Fixed-time schedules attenuate extinction-induced phenomena in the treatment of severe aberrant behavior

Report of the ABAI Task Force on Contingent Electric Skin Shock

As a task force appointed by the Executive Council of the Association for Behavior Analysis International (ABAI), we investigated the clinical use of contingent electric skin shock (CESS) in behavior analytic treatments for severe problem behavior. We studied how CESS is used in contemporary behavior analysis, reinforcement-based alternatives to CESS, and current ethical and professional guidelines for applied behavior analysts. We recommended that ABAI uphold clients' right to receive CESS when it is restricted to extreme cases and used under rigorous professional and legal oversight. Our recommendation was rejected by a vote of the full members of ABAI, who instead endorsed an alternative recommendation, developed by members of the Executive Council, that opposed the use of CESS under any condition. Here we present for the record our report and initial recommendations, the formal statement that was rejected by the members of ABAI, and the statement that was endorsed.

Relapse and its mitigation: Toward behavioral inoculation

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.

The extinction burst: Impact of reinforcement time and level of analysis on measured prevalence

Despite widespread belief in the extinction burst as a common occurrence, relatively little empirical work has focused directly on the phenomenon. In order to provide additional data on the topic, we report reanalyses of published extinction-control groups from our laboratory following training with a variety of schedules and reinforcers. In addition, two prospective experiments were conducted in which rats responded for food on FR 5 or FR 1 schedules prior to a within-session transition to extinction. The results of these reanalyses and experiments suggest that the obtained prevalence of the extinction burst was considerably greater when response rates in the first minute of the transition to extinction were considered as compared to when session-wide response rates were considered. In addition, when reinforcement time was included in baseline response-rate calculations, the obtained prevalence of the extinction burst was higher than when reinforcement time was omitted. These findings highlight the importance of measurement and definitional issues in the obtained prevalence of the extinction burst. Further, a closer alignment of such issues across basic and applied research would be desirable in terms of the development of future theories describing the processes giving rise to the extinction burst.

Baseline reinforcement rate and resurgence of destructive behavior

Concepts from behavioral momentum theory, along with some empirical findings, suggest that the rate of baseline reinforcement may contribute to the relapse of severe destructive behavior. With seven children who engaged in destructive behavior, we tested this hypothesis in the context of functional communication training by comparing the effects of different baseline reinforcement rates on resurgence during a treatment challenge (i.e., extinction). We observed convincing resurgence of destructive behavior in four of seven participants, and we observed more resurgence in the condition associated with high-rate baseline reinforcement (i.e., variable-interval 2 s in Experiment 1 or fixed-ratio 1 in Experiment 2) compared to a low-rate baseline reinforcement condition. We discuss the implications of these results relative to schedules of reinforcement in the treatment of destructive behavior and strategies to mitigate resurgence in clinical settings.

Noncontingent reinforcement without extinction plus differential reinforcement of alternative behavior during treatment of problem behavior

The effects of noncontingent reinforcement (NCR) without extinction during treatment of problem behavior maintained by social positive reinforcement were evaluated for five individuals diagnosed with autism spectrum disorder. A continuous NCR schedule was gradually thinned to a fixed-time 5-min schedule. If problem behavior increased during NCR schedule thinning, a continuous NCR schedule was reinstated and NCR schedule thinning was repeated with differential reinforcement of alternative behavior (DRA) included. Results showed an immediate decrease in all participants' problem behavior during continuous NCR, and problem behavior maintained at low levels during NCR schedule thinning for three participants. Problem behavior increased and maintained at higher rates during NCR schedule thinning for two other participants; however, the addition of DRA to the intervention resulted in decreased problem behavior and increased mands.

Multiple schedules in practical application: Research trends and implications for future investigation

Researchers began studying multiple schedules in basic laboratories, but recent advances have extended research on multiple schedules to a wide variety of socially significant applications, especially during the last decade. Applied researchers have used multiple schedules to (a) promote stimulus control over high-rate appropriate behaviors, (b) thin the schedule of reinforcement following functional communication training, and (c) obtain stimulus control over problem behaviors maintained by automatic reinforcement. In the current paper, we reviewed 31 studies with 147 applications identified through a search of the applied literature on multiple schedules. Using these studies, we (a) reviewed the empirical literature on multiple schedules, (b) recommended multiple-schedule procedures that serve as best practice guidelines for applied behavior analysts, (c) identified the generality and boundaries of current knowledge about the effectiveness of multiple schedules, and (d) critically analyzed the literature to provide directions for future multiple-schedule research.

Contingency analysis of caregiver behavior: Implications for parent training and future directions

Parent training is often a required component of effective treatment for a variety of common childhood problems. Although behavior analysts have developed several effective parent-training technologies, we know little about the contingencies that affect parent behavior. Child behavior is one source of control for parent behavior that likely contributes to the development of childhood problems and outcomes of parent training. We reviewed the evidence supporting child behavior as controlling antecedents and consequences for parent behavior. The implications for parent training are discussed, and recommendations for future research are suggested.

Effects of fixed-time reinforcement schedules on resurgence of problem behavior

Resurgence of problem behavior following the discontinuation of differential reinforcement of alternative behavior (DRA) may be prevented by response-independent reinforcer delivery. In basic research, response-independent reinforcer delivery following DRA prevented resurgence of the initially reinforced response and maintained alternative responding (Lieving & Lattal, 2003, Experiment 3). We evaluated the generality of these results by assessing if fixed-time (FT) reinforcer delivery following DRA would prevent resurgence of problem behavior and maintain appropriate behavior with 4 children with disabilities. For all participants, extinction following DRA produced resurgence of previously reinforced problem behavior and reduced appropriate requests, but FT reinforcer delivery following DRA mitigated resurgence of problem behavior and maintained appropriate requests.

Psychological therapies for people with intellectual disabilities: comments on a matrix of evidence for interventions in challenging behaviour

BACKGROUND

Psychological therapies with a proven efficacy in the general population are being adapted for use with people who have intellectual disabilities in community settings.

METHODS

A systematic review of peer-reviewed literature published between 1980 and 2010 was carried out, to identify the evidence base for effective psychological interventions in challenging behaviour. Relevant databases were searched using applied key terms. Evidence was graded, according to the quality of the research. A best-evidence Matrix was produced to improve guidance for service providers and practitioners in the range, volume and quality of psychological interventions.

RESULTS

There is a limited amount of efficacy research that meets the most stringent standards of empirical evidence.

CONCLUSIONS

It is important to broaden the evidence base and consider the context of psychological interventions, alongside the values underpinning care and treatment.

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.

Recent research on aetiology, development and phenomenology of self-injurious behaviour in people with intellectual disabilities: a systematic review and implications for treatment

BACKGROUND

Behavioural interventions conceptualise self-injurious behaviour (SIB) as developing from early repetitive behaviours through acquisition of homeostatic functions in regulating stimulation and subsequent shaping into SIB through socially mediated or automatic operant reinforcement. Despite high success rates, such interventions rarely completely eliminate SIB, and overall effectiveness has not increased since the 1960s.

METHODS

Research (excluding studies of single genetic syndromes) on the early development, functional properties and phenomenology of SIB in persons with intellectual disabilities (IDs) published from 1999 to 2010 inclusive is reviewed.

RESULTS

Despite evidence to support the operant shaping hypothesis, in some cases tissue-damaging SIB, especially head-banging, emerges at a similar or younger age than stereotyped behaviours or 'proto-SIB', often associated with tantrums following frustrative non-reward and/or abrupt situational transitions. Many young children show undifferentiated patterns of responding in functional analyses of SIB, and SIB is associated with aggression and impulsivity as well as with repetitive behaviour.

CONCLUSIONS

One dynamic in the development of SIB may be Pavlovian conditioning of aggression, originally elicited by aversive events or frustrative non-reward, to stimuli associated with such situations. Integration into operant technology of interventions based on Pavlovian principles such as graduated exposure (with or without counterconditioning) to aversive stimuli may enhance the effectiveness of behavioural interventions.

Progressing from initially ambiguous functional analyses: three case examples

Most often functional analyses are initiated using a standard set of test conditions, similar to those described by Iwata, Dorsey, Slifer, Bauman, and Richman [Iwata, B. A., Dorsey, M. F., Slifer, K. J., Bauman, K. E., & Richman, G. S. (1994). Toward a functional analysis of self-injury. Journal of Applied Behavior Analysis, 27, 197-209 (Reprinted from Analysis and Intervention in Developmental Disabilities, 2, 3-20, 1982)]. These test conditions involve the careful manipulation of motivating operations, discriminative stimuli, and reinforcement contingencies to determine the events related to the occurrence and maintenance of problem behavior. Some individuals display problem behavior that is occasioned and reinforced by idiosyncratic or otherwise unique combinations of environmental antecedents and consequences of behavior, which are unlikely to be detected using these standard assessment conditions. For these individuals, modifications to the standard test conditions or the inclusion of novel test conditions may result in clearer assessment outcomes. The current study provides three case examples of individuals whose functional analyses were initially undifferentiated; however, modifications to the standard conditions resulted in the identification of behavioral functions and the implementation of effective function-based treatments.

Much Ado About Nothing? Some Comments on B. F. Skinner's Definition of Verbal Behavior

Some have suggested that the definition of verbal behavior offered by B. F. Skinner (1957) fails to capture the essence of language insofar as it is too broad and not functional. In this paper, I argue that the ambiguities of Skinner's definition are not an indictment of it, and that suggestions to the contrary are problematic because they suffer a critical error of scientific reasoning. Specifically, I argue that (a) no clear definition of verbal behavior is possible because there is no natural distinction between verbal and nonverbal behavior; (b) attempts at an immutable definition are essentialistic; and (c) Skinner's functional taxonomy of language is in no way affected by the particulars of any definition of verbal behavior.

The effects of antecedent interventions and extinction on toddlers' compliance during transitions

We compared the effects of two antecedent strategies commonly used in early childhood settings to increase compliance during activity transitions: a warning condition, in which children were informed of the transition 2 min before it began, and a condition in which children were allowed access to a toy during the transition. Both antecedent interventions were ineffective when implemented alone; however, when these strategies were combined with extinction, improvements in compliance were observed for all children.

The effects of fixed-time and contingent schedules of negative reinforcement on compliance and aberrant behavior

Prior research has suggested that fixed-time (FT) schedules of reinforcement do not necessarily preclude the acquisition of appropriate behavior (e.g., mands) when combined with differential reinforcement (DRA). These studies also note that dense FT schedules are more likely to interfere with DRA packages than lean FT schedules. In the current investigation, we examined whether similar findings would occur with FT schedules of negative reinforcement. Schedule analyses were conducted with two participants following functional analyses that identified escape from task demands as the maintaining variable for problem behavior. Differential negative reinforcement of alternative behavior (DNRA) was implemented first to establish behavioral control (decreased problem behavior and increased compliance). Breaks (negative reinforcement) were then concurrently delivered on a FT basis under either dense (at a greater rate than that obtained during DNRA alone) or lean (at a lower rate than that obtained during DNRA) reinforcement schedules. In general, results showed that FT escape did not preclude compliance when the FT schedule was lean, but treatment gains were significantly disrupted when dense FT schedules were superimposed.

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 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.

Functional analysis of problem behavior: a review

Functional analysis methodology focuses on the identification of variables that influence the occurrence of problem behavior and has become a hallmark of contemporary approaches to behavioral assessment. In light of the widespread use of pretreatment functional analyses in articles published in this and other journals, we reviewed the literature in an attempt to identify best practices and directions for future research. Studies included in the present review were those in which (a) a pretreatment assessment based on (b) direct observation and measurement of (c) problem behavior was conducted under (d) at least two conditions involving manipulation of an environmental variable in an attempt (e) to demonstrate a relation between the environmental event and behavior. Studies that met the criteria for inclusion were quantified and critically evaluated along a number of dimensions related to subject and setting characteristics, parametric and qualitative characteristics of the methodology, types of assessment conditions, experimental designs, topographies of problem behaviors, and the manner in which data were displayed and analyzed.

The effects of extinction, noncontingent reinforcement and differential reinforcement of other behavior as control procedures

Several techniques have been used in applied research as controls for the introduction of a reinforcement contingency, including extinction, noncontingent reinforcement (NCR), and differential reinforcement of other behavior (DRO). Little research, however, has examined the relative strengths and limitations of these "reversal" controls. We compared the effects of extinction with those of NCR and DRO in both multi-element and reversal designs, with respect to (a) rate and amount of response decrement, (b) rate of response recovery following reintroduction of reinforcement, and (c) any positive or negative side effects associated with transitions. Results indicated that extinction generally produced the most consistent and rapid reversal effects, with few observed negative side effects.

Using antecedent manipulations to distinguish between task and social variables associated with problem behaviors exhibited by children of typical development

In the antecedent functional assessment literature, researchers have introduced task demands and social attention simultaneously while varying the level of task difficulty. Though research has demonstrated situations in which a combination of social and task antecedents occasion socially avoidant responses from children with disabilities, no current studies have been offered to assess the impact of high levels of adult attention devoid of task demands on problem behaviors exhibited by children of typical development. A multiple element design was used to assess the specific effects of task and social antecedents on the problem behaviors of four children of typical development. Results identified two children whose behavior was associated with a combination of difficult task demands and attention in the form of commands and redirections and two children whose behavior was associated only with high levels of adult attention that did not include commands or redirections. These results suggest that antecedent functional assessment procedures can assess the impact of high levels of attention without the presence of task demands.

Fixed-time schedule effects as a function of baseline reinforcement rate

Using an arbitrary response, we evaluated fixed-time (FT) schedules that were either similar or dissimilar to a baseline (response-dependent) reinforcement schedule and extinction. Results suggested that both FT schedules and extinction resulted in decreased responding. However, FT schedules were more effective in reducing response rates if the FT reinforcer rate was dissimilar to baseline reinforcer rates. Possible reasons for this difference were evaluated with data analysis methods designed to identify adventitious response-reinforcer relations.

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.

Effects of noncontingent reinforcement on problem behavior and stimulus engagement: the role of satiation, extinction, and alternative reinforcement

This study examined the effects of noncontingent reinforcement (NCR) with and without extinction on problem behavior and stimulus engagement (consumption of reinforcement) of 4 participants. Reductions in problem behavior using NCR have frequently been attributed to both satiation of the reinforcer and extinction. In the current study, aspects of the NCR treatment effects were difficult to explain based solely on either a satiation or an extinction account. Specifically, it was found that stimulus engagement remained high throughout the NCR treatment analysis, and that problem behavior was reduced to near-zero levels during NCR without extinction. The implications of these findings are discussed with respect to the satiation and extinction hypotheses frequently described in the applied literature. Findings from basic studies examining the effects of response-independent schedules are presented, and are used as the basis for a matching theory account of NCR-related effects. It is proposed that reductions in problem behavior observed during NCR interventions may be a function of the availability of alternative sources of reinforcement.

Variable-time reinforcement schedules in the treatment of socially maintained problem behavior

Noncontingent reinforcement (NCR) consists of delivering a reinforcer on a time-based schedule, independent of responding. Studies evaluating the effectiveness of NCR as treatment for problem behavior have used fixed-time (FT) schedules of reinforcement. In this study, the efficacy of NCR with variable-time (VT) schedules was evaluated by comparing the effects of VT and FT reinforcement schedules with 2 individuals who engaged in problem behavior maintained by positive reinforcement. Both FT and VT schedules were effective in reducing problem behavior. These findings suggest that VT schedules can be used to treat problem behavior maintained by social consequences.