Schedule thinning following communication training: using competing stimuli to enhance tolerance to decrements in reinforcer density

Evaluation of a Treatment Package for Chronic, Stereotypic Hand Mouthing of a Child Diagnosed with Autism

We describe the clinical treatment of repetitive, stereotypic hand mouthing in a 7-year old child with severe developmental delay, conducted in the context of center-based autism service. The client's history included use of mechanical restraint to prevent tissue damage and infection. Prior antecedent- and reinforcement-based interventions were ineffective. Functional analysis results suggested hand mouthing was maintained by automatic reinforcement. Response interruption and redirection (RIRD) initially did not decrease hand mouthing, but the addition of contingent protective equipment, together with modified RIRD, was followed by reduction to near-zero level, which was maintained following withdrawal of the intervention. • Repetitive hand mouthing may require treatment due to tissue damage and other health consequences. • Repetitive hand mouthing is typically maintained in the absence of social contingencies and may be resistant to treatment. • When reinforcement-based interventions are not sufficient, contingent application of nonrestraining protective equipment may produce lasting reduction in hand mouthing. • Successful intervention in this case freed the client from mechanical (arm band) restraint and was followed by gains in skill acquisition.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40617-024-00956-8.

Application of a terminal schedule probe method to inform schedule thinning with multiple schedules

Multiple schedules are effective at decreasing challenging behavior and maintaining alternative behavior at acceptable levels. Currently, no conclusive guidance is available for empirically deriving multiple-schedule components (continuous reinforcement for alternative behavior and extinction for challenging behavior [discriminative stimulus] and extinction for both alternative and challenging behavior [delta stimulus]) during the schedule-thinning process. In the current investigation, we describe a terminal schedule probe method to determine delta stimulus starting points and strategies for subsequent schedule-thinning progressions to reach caregiver-informed terminal schedules. We review schedule-thinning outcomes for a clinical cohort using a consecutive controlled case series approach and report results for two groups: One group included applications of terminal probe thinning (n = 24), and the other involved traditional dense-to-lean thinning (n = 18). Outcomes suggest that the terminal schedule probe method produced effective treatments with less resurgence of challenging behavior and leaner, more feasible, multiple schedules.

Updated Recommendations for Reinforcement Schedule Thinning following Functional Communication Training

Schedule thinning is a necessary treatment procedure following the acquisition of a communication response during functional communication training. In this article, we update and extend the Hagopian et al. Behavior Analysis in Practice, 4, 4-16, (2011) review and recommendations on schedule-thinning procedures following functional communication training. Since their publication, substantial research has been published on the efficacy, efficiency, and social validity of schedule-thinning methods. We provide updated recommendations for schedule thinning based on contemporary literature that has been published since 2011, as well as discuss key areas for future research.

Application of the evolutionary theory of behavior dynamics to severe challenging behavior

The evolutionary theory of behavior dynamics (ETBD) is a genetic algorithm that applies the Darwinian principles of evolutionary biology to model how behavior changes dynamically via selection by contingencies of reinforcement. The ETBD is a complexity theory where low-level rules of selection, reproduction, and mutation operate iteratively to animate "artificial organisms" that generate emergent outcomes. Numerous studies have demonstrated the ETBD can accurately model behavior of live animals in the laboratory, and it has been applied recently to model automatically maintained self-injury. The purpose of the current series of studies was to further extend the application of the ETBD to model additional functional classes of challenging behavior and clinical procedures. Outcomes obtained with artificial organisms generally corresponded well with outcomes observed with clinical cases sourced from consecutive controlled case series studies. Conceptual and methodological considerations on the application of the ETBD to model challenging behavior are discussed.

Efficacy of competing stimulus assessments: A summary of 35 consecutively encountered cases

Competing stimulus assessments (CSAs) are designed to identify stimuli that reduce challenging behavior through competition with its maintaining reinforcers. Recently, Haddock and Hagopian (2020) found that over 92% of CSAs described in published studies identified at least one high-competition stimulus (i.e., a stimulus correlated with at least an 80% reduction in challenging behavior). The current study describes the outcomes of CSAs in a retrospective consecutive controlled case series study of 35 cases (individuals) admitted to an inpatient setting. Findings on the limited relation between the level of stimulus engagement and reductions in challenging behavior were replicated; however, the efficacy of CSAs was lower (only 47% of CSAs were successful in identifying one or more high-competition stimuli). Discrepant findings across studies on the efficacy of CSAs are discussed in terms of differences in the sample participants and how outcomes are reported, which vary depending on the study's research questions.

Gradual Change Procedures in Behavior Analysis

A wide variety of procedures within behavior analysis use gradual change in stimuli, response requirements, reinforcement, or some combination thereof, to effectively change behavior. Such procedures include shaping, thinning, fading, and chaining. Collectively, gradual change procedures represent a conceptually systematic technology of behavior change with wide-ranging empirical support across diverse settings and contexts. However, navigating the gradual change literature can be challenging. Similar terms are used to describe functionally distinct procedures (e.g., stimulus fading, delay fading, demand fading), and distinct terms are used to describe functionally similar procedures (e.g., leaning, demand fading). I propose a taxonomy in which gradual change procedures are categorized according to the functional component of the contingency on which they act. Three broad categories are proposed: Gradual Changes in Discriminative Stimuli, Response Requirement, and Reinforcement. I provide examples of research in each category, across basic and applied settings, including terminology used by the author(s) to describe each procedure. Finally, I discuss benefits of this framework for consumers of the literature.

Procedures for determining and then modifying the extinction component of multiple schedules for destructive behavior

As a component of reinforcer schedule thinning following functional communication training, multiple schedules of reinforcement produce desirable rates and patterns of communication responses as an alternative response to destructive behavior. However, reinforcement schedule thinning is a gradual process that can take many sessions to obtain therapeutic goals. The desired outcome is that manding occurs only during signaled intervals of reinforcement with a sufficiently lean terminal schedule of reinforcement availability and low rates of destructive behavior. The purposes of this study were to (a) evaluate an assessment for informing the initial duration of extinction for alternative responding, (b) evaluate the utility of competing stimuli during extinction for alternative responding, and (c) assess a method for fading the availability of competing stimuli. With these procedures, all 4 participants experienced terminal schedules of reinforcement with rapid, robust reductions in destructive behavior soon after baseline. We discuss the implications and directions for future research.

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.

Schedule Thinning Following Functional Communication Training: Effects of Chained and Multiple Schedules

Functional communication training (FCT) is used to reduce rates of problem behavior by teaching communicative responses that access functionally equivalent reinforcers. During FCT, the communicative response is typically placed on a dense schedule of reinforcement that is unlikely to be maintained in the natural environment. Experiment 1 evaluated the effects of two schedule-thinning procedures (chained schedules and multiple schedules) on problem behavior maintained by escape from demands for three participants following FCT. The chained and multiple-schedule procedures were effective in reducing rates of problem behavior. Compliance increased under both schedules, but the chained schedule resulted in higher levels of compliance with two participants. In Experiment 2, participants' preference for the chained or multiple-schedule procedure was evaluated using a modified concurrent-chain procedure. One participant preferred the chained schedule. One participant preferred the multiple schedule. One participant did not appear to discriminate between conditions.

An intensive telehealth assessment and treatment model for an adult with developmental disabilities

Over the last decade, the provision of applied behavior analysis (ABA) services within a telehealth delivery format has had a flourishing literature base. Research has demonstrated that caregivers can successfully conduct functional analyses and functional communication training to treat challenging behavior with coaching from practitioners via telehealth. Previous limitations include research that has only been conducted with children, typically in 1hr, weekly meetings, so the utility of providing ABA therapy via telehealth across the lifespan is unknown. Additionally, the effects of a more intensive treatment format delivered via telehealth has not been evaluated. The purpose of the current study was to coach caregivers to conduct the assessment and treatment process for a young man with developmental disabilities using an intensive-outpatient model in a telehealth format. Functional analysis procedures led to the development of a function-based treatment to reduce challenging behavior and increase functional communication. Caregivers demonstrated high procedural integrity across all phases of the study and found the intervention highly acceptable and effective. Areas for future research and directions are discussed.

Resurgence and repeated within-session progressive-interval thinning of alternative reinforcement

Resurgence of a previously suppressed target behavior is common when reinforcement for a more recently reinforced alternative behavior is thinned. To better characterize such resurgence, these experiments examined repeated within-session alternative reinforcement thinning using a progressive-interval (PI) schedule with rats. In Experiment 1, a transition from a high rate of alternative reinforcement to a within-session PI schedule generated robust resurgence, but subsequent complete removal of alternative reinforcement produced no additional resurgence. Experiment 2 replicated these findings and showed similar effects with a fixed-interval (FI) schedule arranging similarly reduced session-wide rates of alternative reinforcement. Thus, the lack of additional resurgence following repeated exposure to the PI schedule was likely due to the low overall obtained rate of alternative reinforcement provided by the PI schedule, rather than to exposure to within-session reinforcement thinning per se. In both experiments, target responding increased at some point in the session during schedule thinning and continued across the rest of the session. Rats exposed to a PI schedule showed resurgence later in the session and after more cumulative alternative reinforcers than those exposed to an FI schedule. The results suggest the potential importance of further exploring how timing and change-detection mechanisms might be involved in resurgence.

Using Delay Fading Procedures to Increase Self-Control

Children and adolescents, relative to adults, disproportionately favor smaller, immediate outcomes over larger, delayed outcomes. From a behavioral perspective, this sensitivity toward immediate rewards constitutes impulsive choice, which characterizes numerous behavioral health problems commonly observed during childhood (particularly among individuals with neurobehavioral disabilities). Accordingly, a variety of behavioral technologies have been developed and are widely implemented in applied settings (e.g., self-monitoring programs, interdependent group contingencies, individualized token reinforcement programs) to reduce impulsive responding and promote self-control. Although there is a plethora of research literature detailing these interventions, several promising delay fading procedures may also have clinical utility in applied treatment contexts. The purpose of the present review is to highlight contemporary behavior-analytic research involving delay fading procedures that may increase self-control among children and adolescents and facilitate additional research in the area of self-control.

Mand compliance as a contingency controlling problem behavior: A systematic review

Bowman et al. (1997) described a dynamic contingency in which severe problem behavior was evoked by adult noncompliance with a variety of child mands, which occurred at high rates, and was reinforced by adult compliance with subsequent mands. They discovered this phenomenon with 2 children for whom standard functional analyses were inconclusive. In recent years, similar contingencies have been shown to influence problem behavior, but the manner in which they have been arranged and described has varied across studies. The purpose of this literature review is to (a) describe contingencies involving mand compliance and the circumstances under which they have been evaluated, (b) summarize procedural variations in analysis and treatment, and (c) discuss what is known and yet to be discovered about the contingency as it relates to problem behavior. Future research focused on improving technology for analyzing and treating problem behavior suspected to be sensitive to mand compliance is discussed.

Competing stimulus assessments: A systematic review

The current review summarizes the literature on competing stimulus assessments (CSAs). CSAs are pretreatment assessments designed to systematically identify stimuli that reduce problem behavior (PB), ostensibly through reinforcer competition or substitution. We report on the participant characteristics, outcomes, and predictive validity of published CSAs that included (a) no-stimulus control trial(s), (b) test trials during which each stimulus was available singly and noncontingently, and (c) measurement of PB and stimulus engagement or contact. Results showed that CSAs have broad utility across a variety of topographies and functions of PB. In the majority of CSA applications for which extended analyses, or validations, were performed, stimuli shown to reduce PB during the CSA produced similar reductions during extended analysis. This was the case regardless of topography or function of PB, or whether the stimuli were assumed to be "matched" to the stimulation thought to be produced by PB. Implications for future research are discussed.

Initial outcomes of an augmented competing stimulus assessment

Competing stimulus assessments (CSAs) are designed to identify stimuli that, when made freely available, reduce problem behavior. Although CSAs have demonstrated utility, identifying competing stimuli can be difficult for some individuals. The current study describes outcomes from an augmented CSA (A-CSA) for 6 consecutively encountered cases with treatment-resistant subtypes of automatically maintained problem behavior. When test stimuli were made freely available, only between 0 and 1 effective competing stimuli were identified for each case. Prompting and response blocking were temporarily employed in succession to promote engagement with stimuli and disrupt problem behavior. When those procedures were withdrawn and stimuli made freely available, the number of effective competing stimuli increased in all 6 cases. Findings suggest that procedures designed to promote engagement and disrupt problem behavior may allow the A-CSA to be a platform not only for identifying competing stimuli, but also for actively establishing competing stimuli.

Measuring Happiness Behavior in Functional Analyses of Challenging Behavior for Children with Autism Spectrum Disorder

This two-experiment study assessed the utility of measuring happiness behavior (e.g., smiling and/or laughing) within functional analyses (FA) of challenging behavior, and using results to inform interventions for children with autism spectrum disorder (ASD). In Exp. 1, we concurrently measured happiness behavior within the trial-based FA's of challenging behavior of four children with ASD. Results showed differentiation for both challenging behavior in test trials and happiness behavior within controls. In Exp. 2, we compared interventions based on challenging and happiness behavior from FA results for three of the participants, using a multiple-baseline across-participants design, with embedded reversals. Results suggested that interventions derived from measures of the children's happiness behavior led to reductions challenging behavior that were similar to interventions informed by challenging behavior, and were also associated with increased happiness behavior. Taken together, these two experiments suggest that the measurement of children's happiness behavior in FA of challenging behavior appears to be helpful in determining interventions for children with ASD.

Thinning Schedules of Reinforcement Following Functional Communication Training for Children with Intellectual and Developmental Disabilities: A Meta-analytic Review

Functional communication training (FCT) is an evidence-based practice used to mitigate challenging behavior by increasing functional communication skills. To increase the practicality and feasibility of FCT in natural settings, thinning schedules of reinforcement are typically programmed following FCT. In this review, we meta-analyzed 28 studies that incorporated a thinning schedule procedure following FCT for 51 children with intellectual and developmental disabilities ages 8 and younger. Using Tau-U, the results demonstrated overall moderate effect sizes for both challenging behavior and functional communication responses. Additionally, moderator analyses pertaining to participant characteristics, interventions, and study quality were conducted. Thinning procedures were most effective for children who had stronger communication repertoire. Implications for future research and practice are discussed.

Effects of Daily and Reduced Frequency Implementation of the Good Behavior Game in Kindergarten Classrooms

An effective group contingency, the Good Behavior Game (GBG), has been implemented successfully with a wide range of age groups. However, improvements in student behavior are often not observed when the GBG is abruptly terminated, and research has yet to evaluate the effects of the GBG when the frequency of implementation is reduced. The purpose of the current study was to evaluate the effect of the GBG, implemented daily initially then on a less frequent schedule. The study utilized a multiple baseline design across three kindergarten classrooms to evaluate the effectiveness and maintenance of the GBG at reducing classwide and target student disruptive behavior (DB) and increasing classwide and target student academic engagement. Reduced Frequency data were collected while withholding implementation of the GBG. The results indicate that the GBG was highly effective in improving classwide behavior, which was maintained throughout the final Reduced Frequency phase in which the GBG was reduced in frequency, and moderately effective in improving target student behavior during both phases.

Evaluating competing activities to enhance functional communication training during reinforcement schedule thinning

Arranging periods in which requests for reinforcement are denied in a multiple schedule may result in increased destructive behavior during these periods for individuals who receive functional communication training (FCT) as treatment for severe destructive behavior. Providing access to competing activities during periods of reinforcer unavailability has been shown to minimize destructive behavior. We evaluated methods to identify effective competing activities for use when thinning reinforcement availability in a multiple schedule and compared competing activities embedded within the multiple schedule using an alternating-treatments design. Results suggested at least one competing activity facilitated favorable treatment outcomes for each participant. We discuss building on this empirical approach to identify effective competing activities for use during reinforcement schedule thinning.

Prevalence of resurgence of destructive behavior when thinning reinforcement schedules during functional communication training

Functional communication training is a well-established treatment for socially reinforced destructive behavior that typically includes differential reinforcement of the functional communication response (FCR) in combination with extinction of destructive behavior. However, when the schedule of reinforcement for the FCR is thinned, destructive behavior may resurge (e.g., Greer, Fisher, Saini, Owen, & Jones, 2016). Currently, data are unavailable on the prevalence and characteristics of resurgence during reinforcement schedule thinning. In this study, we evaluated the prevalence of resurgence during reinforcement schedule thinning on a per-case and per-schedule-step basis and also evaluated the magnitude of resurgence in relation to the functions of destructive behavior. We observed resurgence in 19 of the 25 (76%) applications of reinforcement schedule thinning. In some cases, the magnitude of resurgence exceeded the mean levels of destructive behavior observed in baseline. We discuss these results relative to prior translational and applied research on resurgence.

Systematic Changes in Preference for Schedule-Thinning Arrangements as a Function of Relative Reinforcement Density

We treated destructive behavior maintained by both social-positive (i.e., access to tangibles) and social-negative (i.e., escape from demands) reinforcement in an individual diagnosed with autism spectrum disorder using functional communication training (FCT). We then thinned the schedule of reinforcement for the tangible function using a multiple schedule (mult FCT) and later thinned the availability of escape using a chained schedule (chain FCT). Both treatments proved effective at maintaining functional communicative responses while decreasing destructive behavior to near-zero levels. In addition, treatment effects maintained when we rapidly thinned mult FCT to the terminal schedule. Throughout chain-FCT schedule thinning, we assessed client preference for each schedule-thinning arrangement (mult FCT or chain FCT) using a concurrent-chains procedure. Client preference reliably shifted from chain FCT to mult FCT as the response requirement increased and the proportion of session spent in reinforcement began to favor mult FCT. We discuss the clinical implications of these findings.

Resurgence with and without an alternative response

Resurgence is the reemergence of a previously reinforced response that occurs after the elimination or reduction of reinforcement for an alternative response. Resurgence is problematic in the context of treatment because the reemergence of a previously reinforced destructive response could be detrimental to treatment gains. In the current translational study, we examined a modified resurgence procedure in which the alternative response was either present or absent during extinction. Four participants were exposed to three phases that consisted of (1) reinforcement of a target response, (2) extinction of the target response and differential reinforcement of an alternative response, and (3) extinction of both responses. Results for four out of five assessments showed greater resurgence when the alternative response was absent during Phase 3. Results suggest that more robust resurgence might occur if the alternative response is not available as opposed to the alternative response contacting extinction.

Treatment of severe problem behaviour in children with autism spectrum disorder and intellectual disabilities

Children with autism spectrum disorder (ASD) and intellectual disabilities (ID) present with problem behaviour at rates disproportionately higher than their typically-developing peers. Problem behaviour, such as self-injury, aggression, pica, disruption, and elopement result in a diminished quality-of-life for the individual and family. Applied behaviour analysis has a well-established research base, detailing a number of assessment and treatment methods designed to address behaviour problems in children with ASD and ID. Although the variables that lead to the emergence of problem behaviour are not precisely known, those that are currently responsible for the maintenance of these problems can be identified via functional behaviour assessment, which is designed to identify events that occasion problem behaviour, consequences that maintain it, as well as other environmental factors that exert influence on the behaviour. Corresponding function-based treatment is implemented when environmental determinants are identified, with the aim of decreasing or eliminating problem behaviour, as well as teaching the individual to engage in more appropriate, alternative behaviour. In some cases, when problem behaviour is under the control of both environmental and biological variables, including psychiatric conditions, combining behavioural and pharmacological interventions is viewed as optimal, although there is limited empirical support for integrating these approaches.

Employing a Fixed-Lean Multiple Schedule in the Treatment of Challenging Behavior for Children With Autism Spectrum Disorder

Despite its utility, there is limited applied research on employing fixed-lean (FL) schedules of reinforcement in treatment packages to address challenging behavior. One potential reason is that abrupt shifts to terminal schedules of reinforcement have been associated with immediate increases in challenging behavior before subsiding to clinically acceptable levels. The purpose of the present study was to (a) provide evidence demonstrating the utility of a FL multiple schedule (MS) in the treatment of challenging behavior in applied settings, (b) examine the potential effects of alternative stimuli on challenging behavior during a FL MS, and (c) assess the social validity of this treatment package with participants and caregivers. The results of this study showed low levels of challenging behavior and discriminated mands during the FL MS, but no evidence to support the inclusion of alternative stimuli. In addition, caregivers of both participants reported high levels of satisfaction with the treatment package. Implications for research and clinical practice are discussed.

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.

Evaluation of multiple schedules with naturally occurring and therapist-arranged discriminative stimuli following functional communication training

Many studies have shown that (a) functional communication training (FCT) is effective for reducing problem behavior, and (b) multiple schedules can facilitate reinforcer schedule thinning during FCT. Most studies tha have used multiple schedules with FCT have included therapist-arranged stimuli (e.g., colored cards) as the discriminative stimuli (S(D) s), but recently, researchers have evaluated similar multiple-schedule training procedures with naturally occurring S(D) s (e.g., overt therapist behavior). The purposes of the current study were to compare the effects of arranged and naturally occurring S(D) s directly during (a) acquisition of discriminated functional communication responses (FCRs) and (b) generalization of discriminated FCRs when we introduced the multiple schedules in novel contexts in which the naturally occurring stimuli were either relatively easy or difficult to discriminate. Results showed that (a) 2 of 3 participants acquired discriminated responding of the FCR more rapidly with arranged than with naturally occurring stimuli, (b) 2 of 3 participants showed resurgence of problem behavior , and (c) 2 of 3 participants showed greater generalization of discriminated responding to novel contexts with arranged stimuli than with naturally occurring stimuli. We discuss these results relative to the conditions under which naturally occurring and arranged S(D) s may promote rapid and generalized treatment gains.

Using multiple schedules during functional communication training to promote rapid transfer of treatment effects

Multiple schedules with signaled periods of reinforcement and extinction have been used to thin reinforcement schedules during functional communication training (FCT) to make the intervention more practical for parents and teachers. We evaluated whether these signals would also facilitate rapid transfer of treatment effects across settings and therapists. With 2 children, we conducted FCT in the context of mixed (baseline) and multiple (treatment) schedules introduced across settings or therapists using a multiple baseline design. Results indicated that when the multiple schedules were introduced, the functional communication response came under rapid discriminative control, and problem behavior remained at near-zero rates. We extended these findings with another individual by using a more traditional baseline in which problem behavior produced reinforcement. Results replicated those of the previous participants and showed rapid reductions in problem behavior when multiple schedules were implemented across settings.

Stimulus Fading and Response Elaboration in Differential Reinforcement for Alternative Behavior

A hallmark of applied behavior analysis is the development of function-based interventions for problem behavior. A widely recommended function-based intervention is differential reinforcement of alternative behavior (DRA), in which reinforcement is contingent upon socially acceptable alternatives to problem behavior (e.g., teaching communication skills). Typically, DRA is introduced under rich schedules of reinforcement. Although effective for initiating behavior change, rich schedules are often impractical in the natural setting. In this study, we evaluated the extent to which a stimulus fading program could be employed to elaborate alternative behavior (mands) in two individuals diagnosed with an Autism Spectrum Disorder. For both participants, problem behavior was reduced substantially upon implementation of the DRA procedure. Further, problem behavior rates remained low and mand rates decreased to more practical levels as the DRA behavioral requirements increased during the fading program. The fading approach demonstrated in this paper may be a useful component of intervention packages for clinicians.

Decreasing excessive functional communication responses while treating destructive behavior using response restriction

Functional communication training (FCT) is an established treatment for destructive behavior that missucceeds in about 37% of cases when the reinforcement schedule for the functional communication response (FCR) is thinned using multiples schedules (mult FCT; Hagopian, Boelter, & Jarmolowicz, 2011). In this investigation, we evaluated the use of response restriction FCT (RR FCT) in a cohort of patients with poorly differentiated responding of the FCR during mult FCT. Results showed that (a) RR FCT maintained high rates of correct FCRs during the reinforcement component of RR FCT without increasing destructive behavior; (b) children displayed highly discriminated FCRs when an FCR card and a control card were simultaneously available during the reinforcement component of RR FCT; and (c) near-zero rates of destructive behavior were observed during the last five sessions of the terminal reinforcement schedule. Results are discussed relative to differences between mult FCT and RR FCT and successive and simultaneous discriminations.

A component analysis of schedule thinning during functional communication training

One limitation of functional communication training (FCT) is that individuals may request reinforcement via the functional communication response (FCR) at exceedingly high rates. Multiple schedules with alternating periods of reinforcement and extinction of the FCR combined with gradually lengthening the extinction-component interval can effectively address this limitation. However, the extent to which each of these components contributes to the effectiveness of the overall approach remains uncertain. In the current investigation, we evaluated the first component by comparing rates of the FCR and problem behavior under mixed and multiple schedules and evaluated the second component by rapidly switching from dense mixed and multiple schedules to lean multiple schedules without gradually thinning the density of reinforcement. Results indicated that multiple schedules decreased the overall rate of reinforcement for the FCR and maintained the strength of the FCR and low rates of problem behavior without gradually thinning the reinforcement schedule.

Effects of augmentative and alternative communication on challenging behavior: a meta-analysis

The purposes of this review were to (a) use meta-analytic procedures to examine the effectiveness of single-case AAC intervention research on challenging behaviors exhibited by individuals with disabilities, (b) identify study characteristics that moderate intervention effects, and (c) evaluate the quality of research. The authors provided inferential and descriptive analyses of 54 studies representing 111 participants and estimated effect sizes using the Nonoverlap of All Pairs (NAP) method. Overall, AAC interventions were found to be equally effective across a broad spectrum of participants and interventions. AAC interventions were more effective with younger children than with adults. Interventions in which functional behavior assessments (FBA) were used had significantly larger effect sizes than those that did not use FBAs. Further, functional communication training interventions resulted in larger effect sizes than Picture Exchange Communication System interventions. Descriptive analysis revealed that (a) interventions often occurred in atypical environments (e.g., therapy room, experimental room) and with atypical interventionists (e.g., therapists, researchers), and (b) numerous studies did not exhibit quality characteristics of single-case research.

Effects of high, low, and thinning rates of alternative reinforcement on response elimination and resurgence

A common treatment for operant problem behavior is alternative reinforcement. When alternative reinforcement is removed or reduced, however, resurgence of the target behavior can occur. Shahan and Sweeney (2011) developed a quantitative model of resurgence based on behavioral momentum theory that suggests higher rates of alternative reinforcement result in faster response elimination and greater resurgence when removed, whereas lower rates of alternative reinforcement result in slower response elimination but are followed by less resurgence. Thus, the present study was designed to examine whether faster target response elimination and less resurgence could be achieved by beginning with a high rate of alternative reinforcement and gradually thinning it such that a low rate is ultimately removed during a simulated treatment lapse. Results showed that high rates of alternative reinforcement were more effective than low or thinning rates at target response suppression but resulted in resurgence when discontinued. Low and thinning rates, on the other hand, were less effective at response suppression but target responding did not increase when alternative reinforcement was discontinued. The quantitative model cannot currently account for the finding that lower-rate alternative reinforcement may not effectively disrupt behavior relative to an extinction only control. Relative advantages of high, low, thinning, or no alternative reinforcement are discussed with respect to suppression of target response rate during treatment, resurgence when alternative reinforcement is removed, and alternative response persistence, while taking into account differences between this animal model and modern applied behavior analytic treatments.

Evaluation of the divided attention condition during functional analyses

A common condition included in most functional analyses (FAs) is the attention condition, in which the therapist ignores the client by engaging in a solitary activity (antecedent event) but delivers attention to the client contingent on problem behavior (consequent event). The divided attention condition is similar, except that the antecedent event consists of the therapist conversing with an adult confederate. We compared the typical and divided attention conditions to determine whether behavior in general (Study 1) and problem behavior in particular (Study 2) were more sensitive to one of the test conditions. Results showed that the divided attention condition resulted in faster acquisition or more efficient FA results for 2 of 9 subjects, suggesting that the divided attention condition could be considered a preferred condition when resources are available.

An approach to identifying the conditions under which response interruption will reduce automatically reinforced problem behavior

Response interruption is a common intervention for problem behavior maintained by automatic reinforcement, but this intervention is challenging for caregivers to implement with consistent fidelity. In the current study, we challenged the integrity of response interruption across two participants by examining carry over into conditions in which the procedure was not implemented, by removing the presence of an interventionist, and by introducing delays to implementation. The results indicated that these challenges severely compromised treatment efficacy. Conditions under which response interruption procedures are likely to be effective and possible strategies to increase the effectiveness of response interruption are discussed.

Reinforcement schedule thinning following functional communication training: review and recommendations

This paper extends the Tiger, Hanley, and Bruzek (2008) review of functional communication training (FCT) by reviewing the published literature on reinforcement schedule thinning following FCT. As noted by Tiger et al. and others, schedule thinning may be necessary when the newly acquired communication response occurs excessively, to the extent that reinforcing it consistently is not practical in the natural environment. We provide a review of this literature including a discussion of each of the more commonly used schedule arrangements used for this purpose, outcomes obtained, a description of methods for progressing toward the terminal schedule, and a description of supplemental treatment components aimed at maintaining low levels of problem behavior during schedule thinning. Recommendations for schedule thinning are then provided. Finally, conceptual issues related to the reemergence of problem behavior during schedule thinning and areas for future research are discussed.

An evaluation of three methods of saying "no" to avoid an escalating response class hierarchy

We evaluated the effects of three different methods of denying access to requested high-preference activities on escalating problem behavior. Functional analysis and response class hierarchy (RCH) assessment results indicated that 4 topographies of problem behaviors displayed by a 13-year-old boy with high-functioning autism constituted an RCH maintained by positive (tangible) reinforcement. Identification of the RCH comprised the baseline phase, during which computer access was denied by saying "no" and providing an explanation for the restriction. Two alternative methods of saying "no" were then evaluated. These methods included (a) denying computer access while providing an opportunity to engage in an alternative preferred activity and (b) denying immediate computer access by arranging a contingency between completion of a low-preference task and subsequent computer access. Results indicated that a hierarchy of problem behavior may be identified in the context of denying access to a preferred activity and that it may be possible to prevent occurrences of escalating problem behavior by either presenting alternative options or arranging contingencies when saying "no" to a child's requests.

Further examination of discriminated functional communication

One child with developmental disabilities was taught to mand for attention by saying "excuse me." Treatment effects were extended to multiple training contexts by teaching the participant to attend to naturally occurring discriminative stimuli through differential reinforcement of communication during periods of the experimenter's nonbusy activities (e.g., reading a magazine). Results are discussed in terms of future research on the generalization and maintenance of functional communication in the natural environment.