Teaching autistic children to use sign language: some research issues.

Three questions are raised with respect to the use of sign language as an alternative system of communication for nonverbal autistic children. First, does teaching a child to sign facilitate speech development? The data suggest that following simultaneous communication training, mute children are not likely to learn to talk; however, a combination of simultaneous communication training and separate vocal training may have a synergetic effect on speech development. In contrast, children who initially have good verbal imitation skills apparently show gains in speech following simultaneous communication training alone. Second, what is the upper limit of sign acquisition? Data suggest that abstract concepts, syntax, and generative skills can be taught. Procedures used in the operant conditioning of speech may prove useful in training complex signing skills. Third, does sign acquisition result in a general improvement in adaptive functioning? It appears that following sign training, some children do show increases in spontaneous communication, decreases in self-stimulatory behavior, and improvement in social skills. However, these outcomes are often difficult to interpret. Some data are described that help clarify the relationship between sign training and general behavioral improvement.

Setting generality of peer modeling in children with autism.

Behavior development in normal children is greatly facilitated by peer modeling. Unfortunately, autistic children do not typically imitate their normal peers. The present study was undertaken to identify variables that facilitate the acquisition of peer imitation and promote setting generality of imitative skills once they have been acquired. We selected a common preschool activity (Follow-the-Leader) as the vehicle for studying modeling effects. Four preschool children with autism took part in an intervention in which a normal peer demonstrated and, if necessary, physically prompted a variety of actions and object manipulations that defined the activity. Following training, all four children generalized their imitative skill to a new setting involving new actions and object manipulations. Results are discussed with respect to the potentially important role that the use of multiple training objects and/or responses play in enhancing attention to the model and facilitating setting generality as well as the role that intrinsically reinforcing activities may play in maintaining acquired peer imitation.

Functional equivalence of autistic leading and communicative pointing: analysis and treatment.

Several studies have demonstrated that behavior problems can be reduced by teaching new, socially desirable responses that serve the same function as the undesirable behaviors being replaced. The present study was undertaken to extend this strategy systematically to a different area of child development, specifically, language disorder. A less desirable form of requesting, autistic leading, was treated by strengthening a more desirable form of requesting, pointing. The study was conducted using a multiple baseline design across four children with autism. Intervention included verbal and physical prompting of the pointing response as well as tangible reinforcement for child-initiated instances of that response. In a later phase, verbal requesting was also taught to accompany the pointing. Following intervention, response generalization was observed; that is, as pointing became frequent, leading became rare. In addition, stimulus generalization was observed; that is, pointing was exhibited in the presence of new adults, new settings, and new tangible objects. Results are discussed with respect to the principle that functional equivalence and response efficiency can be combined procedurally to treat a variety of undesirable behaviors in an educationally constructive manner.

Acquisition of sign language by autistic children. III: Generalized descriptive phrases.

Sign language training has emerged as a viable alternative to speech for those autistic children who remain nonverbal in spite of remediation efforts. Yet the variables responsible for the acquisition of specific signing skills have not been fully investigated. The present study was undertaken to validate experimentally a portion of a general language intervention program developed by the authors. Specifically, we focused on descriptive signing that involved action-object phrases. Four autistic children were successfully taught such phrases following an intervention composed of prompting, fading, stimulus rotation, and differential reinforcement. After being trained on a small number of action-object phrases, the children displayed skill generalization to new situations. The results were discussed with respect to the likely need for added incidental teaching to bring about communicative use of the skills taught.

Control of echolalic speech in psychotic children.

Immediate echolalia, a common language disorder in psychotic children, was studied in a series of replicated single-subject designs across six schizophrenic and five normal children. In Experiment 1, each child was presented with several questions and commands, some of which set the occasion for specific, appropriate responses and some of which did not. The former were referred to as discriminative stimuli and the latter, as neutral stimuli. The psychotic children tended to echo the neutral stimuli while responding appropriately to the discriminative stimuli; the normal children, in contrast, typically echoed neither type of stimulus. In Experiment 2, three psychotic children were taught appropriate responses to each of several neutral stimuli. Following this training, the children generally responded appropriately to these stimuli without echoing. A plausible interpretation of these results is that the neutral stimuli were initially incomprehensible or meaningless to the children (whereas the discriminative stimuli were comprehensible or meaningful) and that verbal incomprehensibility may be one important determinant of immediate echolalia. Finally, the results are noteworthy in that they isolate a sufficient treatment variable (i.e., the reinforcement of alternative, nonecholalic responses) for eliminating instances of this language anomaly.

Stimulus control of self-destructive behavior in a psychotic child.

This study attemped to isolate some of the stimulus variables that controlled the self-destructive behavior of a psychotic child. In Experiment 1, the child was exposed to several demand and nondemand situations. In Experiment 2, the situation containing demands was modified so that demands now occurred in the context of a positive, ongoing interaction between the child and the adult therapist. The rates of self-destructive behavior underwent several orderly changes: (1) Rates were high in demand situations and low in nondemand and modifieddemand situations; (2) rates decreased sharply when a stimulus correlated with the termination of demands was introduced; and (3) rates of self-destruction typically showed gradual increases within each of those sessions which contained only demands. These results were interpreted as suggesting that (1) self-destruction, under certain circumstances, may be conceptualized as an escape response which is negatively reinforced by the termination of a demand situation and (2) certain modifications of the social environment may provide discriminative stimuli for behaviors other than self-destruction, thereby decreasing this behavior.

Some relationships between informant assessment and functional analysis of problem behavior.

The strengths and limitations of informant assessment of problem behavior was investigated through examination of such behavior across seven situations and 3 participants. The results of informant assessment were compared to those obtained from functional analysis to determine some of the parameters under which informant assessment might provide a practical alternative to functional analysis. The results showed that informant hypotheses about the function of problem behavior were validated by subsequent functional analyses only when informants identified their hypotheses as involving situations likely to evoke problem behavior. Hypotheses involving situations that informants rated as less likely to evoke problem behavior were not validated by subsequent functional analyses. The implications of these findings for improving the validity of informant assessment are discussed.

Temporal inhibition: effects of changes in rate of reinforcement and rate of responding.

Pigeons were trained to key peck on several multiple schedules in which the first of two components was always a simple fixed-interval schedule. The rate of responding at the beginning of the constant fixed-interval schedule was found to decrease with increases in the rate of reinforcement associated with the other component of the multiple schedule, but remained unchanged with decreases in the rate of responding associated with the other component. These results were interpreted as being consistent with the view that the presence and magnitude of the temporal inhibitory effects observed in a given fixed-interval schedule are a function of the properties of reinforcing stimuli, rather than of changes in the rate of responding associated with the time interval immediately preceding the fixed interval in question.

Severe problem behaviors related to social interaction. 1: Attention seeking and social avoidance.

Studies concerning the functional analysis of severe problem behaviors have suggested that it is important to identify the different categories of stimuli that control problem behavior because each has unique treatment implications. The present study explored the differential effects of adult attention on the severe problem behaviors of two groups of children with developmental disabilities. A third group of nonproblem children was examined for comparison purposes. Children participated in three experimental conditions in which the level of adult attention was manipulated: noncontingent high attention, noncontingent low attention, and contingent attention. Results validated the existence of two groups of children who differed as to their social orientation: (a) One group of children commonly initiated social interactions and was most likely to exhibit problem behaviors under conditions of low adult attention, and (b) the other group of children rarely initiated social interactions and exhibited frequent problem behaviors under conditions of high adult attention. Implications of these data for escape and attention theories of child problem behavior are discussed, as are the applied implications for reinforcer assessment and teaching strategies.

Severe problem behaviors related to social interaction. 2: A systems analysis.

The effects of problem behavior displayed by two groups of children with developmental disabilities was investigated. One group of children exhibited problem behavior under conditions of low adult attention and was referred to as the attention-seeking or AS behavior profile group. A second group of children exhibited problem behavior under conditions of high adult attention and was referred to as the socially avoidant or SA behavior profile group. A third group of nonproblem children (NP) was examined for comparison purposes. Pairs of children were placed in a teaching situation, and the effects of child problem behavior upon adult instructional behavior were measured. Results indicated that child behavior affected adult behavior and that different child behavior profiles affected adults differentially. Adults responded to the problem behaviors of the AS behavior profile group by increasing attention, providing higher levels of physical contact, and presenting academic tasks that required continuous adult-child interaction. Conversely, the same adults responded to the problem behaviors of the SA behavior profile group by reducing attention, providing lower levels of physical contact, and presenting academic tasks that required little adult-child interaction. The data indicated that these child effects were powerful, immediate, and durable. Theoretical implications concerning reciprocal social influence and the operant theory of child problem behavior are discussed. Applied implications concerning treatment selection and maintenance are also explored.

The effects of child behavior problems on the maintenance of intervention fidelity.

Maintenance of behavior change has been considered a crucial, through largely unrealized, goal of behavioral interventions. One often overlooked factor is that before interventions can be successful and durable, the intervention protocol must be implemented as planned. This study investigated the effects of child behavior problems on the maintenance of intervention fidelity by teachers across two intervention protocols: escape extinction and functional communication training. A high rate of behavior problems during escape extinction appeared to punish teachers' efforts, and fidelity deteriorated. In contrast, there was a low rate of behavior problems during functional communication training. Teachers maintained high protocol fidelity and those sessions were less stressful and more productive. We propose that intervention protocols can be differentiated by the costs associated with implementing them faithfully. Protocols designed to be user friendly will be more likely to produce high fidelity, and therefore, durable intervention gains.

Food selectivity and problem behavior in children with developmental disabilities. Analysis and intervention.

Excessive food selectivity typifies some children with developmental disabilities. We conducted functional analyses to determine the controlling variables for problem behavior that accompanied food selectivity and analyzed the role of establishing operations in ameliorating food selectivity. Specifically, we studied the differential effects on intervention efficacy of an individual's having or not having access to preferred food items prior to an intervention that involved the presence versus absence of a positive reinforcement contingency applied to food consumption. Participants displayed significantly more problem behavior during the nonpreferred-foods condition. Participants consumed nonpreferred target food items only when prior access to preferred foods was limited and a positive reinforcement contingency was implemented. Functional analysis suggested that problem behavior was maintained by negative reinforcement. Intervention data suggested that establishing operations increased the efficacy of the contingency-based intervention. The implications of applying this intervention in the community were discussed as were the relative merits of stimulus fading versus escape extinction intervention strategies.

Emerging themes in the functional analysis of problem behavior.

The functional control of problem behavior is generally conceptualized as involving attention, escape, sensory reinforcement, and tangible factors. Our analytic tools have now reached a level of sophistication that makes possible consideration of several new, emerging themes in the area of functional analysis. First, we need to examine other functional properties of problem behavior involving social avoidance, biological reinforcement, and respondent conditioning factors. Second, we need to explore the role of context, including social factors such as group interactions, sequencing of tasks and activities, presence or absence of specific individuals, and crowding; as well as biological factors, such as physical illness, exercise, and drugs. Finally, we must consider the multidimensional character of assessment in naturalistic settings and the practical need for developing descriptive analytic procedures that complement and produce results that are congruent with those obtained from traditional functional analyses.

Reduction of severe behavior problems in the community using a multicomponent treatment approach.

Problem behavior often prevents community integration of people with developmental disabilities. Therefore, we evaluated a multicomponent approach for remediating problem behavior in public community settings (specifically, supermarkets). We selected treatments based on hypotheses about the variables controlling the problem behavior (hypothesis-driven model). The multicomponent intervention included choice making, embedding, functional communication training, building tolerance for delay of reinforcement, and presenting discriminative stimuli for nonproblem behavior. Treatment progress was monitored using measures of latency and task completion rather than traditional measures of frequency and time sampling. Results showed substantial increases in task completion and duration of time spent in supermarkets without problem behavior. Outcomes were socially validated by group-home staff and cashiers. We discuss how the intervention approach taken can resolve some of the issues involved in assessing, measuring, and treating problem behavior in the community.

Social influences on "self-stimulatory" behavior: analysis and treatment application.

We tested the hypothesis that the "self-stimulatory" behaviors exhibited by some individuals may be socially mediated. Four developmentally disabled children who exhibited hand flapping and body rocking participated in a series of three experiments conducted to assess the influence of social variables on stereotyped behavior and to develop a treatment based on the assessment. Experiment 1 used an assessment procedure to determine the relative influences of social attention and task demands on stereotyped behavior. For all four children, hand flapping and body rocking increased when difficult academic tasks were introduced. Experiment 2 involved the use of a procedural time-out and demonstrated that removing task demands contingent on stereotyped behavior resulted in increased rates of hand flapping and body rocking. In Experiment 3, these results were used to develop a communication treatment that consisted of teaching the children to request assistance on the difficult tasks. This treatment resulted in significant reductions in self-stimulatory behavior. These results are consistent with the hypothesis that some forms of repetitive stereotyped behavior may come to serve social functions (e.g., escape from aversive situations). Teaching a functionally equivalent communicative alternative to escape-motivated stereotyped behavior can be an effective form of intervention for this problem.

An analysis of maintenance following functional communication training.

The multiple and long-term effects of functional communication training relative to a common reductive procedure (time-out from positive reinforcement) were evaluated. Twelve children participated in a functional analysis of their challenging behaviors (Study 1), which implicated adult attention as a maintaining variable. The children were then matched for chronological age, mental age, and language age and assigned to two groups. One group received functional communication training as an intervention for their challenging behavior, and the second group received time-out as a contrast. Both interventions were initially successful (Study 2), but durable results were achieved only with the group that received functional communication training across different stimulus conditions (Study 3). Students whose challenging behaviors were previously reduced with time-out resumed these behaviors in the presence of naive teachers unaware of the children's intervention history. The value of teaching communicative responses to promote maintenance is discussed as it relates to the concept of functional equivalence.

Functional communication training to reduce challenging behavior: maintenance and application in new settings.

We evaluated the initial effectiveness, maintenance, and transferability of the results of functional communication training as an intervention for the challenging behaviors exhibited by 3 students. Assessment indicated that escape from academic demands was involved in the maintenance of the challenging behaviors. Social attention was also implicated as controlling the behavior of 1 student. The intervention involved teaching alternative assistance-seeking and attention-getting phrases to the students in an effort to replace challenging behavior with these verbal equivalents. Multiple baseline data collected across the 3 students indicated that not only did the intervention substantially reduce challenging behavior but also that these results transferred across new tasks, environments, and teachers, and were generally maintained from 18 to 24 months following the introduction of functional communication training. These results are discussed in light of recent efforts to develop effective interventions for severe challenging behavior and to understand the processes underlying transfer and maintenance of intervention effects.

Reducing behavior problems through functional communication training.

It is generally agreed that serious misbehavior in children should be replaced with socially appropriate behaviors, but few guidelines exist with respect to choosing replacement behaviors. We address this issue in two experiments. In Experiment 1, we developed an assessment method for identifying situations in which behavior problems, including aggression, tantrums, and self-injury, were most likely to occur. Results demonstrated that both low level of adult attention and high level of task difficulty were discriminative for misbehavior. In Experiment 2, the assessment data were used to select replacements for misbehavior. Specifically, children were taught to solicit attention or assistance or both verbally from adults. This treatment, which involved the differential reinforcement of functional communication, produced replicable suppression of behavior problems across four developmentally disabled children. The results were consistent with an hypothesis stating that some child behavior problems may be viewed as a nonverbal means of communication. According to this hypothesis, behavior problems and verbal communicative acts, though differing in form, may be equivalent in function. Therefore, strengthening the latter should weaken the former.

Acquisition of sign language by autistic children. II: Spontaneity and generalization effects.

Autistic children typically do not use their language repertoire in order to communicate. Six autistic children who exhibited poor communication skills were trained to use their sign repertoire to make spontaneous requests of adults. Training consisted of imitative prompting, fading, and differential reinforcement, and included aspects of incidental teaching. The children displayed an increase in the rate and variety of spontaneous sign requests (Experiment 1). Generalization of spontaneity across adults (Experiments 1 and 2) and settings (Experiment 2) was also observed. We suggest that spontaneity may be facilitated when language is brought under the control of broadly defined stimuli such as adult attention rather than narrowly defined stimuli such as the presence of specific objects or verbal prompting in the form of questions. Finally, response generalization was observed as well (Experiment 1). Specifically, as spontaneity increased, self-stimulatory behavior decreased. This result may be accounted for in terms of reinforcer competition, reinforcer consistency, or discriminative stimulus effects.

Elimination of echolalic responding to questions through the training of a generalized verbal response.

Echolalia, the parroting of the speech of others, is a severe communication disorder frequently associated with childhood schizophrenia and mental retardation. Two echolalic children, one schizophrenic and one retarded, were treated in a multiple-baseline design across subjects. Each child was taught to make an appropriate, non-echolalic verbal response (i.e., "I don't know") to a small set of previously echoed questions. After such training, this response generalized across a broad set of untrained questions that had formerly been echoed. The results obtained were the same irrespective of the specific experimenter who presented the questions. Further, each child discriminated appropriately between those questions that had previously been echoed and those that had not. Followup probes showed that treatment gains were maintained one month later. The procedure is economical, in that it produces a rapid and widespread cessation of echolalic responding.