Examination of clinical variables affecting resurgence: A reanalysis of 46 applications.

Despite the efficacy of behavioral interventions, resurgence of challenging behavior (e.g., aggression, self-injury) following successful treatment can still occur. Applied work has focused on identifying treatment-related variables thought to affect the occurrence and magnitude of resurgence. The current study describes the relation between several variables (i.e., phase duration, response rates in baseline and treatment, obtained rates of reinforcement, downshift in reinforcement step size) and resurgence in a retrospective consecutive controlled case series of 46 treatment applications for challenging behavior conducted in an inpatient setting. Only the downshift in reinforcement (e.g., schedule-thinning) step size was correlated with the magnitude of resurgence. These results are consistent with recent findings suggesting that treatment duration and other factors have inconsistent effects on resurgence of challenging behavior.

Mand Modality Preference Assessments among High- and Low-Tech Options for Individuals with Intellectual and Developmental Disabilities: A Systematic Review.

The extant literature demonstrates that individuals with intellectual and developmental disabilities (IDD) exhibit preferences among communication modalities when multiple modalities are available and produce reinforcement on identical reinforcement schedules. High- and low-tech communication options, such as voice output devices and picture cards, are commonly recommended for individuals with limited vocal communication skills. In this study, we conducted a systematic literature review of research studies that implemented mand modality preference assessments (MMPAs) that included both a high- and low-tech communication option with individuals with IDD. We identified 27 studies meeting our inclusion criteria and summarized the participant demographics, MMPA design and procedural variations, and MMPA outcomes. The results suggested that high-tech communication options were generally more preferred over low-tech options. However, there was a high degree of variability in how the studies were conducted and conclusions were reached. We discuss some of the current research gaps and the implications for clinical practice.

Effects of Tier 1 Class-Wide Function-Related Intervention Teams (CW-FIT) on On-task Group Behavior in a Preschool Classroom.

Disruptive behaviors such as elopement, calling-out, and aggression are often a major barrier to instruction in preschool classrooms. One widely used class-wide behavior management system is Class-Wide Function-Related Intervention Teams (CW-FIT). To date, we could only locate two studies on CW-FIT used in preschool settings which found a therapeutic change in on-task behavior as well rates of teacher praise, teacher reprimands, student socials skills, and student problem behaviors. The current study used a withdrawal design to also evaluate the effectiveness of Tier 1 CW-FIT on on-task student behavior and teacher praise and reprimand behavior in a preschool setting during both large and small group activities. Results suggested that the implementation of the Tier 1 components of CW-FIT increased on-task group behavior in both settings. Results for rates of teacher's praise and reprimand statements were variable.

Prevalence of resurgence during thinning of multiple schedules of reinforcement following functional communication training.

The current study examined resurgence of problem behavior during thinning of multiple schedules of reinforcement following functional communication training replicating previous research (Briggs et al., 2018). Data were analyzed at each thinning step from subjects enrolled in an intensive day treatment program over a 5-year period. Results indicated that of the 239 thinning steps analyzed, resurgence was observed in 97 of those steps (40.6%), similar to results of Briggs et al. (2018). The data were also analyzed to estimate the magnitude of resurgence when it was observed. In the first session after the thinning step, the rate of problem behavior observed was 7 times higher than the average of the 5 sessions pre-thinning step.

Behavior Momentum Theory and Humans: A Review of the Literature.

Behavioral Momentum Theory (BMT) is often described as analogous to Newton's (1687) laws of motion. That is to say, similar to an object in motion continuing in motion unless acted upon by a force, responses occurring in a static environment will continue to occur at the same rate, unless presented with a disruptor (Nevin, Tota, Torquato, & Shull, Journal of the Experimental Analysis of Behavior, 53, 359-379, 1990). When evaluating response rates through a behavioral momentum framework, responding continuing after a change in reinforcer conditions is said to persist. Previous research conducted with nonhuman animals indicates greater response persistence following conditions with either higher reinforcer rates or higher reinforcer magnitudes (Nevin, Journal of the Experimental Analysis of Behavior, 21(3), 389-408, 1974; Nevin et al., Journal of the Experimental Analysis of Behavior, 53, 359-379, 1990). Although BMT's implications extend across human and nonhuman species, this literature review attempts to provide practitioners and researchers information regarding response persistence across various conditions with human participants.

Prevalence of renewal of problem behavior during context changes.

Renewal is defined as the reemergence of a previously eliminated behavior following a context change. Determining the prevalence of this effect in clinical practice would allow clinicians to better anticipate the reemergence of problem behavior, such as when a patient is discharged from a treatment facility to return to their home. The current consecutive, case-series analysis determined the prevalence and magnitude of renewal when implementing behavioral treatments for problem behavior. Across 182 context changes, renewal was observed 77 times (42.3%). In the first session following the context change, problem behavior rates increased by a factor of 3 and then decreased across successive sessions. These results indicated that renewal effects may be common, but are also transient and return to rates observed before context changes.

Measurement of nontargeted problem behavior during investigations of resurgence.

Resurgence occurs when a previously extinguished behavior reemerges once a more recently reinforced behavior is placed on extinction. Previous research has suggested that nontargeted responses within the same response class recur alongside target-response resurgence (e.g., da Silva, Maxwell, & Lattal, 2008; Lieving, Hagopian, Long, & O'Connor, 2004). The purpose of this two-experiment investigation was to examine target response resurgence while simultaneously measuring the occurrence of nontargeted responses. Three children diagnosed with autism spectrum disorder who displayed multiple topographies of problem behavior participated. In Experiment 1, a three-phase resurgence procedure was conducted and all three participants displayed target-response resurgence accompanied by the emergence of nontargeted forms of problem behavior. These findings were replicated in Experiment 2 using a 30-min assessment procedure. The implications of these findings as they pertain to the treatment of severe problem behavior and utility of a brief relapse assessment are discussed.

Effects of response preference on resistance to change.

Treatments based on differential reinforcement of alternative behavior, such as functional communication training, are widely used. Research regarding the maintenance of related treatment effects is limited. Nevin and Wacker (2013) provided a conceptual framework, rooted in behavioral momentum theory, for the study of treatment maintenance that addressed two components: (a) reemergence of problem behavior, and (b) continued expression of appropriate behavior. In the few studies on this topic, focus has been on variables impacting the reemergence of problem behavior, with fewer studies evaluating the persistence of appropriate behavior. Given the findings from applied research related to functional communication training, variables related to response topography, such as response preference, may impact this aspect of maintenance. In the current study, the impact of response preference on persistence was evaluated in the context of functional communication training for individuals who did not exhibit problem behavior (Experiment 1) and for individuals with a history of reinforcement for problem behavior (Experiment 2). High-preferred mands were more persistent than low-preferred mands. These findings suggest that response related variables, such as response preference, impact response persistence and further suggest that response related variables should be considered when developing interventions such as functional communication training.

Lag Schedules and Functional Communication Training: Persistence of Mands and Relapse of Problem Behavior.

We evaluated the effects of lag schedules of reinforcement and functional communication training (FCT) on mand variability and problem behavior in two children with autism spectrum disorder. Specifically, we implemented FCT with increasing lag schedules and compared its effects on problem behavior with baseline conditions. The results showed that both participants exhibited low rates of problem behavior during treatment relative to baseline during and following schedule thinning (up to a Lag 5 schedule arrangement). Variable and total mands remained high during schedule thinning. With one participant, variable manding persisted when the value of the lag schedule was reduced to zero. The current results are discussed in terms of implications for training multiple mand topographies during FCT for the potential prevention and/or mitigation of clinical relapse during challenges to treatment.

Basing assessment and treatment of problem behavior on behavioral momentum theory: Analyses of behavioral persistence.

The connection, or bridge, between applied and basic behavior analysis has been long-established (Hake, 1982; Mace & Critchfield, 2010). In this article, we describe how clinical decisions can be based more directly on behavioral processes and how basing clinical procedures on behavioral processes can lead to improved clinical outcomes. As a case in point, we describe how applied behavior analyses of maintenance, and specifically the long-term maintenance of treatment effects related to problem behavior, can be adjusted and potentially enhanced by basing treatment on Behavioral Momentum Theory. We provide a brief review of the literature including descriptions of two translational studies that proposed changes in how differential reinforcement of alternative behavior treatments are conducted based on Behavioral Momentum Theory. We then describe current clinical examples of how these translations are continuing to impact the definitions, designs, analyses, and treatment procedures used in our clinical practice.

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.

Relations between rate of negative reinforcement and the persistence of task completion.

Research has shown that differential reinforcement of alternative behavior (DRA) can be an effective intervention to address problem behavior maintained by negative reinforcement emitted by young children. However, few studies have evaluated the variables that are related to long-term maintenance (i.e., persistence) of treatment effects. Research on behavioral persistence predicts that the rate of reinforcement provided for a target behavior is correlated with its persistence when challenged. There were 2 purposes of the current investigation. First, we evaluated the effects of the rate of negative reinforcement on the persistence of task completion. Second, we applied the findings regarding rate of reinforcement to a treatment context for 3 participants who engaged in destructive behavior that was reinforced by escape from demands. Results were evaluated within a multielement design and indicated that the rate of negative reinforcement had a moderate influence on the persistence of task completion. These results contribute to the existing literature by extending analyses of persistence to treatment contexts.

Further Demonstrations of Individual Preference among Mand Modalities during Functional Communication Training.

Previous research related to functional communication training has demonstrated its effectiveness across various communication modalities. Additionally, at least one study has demonstrated that, while the intervention can be effective across various communication modalities, individual participants demonstrate a preference among available communication modalities (indicated by response allocation under a concurrent schedules arrangement). The current study evaluated preference among concurrently available communication modalities for 18 individuals with developmental disabilities, including autism spectrum disorder and intellectual disability. Results of the study indicated that each of the individuals demonstrated a preference between communicative response modalities, though preference was not always immediately ascertained. The results are discussed within the context of implications for design and implementation of functional communication training.

RESURGENCE OF MANDS FOLLOWING FUNCTIONAL COMMUNICATION TRAINING.

Experimental conditions similar to those described by Lieving and Lattal (2003) were used within two experiments to evaluate the resurgence of mands with humans. Two mands from the same operant class were trained with three participants with developmental disabilities during Experiment 1 and with two participants with developmental disabilities and a history of problem behavior during Experiment 2. The two mands were then placed on extinction. Both persisted, but showed different response strength during extinction. The mand with the weaker response strength was targeted for additional functional communication training and the alternative mand was placed on extinction. Following steady levels of occurrence of the targeted mand and no occurrences of the alternative mand, both mands were placed on extinction again. At least one instance of resurgence of the alternative mand occurred with every participant and resurgence of problem behavior occurred for both participants during Experiment 2.

An evaluation of resistance to change with unconditioned and conditioned reinforcers.

Several reinforcer-related variables influence a response's resistance to change (Nevin, 1974). Reinforcer type (i.e., conditioned or unconditioned) is a reinforcer-related variable that has not been studied with humans but may have clinical implications. In Experiment 1, we identified unconditioned and conditioned reinforcers of equal preference. In Experiments 2, 3, and 4, we reinforced participants' behavior during a baseline phase using a multiple variable-interval (VI) 30-s VI 30-s schedule with either conditioned (i.e., token) or unconditioned (i.e., food; one type of reinforcement in each component) reinforcement. After equal reinforcement rates across components, we introduced a disruptor. Results of Experiments 2 and 3 showed that behaviors were more resistant to extinction and distraction, respectively, with conditioned than with unconditioned reinforcers. Results of Experiment 4, however, showed that when prefeeding disrupted responding, behaviors were more resistant to change with unconditioned reinforcers than with conditioned reinforcers.

An evaluation of generalization of mands during functional communication training.

The primary purpose of this study was to evaluate the generalization of mands during functional communication training (FCT) and sign language training across functional contexts (i.e., positive reinforcement, negative reinforcement). A secondary purpose was to evaluate a training procedure based on stimulus control to teach manual signs. During the treatment evaluation, we implemented sign language training in 1 functional context (e.g., positive reinforcement by attention) while continuing the functional analysis conditions in 2 other contexts (e.g., positive reinforcement by tangible item; negative reinforcement by escape). During the generalization evaluation, we tested for the generalization of trained mands across functional contexts (i.e., positive reinforcement; negative reinforcement) by implementing extinction in the 2 nontarget contexts. The results suggested that the stimulus control training procedure effectively taught manual signs and treated destructive behavior. Specific patterns of generalization of trained mands and destructive behavior also were observed.

Response to Ahrendt, Houlihan, and Buchanan.

While the authors ask a broad question regarding the utility of reinforcement-based programs, I will use token economies as the exemplar in my response below, given that the piece leading to the questions related to changes in the seeming effectiveness of a token economy. The question has two parts, and each part will be addressed separately.

Brief report: Signals enhance the suppressive effects of noncontingent reinforcement.

The effects of noncontingent reinforcement (NCR) schedules on responding were assessed across two parameters: presence of signal and schedule density. Results indicated that signaled NCR schedules were correlated with greater overall reductions in responding and quicker reductions relative to NCR schedules without a signal. The clinical significance of these findings is discussed.

A demonstration of individual preference for novel mands during functional communication training.

Preference for mand topography was evaluated for 2 individuals with developmental disabilities who exhibited problem behavior. The results of a functional analysis showed that each participant's problem behavior was maintained by social reinforcement. Participants were taught two novel mand topographies for the same functional reinforcer, and each proved to be effective in reducing problem behavior. Finally, preference for mand topography was assessed within a concurrent-schedules design. Results indicated that functional communication training was an effective treatment, regardless of the mand used, and that each participant demonstrated a preference for one mand topography relative to the other.

Evaluation of a pre-treatment assessment to select mand topographies for functional communication training.

Recent research has suggested that variables related to specific mand topographies targeted during functional communication training (FCT) can affect treatment outcomes. These include effort, novelty of mands, previous relationships with problem behavior, and preference. However, there is little extant research on procedures for identifying which mand topographies to incorporate into FCT. In the current study, a mand topography assessment was conducted following functional analyses to identify the proficiency with which individuals used several different mand topographies. Two mand topographies (high and low proficiency) were then compared during FCT-based treatments. FCT was more effective when the mand topography identified as high proficiency was incorporated into FCT as compared to FCT that included the lower proficiency response. The results are discussed in terms of the need for individualized assessment procedures for selecting mand topographies that are targeted during FCT.