistence of appropriate and destructive behavior over the course of treatment. FCT continued until appropriate behavior persisted and destructive behavior failed to recur at baseline levels during extinction probes. The completion of FCT was followed by four challenges to the persistence of treatment effects conducted within mixed- or multiple-schedule designs: (a) extended extinction sessions (from 5 to 15 min), (b) introduction of a novel task, (c) removal of the microswitch and communication card, and (d) a mixed schedule of reinforcement in which both appropriate and destructive behavior produced reinforcement. The results showed that although FCT often resulted in quick reductions in destructive behavior and increases in appropriate behavior, destructive behavior often recurred during the extinction probes conducted during the initial treatment. When the effects of treatment persisted during the extinction probes, the remaining challenges to treatment effects resulted in only mild to moderate disruptions in behavior. These results are consistent with the quantitative predictions of behavioral momentum theory and may provide an alternative definition of maintenance as constituting behavioral persistence.

Progressing from brief assessments to extended experimental analyses in the evaluation of aberrant behavior

The role of experimental analyses in guiding treatment is well established. However, not all experimental analyses yield conclusive results. Outcomes may be inconclusive due to time limitations that preclude extended observation and detailed experimental manipulations, or may result from interactions across experimental conditions, multiple control, or other unknown factors. In this study, we describe an assessment sequence that moves through four phases beginning with relatively brief (1 to 2 hr) analyses and culminating in extended analyses that may control for experimental confounding effects (e.g., interaction effects). Data illustrating the model are presented for 20 individuals referred for severe behavior problems including self-injury, aggression, stereotypy, and tantrums. Analyses were considered to be complete only when clear and replicable response patterns emerged. Results showed that clear and replicable response patterns emerged for 85% of the participants.

Functional assessment: Contributions and future directions

Functional assessment is at once redefining the standards for clinical interventions and reemphasizing the importance of studying basic behavioral mechanisms. This commentary describes one perception of what we are learning from current research on functional assessment and suggests directions for the future.

An Evaluation of Manding Across Functions Prior to Functional Communication Training

The purpose of this study was to evaluate whether destructive behavior and manding were maintained by the same social reinforcers. A summary of 10 participants that met criteria for differentiated functional analysis and mand analysis results were included in this study. All participants were preschool-aged children with developmental disabilities who engaged in destructive behavior. All procedures were conducted in the participants' homes by their parent with investigator coaching. Functional analyses (attention, escape, and tangible test conditions) of destructive behavior and manding were conducted within multielement designs and showed social functions. The functional analysis of destructive behavior and functional analysis of mands identified the same reinforcers for only 2 of the 10 participants. The analysis of mands identified a reinforcer that was not identified by the analysis of destructive behavior for 5 participants (over-identification), did not identify a reinforcer that was identified by the analysis of destructive behavior for 2 participants (under-identification), and identified mixed reinforcers (combination of over-identification and under-identification) for 1 participant. Results suggest that the analysis of destructive behavior and the analysis of mands identified different reinforcers and are not interchangeable.

Behavioral treatments in autism spectrum disorder: what do we know?

Although there are a large and growing number of scientifically questionable treatments available for children with autism spectrum disorder (ASD), intervention programs applying the scientific teaching principles of applied behavior analysis (ABA) have been identified as the treatment of choice. The following article provides a selective review of ABA intervention approaches, some of which are designed as comprehensive programs that aim to address all developmental areas of need, whereas others are skills based or directed toward a more circumscribed, specific set of goals. However, both types of approaches have been shown to be effective in improving communication, social skills, and management of problem behavior for children with ASD. Implications of these findings are discussed in relation to critical areas of research that have yet to be fully explored.

A critical item analysis of the QABF: development of a short form assessment instrument

Due to the relative inability of individuals with intellectual disabilities (ID) to provide an accurate and reliable self-report, assessment in this population is more difficult than with individuals in the general population. As a result, assessment procedures must be adjusted to compensate for the relative lack of information that the individual may be able to provide and rely more on the behavioral expression of communication. One method commonly used is the indirect functional assessment that utilizes behavior rating scales developed to gather behavioral data in a short time. One of the few empirically derived and psychometrically sound scales is the Questions About Behavioral Function (QABF), a 25-item questionnaire designed to rate specific behavioral functions and maintaining variables. The purpose of this study was to use both exploratory and confirmatory factor analytic procedures to examine the psychometric properties of the QABF, conduct an item analysis, and determine if a short form version could be developed that is both psychometrically valid and reliable, and clinically useful. Results of the item selection procedure indicated that the original 25 items could be reduced to 15. Evaluation of the 15-item short form showed that the QABF-SF maintained the original five-factor structure of the original form, while maintaining an equivalent degree of reliability and validity. The QABF-SF appears to be a useful tool to aid clinicians in the brief functional assessment of behavior in individuals with ID.

A review of empirical support for differential reinforcement of alternative behavior

Differential reinforcement of alternative behavior (DRA) is one of the most common behavior analytic interventions used to decrease unwanted behavior. We reviewed the DRA literature from the past 30 years to identify the aspects that are thoroughly researched and those that would benefit from further emphasis. We found and coded 116 empirical studies that used DRA, later grouping them into categories that met APA Division 12 Task Force criteria. We found that DRA has been successful at reducing behaviors on a continuum from relatively minor problems like prelinguistic communication to life-threatening failure to thrive. DRA with and without extinction is well established for treating destructive behavior of those with developmental disabilities, and to combat food refusal.

The effects of consequence manipulation during functional analysis of problem behavior maintained by negative reinforcement

Two distinct analytic methods have been used to identify the function of problem behavior. The antecedent-behavior-consequence (ABC) method (Iwata, Dorsey, Slifer, Bauman, & Richman, 1982/1994) includes the delivery of consequences for problem behavior. The AB method (Carr & Durand, 1985) does not include consequence delivery, instead relying exclusively on antecedent conditions to evoke the behavior. The AB and ABC functional analysis methods were compared in this study with 4 children with developmental disabilities who engaged in task-related problem behavior. Results show that the ABC method identified an escape method for all four cases, whereas the AB method failed to identify a function for any case.

Social interaction and repetitive motor behaviors

Students with autism have difficulty initiating social interactions and may exhibit repetitive motor behavior (e.g., body rocking, hand flapping). Increasing social interaction by teaching new skills may lead to reductions in problem behavior, such as motor stereotypies. Additionally, self-monitoring strategies can increase the maintenance of skills. A multiple baseline design was used to examine whether multi-component social skills intervention (including peer training, social initiation instruction, and self-monitoring) led to a decrease in repetitive motor behavior. Social initiations for all participants increased when taught to initiate, and social interactions continued when self-monitoring was introduced. Additionally, participants' repetitive motor behavior was reduced. Changes in social behavior and in repetitive motor behavior maintained more than one month after the intervention ended.

Verbal communication outcomes in children with autism after in-home father training

BACKGROUND

This retrospective study examined the efficacy of in-home father training on the communicative outcomes of children with autism. The in-home training consisted of two components: (1) expectant waiting; and (2) imitation with animation.

METHODS

Efficacy of parent training was examined by measuring the ratio of utterances produced by the parents to the utterances produced by the children and the number of verbal imitation by the parents. Outcomes of the children's verbal production were examined by measuring the number of (1) single word utterances; (2) different words produced; and (3) verbal response to questions.

RESULTS

Following training there was a decrease in the ratio of parent to child utterances and an increase in (1) the use of imitation by the parents; and (2) the number of single words and different words produced by the children.

DISCUSSION

Results of this study suggested that the parents had learned to wait for their children to communicate verbally during communicative interactions and to interact more efficiently with their children by using verbal imitation. Overall, the results of this study support the efficacy of parent training that focuses on promotion of social reciprocity, and have important implications for clinicians and future research.

Speech-language pathologists' roles in the delivery of positive behavior support for individuals with developmental disabilities

Positive behavior support interventions such as functional communication training (FCT) and visual schedules are increasingly being used with individuals with autism and other severe developmental disabilities who engage in problem behavior and use augmentative and alternative communication (AAC). The increasing use of these communication interventions has implications for speech-language pathologists who provide support to these individuals. The purpose of this tutorial is to summarize the research regarding the use of FCT/AAC interventions and visual schedules, and to provide suggestions for the roles that speech-language pathologists can play with regard to assessment, intervention design, and implementation in school and home settings.

Understanding and Intervening With the Challenging Behavior of Young Children With Autism Spectrum Disorder

Young children with autism and behavioral challenges are at great risk for lives that are characterized by social isolation and segregated placements. These restrictive placements often occur when the child’s challenging behavior interferes with successful adaptation in educational, therapeutic, and community environments. In this article, positive behavior support is described as a process that may be used to understand and intervene effectively with the challenging behavior of young children with autism. The article describes the history, empirical support, and implementation steps of positive behavior support. A case study is provided to illustrate successful application of the process.

Communication intervention for children with autism: a review of treatment efficacy

Empirical studies evaluating speech and language intervention procedures applied to children with autism are reviewed, and the documented benefits are summarized. In particular, interventions incorporating sign language, discrete-trial training, and milieu teaching procedures have been used successfully to expand the communication repertoires of children with autism. Other important developments in the field stem from interventions designed to replace challenging behaviors and to promote social and scripted interactions. The few studies of the parent and classroom training studies that included language measures also are analyzed. This article seeks to outline the extent to which previous research has helped identify a compendium of effective instructional practices that can guide clinical practice. It also seeks to highlight needs for further research to refine and extend current treatment approaches and to investigate more comprehensive treatment packages.

An application of the matching law to severe problem behavior

We evaluated problem behavior and appropriate behavior using the matching equation with 4 individuals with developmental disabilities. Descriptive observations were conducted during interactions between the participants and their primary care providers in either a clinical laboratory environment (3 participants) or the participant's home (1 participant). Data were recorded on potential reinforcers, problem behavior, and appropriate behavior. After identifying the reinforcers that maintained each participant's problem behavior by way of functional analysis, the descriptive data were analyzed retrospectively, based on the matching equation. Results showed that the proportional rate of problem behavior relative to appropriate behavior approximately matched the proportional rate of reinforcement for problem behavior for all participants. The results extend prior research because a functional analysis was conducted and because multiple sources of reinforcement (other than attention) were evaluated. Methodological constraints were identified, which may limit the application of the matching law on both practical and conceptual levels.

Reinforcement schedule thinning following treatment with functional communication training

We evaluated four methods for increasing the practicality of functional communication training (FCT) by decreasing the frequency of reinforcement for alternative behavior. Three participants whose problem behaviors were maintained by positive reinforcement were treated successfully with FCT in which reinforcement for alternative behavior was initially delivered on fixed-ratio (FR) 1 schedules. One participant was then exposed to increasing delays to reinforcement under FR 1, a graduated fixed-interval (FI) schedule, and a graduated multiple-schedule arrangement in which signaled periods of reinforcement and extinction were alternated. Results showed that (a) increasing delays resulted in extinction of the alternative behavior, (b) the FI schedule produced undesirably high rates of the alternative behavior, and (c) the multiple schedule resulted in moderate and stable levels of the alternative behavior as the duration of the extinction component was increased. The other 2 participants were exposed to graduated mixed-schedule (unsignaled alternation between reinforcement and extinction components) and multiple-schedule (signaled alternation between reinforcement and extinction components) arrangements in which the durations of the reinforcement and extinction components were modified. Results obtained for these 2 participants indicated that the use of discriminative stimuli in the multiple schedule facilitated reinforcement schedule thinning. Upon completion of treatment, problem behavior remained low (or at zero), whereas alternative behavior was maintained as well as differentiated during a multiple-schedule arrangement consisting of a 4-min extinction period followed by a 1-min reinforcement period.

Relative influences of establishing operations and reinforcement contingencies on self-injurious behavior during functional analyses

In the typical functional analysis in which the antecedent and consequent events associated with problem behavior are manipulated, the control condition involves elimination of both the relevant establishing operation (EO) and its associated contingency through a schedule of noncontingent reinforcement (usually fixed-time [FT] 30 s). In some functional analyses, however, antecedent events are manipulated in the absence of differential consequences, and a common test condition in such analyses also involves the delivery of reinforcement on an FT 30-s schedule. Thus, the same schedule of reinforcement (FT 30 s) is not considered to be an EO in the former type of analysis but is considered to be an EO in the latter. We examined the relative influences of EOs and reinforcement contingencies on problem behavior by exposing 6 individuals who engaged in self-injurious behavior (SIB) to four combinations of functional analysis conditions: EO present/contingency present, EO absent/contingency present, EO present/contingency absent, and EO absent/contingency absent. Results indicated that the only condition in which high rates of SIB were observed consistently was one in which the EO and the reinforcement contingency were both present. Implications of these results for the design of functional analysis test and control conditions are discussed.