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.

Understanding behavior under nonverbal transitive-inference procedures: Stimulus-control-topography analyses.

Following training with verbal stimulus relations involving A is greater than B and B is greater than C, verbally-competent individuals reliably select A>C when asked "which is greater, A or C?" (i.e., verbal transitive inference). This result is easy to interpret. Nonhuman animals and humans with and without intellectual disabilities have been exposed to nonverbal transitive-inference procedures involving trained arbitrary stimulus relations. Following the training of A+B-, B+C-, C+D-, and D+E-, B reliably is selected over D (i.e., nonverbal transitive inference). Such findings are more challenging to interpret. The present research explored accounts of nonverbal transitive inference based in transitive inference per se, reinforcement, such as value-transfer theory, and operant stimulus control. In Experiment 1, college students selected B>G following the training of A+B-, B+C-, C+D-///E+F-, F+G-, and G+H- (where///signifies the omission of D+E-). In Experiment 2, college students selected B>G following the training of A+B-, B+C-, C+D-///E+F-, F+G-, and G+X- (where X refers to 10 stimuli that alternated across trials). In Experiment 3, college students selected G>B following the training of Y+B-, B+C-, C+D-///E+F-, F+G-, and G+X- (where Y and X refer to 10 stimuli, respectively, that alternated across trials). These findings are discussed in the context of operant stimulus control by offering an approach based in stimulus B typically acquiring only a select stimulus control topography.

Aversive properties of negative incentive shifts in Fischer 344 and Lewis rats.

Research on incentive contrast highlights that reward value is not absolute but rather is based upon comparisons we make to rewards we have received and expect to receive. Both human and nonhuman studies on incentive contrast show that shifting from a larger more-valued reward to a smaller less-valued reward is associated with long periods of nonresponding - a negative contrast effect. In this investigation, we used two different genetic rat strains, Fischer 344 and Lewis rats that putatively differ in their sensitivity to aversive stimulation, to assess the aversive properties of large-to-small reward shifts (negative incentive shifts). Additionally, we examined the extent to which increasing cost (fixed-ratio requirements) modulates negative contrast effects. In the presence of a cue that signaled the upcoming reward magnitude, lever pressing was reinforced with one of two different magnitudes of food (large or small). This design created two contrast shifts (small-to-large, large-to-small) and two shifts used as control conditions (small-to-small, large-to-large). Results showed a significant interaction between rat strain and cost requirements only during the negative incentive shift with the emotionally reactive Fischer 344 rats exhibiting significantly longer response latencies with increasing cost, highlighting greater negative contrast. These findings are more consistent with emotionality accounts of negative contrast and results of neurophysiological research that suggests shifting from a large to a small reward is aversive. Findings also highlight how subjective reward value and motivation is a product of gene-environment interactions.

Adventitious Reinforcement of Maladaptive Stimulus Control Interferes with Learning.

Persistent error patterns sometimes develop when teaching new discriminations. These patterns can be adventitiously reinforced, especially during long periods of chance-level responding (including baseline). Such behaviors can interfere with learning a new discrimination. They can also disrupt already learned discriminations, if they re-emerge during teaching procedures that generate errors. We present an example of this process. Our goal was to teach a boy with intellectual disabilities to touch one of two shapes on a computer screen (in technical terms, a simple simultaneous discrimination). We used a size-fading procedure. The correct stimulus was at full size, and the incorrect-stimulus size increased in increments of 10 %. Performance was nearly error free up to and including 60 % of full size. In a probe session with the incorrect stimulus at full size, however, accuracy plummeted. Also, a pattern of switching between choices, which apparently had been established in classroom instruction, re-emerged. The switching pattern interfered with already-learned discriminations. Despite having previously mastered a fading step with the incorrect stimulus up to 60 %, we were unable to maintain consistently high accuracy beyond 20 % of full size. We refined the teaching program such that fading was done in smaller steps (5 %), and decisions to "step back" to a smaller incorrect stimulus were made after every 5-instead of 20-trials. Errors were rare, switching behavior stopped, and he mastered the discrimination. This is a practical example of the importance of designing instruction that prevents adventitious reinforcement of maladaptive discriminated response patterns by reducing errors during acquisition.

Effect of signaled reinforcer magnitude on delayed matching-to-sample performance in individuals with intellectual disabilities.

The present study investigated effects of signaled reinforcer magnitude in a delayed identity matching-to-sample procedure. Four individuals with intellectual disabilities were trained on conditional discrimination with three geometric stimuli as sample and comparison stimuli. Retention intervals ranged from 0.1 to 16s. The magnitude of the reinforcer (different durations of access to a video game) was signaled by the background color of the screen. Matching accuracy was overall higher when the larger reinforcer was signaled, independently of retention intervals.

Extended pausing by humans on multiple fixed-ratio schedules with varied reinforcer magnitude and response requirements.

We conducted three experiments to reproduce and extend Perone and Courtney's (1992) study of pausing at the beginning of fixed-ratio schedules. In a multiple schedule with unequal amounts of food across two components, they found that pigeons paused longest in the component associated with the smaller amount of food (the lean component), but only when it was preceded by the rich component. In our studies, adults with mild intellectual disabilities responded on a touch-sensitive computer monitor to produce money. In Experiment 1, the multiple-schedule components differed in both response requirement and reinforcer magnitude (i.e., the rich component required fewer responses and produced more money than the lean component). Effects shown with pigeons were reproduced in all 7 participants. In Experiment 2, we removed the stimuli that signaled the two schedule components, and participants' extended pausing was eliminated. In Experiment 3, to assess sensitivity to reinforcer magnitude versus fixed-ratio size, we presented conditions with equal ratio sizes but disparate magnitudes and conditions with equal magnitudes but disparate ratio sizes. Sensitivity to these manipulations was idiosyncratic. The present experiments obtained schedule control in verbally competent human participants and, despite procedural differences, we reproduced findings with animal participants. We showed that pausing is jointly determined by past conditions of reinforcement and stimuli correlated with upcoming conditions.

Evaluation of stimulus control over a communication response as an intervention for stereotypical responding.

Stereotypical behavior maintained by automatic reinforcement often does not result in harm but may be undesirable in some situations. In the current investigation, participants were 2 individuals who engaged in nonharmful stereotypical responses shown in an analogue functional analysis to be insensitive to social contingencies. After bringing these responses under stimulus control using differential punishment, both participants learned a mand to terminate punishment for stereotypy. We also assessed whether the mand could be brought under stimulus control.

Discriminative control of punished stereotyped behavior in humans.

The purpose of this experiment was to establish discriminative control of responding by an antecedent stimulus using differential punishment because the results of past studies on this topic have been mixed. Three adults with mental retardation who exhibited stereotypy not maintained by social consequences (i.e., automatic reinforcement) participated. For each subject, stereotypy occurred frequently in the presence of a stimulus correlated with nonpunishment of stereotypy and rarely, if ever, in the presence of a stimulus correlated with punishment of stereotypy. Latency measures showed that the antecedent stimulus correlated with punishment served as the discriminative stimulus for the suppression of stereotypy. These results are important insofar as they show that discriminative control by an antecedent stimulus develops with punishment, and because it sometimes may be desirable to establish such control of socially inappropriate behavior.

Relevance of donepezil in enhancing learning and memory in special populations: a review of the literature.

This review discusses the laboratory and clinical research supporting the rationale for the efficacy of donepezil (Aricept USA) in enhancing cognition in autism, Alzheimer disease, Down syndrome, traumatic brain injury, Attention Deficit Hyperactivity Disorder (ADHD), and schizophrenia. While preliminary animal models have shown effective, human studies exclusive of Alzheimer disease are sparse. Although attention and memory are unlikely a sole operation of the cholinergic system, evidence indicates a promising direction for further examination of this hypothesis in autism. Studies that examine changes in operationally defined behaviors and reliable and valid measure of changes in attention and memory are needed.

Intertrial sources of stimulus control and delayed matching-to-sample performance in humans.

Two experiments compared delayed matching-to-sample (DMTS) accuracy under 2 procedures in adults with mental retardation. In the trial-unique procedure, every trial in a session contained different stimuli. Thus, comparison stimuli that were correct on one trial were never incorrect on other trials in that session (or vice versa). In the 2-sample DMTS procedure, the same 2 comparison stimuli were presented on each trial, and their function changed quasi-randomly across trials conditional upon the sample stimulus. Across 2 experiments, 7 of 8 subjects showed the highest overall accuracy under the trial-unique procedure, and no subject showed consistently higher accuracy under the 2-sample procedure. Negative, exponential decay functions fit to logit p values showed that this difference was due largely to the steeper delay-mediated decline in sample control for the 2-sample procedure. Stimulus-control analyses indicated that, under the 2-sample procedure, the selection of the comparison stimulus on Trial N was often controlled by the comparison stimulus selection on Trial N-1 rather than the Trial-N sample stimulus. This source of competing stimulus control is not present in trial-unique procedures. Experiment 2 manipulated intertrial interval duration. There was a small but consistent increase in accuracy as a function of intertrial interval duration under the 2-sample procedure, but not under the trial-unique procedure.

Use of an automated, load-distributing band chest compression device for out-of-hospital cardiac arrest resuscitation.

CONTEXT: Only 1% to 8% of adults with out-of-hospital cardiac arrest survive to hospital discharge. OBJECTIVE: To compare resuscitation outcomes before and after an urban emergency medical services (EMS) system switched from manual cardiopulmonary resuscitation (CPR) to load-distributing band (LDB) CPR. DESIGN, SETTING, AND PATIENTS: A phased, observational cohort evaluation with intention-to-treat analysis of 783 adults with out-of-hospital, nontraumatic cardiac arrest. A total of 499 patients were included in the manual CPR phase (January 1, 2001, to March 31, 2003) and 284 patients in the LDB-CPR phase (December 20, 2003, to March 31, 2005); of these patients, the LDB device was applied in 210 patients. INTERVENTION: Urban EMS system change from manual CPR to LDB-CPR. MAIN OUTCOME MEASURES: Return of spontaneous circulation (ROSC), with secondary outcome measures of survival to hospital admission and hospital discharge, and neurological outcome at discharge. RESULTS: Patients in the manual CPR and LDB-CPR phases were comparable except for a faster response time interval (mean difference, 26 seconds) and more EMS-witnessed arrests (18.7% vs 12.6%) with LDB. Rates for ROSC and survival were increased with LDB-CPR compared with manual CPR (for ROSC, 34.5%; 95% confidence interval [CI], 29.2%-40.3% vs 20.2%; 95% CI, 16.9%-24.0%; adjusted odds ratio [OR], 1.94; 95% CI, 1.38-2.72; for survival to hospital admission, 20.9%; 95% CI, 16.6%-26.1% vs 11.1%; 95% CI, 8.6%-14.2%; adjusted OR, 1.88; 95% CI, 1.23-2.86; and for survival to hospital discharge, 9.7%; 95% CI, 6.7%-13.8% vs 2.9%; 95% CI, 1.7%-4.8%; adjusted OR, 2.27; 95% CI, 1.11-4.77). In secondary analysis of the 210 patients in whom the LDB device was applied, 38 patients (18.1%) survived to hospital admission (95% CI, 13.4%-23.9%) and 12 patients (5.7%) survived to hospital discharge (95% CI, 3.0%-9.3%). Among patients in the manual CPR and LDB-CPR groups who survived to hospital discharge, there was no significant difference between groups in Cerebral Performance Category (P = .36) or Overall Performance Category (P = .40). The number needed to treat for the adjusted outcome survival to discharge was 15 (95% CI, 9-33). CONCLUSION: Compared with resuscitation using manual CPR, a resuscitation strategy using LDB-CPR on EMS ambulances is associated with improved survival to hospital discharge in adults with out-of-hospital nontraumatic cardiac arrest.

Rate-decreasing effects of the atypical neuroleptic risperidone attenuated by conditions of reinforcement in a woman with mental retardation.

Effects of two doses of risperidone on the performance of a matching task under tangible reinforcement and nonreinforcement conditions were measured in a woman with mental retardation. In both conditions, time to complete the task increased and response rates decreased under two doses of risperidone. Accuracy was generally unchanged. These changes were much smaller in the tangible reinforcement condition; thus, reinforcement seemed to protect performance from the rate-decreasing effects of risperidone.

Um analista do comportamento olha para tratamentos tradicionais de pedófilos e estupradores / A behavior analyst looks at traditional treatment of pedophiles and rapists

O artigo discute o tratamento do comportamento de estupradores e pedófilos de um ponto de vista analítico-comportamental, ou seja, do ponto de vista da relação entre o ambiente de tratamento e as condições em que a violação sexual ocorre. Consideramos a relação entre a resposta tratada na terapia e a resposta que ocorre no ambiente não clínico, os estímulos presentes no ambiente de tratamento e os estímulos presentes no ambiente não clínico, e a relação das conseqüências aplicadas durante a terapia e aquelas que poderiam ocorrer no ambiente não clínico. Além disso, nós especulamos sobre a função que o comportamento verbal pode ter na mudança do comportamento e das condições que devem estar presentes para mudanças no comportamento verbal resultarem em mudanças em comportamento sexualmente ofensivo. Os tratamentos considerados foram: terapia tradicional da fala, sensibilização encoberta, tratamento direto do comportamento precursor em ambientes não clínicos, e prevenção de recaída.(AU)

The paper discusses treatment of the behavior of rapists and pedophiles from a behavior analytic view point. We look at the treatment programs from the standpoint of the relation between the treatment environment and the conditions in which sexual offenses occur. Hence, we consider the relationship between the response treated in therapy and the response occurring in the non-treatment environment, the stimuli present in the treatment environment and the stimuli present in the non-treatment environment, and the relationship of the consequences applied during therapy and those that might occur in the non-treatment environment. Moreover, we speculate about the role that verbal behavior may have in changing behavior and the conditions that must be present for changes in verbal behavior to result in changes in sexually offensive behavior. Among the treatments considered are: traditional talk therapy, covert sensitization, direct treatment of precursor behavior in non-clinical environments, and relapse prevention.(AU)

Recombinative generalization of within-syllable units in nonreading adults with mental retardation.

Two adults with mental retardation demonstrated the recombination of within-syllable units (onsets and rimes) using a spoken-to-printed-word matching-to-sample (MTS) procedure. Further testing with 1 participant showed comprehension of the printed words. Printed-word naming was minimal before, but greater after, comprehension tests. The findings suggest that these procedures hold promise for further basic and applied analyses of word-attack skills.

Multimodal evaluation of risperidone for destructive behavior: functional analysis, direct observations, rating scales, and psychiatric impressions.

Risperidone, an atypical neuroleptic, has become a popular option for treating destructive behaviors of persons with developmental disabilities. A few studies have been conducted that evaluate the effects of risperidone on destructive behavior; however, none of these studies have combined objective measures with rating scales to evaluate the effects of risperidone on destructive behavior across home and clinical settings. This study evaluated the wide range of effects of risperidone on destructive behavior of 2 persons with developmental disabilities using weekly functional analysis sessions, daily observations, hourly home data, weekly rating scales, and monthly psychiatric impressions. Results indicate that risperidone does decrease destructive behavior and that, for the most part, all of the various measures yielded similar results.