Using a fading procedure to increase fluid consumption in a child with feeding problems.

Stimulus fading was combined with differential reinforcement and extinction to increase intake of a calorie-dense fluid by a 6-year-old child with feeding problems. The fading procedure consisted of adding Carnation Instant Breakfast and then milk to water (a fluid the child would drink).

Treatment of multiply controlled destructive behavior with food reinforcement.

We evaluated the extent to which the positive reinforcement of communication would reduce multiply controlled destructive behavior in the absence of relevant extinction components. When edible reinforcement for appropriate communication and nonfood reinforcers for problem behavior were available simultaneously, responding was allocated almost exclusively toward the behavior that produced edible reinforcement.

Analysis of aberrant behaviour associated with Rett syndrome.

PURPOSE: The purpose of this study was to identify the variables involved in the maintenance of aberrant behaviours associated with Rett syndrome. The occurrence of aberrant behaviours associated with Rett syndrome is typically attributed to biological variables associated with the disorder. In some cases. however, these behaviours have been shown to be sensitive to manipulations of environmental variables (i.e. operant contingencies). However, little research exists regarding the variables involved in the maintenance of these behaviours and the manner in which these variables can be manipulated to effectively reduce the occurrence of these behaviours. METHOD: We conducted functional analyses of the aberrant behaviours exhibited by two females diagnosed with Rett syndrome. Following the functional analyses, treatments were developed to disrupt the relationship between the aberrant response and the reinforcer maintaining it. RESULTS: Results from the functional analysis suggested that in both cases the aberrant behaviours (i.e. hand wringing and hand mouthing) were maintained by automatic reinforcement. Treatment, which included interrupting hand wringing for one individual and preventing hand mouthing for the other participant, resulted in dramatic changes in the levels of aberrant behaviour for both participants. These changes suggested that preventing reinforcement delivery reduced the motivation to engage in aberrant behaviour. CONCLUSIONS: These results suggest that operant variables can be manipulated to influence the occurrence of aberrant behaviour associated with Rett syndrome.

An evaluation of the effects of matched stimuli on behaviors maintained by automatic reinforcement.

The purpose of the current investigation was to extend the literature on matched stimuli to three dissimilar forms of aberrant behavior (dangerous climbing and jumping, saliva manipulation, and hand mouthing). The results of functional analyses suggested that each behavior was automatically reinforced. Preference assessments were used to identify two classes of stimuli: items that matched the hypothesized sensory consequences of aberrant behavior (matched stimuli) and items that produced sensory consequences that were not similar to those produced by the aberrant behavior (unmatched stimuli). The effects of providing continuous and noncontingent access to either the most highly preferred matched or the most highly preferred unmatched stimuli were assessed relative to a condition in which no stimuli were available. Overall results suggested that providing access to items that matched the hypothesized sensory consequences of aberrant behavior may be more effective than simply selecting stimuli either arbitrarily or based on the results of preference assessments alone.

Noncontingent reinforcement: effects of satiation versus choice responding.

Recent research findings suggest that the initial reductive effects of noncontingent reinforcement (NCR) schedules on destructive behavior result from the establishing effects of an antecedent stimulus (i.e., the availability of "free" reinforcement) rather than extinction. A number of authors have suggested that these antecedent effects result primarily from reinforcer satiation, but an alternative hypothesis is that the individual attempts to access contingent reinforcement primarily when noncontingent reinforcement is unavailable, but chooses not to access contingent reinforcement when noncontingent reinforcement is available. If the satiation hypothesis is more accurate, then the reductive effects of NCR should increase over the course of a session, especially for denser schedules of NCR, and should occur during both NCR delivery and the NCR inter-reinforcement interval (NCR IRI). If the choice hypothesis is more accurate, then the reductive effects of NCR should be relatively constant over the course of a session for both denser and leaner schedules of NCR and should occur almost exclusively during the NCR interval (rather than the NCR IRI). To evaluate these hypotheses, we examined within-session trends of destructive behavior with denser and leaner schedules of NCR (without extinction), and also measured responding in the NCR interval separate from responding in the NCR IRI. Reductions in destructive behavior were mostly due to the participants choosing not to access contingent reinforcement when NCR was being delivered and only minimally due to reinforcer satiation.

An evaluation of the properties of attention as reinforcement for destructive and appropriate behavior.

The analogue functional analysis described by Iwata, Dorsey, Slifer, Bauman, and Richman (1982/1994) identifies broad classes of variables (e.g., positive reinforcement) that maintain destructive behavior (Fisher, Ninness, Piazza, & Owen-DeSchryver, 1996). However, it is likely that some types of stimuli may be more effective reinforcers than others. In the current investigation, we identified 2 participants whose destructive behavior was maintained by attention. We used concurrent schedules of reinforcement to evaluate how different types of attention affected both destructive and appropriate behavior. We showed that for 1 participant praise was not an effective reinforcer when verbal reprimands were available; however, praise was an effective reinforcer when verbal reprimands were unavailable. For the 2nd participant, we identified a type of attention that effectively competed with verbal reprimands as reinforcement. We then used the information obtained from the assessments to develop effective treatments to reduce destructive behavior and increase an alternative communicative response.

The effects of noncontingent and contingent attention for self-injury, manding, and collateral responses.

To date, most functional analysis studies have focused on the effects of treatment contingencies on specific targeted aberrant and alternative responses. In the current investigation, the main and collateral effects of the assessment and treatment of attention-maintained self-injury were assessed. Specifically, we evaluated the effects of noncontingent and contingent social attention on four categories of behavior: self-injury, a novel mand, preexisting prosocial responses (e.g., babbling and reaching out), and other aberrant responses (i.e., aggression and destruction). Results suggested that self-injury, prosocial responses, and other aberrant behaviors were within the same functional response class. Possible impact of these results when selecting mands for functional communication training is discussed.

On the establishing and reinforcing effects of termination of demands for destructive behavior maintained by positive and negative reinforcement.

The results of functional analyses suggested that the destructive behavior of two individuals was sensitive to escape and attention as reinforcement. In an instructional context, we evaluated the effects of reinforcing compliance with functional reinforcers when destructive behavior produced a break. For one participant we also evaluated the effects of reinforcing compliance with functional reinforcers when destructive behavior produced no differential consequence (escape extinction). We hypothesized that destructive behavior failed to decrease in an instructional context when compliance resulted in a break because presentation of a break evoked attention-maintained destructive behavior. The results of a reinforcer assessment supported this hypothesis by demonstrating that demands functioned as positive reinforcement when no alternative activities were available. These results are discussed in terms of the importance of establishing operations in determining the appetitive or aversive properties of stimuli when destructive behavior is multiply controlled.

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.

Effects of wrist weights on self-injurious and adaptive behaviors.

The effects of wrist weights on the self-injurious and adaptive behaviors of a young boy with profound mental retardation were evaluated. Application of wrist weights reduced SIB by 92% and was associated with either increases or stable levels of multiple novel and preexisting adaptive behaviors.

The evaluation and treatment of aggression maintained by attention and automatic reinforcement.

In the current investigation, we used direct and indirect methods to assess and treat several topographies of aggression that were hypothesized to have separate operant functions in a young boy with severe mental ratardation and pervasive developmental disorder. First, a functional analysis of aggression, using the methods described by Iwata, Dorsey, Slifer, Bauman, and Richman (1982/1994), was conducted and produced inconclusive results. Next, indirect methods were used to develop a second functional analysis, which showed that chin grinding (firmly pressing and grinding his chin against the skin and bones of others) persisted independent of social contingencies and that the other topographies of aggression (e.g., hitting, kicking) were maintained by social positive reinforcement (attention). A treatment designed to decrease aggression maintained by attention--functional communication training with extinction--reduced all forms of aggression except chin grinding. This latter topography of aggression, which we hypothesized was maintained by automatic reinforcement, was reduced when the response--reinforcer relation was interrupted through response blocking and the child was provided with an alternative form of chin stimulation.

Using chronotherapy to treat severe sleep problems: a case study.

Chronotherapy was used to treat severe sleep problems (irregular sleep onset times, frequent night and early wakings, and short total sleep times) in a girl with mental retardation. Chronotherapy involved systematically delaying the child's bedtime each night while maintaining a regular schedule during waking hours until an age-appropriate bedtime was achieved. Immediate improvements in the child's sleep pattern were observed with the introduction of treatment, and an age-appropriate bedtime was achieved in 11 days. Four months of follow-up data indicated that improvements maintained in the home. Although chronotherapy was developed specifically for adults with delayed sleep phase insomnia, the current results suggest that the treatment may be useful for other populations and problems.

Combining stimulus fading, reinforcement, and extinction to treat food refusal.

The food refusal of a 6-year-old girl with destructive behavior was treated using stimulus fading, reinforcement, and escape extinction. Intake increased and compliance with prompting procedures remained relatively stable despite the increased consumption requirement.

On the relative reinforcing effects of choice and differential consequences.

Research on the reinforcing effects of providing choice-making opportunities to individuals with developmental disabilities (i.e., allowing them to choose reinforcers or tasks) has produced inconsistent results, perhaps because the mechanisms underlying such effects remain unclear. Choice may produce a reinforcement effect because it is correlated with differential consequences (i.e., choice may increase one's access to higher preference stimuli), or it may have reinforcement value independent of (or in addition to) the chosen stimulus. In Experiment 1, we used a concurrent-operants arrangement to assess preference for a choice condition (in which participants selected one of two available reinforcers) relative to a no-choice condition (in which the therapist selected the same reinforcers on a yoked schedule). All 3 participants preferred the choice option. In Experiment 2, we altered the schedules so that the participant selected one of two lower preference reinforcers in the choice condition, whereas the therapist selected a higher preference stimulus for the participant either half or all of the time in the no-choice condition. Participants typically allowed the therapist to select reinforcers for them (i.e., they allocated responding to the no-choice condition) when it resulted in greater access to higher preference stimuli.

Assessment of preference for varied versus constant reinforcers.

One method that has been demonstrated to improve the effectiveness of reinforcement is stimulus (reinforcer) variation (Egel, 1980). Egel found that bar pressing increased and responding occurred more rapidly during varied reinforcement than during constant reinforcement when identical stimuli were used across phases for 10 individuals with autism. The purpose of the current investigation was to assess the preferences of 7 individuals for varied presentation of slightly lower quality stimuli relative to constant access to the highest quality stimulus. Varied presentation was preferred over constant reinforcer presentation with 4 participants, and the opposite was true for 2 participants. One participant did not demonstrate a preference. These results suggest that stimulus variation may allow less preferred reinforcers to compete effectively with a more highly preferred reinforcer for some individuals.

Evaluation of client preference for function-based treatment packages.

Functional communication training (FCT) and noncontingent reinforcement (NCR) are commonly prescribed treatments that are based on the results of a functional analysis. Both treatments involve delivery of the reinforcer that is responsible for the maintenance of destructive behavior. One major difference between the two treatment procedures is that client responding determines reinforcement delivery with FCT (e.g., reinforcement of communication is delivered on a fixed-ratio 1 schedule) but not with NCR (e.g., reinforcement is delivered on a fixed-time 30-s schedule). In the current investigation, FCT and NCR were equally effective in reducing 2 participants' destructive behavior that was sensitive to attention as reinforcement. After the treatment analysis, the participants' relative preference for each treatment was evaluated using a modified concurrent-chains procedure. Both participants demonstrated a preference for the FCT procedure. The results are discussed in terms of treatment efficacy and preference for control over when reinforcement is delivered. In addition, a method is demonstrated in which clients with developmental disabilities can participate in selecting treatments that are designed to reduce their destructive behavior.

The establishing effects of client location on self-injurious behavior.

Three functional assessments were conducted with a client with self-injurious behavior (SIB), which indicated that SIB appeared to be sensitive to attention as reinforcement. In addition, levels of SIB were much higher when the client was seated in his wheelchair. An additional analysis was conducted in which client location (in and out of wheelchair) was altered while reinforcement contingencies (attention) for SIB were held constant. Levels of SIB again were higher when the client was positioned in his wheelchair, even though the consequences for SIB were identical. The results of this final analysis suggested that the wheelchair functioned as an establishing stimulus altering the efficacy of social positive reinforcement.

Stimulus control and resistance to extinction in attention-maintained SIB.

A functional analysis of the self-injurious behavior (SIB) of a young man diagnosed with severe mental retardation demonstrated that SIB was sensitive to social attention as reinforcement. In addition, lower but consistent rates of SIB occurred in sessions where a person was present (Demand and Toy Play), and a gradual decrease in SIB was observed across sessions where a person was not present (Alone). Evaluation of the within-session trends of SIB during the functional analysis demonstrated that SIB maintained throughout each Social Attention session and declined within and across Alone sessions. This pattern of responding suggested that the presence of a person may have differentially affected rates of SIB independent of the programmed consequences for SIB. In a subsequent analysis, SIB was reduced to near-zero levels in the absence of a person, but maintained in the presence of a person even when attention was withheld, suggesting that the response was highly resistant to extinction. The results of these assessments then were used to develop a treatment to reduce the client's SIB. During treatment, a person was present and delivered attention only when the client appropriately communicated. SIB resulted in the removal of the antecedent stimulus that exerted control over the response (i.e., the person left the room). The findings of this investigation are discussed in terms of the differential effects of stimuli on interpretation of functional analysis results and the subsequent development of treatment.

Noncontingent presentation of attention and alternative stimuli in the treatment of attention-maintained destructive behavior.

Previous research has demonstrated that destructive behavior may be reduced through noncontingent presentation of attention when attention is identified as the stimulus responsible for behavioral maintenance. Because it may not always be possible to deliver attention in all situations, we examined the extent to which alternative stimuli that have been identified through a choice assessment would substitute for attention (the functional analysis-based reinforcer) in a noncontingent reinforcement procedure. Prior to treatment, functional analyses demonstrated that the destructive behavior of 2 clients with mental retardation was maintained by adult attention. Next, a stimulus choice assessment identified highly preferred tangible items for the 2 clients. Finally, we compared the effectiveness of two noncontingent reinforcement procedures: continuous noncontingent access to attention and continuous noncontingent access to the tangible item identified in the choice assessment. For both clients, these noncontingent reinforcement procedures reduced destructive behavior. The results are discussed in terms of the clinical implications for the treatment of destructive behavior using functional and alternative stimuli.