Recent advances in the assessment of aberrant behavior maintained by automatic reinforcement in individuals with developmental disabilities.

Many aberrant behaviors exhibited by individuals with developmental disabilities are maintained by "automatic reinforcement". These behaviors are often difficult to treat, with the most effective behavioral interventions often resulting in only moderate success. However, a series of recent studies has advanced our ability to understand and treat these behaviors through the innovative use of behavioral assessment. We review the recent development of three categories of assessments: (a) nonhypothesis-based stimulus preference assessments, (b) hypothesis-based stimulus preference assessments, and (c) hypothesis-based assessments incorporating noncontingent reinforcement and sensory extinction procedures. We consider each category's contribution to both our ability to prescribe effective behavioral interventions and our ability to more fully understand the concept of automatic reinforcement.

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

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

Reliability of the Matson Evaluation of Social Skills in Individuals with Severe Retardation (MESSIER).

Recently, the concepts of social competence and social skills have become important aspects of the evolving definitions of mental retardation. However, no psychometrically sound instruments exist for assessing social skills in lower functioning developmentally disabled people. This study examined the psychometric properties of the Matson Evaluation of Social Skills for Individuals with Severe Retardation (MESSIER)--a new scale designed to measure social skills in adults with severe developmental disabilities. The authors conducted a preliminary evaluation of the test-retest and interrater reliability of the MESSIER. It was determined that the MESSIER has high stability across raters and good stability over time. In addition, good internal consistency was established with coefficient alpha. Potential uses for the scale and directions for future research are discussed.

Treatment of pica through multiple analyses of its reinforcing functions.

We conducted functional analyses of the pica of 3 participants. The pica of 1 participant appeared to be maintained by automatic reinforcement; that of the other 2 participants appeared to be multiply controlled by social and automatic reinforcement. Subsequent preference and treatment analyses were used to identify stimuli that would complete with the automatic function of pica for the 3 participants. These analyses also identified the specific aspect of oral stimulation that served as automatic reinforcement for 2 of the participants. In addition, functional analysis-based treatments were used to address the socially motivated components of 2 of the participants' pica. Results are discussed in terms of (a) the importance of using the results of functional analyses to develop treatments for pica and (b) the advantages of developing indirect analyses to identify specific sources of reinforcement for automatically reinforced behavior.

Effectiveness of functional communication training with and without extinction and punishment: a summary of 21 inpatient cases.

Functional communication training (FCT) is a frequently used treatment for reducing problem behavior exhibited by individuals with developmental disabilities. Once the operant function of problem behavior is identified by a functional analysis, the client is taught to emit an appropriate communicative response to obtain the reinforcer that is responsible for behavioral maintenance. Studies on FCT have typically used small numbers of participants, have reported primarily on clients for whom FCT was successful, and have varied with respect to their use of other treatment components. The main purposes of the present study were to evaluate the efficacy of FCT for treating severe problem behavior in a relatively large sample of individuals with mental retardation (N = 21) and to determine the contribution of extinction and punishment components to FCT treatment packages. FCT with extinction was effective in reducing problem behavior for the majority of clients and resulted in at least a 90% reduction in problem behavior in nearly half the applications. However, when demand or delay-to-reinforcement fading was added to FCT with extinction, treatment efficacy was reduced in about one half of the applications. FCT with punishment (both with and without fading) resulted in at least a 90% reduction in problem behavior for every case in which it was applied.

Comparing methods for maintaining the safety of a child with pica.

Pica, a potentially life-threatening behavior problem exhibited among persons with mental retardation is sometimes addressed by methods such as application of restraints to reduce or eliminate associated risks (Rojahn, Schroeder, & Mulick, 1980). However, restraints may be associated with decreases in social interaction and negative impact on quality of life. We evaluated two methods (restraint vs. no restraint) for maintaining the safety of a client with pica on three dimensions: (a) level of pica, (b) therapist effort, and (c) impact on quality of life. Both methods prevented pica, however, the no restraint condition required less therapist effort and had less negative impact on quality of life. All three dimensions were included in a clinical decision-making model to determine the least restrictive, safe level of restraint for a 4-year-old girl while assessment and treatment procedures were conducted. The clinical utility of this multifactor decision-making model is discussed.

A social skills training program for preschoolers with developmental delays. Generalization and social validity.

This investigation was designed to assess a social skills training program with 32 developmentally delayed preschoolers. Subjects were evaluated in an unstructured play session, matched for levels of appropriate and inappropriate social behaviors, and assigned to either a treatment or control condition. The treatment group (N = 16) was presented with a 6-week protocol involving positive reinforcement, modeling, rehearsal, feedback, and time out. Controls (N = 16) received no instruction beyond regular classroom activities during the 6 weeks. The two groups were reevaluated in a posttest session and again in a generalization setting where two peers with developmental delays (not included in either experimental condition) were included. Prosocial behaviors were successfully taught and maintained in generalization settings. Efforts to reduce inappropriate behaviors were less successful. A test of social validity via teachers' ratings of videotapes of pretest and posttest assessments was also conducted. Implications for generalization and social validity research are discussed.