|Evaluating Components and Variables Associated With the Treatment of Problem Behavior Maintained by Negative Reinforcement
|Monday, May 30, 2016
|3:00 PM–3:50 PM
|Grand Ballroom CD South, Hyatt Regency, Gold East
|Area: DDA/PRA; Domain: Translational
|Chair: Mindy Christine Scheithauer (Emory University/Marcus Autism Center)
|CE Instructor: Mindy Christine Scheithauer, Ph.D.
Problem behaviors (PB), such as aggression and disruption, are prevalent among individuals with developmental delays. These behaviors negatively impact development and create a stressor for caregivers. PB is often maintained by negative reinforcement (i.e., escape from demands or aversive situations). The current symposium discusses the effects of specific treatment components and variables associated with the treatment of PB maintained by negative reinforcement exhibited by individuals with developmental delays. The first presentation evaluates diaphragmatic breathing (DB), an intervention commonly recommended, which lacks quantitative evidence for reducing PB. The experimenter prompted DB contingent on precursor behaviors in a demand context and observed decreased rates of PB in one participant, while another required additional treatment components. The second presentation evaluated the weekly frequency of treatment sessions targeting tolerance of dental appointments, finding that more frequent treatment sessions may promote superior outcomes. The final presentation describes the use of a multiple schedule in the treatment of PB maintained by escape from interruption to ones environment. Multiple schedules were used to successfully thin the reinforcement schedule in treatment with two participants. This symposium provides guidelines for clinicians designing treatments for PB maintained by negative reinforcement and provides important extensions to the current literature.
|Keyword(s): Autism, Escape, Negative Reinforcement, Problem Behavior
|Evaluation of Diaphragmatic Breathing on Decreasing Escape-Maintained Aggression
|LAUREN PHILLIPS (University of Houston - Clear Lake), Jennifer N. Fritz (University of Houston-Clear Lake), Lisa Rettig (University of Houston-Clear Lake)
|Abstract: The use of coping skills, such as diaphragmatic breathing (DB), is sometimes recommended to prevent or reduce the occurrence of problem behavior. For example, the Autism Speaks Challenging Behaviors Tool Kit (2012) advises parents to prompt their children to take deep breaths when they are engaging in challenging behaviors and then to praise independent responding. However, research to date only has demonstrated qualitative improvements in behavior for participants through the use of DB, and further investigation is needed to assess quantitative decreases in problem behavior. In this study, the effectiveness of DB was assessed on reducing the rate of aggression maintained by social negative reinforcement exhibited by two individuals diagnosed with autism spectrum disorder. A precursor assessment was conducted to determine behaviors that reliably occurred before aggression, and DB was prompted contingent on precursors during treatment without extinction. Treatment was evaluated using an ABAB reversal design, and reliability was calculated for at least 50% of sessions and averaged over 90%. DB treatment without extinction was effective at reducing aggression for one of two participants. A different treatment that included extinction was required to produce socially significant reductions in the second participant’s aggression.
An Evaluation of Inter-Session Interval Duration in Treating Problem Behavior During Mock Dental Exams
|JULIA SZALWINSKI (New England Center for Children; Western New England University), Jessica L. Thomason-Sassi (New England Center for Children; Western New England University)
Dental professionals have reported that problem behavior in individuals with autism precludes adequate care (Kuhn et at., 1994). Prior research has illustrated effective treatments for escape-maintained behavior in this context; however, there is little information on whether the amount of time between treatment sessions impacts treatment effectiveness. However, prior literature has shown that intertrial interval (ITI) duration could have an effect on skill acquisition (e.g.,Tincani et al., 2005). The purpose of this study was to determine whether the length of the ITI impacts the effectiveness of an intervention for escape-maintained problem behavior. The intervention consisted of demand fading and extinction for problem behavior; in one condition, treatment sessions were conducted weekly, and in the second condition treatment sessions were conducted 3-5 times per week. Participants included two students from a residential school for children with autism. A multiple baseline across subjects design is being used to demonstrate experimental control. Results for Subject 1 suggest that ITI is an important variable, in that more frequent sessions produce better treatment outcomes. Subject 2 has not yet experienced the second treatment condition. Inter-observer agreement was calculated for 47% of sessions with 97.4% agreement.
Use of a Multiple Schedule for Problem Behaviors Maintained by Avoidance of Interrupted Play
|SARAH J. MILLER (Marcus Autism Center; Emory University School of Medicine), Nathan Call (Marcus Autism Center; Emory University School of Medicine), Jessica Alvarez (New Directions Counseling Center), Seth B. Clark (Marcus Autism Center), Joanna Lomas Mevers (Marcus Autism Center/Emory University School of Medicine)
Up to 96% of individuals with autism spectrum disorder exhibit complex repetitive behavior (McDougle et al., 1992). Functional analyses have demonstrated that some individuals engage in problem behavior maintained by termination of interruption of repetitive or rigid behaviors, such as a therapist manipulating items the participant has arranged (e.g., Fisher, Adelinis, Thompson, Worsdell, & Zarcone, 1998; Leon, Lazarchick, Rooker, & DeLeon, 2013). In both of these previous studies, participants were taught a functional communication response to terminate or avoid the interruption, resulting in a decrease in problem behavior. However, both studies reinforced mands on a FR1 schedule, and such dense schedules of reinforcement may not always be feasible in the natural environment. The current study used a multiple schedule for two individuals whose problem behavior was determined to be maintained by avoidance of interruption of repetitive play. During the multiple schedule, participants were required to tolerate a periods of interruption of increasing duration without engaging in problem behavior. Access to repetitive play served as the reinforcer for tolerating interruptions. Results show that participants were able to tolerate periods of interruption as a result of treatment.