Approaches for Treating Multiply Controlled Problem Behavior.

A portion of problem behavior is maintained by multiple reinforcement contingencies. Treating multiply controlled problem behavior may be more complex than treating problem behavior maintained by a single contingency. Several approaches for addressing multiply controlled problem behavior have been described in the literature. The purpose of this review is to provide practitioners with an overview of function-based approaches for addressing multiply controlled problem behavior. In particular, we present guidelines for functional analysis and treatment. We also describe strengths and limitations of published treatment approaches and discuss strategies for mitigating these limitations. Finally, we describe areas for future research.

Behavioral contrast: An exploratory survey of practitioner experiences.

Behavioral contrast is defined as a change in reinforcement conditions in one context that causes a change in behavior in the opposite direction in another, unchanged context. Although behavioral contrast has implications for applied behavior analysts, researchers have not examined ramifications or identified common methods of mitigating contrast in applied settings. Therefore, we surveyed Board Certified Behavior Analysts in an exploratory investigation to determine practitioner experiences with behavioral contrast. Participants' responses reflected a variety of themes: contrast resulted in conversations with stakeholders; supporting stakeholders and mitigating factors are important; contrast is due to inconsistencies across settings; and contrast affects stakeholder buy-in, hurts rapport or relationships, and produces negative emotions. Our results suggest that contrast is not an innocuous occurrence in applied settings. We recommend a variety of areas for future research to further predict and control contrast and to identify the extent to which it affects clinical practice.

Evaluating a treatment without extinction for elopement maintained by access to stereotypy.

Elopement is a common and potentially dangerous form of problem behavior. Results of a functional analysis found that the elopement of a child with autism was maintained by access to stereotypy in the form of door play. We implemented functional communication training and contingency-based delays dependent on the absence of elopement and increased the amount of time the participant waited prior to engaging in stereotypy. We also conducted treatment-extension probes, with the participant waiting up to 10 min without elopement.

Evaluation of a trial-based interview-informed synthesized contingency analysis.

We evaluated the viability of an interview-informed synthesized-contingency analysis (IISCA) conducted in a trial-based format with 3 children with autism spectrum disorders who engaged in problem behavior. We compared results to those from typical trial-based and traditional functional analyses and found high degrees of correspondence. The trial-based IISCA format took the least amount of time to conduct and was associated with the lowest frequencies of problem behavior. Results are discussed in terms of merits of each of the 3 types of functional analysis arrangements and directions for future research.

Functional Communication Training for Multiple Reinforcers: an Evaluation of Isolated Control Following a Synthesized Context.

We evaluated the effectiveness of teaching 2 functionally and topographically dissimilar communication responses within the same sessions following a functional analysis with a synthesized contingency. We also conducted stimulus-control probes to determine the extent to which communication responses and problem behavior occurred when each contingency was presented in isolation. The child in the current study acquired communicative responses for both reinforcers, and problem behavior decreased during functional communication training (FCT). Further, relevant communication responses occurred in the respective stimulus-control probes. Results are discussed in terms of implications for research and practice regarding methods for conducting FCT following functional analyses with synthesized contingencies.

Treatment of Elopement Without Blocking With a Child With Autism.

Elopement is a dangerous behavior common in children with autism spectrum disorder (ASD). Relative to other forms of problematic behavior, elopement has received little attention in both assessment and treatment. The current study entailed a functional analysis of elopement of one child with ASD, results of which suggested a partially automatic function. We then evaluated a differential reinforcement procedure, along with a rule, which successfully decreased elopement without the use of blocking. A changing-criterion design embedded within a withdrawal design was used to gradually increase the criterion for maintaining a close proximity to a therapist prior to being allowed to run.

Behavioral contrast: Research and areas for investigation.

Behavioral contrast occurs when a change in reinforcement rate in one context results in a change in behavior in the opposite direction in an unchanged context. Despite decades of study by basic researchers, behavioral contrast has remained largely an unstudied phenomenon among applied researchers. The purpose of this paper is to occasion translational and applied research on behavioral contrast with the aim of predicting and controlling socially significant behavior in unchanged contexts. We present a brief history of contrast and related definitions, review research with human and nonhuman subjects, and suggest future directions for applied and translational researchers.

Systematic Review of Functional Analysis and Treatment of Elopement (2000-2015).

Elopement is a dangerous behavior that is emitted by a large proportion of individuals with intellectual and developmental disabilities. Functional analysis and function-based treatments are critical in identifying maintaining reinforcers and decreasing elopement. The purpose of this review was to identify recent trends in the functional analysis and treatment of elopement, as well as determine the efficacy (standardized mean differences) of recent treatments. Over half of subjects' elopement was maintained by social positive reinforcement, while only 25% of subjects' elopement was maintained by social negative reinforcement. Elopement was rarely maintained by automatic reinforcement, and none of the studies in the current review evaluated treatments to address automatically maintained elopement. Functional communication training was the most common intervention regardless of function. Results are discussed in terms of clinical implications and directions for future research.

Preference and reinforcer efficacy of high- and low-tech items: A comparison of item type and duration of access.

This study examined the interactions of stimulus type (high- vs. low-tech) and magnitude (duration of access) on preference and reinforcer efficacy. Two preference assessments were conducted to identify highly preferred high-tech and low-tech items for each participant. A subsequent assessment examined preference for those items when provided at 30-s and 600-s durations. We then evaluated reinforcer efficacy for those same items when provided for a range of durations using progressive-ratio schedules. Results suggested item type and access duration interacted to influence preference and reinforcer efficacy. Participants preferred high-tech items at longer durations of access and engaged in more responding when the high-tech item was provided for long durations, but these patterns were reversed for the low-tech item. In addition, participants engaged in less responding when the high-tech item was provided for short durations and when the low-tech item was provided for long durations.

Assessing preference for social interactions.

We examined a procedure to assess preference for social interactions in individuals with intellectual and developmental disabilities. Preferences were identified in five individuals using a paired-choice procedure in which participants approached therapists who provided different forms of social interactions. A subsequent tracking test showed that participants' approaches were under control of the form of social interaction provided as opposed to idiosyncratic features of the therapists. Results of a reinforcer assessment found that the social interaction identified as preferred also functioned as a reinforcer for all five participants.

Effects of preference and reinforcer variation on within-session patterns of responding.

We examined correspondence between preference assessment outcome and within-session patterns of responding in one subject with autism. Responding maintained by a single highly preferred item resulted in a greater total number of responses, a slower decline in within-session response rates, and a greater proportion of short interresponse times compared to responding maintained by varied moderately preferred (MP) stimuli. Presenting varied MP stimuli within the same session produced greater levels and more sustained responding than presenting those same stimuli individually.