Association for Behavior Analysis International

Children with intellectual and developmental disabilities often engage in challenging (e.g., self-injury, aggression, disruption) and repetitive behaviors. For a subset of these individuals, the behavior is maintained by automatic reinforcement. Behavior maintained by automatic reinforcement presents several challenges in assessment and treatment. The current symposium includes three studies that address some of these challenges. The first study presents data from assessments and treatments of repetitive behaviors maintained by automatic reinforcement, with an emphasis on predictions made by classification following assessment based on the three subtypes of automatically maintained behavior that have been previously studied with self-injury. Second, we will present outcomes from extended alone and ignore assessments, a common evaluation conducted to determine whether behavior is automatically-maintained. Specifically, this study will present on differences in the rate and variability of behavior when conducting alone compared to ignore assessments and differences across topography of behavior. The last study highlights potential safety concerns associated with the assessment of automatically maintained self-injury. An evaluation of solutions to decrease safety risks associated with assessing these behaviors is discussed.

Target audience includes practitioners and applied researchers with a BCBA or BCBA-D. It is also appropriate for psychologists who conduct behavioral assessments and treatments. This should also qualify as psychology CEUs, but I did not see this option listed above.

Hagopian and colleagues (2015/2017) have suggested that self-injurious behavior (SIB) that is automatically reinforced presents as three subtypes. Subtype 1 consists of differentiation between the alone/no interaction and the play control conditions. This form of SIB is generally responsive to alternative reinforcement alone. Subtype 2 SIB consists of a lack of differentiation between those FA conditions and is not generally responsive to alternative reinforcement. Subtype 3 is Subtype 2 SIB that presents with self-restraint. This study aimed to prospectively identify, from standard functional analyses (FA), whether similar subtypes present with stereotypic behavior. Two types of treatment evaluations followed the FAs of stereotypy. In one, an Augmented Competing Stimulus Assessment (A-CSA), which assessed competing stimuli to stereotypy. In the other, the effects of prompting and reinforcement for appropriate behavior was examined in four classroom contexts where stereotypy was observed to occur. There are currently 12 participants across the two experiments. Subtypes have emerged and treatment effects have and have not been obtained with alternative reinforcement. Treatment results will be discussed with the Subtyping obtained in the FA as context. Interobserver agreement data were collected in all experimental conditions and mean IOA was consistently above 85% for all dependent measures.

Automatically maintained self-injurious behavior (ASIB) has been shown to be generally more resistant to treatment and to produce more injuries relative to socially maintained self-injury. Assessing, treating, and conducting research on severe ASIB poses many practical and ethical challenges. Among them is the necessity to observe the behavior in order to assess it and to evaluate treatment outcomes, while also maintaining the safety of the client or research participant. The current study describes a systematic approach for identifying the optimal level, type, and combination of protective procedures that allows some self-injury to occur, but minimizes the potential for injury. Protective procedures can include mechanical devices that limit the occurrence of the behavior, protective equipment that protect areas of the body from injury, response blocking to prevent the completion of the response, and abbreviated session durations that limit exposure to situations in which the behavior is occurring. The potential utility of this approach and the need for additional research to further develop these methods are discussed.

Extended alone or ignore assessments are often conducted to determine whether challenging behavior is maintained by automatic reinforcement. The current study conducted a consecutive case series analysis of over 60 children and young adults who completed extended alone or ignore assessments as part of their admission to an intensive treatment center for challenging behavior. We evaluated the variability and average level of targeted behavior across topographies of challenging behavior and assessment types (alone or ignore). Minimal differences were identified when comparing variability in alone vs. ignore assessments. Across topographies, some behaviors were associated with less variability across sessions compared to others (e.g., pica was generally exhibited with very little variability across sessions). Results are presented in the context of guidelines for what clinicians should expect when conducting extended alone or ignore assessments as well as future research directions for identifying aspects of reinforcement history that might contribute to differing patterns of responding in these types of assessments.