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| Recent Advances in the Tretment of Severe Behavior Disorders Maintained by Automatic Reinforcement |
| Monday, May 30, 2005 |
| 10:30 AM–11:50 AM |
| Stevens 2 (Lower Level) |
| Area: DDA; Domain: Applied Research |
| Chair: Joel Eric Ringdahl (University of Iowa) |
| Abstract: The successful treatment of aberrant behavior maintained by automatic reinforcement continues to be an important area of research within applied behavior analysis and developmental disabilities. Varyious treatment approaches have been successful in reducing aberrant behavior maintained by automatic reinforcement. In the proposed symposium, four papers will be presented providing examples of these various approaches. Specific approaches evaluated will include antecedent manipulations (e.g., prompting or noncontingent reinforement), differential reinforcement, a combination of antecedent and contingency-based treatment approaches, and the use of restraint. For each approach, novel extensions of the current literature will be provided. |
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| Altering Aumatically-Reinforced Sterotypy: The Effects of Direct and Indirect Intervention |
| KATHLEEN M. CLARK (New England Center for Children), Mary K. Kubala (ASTAR Center), William H. Ahearn (New England Center for Children) |
| Abstract: We have examined the effects of both direct (response interruption plus redirection) and indirect (response independent access to preferred activities) interventions for treating stereotypy maintained by automatic reinforcement. Both procedures are generally effective for decreasing stereotypy, however, indirect treatment does not provide an active redirection of behavior. If contextually appropriate behavior occurs without prompting, it may be preferable to use more intensive direct intervention. This presentation will illustrate the effects of direct treatment for stereotypy for four children diagnosed with an Autism Spectrum Disorder. For all participants functional analysis found stereotypy to be maintained by automatic reinforcement. With the first student, direct and indirect interventions were directly compared via a multi-element design. Direct intervention produced lower levels of stereotypy than indirect intervention. However, lower levels of appropriate behavior occurred. With the three remaining participants, the effects of adding materials to the treatment context in which direct intervention was implemented was examined to determine if unprompted appropriate behavior would be fostered. It was found that adding materials to the treatment setting resulted in increased levels of independent appropriate behavior. Interobserver agreement data were collected in all phases of the analyses and intervention comparisons and mean total agreement scores exceeded 85%. |
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| Use of a Differential Reinforcement Procedure to Reduce Problem Behavior Maintained by Automatic Reinforcement |
| JASON M. STRICKER (University of Iowa), Wendy K. Berg (University of Iowa), Joel Eric Ringdahl (University of Iowa), David P. Wacker (University of Iowa), Kelly M. Vinquist (University of Iowa) |
| Abstract: Functional analyses conducted for two boys with mental retardation indicated that problem behavior (self-injury for Charlie and property destruction for Steven) was maintained by automatic reinforcement. A concurrent operants assessment was conducted to identify social stimuli that were relatively more preferred than the automatic reinforcement associated with problem behavior. At least one set of social stimuli that competed effectively with automatic reinforcement (i.e. the alternative stimuli were selected to the exclusion of access to automatic reinforcement) was identified for each boy. A differential reinforcement of alternative behavior (DRA) treatment was implemented using the social stimuli identified in the concurrent operants as the reinforcer for engaging in the alternative response. The alternative response was one manipulation of a nonpreferred toy without engaging in problem behavior. Reversals were conducted to the play condition of the functional analysis because the play and DRA sessions contained the same antecedent stimuli (toys and attention) and only differed in the consequences for problem behavior, thereby allowing an evaluation of the effects of the DRA contingency on behavior. The DRA treatment resulted in a 92% reduction in problem behavior for Steven and 78% reduction for Charlie. Interrater agreement scores averaged 96% for Charlie and 93% for Steven. |
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| Examination of Treatment Procedures for Increasing Approprite Item Engagement and Decreasing Stereotypy During Preference Assessments |
| HEATHER MORRISON (New England Center for Children), Eileen M. Roscoe (New England Center for Children), Carly Moher Eby (New England Center for Children) |
| Abstract: A number of studies have shown an inverse relationship between behavior maintained by automatic reinforcement and item engagement. Lindberg, Iwata, and Kahng (1999) did not, however, observe reductions in participants’ automatically reinforced SIB as a result of increased item engagement. Response blocking and protective equipment was necessary to reduce problem behavior. The purpose of this study was to extend this line of research by comparing the effects of two commonly used treatment procedures (i.e., prompting and reinforcement) for increasing appropriate item engagement and decreasing problem behavior in the context of a duration-based preference assessment. A functional analysis was conducted to verify that participants’ behavior (i.e., mouthing, hand flapping) was maintained by automatic reinforcement. Following this, a series of duration-based preference assessments were conducted during which leisure items were singly presented for 3 min each. Within the context of the preference assessment, two treatment procedures, prompting and prompting with reinforcement, were compared using a reversal design. Results indicated that prompting alone was effective in increasing appropriate item engagement and decreasing problem behavior; however, reinforcement was necessary to obtain clinically acceptable levels of item engagement and problem behavior. Interobserver agreement was assessed during 33% of sessions and averaged above 90%. |
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| Restraint Fading as a Treatment for SIB: Determination of the Least Restrictive Starting Point |
| JOHN M. HUETE (Kennedy Krieger Institute), SungWoo Kahng (Kennedy Krieger Institute), Stephanie A. Contrucci Kuhn (Kennedy Krieger Institute), Patricia F. Kurtz (Kennedy Krieger Institute), Heather M. Teichman (Kennedy Krieger Institute), Geri Ruffin (Kennedy Krieger Institute), Thompson Davis (Kennedy Krieger Institute), Lindsay S. Hauer (Kennedy Krieger Institute) |
| Abstract: In cases of severe hand-to-head SIB, arm splints are sometimes used to prevent severe injury. Although arm splints inhibit hand-to-head SIB, they also interfere with adaptive skills that require arm movements. Procedures for gradually fading arm sleeve rigidity and increasing flexion have been reported (Fisher et al., 1997); but, these can be lengthy with the individual spending extended periods in unnecessarily restrictive arm sleeves. Wallace et al. (1997) described a procedure for evaluating the minimum level of rigidity necessary to maintain low rates of SIB and higher levels of adaptive behavior when using arm splints. We used this methodology to determine the starting point for restraint fading. The participants were four individuals who engaged in very severe SIB. The results provided additional support that the restraint analysis identifies an effective but less restrictive starting point for arm splints, has less of an adverse impact on adaptive behavior, and may circumvent problems that arise from an excessively restrictive restraint protocol. |
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