Noncontingent delivery of arbitrary reinforcers as treatment for self-injurious behavior

Parents Are People Too: Implementing Empirically Based Strategies During Daily Interactions

The outcomes of the COVID-19 pandemic have resulted in decision-making related to in-person versus remote behavior-analytic service delivery. For those service providers who shifted from delivering in-person therapy to remote consultation, parents have presumably, at least at times, assumed a role similar to a registered behavior technician (RBT). We suggest that behavior analysts recommend two empirically based strategies to parents that they could incorporate into their daily lives during service disruptions: environmental enrichment and differential reinforcement of alternative behavior. We provide examples of naturally occurring contexts during which parents could integrate these procedures: (1) self-care or daily living activities, (2) physical activity, and (3) preferred learning activities. We support selecting these strategies and their application during exemplar contexts under the premise that they do not result in additional time expenditure, afford parents opportunities to complete essential (household, work-related, or personal) tasks, and still result in therapeutic gains.

Efficiency and preference for alternative activities during schedule thinning with functional communication training

Functional communication training is an effective treatment for decreasing socially reinforced destructive behavior (Carr & Durand, 1985). Clinicians frequently use multiple schedules to thin the reinforcement schedule (Hanley et al., 2001). Individuals are often taught to wait for functional reinforcers without alternative programmed stimuli. However, concurrently available items and activities are often accessible in the natural environment. In this study, we taught 4 participants a functional communication response to access functional reinforcers. We implemented a multiple schedule during schedule thinning, comparing a control condition (nothing available during S^Δ intervals) to separate conditions with items/activities (moderately preferred tangible items, attention, demands) noncontingently available during S^Δ intervals. After reaching the terminal schedule in one condition, therapists assessed participant preference across S^Δ conditions. For all participants, the terminal schedule was reached with alternative items and activities, and participant preference corresponded with the most efficient schedule thinning condition. Therapists also indicated preference for alternative items/activities.

Noncontingent reinforcement: Arbitrary versus maintaining reinforcers for escape-maintained problem behavior

Noncontingent reinforcement (NCR) involves the delivery of maintaining reinforcers on a time-dependent schedule and often includes extinction. However, arbitrary reinforcers may be equally efficacious during NCR without extinction for treating escape-maintained problem behavior. The purpose of this study was to extend previous research on NCR by evaluating the relative efficacy of NCR without extinction and comparing maintaining versus arbitrary reinforcers for 4 individuals with escape-maintained problem behavior. Two different NCR conditions, NCR using the maintaining reinforcer (escape) and NCR using an arbitrary reinforcer (an edible), were evaluated using multielement and reversal designs. Treatment effects varied across participants. Results for 2 participants showed a reduction in problem behavior during NCR without extinction with both the arbitrary and maintaining reinforcers. For 1 participant, results showed a reduction in problem behavior with both the arbitrary and maintaining reinforcers only when extinction was added to NCR. For the 4th participant, the maintaining reinforcer was effective during NCR without extinction, but the arbitrary reinforcer was ineffective.

The Use of Stimulus Preference Assessments for Persons with Neurocognitive Disorder: A Literature Review

Objectives: Stimulus preference assessments are a systematic, observation-based approach for identifying preferences among individuals with impaired communication skills. The purpose of this paper is to provide a review of the existing empirical literature that has utilized these methods with persons who have neurocognitive disorder (NCD).Methods: Studies were identified by searching online databases using a variety of search terms. Articles were included in the review if they were peer-reviewed, in English, were empirical in nature, and conducted a stimulus preference assessment with older adults diagnosed with NCD.Results: Eleven articles met the search criteria. Results revealed that data from stimulus preference assessments could increase activity engagement, increase requests for preferred items, identify reinforcers, and reduce behavioral and psychological symptoms.Conclusions: A small body of empirical literature suggests that data derived from stimulus preference assessments can be used to improve the lives of persons with NCD and their caregivers. Additional research is needed, however, to determine how effectively these procedures can be implemented into everyday practice in long-term care facilities.Clinical Implications: Stimulus preference assessments may provide a clinically useful means for efficiently identifying preferences in persons with severe NCD who cannot verbalize their needs.

Functional analysis and treatment of self-injurious feather plucking in a black vulture (Coragyps atratus)

The etiology and maintenance of self-injurious feather plucking (FP) have been attributed to biological and environmental processes, yet a definitive solution has not been found. The current study investigated the application of a functional analysis and function-based treatment to reduce the FP of a black vulture (Coragyps atratus). FP was found to be maintained by positive reinforcement in the form of contingent attention. A treatment consisting of noncontingent reinforcement decreased FP, and levels of FP remained low during schedule thinning. The current study further demonstrates the validity of function-based assessment and treatment with captive animals.

Comparison of Function-Based, Nonfunction-Based, and Combined Treatments for Escape-Maintained Aggression in a Child With Attention Deficit Hyperactivity Disorder: A Case Study

In applied behavior analysis, the use of function-based treatments to reduce problem behavior is well-supported. However, in some cases, function-based treatments alone may not be as effective as nonfunction-based treatments or function-based treatments with additional, nonfunction-based components. In this case study, we compared the delivery of preferred edible items (a nonfunction-based treatment), a break from a task (a function-based treatment), and an enhanced break, which consisted of a break plus access to a preferred tangible item (combination of a nonfunction-based and function-based treatment), to treat escape-maintained aggression exhibited by a young child with attention deficit hyperactivity disorder. Across all three treatments, reinforcement (i.e., edible, break, or enhanced break) was delivered contingent upon compliance with instructions and problem behavior resulted in escape. The nonfunction-based treatment and the combination treatment reduced aggression to zero levels; the function-based treatment did not. Finally, we allowed the participant to choose which of the three treatments he preferred to experience; he selected the combination treatment most often.

Group Procedures for Decreasing Problem Behavior Displayed by Detained Adolescents

As one component of providing treatment in a residential facility, Brogan, Falligant, and Rapp decreased problem behavior by two groups of detained adolescents using group contingency procedures. The current series of studies evaluated the extent to which group procedures could be extended to other contexts within a residential facility. In Study 1, fixed-time delivery of attention by dormitory staff decreased problem behavior displayed by a group of five to 11 detained adolescents during free periods. In Study 2, rules from a therapist plus contingencies for following those rules increased appropriate line walking during specific transition periods. Subsequently, rules alone maintained appropriate line walking, however, direct training was required to produce appropriate line walking during other transitions. Measures of social validity indicated the procedures and outcomes in both studies were acceptable to facility personnel.

A multicomponent approach to thinning reinforcer delivery during noncontingent reinforcement schedules

We evaluated a noncontingent reinforcement procedure that involved initially providing three subjects with signaled, continuous access to the functional reinforcer for aggression and slowly increasing the amount of time subjects were exposed to the signaled unavailability of the reinforcer. Additionally, alternative potential reinforcers were available throughout the sessions. Results showed immediate and substantial reductions in aggression for all three subjects. The clinical utility of this intervention is discussed, and future research directions are recommended.

Assessing Influence of Stimulation on Mood and Aberrant Behavior of Persons with Multiple Disabilities during Brief Treadmill Sessions

This study assessed the influence of favorite stimuli on indices of happiness, e.g., smiling or excited vocalizations, and aberrant behavior, e.g., cantilena-like vocalizations or hand waving, of two young adults with multiple disabilities during 5-min. treadmill sessions. Several favorite stimuli, e.g., music and vibratory events, were available for the participants. The stimuli were presented in a rotation fashion during the sessions. To control for the effects of the stimuli, treadmill sessions without stimuli were also conducted. Analysis showed that the treadmill sessions with stimuli led to higher indices of happiness and lower aberrant behavior for both participants, compared to the treadmill sessions without stimuli.

An integrated model for guiding the selection of treatment components for problem behavior maintained by automatic reinforcement

We evaluated the usefulness of 2 assessments to guide treatment selection for individuals whose prior functional analysis indicated that automatic reinforcement maintained their problem behavior. In the 1st assessment, we compared levels of problem behavior during a noncontingent play condition and an alone or ignore condition. In the 2nd, we assessed participants' relative preferences for automatic reinforcement and social reinforcers in a concurrent-operants arrangement. We used the results of these 2 assessments to assign 5 participants to a treatment based on noncontingent access to social reinforcers or to a treatment based on differential access to social reinforcers. We conducted monthly probes with the participants over 10 to 12 months to evaluate the effects of the treatment procedures. All participants showed reductions in problem behavior over this period.

Noncontingent reinforcement: a further examination of schedule effects during treatment

We conducted 2 studies to determine whether dense and thin NCR schedules exert different influences over behavior and whether these influences change as dense schedules are thinned. In Study 1, we observed that thin as well as dense NCR schedules effectively decreased problem behavior exhibited by 3 individuals. In Study 2, we compared the effects of 2 NCR schedules in multielement designs, one with and the other without an extinction (EXT) component, while both schedules were thinned. Problem behavior remained low as the NCR schedule with EXT was thinned, but either (a) did not decrease initially or (b) subsequently increased as the NCR schedule without EXT was thinned. These results suggest that dense schedules of NCR decrease behavior by altering its motivating operation but that extinction occurs as the NCR schedule is thinned. The benefits and limitations of using dense or thin NCR schedules are discussed.

Decreasing problem behavior associated with a walking program for an individual with developmental and physical disabilities

In the current investigation, a functional analysis suggested that positive reinforcement in the form of physical contact maintained the self-injurious behavior of a girl with developmental and physical disabilities. We used the information obtained from the functional analysis to develop a treatment for noncompliance with walking in which a therapist removed physical interaction following inappropriate behavior during walks.

Further evaluation of leisure items in the attention condition of functional analyses

Research suggests that including leisure items in the attention condition of a functional analysis may produce engagement that masks sensitivity to attention. In this study, 4 individuals' initial functional analyses indicated that behavior was maintained by nonsocial variables (n = 3) or by attention (n = 1). A preference assessment was used to identify items for subsequent functional analyses. Four conditions were compared, attention with and without leisure items and control with and without leisure items. Following this, either high- or low-preference items were included in the attention condition. Problem behavior was more probable during the attention condition when no leisure items or low-preference items were included, and lower levels of problem behavior were observed during the attention condition when high-preference leisure items were included. These findings suggest how preferred items may hinder detection of behavioral function.

Helping a man with multiple disabilities increase object-contact responses and reduce hand stereotypy via a microswitch cluster program

BACKGROUND

People with profound and multiple disabilities often display aberrant behaviours (such as stereotypical movements) which can inhibit learning and lead to social stigmatisation. This study was designed to help a man with multiple disabilities increase his object-contact responses and reduce hand stereotypy (in this case, hand/wrist rotation).

METHOD

An A-B-A-B design with a 3-month post-intervention check was employed. At baseline, a combination of microswitches (or microswitch cluster) was used to monitor the man's object-contact responses and hand stereotypy. During the intervention phases and post-intervention check, the microswitch cluster was combined with preferred stimuli for object-contact responses occurring without hand stereotypy. The stimulation lasted for 8 seconds if the man remained free from hand stereotypy for that time, but was interrupted if the stereotypy appeared.

RESULTS

The intervention showed an increase in object-contact responses occurring without hand stereotypy and a reduction in session time with hand stereotypy. These data were maintained at the 3-month post-intervention check.

CONCLUSION

Replication of these findings with other individuals would confirm the utility of this type of intervention for increasing constructive responding and reducing stereotyped behaviours.

A Girl With Multiple Disabilities Increases Object Manipulation and Reduces Hand Mouthing Through a Microswitch-Based Program

The study was an effort to help a girl with multiple disabilities increase object manipulation responses and reduce hand mouthing, carried out according to an ABAB sequence (in which A represented baseline phases; B, treatment phases) and including a 3-month follow-up. During the baseline phases, a microswitch cluster (i.e., a combination of microswitches) was used to monitor the girl's object manipulation responses and hand mouthing. Indices of happiness were also recorded. During the treatment phases and follow-up, the microswitch cluster was combined with the use of preferred stimuli for object manipulation responses. The stimuli lasted an 8-s period at each response if the girl remained free from hand mouthing through that period, but were interrupted if hand mouthing appeared. The results show that the girl increased object manipulation responses, learned to refrain from hand mouthing for most of the session time, maintained this performance over time, and showed an increase in indices of happiness.

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.

Noncontingent reinforcement as treatment for food refusal and associated self-injury

We examined the use of noncontingent reinforcement to decrease self-injury and increase bite acceptance in a child who exhibited food refusal. First, a brief functional analysis suggested that self-injury was maintained by escape from food presentation. Next, we evaluated an intervention that involved noncontingent access to a video during feeding sessions. Results of the intervention showed a decrease in self-injury and an increase in bite acceptance.

Noncontingent reinforcement, alternative reinforcement, and the matching law: a laboratory demonstration

Basic researchers, but not most applied researchers, have assumed that the behavior-decelerating effects of noncontingent reinforcement result at least partly from adventitious reinforcement of competing behaviors. The literature contains only sketchy evidence of these effects because few noncontingent reinforcement studies measure alternative behaviors. A laboratory model is presented in which concurrent schedules of contingent reinforcement were used to establish a "target" and an "alternative" behavior. Imposing noncontingent reinforcement decreased target behavior rates and increased alternative behavior rates, outcomes that were well described by the standard quantitative account of alternative reinforcement, the generalized matching law. These results suggest that adventitious reinforcement of alternative behaviors can occur during noncontingent reinforcement interventions, although the range of conditions under which this occurs remains to be determined in future studies. As an adjunct to applied studies, laboratory models permit easy measurement of alternative behaviors and parametric manipulations needed to answer many research questions.

Enhancing the effects of extinction on attention-maintained behavior through noncontingent delivery of attention or stimuli identified via a competing stimulus assessment

Recent research has shown that the noncontingent delivery of competing stimuli can effectively reduce rates of destructive behavior maintained by social-positive reinforcement, even when the contingency for destructive behavior remains intact. It may be useful, therefore, to have a systematic means for predicting which reinforcers do and do not compete successfully with the reinforcer that is maintaining destructive behavior. In the present study, we conducted a brief competing stimulus assessment in which noncontingent access to a variety of tangible stimuli (one toy per trial) was superimposed on a fixed-ratio 1 schedule of attention for destructive behavior for individuals whose behavior was found to be reinforced by attention during a functional analysis. Tangible stimuli that resulted in the lowest rates of destructive behavior and highest percentages of engagement during the competing stimulus assessment were subsequently used in a noncontingent tangible items plus extinction treatment package and were compared to noncontingent attention plus extinction and extinction alone. Results indicated that both treatments resulted in greater reductions in the target behavior than did extinction alone and suggested that the competing stimulus assessment may be helpful in predicting stimuli that can enhance the effects of extinction when noncontingent attention is unavailable.

DESCRIPTORS

Attention-maintained problem behavior, competing stimuli, extinction, functional analysis, noncontingent reinforcement

On the relative contributions of noncontingent reinforcement and escape extinction in the treatment of food refusal

In the current investigation, we evaluated the relative effects of noncontingent reinforcement (NCR), escape extinction, and a combination of NCR and escape extinction as treatment for the feeding problems exhibited by 4 children. For each participant, consumption increased only when escape extinction was implemented, independent of whether NCR was present or absent. These results were consistent with prior research suggesting that positive reinforcement alone is insufficient for increasing consumption, and that escape extinction often is necessary to increase and maintain food acceptance. However, NCR appeared to decrease inappropriate behavior for some participants.

Effects of reinforcer consumption and magnitude on response rates during noncontingent reinforcement

Results of previous research on the effects of noncontingent reinforcement (NCR) have been inconsistent when magnitude of reinforcement was manipulated. We attempted to clarify the influence of NCR magnitude by including additional controls. In Study 1, we examined the effects of reinforcer consumption time by comparing the same magnitude of NCR when session time was and was not corrected to account for reinforcer consumption. Lower response rates were observed when session time was not corrected, indicating that reinforcer consumption can suppress response rates. In Study 2, we first selected varying reinforcer magnitudes (small, medium, and large) on the basis of corrected response rates observed during a contingent reinforcement condition and then compared the effects of these magnitudes during NCR. One participant exhibited lower response rates when large-magnitude reinforcers were delivered; the other ceased responding altogether even when small-magnitude reinforcers were delivered. We also compared the effects of the same NCR magnitude (medium) during 10-min and 30-min sessions. Lower response rates were observed during 30-min sessions, indicating that the number of reinforcers consumed across a session can have the same effect as the number consumed per reinforcer delivery. These findings indicate that, even when response rate is corrected to account for reinforcer consumption, larger magnitudes of NCR (defined on either a per-delivery or per-session basis) result in lower response rates than do smaller magnitudes.

Effects of alternative reinforcement on human behavior: the source does matter

Competing theories regarding the effects of delivering periodic response-independent reinforcement (more accurately, response-independent points exchanged for money) on a baseline rate of behavior were evaluated in human subjects. Contiguity theory holds that these events decrease target responding because incompatible behavior is adventitiously strengthened when the point deliveries follow target behavior closely in time. Matching theory holds that response-independent points, like any other alternative reinforcer, should reduce target responding. On this view, temporal contiguity between target responding and response-independent point delivery is unimportant. In our experiment, four different responses (moving a joystick in four different directions) were reinforced with points exchangeable for money according to four independent variable-interval schedules. Different schedules of point delivery were then superimposed on these baselines. When all superimposed point deliveries occurred immediately after one of the four responses (the target response), time allocated to target responding increased. When the superimposed point deliveries could be delivered at any time, time allocated to target responding declined and other behavior increased. When superimposed points could never immediately follow target responses, time allocated to target responding decreased further and other behavior or pausing predominated. The findings underscore the contribution of temporal contiguity in the effects of response-independent deliveries of food, money, points, etc.

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.

Antecedent manipulations in a tangible condition: effects of stimulus preference on aggression

After a functional analysis indicated that aggression of an 8-year-old boy with autism was maintained by access to preferred items, antecedent manipulations involving the relative preference of restricted and noncontingently available stimuli were conducted. Restricting highly preferred items evoked the highest rates of aggression regardless of the preference level of the noncontingently available alternative items. Restricting less preferred stimuli was associated with moderate rates of aggression even when the alternative items were more preferred.

A review of "noncontingent" reinforcement as treatment for the aberrant behavior of individuals with developmental disabilities

The term noncontingent reinforcement (NCR) refers to the delivery of an aberrant behavior's known reinforcer on a response-independent basis. The typical result is a decrease in responding from baseline (i.e., reinforcement) levels. NCR has become one of the most reported function-based treatments for aberrant behavior in the recent literature. The purpose of this review is to briefly discuss the history of the procedure and summarize the findings from the treatment research literature. The review is organized into the following sections: (a) basic research on NCR, (b) NCR as a control procedure, (c) NCR as a function-based treatment, (d) considerations in the programming of NCR schedules, (e) behavior-change mechanisms underlying NCR effects, and (t) directions for future research.

Noncontingent attention for the treatment of excessive medical complaints in a medically fragile man with mental retardation

Providing medical care to individuals with developmental disabilities who have medical problems may pose several challenges with regard to accurate and reliable report of symptoms. In addition, medical complaints may take on operant functions such as an attention function or an escape function as a result of the natural consequences in the environment. It may be difficult to withhold reinforcers for medical complaints such as attention or escape, making a standard analog functional analysis or extinction-based intervention less appropriate. Recent studies have shown that noncontingent reinforcement without extinction and noncontingent reinforcement using alternative reinforcers can be effective in reducing problem behavior. One practical implication of these findings is that noncontingent reinforcement may be an appropriate treatment in cases where the reinforcer responsible for behavioral maintenance cannot be identified or withheld. In the current study, attention served as a reinforcer for a young man with medical complaints and noncontingent attention without ignoring effectively reduced the participant's excessive medical complaints.

A method for identifying satiation versus extinction effects under noncontingent reinforcement schedules

We evaluated one method for determining whether response suppression under noncontingent reinforcement (NCR) is a function of satiation or extinction. Three individuals with developmental disabilities who engaged in self-injurious behavior (SIB) or aggression participated. Results of functional analyses indicated that their problem behavior was maintained by social-positive reinforcement. NCR procedures, individualized for each participant, were implemented in a multiple baseline across subjects design and were associated with decreases in all participants' problem behavior. Identification of the mechanism by which NCR produced these effects was based on examination of cumulative records showing response patterns during and immediately following each NCR session. Satiation during NCR should lead to a temporary increase in responding during the post-NCR (extinction) period due to a transition from the availability to the unavailability of reinforcement (satiation to deprivation). Alternatively, extinction during NCR should reveal no increase in responding during the extinction period because the contingency for the problem behavior would remain unchanged and the transition from satiation to deprivation conditions would be irrelevant. Results suggested that the operative mechanisms of NCR were idiosyncratic across the 3 participants and appeared to change during treatment for 1 of the participants.