Single- vs. combined-category preference assessments for edible, leisure, and social-interaction stimuli.

A concern when conducting combined-category preference assessments is the potential for displacement effects, a shift in the preference ranking from highly preferred to moderately or less preferred for stimuli in two of three stimulus categories (e.g., edible, leisure, or social-interaction). In this study, we evaluated potential displacement effects in combined-category arrays of edible, leisure, and social-interaction stimuli for five individuals with autism. First, single-category paired-stimulus preference assessments were implemented to identify two highly preferred stimuli from each category. When these stimuli were included in a combined-category preference assessment, displacement effects were observed for three of five participants. During a subsequent reinforcer assessment, stimuli identified as less preferred in the combined-category preference assessment functioned as reinforcers for two participants. Additionally, although social interaction was not identified as highly preferred for three of the five participants, it functioned as a reinforcer for four participants.

A comparison of brief and extended session duration functional analyses.

Many behavior analysts do not conduct a functional analysis (FA) prior to treatment in a clinical setting (e.g., Roscoe et al., 2015). When asked for an explanation, respondents commonly report that an FA is too time consuming. One way to address this perceived constraint is to evaluate the utility of an abbreviated FA with 5-min session durations. In the current study, 2 independent FAs, 1 with 5-min sessions and 1 with 10-min sessions, were conducted for the problem behavior of 5 individuals diagnosed with autism spectrum disorder (ASD). For all participants, the 5- and 10-min session duration FAs yielded the same identified function of problem behavior: escape from demands. A brief differential reinforcement of alternative behavior (DRA) analysis was subsequently conducted and found to be effective at decreasing problem behavior and increasing an appropriate communication response across participants. These findings demonstrate the utility of conducting an FA using briefer session durations followed by a brief DRA analysis.

Noncontingent reinforcement: Arbitrary versus maintaining reinforcers for escape-maintained problem behavior.

Noncontingent reinforcement (NCR) involves the delivery of maintaining reinforcers on a time-dependent schedule and often includes extinction. However, arbitrary reinforcers may be equally efficacious during NCR without extinction for treating escape-maintained problem behavior. The purpose of this study was to extend previous research on NCR by evaluating the relative efficacy of NCR without extinction and comparing maintaining versus arbitrary reinforcers for 4 individuals with escape-maintained problem behavior. Two different NCR conditions, NCR using the maintaining reinforcer (escape) and NCR using an arbitrary reinforcer (an edible), were evaluated using multielement and reversal designs. Treatment effects varied across participants. Results for 2 participants showed a reduction in problem behavior during NCR without extinction with both the arbitrary and maintaining reinforcers. For 1 participant, results showed a reduction in problem behavior with both the arbitrary and maintaining reinforcers only when extinction was added to NCR. For the 4th participant, the maintaining reinforcer was effective during NCR without extinction, but the arbitrary reinforcer was ineffective.

Increasing item engagement and decreasing automatically reinforced problem behavior within a modified competing stimulus assessment.

A competing stimulus assessment (CSA) is commonly used to identify leisure items for use in treatments designed to decrease automatically reinforced problem behavior. However, this type of assessment may not yield useful information if participants do not readily engage with leisure items. The purpose of this study was to evaluate a modified CSA that included additional treatment components (i.e., prompting, prompting plus differential reinforcement of alternative behavior). The modified CSA identified the treatment components and leisure items that were most effective for increasing leisure-item engagement and decreasing problem behavior for each participant. Modified CSA outcomes maintained during an extended treatment analysis in a natural setting and when intervention components were faded.

Negative reinforcer magnitude manipulations for treating escape-maintained problem behavior.

The purpose of the current study was to evaluate the effects of different magnitudes of escape for compliance relative to the magnitudes of escape for problem behavior in a concurrent-schedule arrangement. Three individuals who exhibited escape-maintained problem behavior participated. A large differential magnitude condition (240-s escape for compliance, 10-s escape for problem behavior) was compared to equal (30-s escape for compliance and problem behavior) and moderate differential magnitude (90-s escape for compliance, 10-s escape for problem behavior) conditions. The authors also evaluated the impact of correcting for reinforcer access time (i.e., time on escape intervals) on intervention interpretation. For all participants, problem behavior decreased during only the large differential magnitude condition, and including reinforcer access time in the overall session time did not affect interpretation of treatment outcomes. Providing larger escape magnitudes for compliance relative to problem behavior may facilitate treatment involving concurrent-reinforcement schedules for escape-maintained problem behavior.

An evaluation of differential reinforcement with stimulus fading as an intervention for medical compliance.

Individuals with autism spectrum disorder (ASD) often exhibit noncompliance during medical exams. One intervention used to address this concern is differential reinforcement. Although differential reinforcement includes extinction, it may not be feasible or safe to implement extinction during medical exams. In the current study, we evaluated differential reinforcement without extinction and differential reinforcement without extinction plus stimulus fading, for increasing compliance during routine medical exams exhibited by 4 individuals with ASD. An indirect assessment identified problematic medical procedures, and a functional analysis showed that participants' disruptive behavior was maintained by escape from medical tasks. Differential reinforcement without extinction was insufficient in increasing medical compliance with 3 of 4 participants. The addition of a modified stimulus fading procedure that involved gradually introducing smaller components of problematic exam steps was effective in increasing medical compliance with all exam steps.

Evaluation of an indirect assessment for identifying tasks for functional analysis.

Although a demand analysis is helpful for identifying potential establishing operations for the functional analysis (FA) demand condition, it may not always be practical due to time constraints. A potential alternative is the Negative Reinforcement Rating Scale (NRRS), an indirect assessment tool that may serve as a time efficient alternative to a demand analysis. The experimenter assessed the reliability and validity of the NRRS for 5 individuals with autism spectrum disorder who exhibited problem behavior. Multiple types of interrater reliability were assessed across 2 informants, and NRRS outcomes were compared to a subsequent demand analysis and FA to assess its validity. Reliability was high (M = 84%) for NRRS numerical ratings of categories but low (M = 32.9%) for specific examples provided. NRRS-identified highly aversive tasks yielded better correspondence with demand analysis outcomes than did NRRS-identified less aversive tasks.

A comparison of differential reinforcement procedures for treating automatically reinforced behavior.

Children diagnosed with autism spectrum disorder (ASD) often exhibit stereotypy, which can be socially stigmatizing, interfere with daily living skills, and affect skill acquisition. We compared differential reinforcement of alternative behavior (DRA) and differential reinforcement of other behavior (DRO) when neither procedure included response blocking or interruption for (a) reducing stereotypy, (b) increasing task engagement, and (c) increasing task completion. DRA contingencies yielded superior outcomes across each measure when evaluated with 3 individuals with autism spectrum disorder.

Comparing self-directed methods for training staff to create graphs using Graphpad Prism.

An important skill for behavior analysts is creating graphs that clearly convey outcomes and conform to publication conventions. GraphPad Prism is software designed for creating scientific graphs, but no prior research has empirically evaluated training graphing skills using Prism. Two effective training methods are enhanced written instructions (EWI) and video modeling with voiceover instructions (VMVO), but no single-subject studies have compared the effects of these methods. In this study, we compared the efficacy and social validity of EWI and VMVO for training staff to create graphs using Prism. A single-subject design was employed to compare the effects of the methods on the individual performance of 11 graduate students. EWI and VMVO were both found to be effective, and more participants chose to use EWI.

An evaluation of a punisher assessment for decreasing automatically reinforced problem behavior.

We extended research on the identification and evaluation of potential punishers for decreasing automatically reinforced problem behavior in four individuals with autism spectrum disorder. A punisher selection interview was conducted with lead clinicians to identify socially acceptable punishers. During the treatment evaluation, treatment phases were introduced sequentially and included noncontingent reinforcement (NCR), NCR and differential reinforcement of alternative behavior (DRA), and NCR-and-DRA with punishment. During the NCR-and-DRA with punishment phase, four to five potential punishers were evaluated using a multielement design. Dependent measures included the target problem behavior, appropriate item engagement, and emotional responding. For all participants, NCR-and-DRA was not effective and punishment was necessary. However, the most effective punisher identified in the context of NCR-and-DRA differed across participants.

A comparison of preference-assessment methods.

In Study 1, we evaluated preference stability across 4 preference-assessment methods for 6 individuals, 5 of whom had autism spectrum disorder and 1 of whom had traumatic brain injury. We also measured participants' problem behavior as a corollary measure during all assessment methods. The highest mean correlation coefficients and Kendall rank coefficients of concordance across administrations were observed for the paired-stimulus and multiple-stimulus-without-replacement methods. Lower correspondence across administrations was observed for the free-operant and response-restriction methods. Although differentially higher levels of problem behavior did not occur with a single method, lower levels were consistently observed with the free-operant method. During Study 2, we evaluated the implications of lower coefficients on reinforcer efficacy by comparing an initially identified and an immediately identified high-preference stimulus in a reinforcer assessment. Initially identified and immediately identified high-preference stimuli were equally effective reinforcers, suggesting that fluctuations in preference do not necessarily affect reinforcer efficacy in practice.

A statewide survey assessing practitioners' use and perceived utility of functional assessment.

The field of applied behavior analysis emphasizes the importance of conducting functional assessment before treatment development for problem behavior. There is, however, little information regarding the extent to which practitioners are using functional assessment in applied settings for individuals with developmental disabilities (DD). The purpose of the current study was to conduct a survey to assess the degree to which various types of functional assessment are implemented in agencies that serve individuals with DD in Massachusetts. Practitioners were asked to indicate their perception about and use of the various categories of functional assessment (e.g., indirect assessment, descriptive assessment, and functional analysis). From the 205 respondents who completed the survey, the most frequently used functional assessment was descriptive assessment. Results indicated that although the majority (67.8%) of practitioners believe functional analysis to be the most informative assessment tool for selecting behavioral treatment, only 34.6% of respondents indicated that they typically use functional analysis to inform the development of a behavior plan.

REDUCING AMBIGUITY IN THE FUNCTIONAL ASSESSMENT OF PROBLEM BEHAVIOR.

Severe problem behavior (e.g., self-injury and aggression) remains among the most serious challenges for the habilitation of persons with intellectual disabilities and is a significant obstacle to community integration. The current standard of behavior analytic treatment for problem behavior in this population consists of a functional assessment and treatment model. Within that model, the first step is to assess the behavior-environment relations that give rise to and maintain problem behavior, a functional behavioral assessment. Conventional methods of assessing behavioral function include indirect, descriptive, and experimental assessments of problem behavior. Clinical investigators have produced a rich literature demonstrating the relative effectiveness for each method, but in clinical practice, each can produce ambiguous or difficult-to-interpret outcomes that may impede treatment development. This paper outlines potential sources of variability in assessment outcomes and then reviews the evidence on strategies for avoiding ambiguous outcomes and/or clarifying initially ambiguous results. The end result for each assessment method is a set of best practice guidelines, given the available evidence, for conducting the initial assessment.

Functional analysis of problem behavior: A systematic approach for identifying idiosyncratic variables.

When inconclusive functional analysis (FA) outcomes occur, a number of modifications have been made to enhance the putative establishing operation or consequence associated with behavioral maintenance. However, a systematic method for identifying relevant events to test during modified FAs has not been evaluated. The purpose of this study was to develop and evaluate a technology for systematically identifying events to test in a modified FA after an initial FA led to inconclusive outcomes. Six individuals, whose initial FA showed little or no responding or high levels only in the control condition, participated. An indirect assessment (IA) questionnaire developed for identifying idiosyncratic variables was administered, and a descriptive analysis (DA) was conducted. Results from the IA only or a combination of the IA and DA were used to inform modified FA test and control conditions. Conclusive FA outcomes were obtained with 5 of the 6 participants during the modified FA phase.

Evaluation of assessment methods for identifying social reinforcers.

Although researchers have evaluated assessment methods for identifying preferred tangible and edible items for children with developmental disabilities, few have evaluated assessment methods for identifying preferred topographies of attention. In the current study, indirect and direct assessments were conducted to identify 7 topographies of attention to include in subsequent preference and reinforcer assessments. Two different assessment formats were evaluated until reliable results were achieved with 1 of them. In both formats, a therapist presented photos that depicted the topographies of attention included in the stimulus array, and a control card (resulting in no consequence) was included. After evaluation of the 2 formats, a reinforcer assessment was conducted with a socially relevant target behavior (i.e., mands) to determine the predictive validity of the preference assessments.

Functional analysis screening for problem behavior maintained by automatic reinforcement.

A common finding in previous research is that problem behavior maintained by automatic reinforcement continues to occur in the alone condition of a functional analysis (FA), whereas behavior maintained by social reinforcement typically is extinguished. Thus, the alone condition may represent an efficient screening procedure when maintenance by automatic reinforcement is suspected. We conducted a series of 5-min alone (or no-interaction) probes for 30 cases of problem behavior and compared initial predictions of maintenance or extinction to outcomes obtained in subsequent FAs. Results indicated that data from the screening procedure accurately predicted that problem behavior was maintained by automatic reinforcement in 21 of 22 cases and by social reinforcement in 7 of 8 cases. Thus, results of the screening accurately predicted the function of problem behavior (social vs. automatic reinforcement) in 28 of 30 cases.

Assessment and treatment of chronic hand mouthing.

Hand mouthing (HM) is a chronic problem in many individuals with intellectual disabilities. Although the prevalence of mouthing has been estimated, data on the frequency, severity, or functions of the behavior were not included. In Study 1, we examined the prevalence and risk of HM. Results obtained from interviews showed that the prevalence of HM in two institutional samples (N = 802) was 12.7%, whereas direct observation yielded a lower estimate of prevalence (8%). Moreover, a large proportion of observed HM (39.1%) was self-injurious in nature. In Study 2, we used modified functional analyses (FAs) to examine the HM of 64 individuals. Results indicated that maintenance by automatic reinforcement accounted for 98.4% of the cases (all but one case). In Study 3, we implemented a progressive series of interventions for HM exhibited by 14 individuals. The following interventions were implemented in sequential order: (a) noncontingent reinforcement (NCR, effective with 6 subjects), (b) either NCR plus differential reinforcement of alternative behavior (DRA) plus response blocking (effective with 5 subjects) or NCR plus response blocking only (effective with 2 subjects), and (c) NCR plus brief manual restraint (effective with 1 subject).

Does supplementary reinforcement of stereotypy facilitate extinction?

Results of several studies suggest that delivery of supplemental (social) reinforcement for stereotypy might facilitate its subsequent extinction. We examined this possibility with 9 subjects who engaged in stereotypy by including methodological refinements to ensure that (a) subjects' stereotypy was maintained in the absence of social consequences, (b) supplementary reinforcers were highly preferred and were shown to be reinforcers for some behavior, and (c) subjects were exposed to lengthy reinforcement and extinction conditions. In spite of these modifications, only 4 subjects' stereotypy increased when supplementary reinforcement was delivered contingent on stereotypy, and no subject's stereotypy decreased below initial baseline levels when social reinforcement was subsequently withheld. Decreases in stereotypy occurred with the implementation of noncontingent reinforcement. Thus, delivery of supplementary reinforcers either did not increase stereotypy or did not facilitate extinction of stereotypy maintained by automatic reinforcement. We discuss the practical and conceptual bases of these results with respect to our current understanding of function-based interventions.

Reliability and validity of the functional analysis screening tool.

The Functional Analysis Screening Tool (FAST) is a 16-item questionnaire about antecedent and consequent events that might be correlated with the occurrence of problem behavior. Items are organized into 4 functional categories based on contingencies that maintain problem behavior. We assessed interrater reliability of the FAST with 196 problem behaviors through independent administration to pairs of raters (Study 1). Mean item-by-item agreement between pairs of raters was 71.5%. Agreement for individual items ranged from 53.3% to 84.5%. Agreement on FAST outcomes, based on comparison of informants' highest totals, was 64.8%. We assessed the validity of the FAST by comparing its outcomes with results of 69 functional analyses (Study 2). The FAST score predicted the condition of the functional analysis in which the highest rate of problem behavior occurred in 44 cases (63.8%). Potential uses of the FAST in the context of a clinical interview, as well as limitations, are discussed.

Idiosyncratic variables that affect functional analysis outcomes: a review (2001-2010).

Although typical functional analyses often produce clear outcomes, some studies have reported ambiguous results that cannot be interpreted. Such undifferentiated outcomes may occur if test conditions do not include relevant antecedent or consequent events. Clinicians then may try to modify the functional analysis conditions to include those events. Hanley, Iwata, and McCord (2003) reviewed the functional analysis literature through 2000 and described idiosyncratic variables included in modified functional analyses. The objective of the present review was to present a quantitative analysis of idiosyncratic antecedents and consequences in modified functional analyses during the past decade (2001 to 2010). We discuss the range of stimulus parameters tested and the assessment strategies used for informing the modified analysis conditions.