Effects of Positive and Negative Reinforcement in a Concurrent Operants Arrangement on Compliance and Problem Behavior / Efectos del Reforzamiento Positivo y Negativo en un Arreglo de Operantes Concurrentes sobre la Obediencia y la Conducta Problemática

Functional analysis (Iwata, Dorsey, Slifer, Bauman, & Richman, 1982/1994) is a robust approach to identifying function-based interventions for problem behavior, including self-injury, aggression, and destruction. Such interventions, however, may be difficult for untrained caregivers to implement with fidelity in natural environments. Further research is needed to identify simple antecedent strategies for promoting appropriate behavior among children with significant problem behavior. The purpose of the current study was to utilize a concurrent schedules arrangement to identify conditions under which two children with autism spectrum disorder (ASD) and developmental delays who engaged in problem behaviors would choose to complete academic tasks to earn access to preferred items. In both cases, problem behaviors were shown to be sensitive to reinforcement in the forms of escape from task demands and access to preferred items. A concurrent operant arrangement in which the participants could choose to complete work tasks to earn access to preferred activities, or to take a break without demands or preferred items, was implemented. The schedule requirements in the demand component were systematically increased across opportunities, while the amount and type of reinforcement was kept constant. The results show, at the lowest levels of task demands, both participants allocated more opportunities to the work option. At higher levels, however, both participants allocated a majority of their choices to the break option. Despite the absence of preferred items in the break component, no instances of problem behavior were observed following selection of the break option. This indicates that this type of analysis could be used to identify conditions for compliance among individuals who engage in escape- or multiply-maintained problem behaviors, without the need to provoke or reinforce problem behavior. Limitations of the current study and recommendations for future research are discussed.

El análisis funcional (Iwata, Dorsey, Slifer, Bauman, & Richman, 1982/1994) es una aproximación robusta para identificar intervenciones basadas en la función para la conducta problemática, incluyendo la autolesión, agresión y destrucción. Tales intervenciones, no obstante, pueden ser difíciles de implementar fidedignamente en escenarios naturales por cuidadores no entrenados. Se requiere más investigación para identificar estrategias antecedentes simples para promover la conducta apropiada entre niños con problemas significativos de conducta. El propósito del presente estudio fue utilizar un arreglo de programas concurrentes para identificar las condiciones bajo las cuales dos niños con trastorno del espectro autista (ASD, por sus siglas en inglés) y retraso en el desarrollo que emitían conducta problemática escogerían completar tareas académicas para ganar acceso a ítems preferidos. En ambos casos, las conductas problemáticas fueron sensibles al reforzamiento consistente en escape de las demandas de la tarea y en acceso a ítems preferidos. Se implementó un arreglo de programas concurrentes en el que los participantes podían escoger entre completar una tarea académica para ganar acceso a ítems preferidos o tomar un descanso sin demandas y sin ítems preferidos. Los requisitos del programa en el componente de demanda fueron incrementados sistemáticamente a través de las oportunidades de elección, mientras que el tipo y cantidad de reforzamiento se mantuvo constante. Los resultados mostraron que en el nivel más bajo de demandas, ambos participantes prefirieron la opción de trabajo. A niveles de demanda más altos, no obstante, ambos participantes eligieron la opción de tomar un descanso. A pesar de la ausencia de ítems preferidos en el componente de descanso, no se observaron instancias de conducta problemática después de esta opción. Esto indicó que este tipo de análisis puede ser usado para identificar condiciones que conducen a la obediencia entre individuos cuya conducta problemática se mantiene por escape o bien por múltiples reforzadores, sin la necesidad de provocar o reforzar la conducta problemática. Se discuten las limitaciones del presente estudio y se ofrecen recomendaciones para futura investigación.

Self-injury among a community cohort of young children at risk for intellectual and developmental disabilities.

OBJECTIVE: To identify risk factors for self-injurious behavior in young children with developmental delay and to determine whether that group is also more likely to exhibit other challenging behaviors. STUDY DESIGN: A retrospective chart review of 196 children < 6 years of age referred for comprehensive neurodevelopmental evaluations. We analyzed child developmental level, receptive and expressive communication level, mobility, visual and auditory impairment, and co-morbid diagnoses of cerebral palsy, seizure disorders, and autism. RESULTS: Sixty-three children (32%; mean age = 42.7 mo, 63% male) were reported to engage in self-injurious behavior at the time of the evaluation. Children with and without self-injurious behavior did not differ on overall developmental level, expressive or receptive language level, mobility status or sensory functioning, or in rates of identification with cerebral palsy, seizure disorders, or autism. However, the self-injurious behavior group was rated significantly higher by parents on destructive behavior, hurting others, and unusual habits. CONCLUSIONS: Although self-injurious behavior was reported to occur in 32% of the cohort, the modal frequency was monthly/weekly and the severity was low. No significant differences were found for risk markers reported for adults, adolescents, and older children with intellectual and developmental disabilities. However, self-injurious behavior was comorbid with other behavior problems in this sample.

Relation between pain and self-injurious behavior in nonverbal children with severe cognitive impairments.

OBJECTIVES: To explore whether self-injurious behavior (SIB) alters pain expression in children with severe cognitive impairments and the relation between SIB and chronic pain. STUDY DESIGN: Caregivers of 101 nonverbal children 3 to 18 years of age (55% boys) completed the Non-Communicating Children's Pain Checklist-Revised (NCCPC-R) retrospectively and for an observed pain episode. Caregivers of children with SIB (n = 44) completed the Behavior Problems Inventory, the Self-Injury Grid, and the Self-Injury and Self-Restraint Checklist. RESULTS: Multivariate analysis of variance indicated that NCCPC-R scores did not differ between children with and those without SIB. However, t tests indicated that children with chronic pain (n = 13) self-injured less body surface (P =.01) and fewer body sites (P =.04) than did children without (n = 31). Multiple Correspondence Analysis generated 2 dimensions (49% variance), suggesting a distinction between two SIB forms: (1) high frequency of SIB to the head/hand and absence of chronic pain and (2) less frequent SIB near the site of pain. CONCLUSIONS: Children with severe cognitive impairments who display SIB do not have reduced pain expression, and chronic pain may influence the frequency and location of SIB. Further research should examine the usefulness of these findings for management of SIB and pain.