Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.

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46th Annual Convention; Online; 2020

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Poster Session #393
DDA Monday Poster Session
Monday, May 25, 2020
1:00 PM–3:00 PM
Virtual
90. Toilet Training Protocol for Preschoolers With Disabilities
Area: DDA; Domain: Applied Research
JI YOUNG KIM (Teachers College, Columbia University), Madeline Frank (Teachers College Columbia University), Daniel Mark Fienup (Teachers College, Columbia University)
Discussant: Kelly M. Schieltz (University of Iowa)
Abstract:

We describe a decision protocol for choosing among potentially efficacious toilet training interventions and tested its effects with 3 preschool participants with disabilities. We utilized a decision protocol (Keohane and Greer 2005) to determine whether to initially implement interval or rapid training interventions as well as to determine whether adequate progress was being made with a particular toilet training intervention. We utilized the decision protocol to individualize toilet training procedure and evaluated its effects in a delayed multiple baseline design. Results indicated that the toileting skills of all participants improved with increased numbers of target voids on the toilet and decreased numbers of accidents as a result of individualized training procedures.

 
91. A Chance to Dance: A Case Study Examining the Benefits of Recreational Dance and Behavior Analysis
Area: DDA; Domain: Applied Research
MADELINE PONTONE (Brock University), Tricia Corinne Vause (Brock University), Courtney Denise Bishop (Brock University ), Dana Kalil (Brock University), Nicole Staite (Brock University), Sarah Davis (Brock University)
Discussant: Kelly M. Schieltz (University of Iowa)
Abstract: Dance programs for children and youth with neurodevelopmental disorders demonstrate potential for improvements in motor skills and collateral outcomes including emotional regulation but programs with necessary adaptations for this population are lacking. Dance with a B-E-A-T! is a package combining a recreational dance class and principles of behavior analysis such as chaining, least-to-most-prompting, and a token economy, which aims to improve motor skills, social skills, coping skills, and self-confidence. Participant Allie (pseudonym), age 9 with a formal diagnosis of ASD and comorbid issues such as anxiety, took part in this 8-week program with three additional children and four research assistants (1:1 ratio). Data collection included demographics, pre and post motor probes of 12 specific dance skills, and a self-efficacy and consumer satisfaction questionnaire. Allie showed improvement across eight motor probes, with an increase in correct performance from 37% to 80%. A parent self-efficacy questionnaire and a semi-structured interview with Allie’s mother identified an increase in dance skills, emotional regulation, worry and coping skills, and overall satisfaction with the program. Thematic analysis of the interview identified key themes such as the benefit of individualized programming and inclusion. Facilitators and barriers identified by the child and her parent will be discussed.
 
92. Teaching Life Skills Using a Modified Behavioural Skills Training Framework
Area: DDA; Domain: Applied Research
MICHAEL PALMER (University of New Brunswick), Rachele Phinney (University of New Brunswick)
Discussant: Kelly M. Schieltz (University of Iowa)
Abstract:

The global prevalence of those with visual impairments is 253 million. To date, little behaviour analytic research has been conducted to determine optimum teaching procedures for those this population. To teach individuals with visual impairments life skills, traditional behavioural skills training (T-BST) and a modified BST (M-BST) were compared using an alternating treatments design. T-BST involved visual modeling, practicing the skill, providing vocal feedback about the performance, and practicing the skill until a performance criterion was met. M-BST involved using hand-under-hand guidance instead of visual modeling and corrective physical feedback along with vocal feedback. Trials to criterion and percent of correct steps were measured. Two participants, who were momentarily visually impaired, learned two tasks each, one taught with T-BST and the other M-BST. Both T-BST and M-BST increased the percent of steps correct in training and decreased the trials to criterion. No differences between the two training techniques were found. In addition, participants’ skills maintained at follow-up and required no additional training. The rapid acquisition of the skills in this study may be indicative of the effectiveness of BST as a means of teaching skills across populations.

 
93. Assessing and Teaching Job-Related Social Skills to Italian Adults With Developmental Disabilities
Area: DDA; Domain: Applied Research
Claudio Radogna (DALLA LUNA - BARI, ITALY), GUIDO DANGELO (DALLA LUNA - BARI, ITALY)
Discussant: Kelly M. Schieltz (University of Iowa)
Abstract:

Working is an essential component of community participation, however in Italy only few people with intellectual disabilities are employed. This may happen because only a few programs focus on vocational skills. To date, just a handful of studies have managed to systematically assess and train people with developmental disabilities on the skills required to find, obtain and keep a job. In the present study, a multiple baseline across participants was used to evaluate the effectiveness of a treatment package to teach job-related social skills to three young adults with developmental disabilities. Behavioral Skill Training and individualized prompting strategies were used to teach a set of skills (e.g., making confirming statements for clear and vague instructions; asking for help completing tasks; apologizing; asking the supervisor what task should be completed next). Results shown that the treatment was effective in teaching previously identified social skills, as well as in promoting generalization.

This research has some implications for identifying curricula of work-related social competences and planning the transition between the end of the study cycle and inclusion into work / production activities, in order to improve the professional outcomes of people with different developmental disorders.

 
94. Extending Brief Error-Correction Assessments to Adults With Intellectual or Developmental Disabilities
Area: DDA; Domain: Applied Research
J TURNER BUTLER BRAREN (University of South Florida), Andrew L. Samaha (University of South Florida), Karie John (University of South Florida)
Discussant: Kelly M. Schieltz (University of Iowa)
Abstract:

Previous research evaluating the predictive validity of error-correction assessments has shown high correspondence between error-correction assessments and validation assessments (e.g., McGhan & Lerman, 2013). However, error-correction assessments are often lengthy to conduct and limited to the acquisition of vocal-verbal targets (e.g., reading sight words) or low-effort motor targets (e.g., matching to sample). Additionally, previous research on error-correction assessments predominately use young children (ages 3- to 10-years-old) as participants. We extended the results of Carroll, Owsiany, and Cheatham (2018) by evaluating the predictive validity of a brief error-correction assessment (brief assessment) in adults with intellectual or developmental disabilities. A brief assessment and a validation assessment were conducted for each participant. During each assessment, six error-correction procedures (ECP) were compared when teaching participants to assemble arbitrary Lego structures and data were collected on variables related to acquisition (e.g., correct responding, errors) and intrusiveness (e.g., number of prompts delivered, protests). Additionally, we evaluated the relationship between the intrusiveness of ECPs and the occurrence of problem behavior.

 
95. Increasing Community Capacity to Address Problematic Behaviour in Adults with Developmental Disabilities
Area: DDA; Domain: Service Delivery
LAURA E. MULLINS (Brock University), Pauline Le-Drew (Regional Support Associates), Gail Clark (Regional Support Associates)
Discussant: Kelly M. Schieltz (University of Iowa)
Abstract:

Increased complexity of support needs of persons with developmental disabilities (DD) living in the community and improved governance for agencies supporting adults engaging in challenging behaviour has increased demand for clinical behavioural services in Ontario. Waitlists have increased as clinical providers are required to help those most in need. In response, Regional Support Associates, a Ministry funded clinical provider for adults with DD, developed the Community Capacity Development Initiative (CCDI). CCDI was designed to complement RSA services while simultaneously building capacity within Developmental Service Agencies (DSA). CCDI is a comprehensive training focused on increasing DSA staff's ability to address problematic behaviours through the completion of a Functional Behaviour Assessment and the development of a Behaviour Support Plan. Results for a scoping review drawing from Organizational Behaviour Management and Implementation Sciences, this presentation will review factors influencing DSA's ability to increase capacity (e.g., skill acquisition, treatment adherence, generalization and maintenance). Some relevant factors include environmental factors, organizational resources, leadership style, training approaches (e.g., BST and multiple exemplars), the complexity of interventions and relationship with change agents. An overview of the CCDI training model included the training approach and efforts incorporated to address factors influencing capacity development will also be reviewed.

 
96. Helping Two Kindsof Solitude: Increasing Well-Being Levels for Adolescents With Developmental Disability and for Elderly Persons
Area: DDA; Domain: Service Delivery
FEDERICA BERARDO (TICE Live and Learn), Giada Gueli (TICE Live and Learn), Sara Guandalini (TICE Live and Learn), Luca Vascelli (TICE Live and Learn), francesca cavallini (University of Parma)
Discussant: Kelly M. Schieltz (University of Iowa)
Abstract:

Families of adolescents with developmental disability often struggle in identifying setting in which to carry out social activities. At the same time relatives of elderly people usually are in trouble identifying new activities and social relations. The purpose of the study was to develop an intervention that could combine and help two kind of solitude: old people that usually spend a lot of time alone or with a only caregiver and adolescents with special needs who often do not have activities to perform during the afternoon. The study evaluated the effects of a training including role playing and in vivo modeling on conversational skills on pleasantness indicators during conversation for both adolescents and elderly people. Also, a questionare was used to investigate the well-being level of the elderly person and his caregiver. Participants were four adolescents and four elderly people; each adolescent was paired with a elderly person. A changing criterion design was used for each pair. Initial results suggest an increase of the intervals in which all the pleasantness indicators are present for both adolescents and elderly people. Attached data have being collected for the first pair. Data collection is still in progress for all the participants. Based on the final results, a second study could be implemented to investigate how this intervention could evolve in a real opportunity of job and self-employment for the adolescents. The study provides evidence of the need and the importance of creating interventions with a high social impact for categories of people with different kind of need. Also the project underline how each person could be a promoter of potentialities for others.

 
97. Assessing Visual and Auditory Discrimination Skills of People With Multiple Disabilities
Area: DDA; Domain: Basic Research
RYAN HECKERT (University of Manitoba), Braden Milani (University of Manitoba), Brennan Foidart (University of Manitoba), C.T. Yu (University of Manitoba)
Discussant: Kelly M. Schieltz (University of Iowa)
Abstract:

Individuals with severe multiple disabilities, who have minimal body movements, are unable to partake in assessments that require an active response. Their abilities to make visual and auditory discriminations are often unknown. In one discrimination skills assessment, we replaced the standard response of placing a manipulandum into a container (active response) with microswitches that could be pressed by using the elbow or fist. This type of response involves gross motor arm movements of just a few centimeters. The modified procedure was evaluated in a combined multiple baseline and reversal design across five 2-choice visual and auditory discrimination tasks, and the evaluation was replicated across three participants. The results showed that all participants were able to respond using the microswitches at a much higher level compared to baseline (active response), in which no responses were recorded. Furthermore, the results showed that participants were successful in making a two-choice position-visual or simple visual discrimination using the microswitches. Information about the discrimination abilities of these participants may be useful to caregivers in providing supports to these individuals.

 
98. Parent Training in Bosnia-Herzegovina: An Analysis of Pyramidal Training as a Method of Disseminating Effective Practices
Area: DDA; Domain: Applied Research
BLAKE HANSEN (Brigham Young University), Katie Barton (Brigham Young University), Rebecca Barton (Brigham Young University; Kids on the Move), Hannah Kruman (Bloom Behavior and Consulting Services), Emma Orton (Utah Behavior Services)
Discussant: Kelly M. Schieltz (University of Iowa)
Abstract: The present study evaluated the effects of pyramidal parent training to disseminate two research-based practices for parents in Bosnia-Herzegovina. In the first condition, Parents 1-2 were trained by a therapist to implement response interruption and redirection (RIR), and Parent 3 was trained by a therapist to implement activity schedules (AS). In the second condition, Parents 1-2 trained Parent 3 on RIR and Parent 3 trained Parents 1-2 on AS. The study used a reversal design to evaluate the effects of the two trainings. Results indicated that parents acquired the two skills at the same levels regardless of who trained them. During the training phases, all parents reached 100% of steps for each skill. At follow up, all parents demonstrated 80% of steps or better for activity schedules, and two parents showed 80% or better for response interruption and redirection. All three parents delivered the training at high levels of fidelity. These findings suggest that parents in Bosnia-Herzegovina and similar environments can effectively train other parents on discrete skills such as those used in the present study.
 
99. The Effects of Reinforcer Schedule on Visuo-Spatial Working Memory Tasks With Different Difficulty Levels: Comparison of Distributed and Accumulated Reinforcement
Area: DDA; Domain: Applied Research
Dongjoo Chin (Yonsei University), CHANSOL PARK (Yonsei University)
Discussant: Kelly M. Schieltz (University of Iowa)
Abstract:

The effectiveness of accumulated reinforcement on participants with developmental disabilities has been emphasized over distributed reinforcement, but the generalized effect of accumulated reinforcement is hampered in part by lack of controlling task characteristics or participant characteristics. The present study evaluated if the efficacy of, and preference for distributed and accumulated reinforcement were different between two task difficulties of a visuospatial working memory task. Participants were children with intellectual disabilities who were 7 years old or older and under 13 years old. 77 participants conducted four sets of visuospatial working memory task(distributed and accumulated reinforcement in an easy task, distributed and accumulated reinforcement in a difficult task). The performance was evaluated by accuracy rate, response rate per minute, and correct response rate per minute. Preference was evaluated by three-point likert scale and selection ratio between distributed and accumulated reinforcement. As to performance, the increase of response rate per minute and correct response rate per minute in the accumulated reinforcement was greater than the distributed reinforcement only for the difficult task. There was no difference in preference. Implications and limitations of current research and suggestions for future research were discussed.

 
101. The Usage Pattern of Collection-Based Reinforcement System for Youths With Intellectual Disabilities
Area: DDA; Domain: Applied Research
Hoomyung Lee (Yonsei University), Seungeun Oh (Yonsei University), NARAE SHIN (Yonsei University)
Discussant: Sarah Slocum (Marcus Autism Center and Emory School of Medicine)
Abstract:

Despite the increasing number of intervention apps for youths with developmental disabilities (DD), studies on how much youths with DD are immersed in the reinforcement system of these apps are limited. The purpose of this study was to examine the usage pattern of the collection-based reinforcement system embedded in an intervention app to enhance the executive functions of youths with intellectual disabilities (ID). Participants were 34 youths aged from 7 to 15 with ID (IQ 50-70) only, or ID comorbid with other DD. Participants played six games for 10 to 15 minutes on a daily basis for 100 days at home. Based on attendance and performance, participants were given points with which they could purchase items from one of three collection themes of their choice (e.g., subway stations, songs, and traditional outfits). The results showed that 71% (N=24) of participants actively engaged in the reinforcement system, and half of them were heavy users who spent most of their points. However, 29% (N=10) of participants never or barely used their points for purchasing items. The results suggest that the collection-based reinforcement system can be effective in intervention apps for youths with ID, though for some, additional strategies are necessary.

 
102. Effects Of Paraprofessional Training In Errorless Teaching Procedures On Rate Of Acquisition Of Imitating And Matching Skills
Area: DDA; Domain: Applied Research
ANNIE LISA GREEN (University of West Florida; Arlington Community Schools)
Discussant: Sarah Slocum (Marcus Autism Center and Emory School of Medicine)
Abstract: Paraprofessionals ability to efficiently implement evidence based and systematic teaching procedures face many challenges in the special education classroom. Behavior Skills Training is one way to teach new skills through instructions, modeling, rehearsal, and feedback. Errorless teaching is an effective instructional strategy that paraprofessionals can use to teach new skills to students. Using a multiple base design, the fidelity of implementing an eight-step errorless teaching procedure by one paraprofessional in a preschool classroom was utilized to assess the acquisition rate of a student’s imitation and match to sample skills. Following errorless teaching training, there was not an increase rate in the students imitation or match to sample performance. Even with re-training and coaching, it was discovered that more intense training is required to trouble shoot within the errorless correction steps to ensure fidelity. Further refinement for future research in training paraprofessionals would consider the training environment, number of participants, and managing disruptive behavior between errorless steps.
 
104. A Preliminary Study of Evaluating an App-Based Neurorehabilitation Program for Youths With Developmental Disability
Area: DDA; Domain: Applied Research
HYEYEON JANG (University of Yonsei)
Discussant: Sarah Slocum (Marcus Autism Center and Emory School of Medicine)
Abstract:

One-on-one ABA training by professionals is a well-established treatment method for enhancing cognitive functions of youths with developmental disability (DD). However, in schools where minimizing manpower and costs is important, these interventions are rarely provided, possibly due to low accessibility and high costs. In this study, an app-based cognitive rehabilitation training program (YESS_Yonsei Executive function Training System for Special Kids) was developed and its effectiveness was evaluated. 28 youths with DD were assigned to two groups, the YESS(n=18) and the control group(n=10). YESS group completed 6 games per day while the control group did not receive any training for a mean of 56 days and their executive function, behaviors, and adjustments were assessed before and after the training or waiting time period. Parents and teachers completed questionnaires before and after the training. Results showed improvements in the planning and inhibition task, and a decrease in parental stress for both groups, but between-group interactions were not observed. Based on the detailed analysis of this YESS program, the development of app-based cognitive function improvement program and the future improvement of effectiveness verification research were proposed and discussed.

 
105. Considerations in the Selection of Representative and Practical Data Collection Methods
Area: DDA; Domain: Applied Research
JULIA IANNACCONE (Douglass Developmental Disabilities Center, Rutgers University), Kate E. Fiske Massey (Douglass Developmental Disabilities Center, Rutgers University), SungWoo Kahng (Rutgers University), Robert LaRue (Rutgers University)
Discussant: Sarah Slocum (Marcus Autism Center and Emory School of Medicine)
Abstract:

Practical matters should be considered when selecting a data collection method used by direct-care professionals (DCPs) tracking high rate behaviors. First, frequency can be compared to other methods, such as partial interval and momentary time sampling, through visual analysis. Second, the interobserver agreement (IOA) between DCP data and supervisory behavior analyst data can be evaluated to determine the feasibility of each method. Third, staff preference can also be considered by using a social validity questionnaire. After considering these factors and choosing a method, behavior skills training (BST) can be used to provide remedial training. The present study evaluated the results of using these three factors to select a practical and representative data collection method. Consistent results were found indicating that, for the present client diagnosed with autism, partial interval data was the appropriate data collection method. That is, higher similarity to frequency data in visual analysis, higher IOA between DCPs and supervisory behavior analysts, and an overall high preference was found for partial interval data. Subsequently, BST was used to successfully train DCPs to collect data with high IOA. The current study demonstrates the utility of these factors in determining data collection methods and the effectiveness of BST to provide remedial data training.

 
106. Comparison of Prompt Assignments Within Total Task Chaining
Area: DDA; Domain: Applied Research
DANIELA SILVA (Douglass Developmental Disabilities Center; Rutgers, The State University of New Jersey), Catherine Kishel (Douglass Developmental Disabilities Center; Rutgers, The State University of New Jersey), Kate E. Fiske Massey (Douglass Developmental Disabilities Center; Rutgers, The State University of New Jersey)
Discussant: Sarah Slocum (Marcus Autism Center and Emory School of Medicine)
Abstract:

Past research has shown the effectiveness of various prompt types in total task chains (e.g., Horner & Keilitz, 1975; Tekin-Iftar & Birkan, 2010), however, there is a lack of information in the literature regarding how to best assign prompts in the steps of total task chains. The purpose of the current study was to compare the effects on skill acquisition of three different prompt assignment methods within total task chaining. Using an alternating treatments design, this study compared the skill acquisition of five adolescents diagnosed with an autism spectrum disorder across single prompt (SP), multiple prompt (MP), and least-to-most (LTM) prompt assignment conditions. The SP method involved assigning the single most intrusive prompt needed to all the steps of a chain, whereas the MP method involved assigning the least intrusive prompt needed on each step of the chain. The LTM condition began each step with an opportunity for the participant to respond independently and the intrusiveness of the prompts increased until it occasioned the correct response. Initial results of five participants in phase 1 demonstrate idiosyncratic results across participants, with three participants acquiring the LTM condition, one acquiring the SP condition, and one acquiring the MP condition first. Data will be replicated in phase 2 with new task materials. Implications of the use of different prompt assignments within total task chaining will be discussed.

 
108. The Effects of Behavioral Skills Training and In Situ Feedback in Teaching Safety Skills to Young Adults With Developmental and Intellectual Disabilities
Area: DDA; Domain: Applied Research
DANIELLE WATSON (The Chicago School of Professional Psychology), Teresa Cardon (The Chicago School of Professional Psychology), Julie A. Brandt (The Chicago School of Professional Psychology )
Discussant: Sarah Slocum (Marcus Autism Center and Emory School of Medicine)
Abstract:

Individuals with developmental and/or intellectual disabilities are at an increased risk of maltreatment. A nonconcurrent multiple baseline design across participants was implemented to investigate the effects of behavioral skills training (BST) with in situ feedback to teach safety skill responses to adults with developmental and/or intellectual disabilities to prevent abduction, and physical and sexual abuse. Throughout the study, confederates delivered vocal statements to participants related to abduction, or physical or sexual abuse. Participants responded variably during baseline (e.g., attempts to comply with statements, vocalizing denial but failing to move to safety, failing to report any events to a trusted adult). Using BST and in situ feedback, participants learned a three-step response sequence (i.e., refusal, moving to safety, and reporting to a trusted adult). Participants’ scores remained higher than in baseline during the generalization phase, and participants maintained 100% accurate responding when probed at a two to four week follow-up. These results extend the evidence supporting the use of BST and in situ feedback as an effective intervention for teaching safety skills to a range of populations, across various dangerous situations, and sets the stage for many future research and practical safety training projects.

 
109. Beat the Clock: Goal Setting to Reduce Transition Time at a Residential Summer Camp
Area: DDA; Domain: Applied Research
BRADLEY SCOTT BLOOMFIELD (University of Alabama), Gemima Fauvel (University of Alabama), Zoe Miller (Tufts University)
Discussant: Sarah Slocum (Marcus Autism Center and Emory School of Medicine)
Abstract: Youth frequently have difficulties with timely transitions between activities (Hine, Ardoin, & Foster, 2015). Although there is an abundance of school-based research targeting challenging behavior, the field has less evidence of the application of these procedures to recreational settings. Summer camps have historically provided a space to target the prevention of problem behaviors (Thurber, Scanlan, Scheuler, & Henderson, 2007). The current study presents a brief intervention, titled “beat the clock”, to reinforce quick transitions to the next activity at a residential summer camp for youth with social, emotional, and behavioral challenges. Participants included 6 males 12-14 years of age. The study utilized an ABAB design. The intervention included a group goal for the time to walk to the next activity, and a visual countdown clock representing the time remaining to meet the goal. Following implementation of the intervention, there was a significant reduction in time required to transition to the next activity. Implications of the brief intervention at a residential summer camp will be discussed.
 
109A. Utilizing a Non-Concurrent Multiple Baseline to Limiting Risk During a Treatment Analysis
Area: DDA; Domain: Service Delivery
GABRIEL LOPERGOLO (Bancroft), Kelly Trucksess (Bancroft), Brittany Diamanti (Bancroft), Hailee Perez (Bancroft), Adrianna Whitman (Bancroft), Timothy Nipe (Bancroft)
Discussant: Sarah Slocum (Marcus Autism Center and Emory School of Medicine)
Abstract:

Self-injurious behavior (SIB) is a common topography among individuals diagnosed with developmental disabilities. Head directed self-injurious behavior can lead to significant and long-lasting injury and will typically require some form of intervention. Due to the dangerous nature of head directed self-injury, standard forms of assessment can put the individual at increased risk if allowed to engage in repeated instances of the behavior. In this study, a non-concurrent multiple baseline design across functions with latency as the dependent measure was utilized in order to establish experimental control. This approach limited repeated instances of SIB during baseline and eliminating the need for a return to baseline during treatment. Results indicated that latency to SIB increased when the Picture Exchange Communication System (PECS) was introduced across three identified functions: escape from demands, social avoidance, and access to tangible items. This study indicates that the use of latency as a dependent measure in combination with a multiple baseline design may offer clinicians an alternative to more traditional designs to decrease the risk of injury when SIB is the targeted behavior.

 
109B. Reducing Pica by Teaching the Exchange of Inedible Items
Area: DDA; Domain: Applied Research
KELSEY ELBON (Bancroft), Hailee Perez (Bancroft), Adrianna Whitman (Bancroft), Amanda Marie Finlay (Bancroft), Timothy Nipe (Bancroft)
Discussant: Sarah Slocum (Marcus Autism Center and Emory School of Medicine)
Abstract:

Pica, or the persistent ingestion of non-edible objects, is dangerous and may lead to various health implications such as gastrointestinal complications, lead poisoning, infections, and other dental health problems. Pica is challenging to treat, and is maintained in the absence of social consequences (Piazza, et. al. 1998). The identification and use of items that compete effectively with pica to reduce ingestion of inedible items has shown to work under very controlled conditions. However, the noncontingent delivery of items on a schedule rich enough to compete with pica may be difficult or even unethical to utilize over long periods of time. There is a small body of research has shown that utilizing differential reinforcement of an alternative behavior, i.e., the exchange of an inedible item, may reduce rates of pica, e.g., Kern, Starosta and Adelman, 2006, while circumventing some of these concerns. The current study demonstrates the efficacy of differentially reinforcing the exchange of edible items that had previously been identified to effectively compete with pica with the inedible items the individual encountered across sessions.

 
 

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