Mask Compliance Training for Individuals With Intellectual and Developmental Disabilities.

Since the arrival of the novel coronavirus, recommendations for public masking have emerged to decrease infection rates. For a variety of reasons, tolerating wearing a mask is challenging for many individuals with intellectual and developmental disabilities (IDDs). Therefore, we evaluated behavioral strategies to promote compliance with wearing a mask with six hospitalized individuals diagnosed with IDDs. One participant was compliant with wearing the mask for extended durations during baseline while engaging in various activities (e.g., academics, leisure). For the other five individuals, engagement in activities alone was ineffective. Blocking mask removal, reinforcement for mask wearing, and noncontingent access to preferred activities or competing stimuli were then evaluated using a changing-criterion design in which the duration participants were required to tolerate the mask gradually increased. Increases in compliance with mask wearing were achieved with all participants; however, the terminal duration was attained for only four of the five individuals. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40617-021-00583-7.

A Survey-Based Method to Evaluate Optimal Treatment Selection for Escape-Maintained Problem Behavior.

Geiger, Carr, and LeBlanc (2010) developed a decision-making model for escape-maintained problem behavior that could be used to guide the course of treatment selection. We used a digital survey to evaluate the model's potential usefulness. We presented novice and expert practitioners' written hypothetical scenarios and asked them to determine the optimal treatment in a given situation. Some participants were given the model, whereas others were instructed to use their best clinical judgment. Using logistic regression analyses, the general findings for our scenarios were the following: (a) experts without the aid of a decision model had better odds of selecting the optimal treatment than novices without the decision model, (b) experts with the decision model did not have greater odds of selecting optimal treatment than experts without the model, and

Behavior analytic approaches to problem behavior in intellectual disabilities.

PURPOSE OF REVIEW: The purpose of the current review is to summarize recent behavior analytic research on problem behavior in individuals with intellectual disabilities. We have focused our review on studies published from 2013 to 2015, but also included earlier studies that were relevant. RECENT FINDINGS: Behavior analytic research on problem behavior continues to focus on the use and refinement of functional behavioral assessment procedures and function-based interventions. During the review period, a number of studies reported on procedures aimed at making functional analysis procedures more time efficient. Behavioral interventions continue to evolve, and there were several larger scale clinical studies reporting on multiple individuals. There was increased attention on the part of behavioral researchers to develop statistical methods for analysis of within subject data and continued efforts to aggregate findings across studies through evaluative reviews and meta-analyses. SUMMARY: Findings support continued utility of functional analysis for guiding individualized interventions and for classifying problem behavior. Modifications designed to make functional analysis more efficient relative to the standard method of functional analysis were reported; however, these require further validation. Larger scale studies on behavioral assessment and treatment procedures provided additional empirical support for effectiveness of these approaches and their sustainability outside controlled clinical settings.

Parametric analysis of response interruption and redirection as treatment for stereotypy.

Response interruption and redirection (RIRD), a procedure in which demands are delivered contingent on stereotypy, has been shown to reduce vocal and motor stereotypy maintained by automatic reinforcement. However, RIRD can be time consuming and can interrupt ongoing activities and access to reinforcement for appropriate behavior. We attempted to address these limitations by comparing the effectiveness of RIRD using the standard 3-demand procedure to RIRD using just 1 demand. Results showed that RIRD with 1 demand was effective in reducing stereotypy for all participants, required fewer demands overall, and resulted in shorter implementation time. In addition, 2 participants showed an increase in appropriate play during RIRD. These results suggest RIRD with 1 demand may be an effective and less intrusive procedure for reducing stereotypy.

Parameters of reinforcement and response-class hierarchies.

Shabani, Carr, and Petursdottir (2009) examined the effects of a response-response relation (effort) on the development of a response-class hierarchy using a laboratory model. Response-reinforcer relations may have similar influences. Using a similar translational approach, we examined the effects of reinforcer rate, quality, delay, and magnitude in a series of separate experiments conducted with 8 individuals with intellectual disabilities. Response-class hierarchies emerged along the dimension of rate for 3 of 6 subjects, quality for 5 of 5 subjects, delay for 2 of 8 subjects, and magnitude for 5 of 6 subjects.

The effect of rules on differential reinforcement of other behavior.

Previous research on the treatment of problem behavior has shown differential reinforcement of other behavior (DRO) to be an effective behavior-reduction procedure. However, the extent to which presession descriptions of the DRO contingency enhance intervention effects has not been examined. In the current study, we compared a condition in which a presession rule that described the DRO contingency was given to a condition in which no rule was given for 4 participants. The target behavior was toy play, which served as an analogue to problem behavior maintained by automatic reinforcement. Results showed that DRO was more efficient for 1 participant and more effective for 2 participants when a rule was given.

Examination of the influence of contingency on changes in reinforcer value.

This study examined how the amount of effort required to produce a reinforcer influenced subsequent preference for, and strength of, that reinforcer in 7 individuals with intellectual disabilities. Preference assessments identified four moderately preferred stimuli for each participant, and progressive-ratio (PR) analyses indexed reinforcer strength. Stimuli were then assigned to one of four conditions for 4 weeks: fixed-ratio (FR) 1 schedule, escalating FR schedule, yoked noncontingent (NCR) delivery, and restricted access. Preference assessments and PR schedules were then repeated to examine changes in selection percentages and PR break points. Selection percentages decreased for all NCR stimuli but increased for most of the restricted stimuli. There were no systematic changes in selection percentages for either of the contingent stimuli. Break points increased, on average, for all conditions, but the increase was highest for the restricted stimuli and lowest for the NCR stimuli. These results are discussed in relation to recent basic research addressing the influence of effort on stimulus value.

The influence of matching and motor-imitation abilities on rapid acquisition of manual signs and exchange-based communicative responses.

Establishing a relation between existing skills and acquisition of communicative responses may be useful in guiding selection of alternative communication systems. Matching and motor-imitation skills were assessed for 6 children with developmental disabilities, followed by training to request the same set of preferred items using exchange-based communication and manual signs. Three participants displayed both skills and rapidly acquired both communicative response forms. Three others displayed neither skill; 1 mastered exchange-based responses but not manual signs, and neither of the other 2 easily acquired either response form.

On the correspondence between preference assessment outcomes and progressive-ratio schedule assessments of stimulus value.

The current study examined whether stimuli of different preference levels would be associated with different amounts of work maintained by the stimuli, as determined through progressive-ratio schedule break points. Using a paired-choice preference assessment, stimuli were classified as high, moderate, or low preference for 4 individuals with developmental disabilities. The stimuli were then tested three times each using a progressive-ratio schedule (step size of 1; the break-point criterion was 1 min). In 10 of 12 possible comparisons, higher preference stimuli produced larger break points than did lower preference stimuli.

Effects of conversational versus technical language on treatment preference and integrity.

Problem behaviors present a significant challenge for individuals with developmental disabilities and their caregivers. Interventions based on behavioral principles are effective in treating problem behaviors; however, some caregivers have difficulty adhering to treatment recommendations. Treatment adherence may be affected by the technical nature of behavioral terminology. Research suggests that caregivers better understand and are more comfortable with interventions described in conversational language; however, the effects of technical language on treatment implementation are unknown. In the current investigation, implementation of a behavioral treatment was monitored after caregivers were given either a technical or conversational description of the intervention. Implementation was more accurate when the treatment description was written in conversational language, suggesting that clinicians should write behavioral plans in conversational language.