A comparison of parental attention and preferred items during tummy time: A consecutive controlled case series evaluation.

Tummy time is an activity for infants to practice their early motor skills. Although most pediatricians recommend tummy time, parents may avoid the procedures due to indices of infant discomfort during this period. This consecutive controlled case series evaluation compared the effects of preferred items selected from a preference assessment with those of parental attention on head evaluation and negative vocalizations during tummy time. In addition, we directly evaluated parental choice by inviting parents to select which tummy time treatment they wanted to implement. We found that both preferred items and parental attention effectively increased head elevation and decreased negative vocalizations during tummy time; however, parents tended to prefer the treatment that included the preferred item.

Functional Analysis of Contextually Inappropriate Social Behavior in Children With Down Syndrome.

BACKGROUND: Children with Down syndrome often engage in contextually inappropriate social behavior, which researchers suggest may function to escape from difficult activities to preferred social interactions. Caregivers may reinforce the behavior, perceiving it only as evidence of the child's social strength, when, in fact, the pattern may also prevent or slow the development of critical skills. Unlike overt forms of challenging behavior, contextually inappropriate social behavior had never been subjected to experimental analysis. AIMS: The purpose of the current study was to identify and demonstrate functional control of contextually inappropriate social behavior to caregiver-informed contingencies. METHOD AND PROCEDURES: We interviewed caregivers and subjected contextually inappropriate social behavior to functional analyses for nine young children with Down syndrome. OUTCOMES AND RESULTS: We found sensitivity to the caregiver-informed contingencies for all nine participants with strong functional control and large effect sizes for most. CONCLUSIONS AND IMPLICATIONS: Caregivers may not perceive contextually inappropriate social behavior as problematic, yet patterns of contextually inappropriate and other problem behaviors suggest decreased engagement and poor task persistence. Assessments that lead to intervention decisions may be more informative when they include questions about social topographies of behavior not typically considered as problematic. Once caregivers are aware of the pattern, they may be better prepared to intervene.

Varying reinforcer dimensions during differential reinforcement without extinction: A translational model.

Procedural arrangements of differential reinforcement of alternative behavior without extinction often involve presenting the same reinforcers for problem behavior and appropriate behavior, which is typically ineffective at reducing problem behavior and increasing an alternative response. However, manipulating reinforcement dimensions such that the contingencies favor the alternative response may improve treatment outcomes when using differential reinforcement of alternative behavior without extinction by increasing appropriate behavior and reducing problem behavior. We conducted this translational study with 32 college students completing a button-pressing task on a computer program in which they could engage in analogs to problem behavior and appropriate behavior. The effects of manipulating magnitude, immediacy, quality, and a combination of all three dimensions for the alternative response were evaluated. Overall, all dimension manipulations reduced the analog to problem behavior, with the largest reductions observed during the quality probe and the probe with all dimensions combined. These results support the notion that differential reinforcement of alternative behavior without extinction can be an effective form of treatment.

Validating a Computerized Program for Supporting Visual Analysis During Functional Analysis: The Problem Behavior Multilevel Interpreter (PB.MI).

Computerized programs have been specifically developed in the field of applied behavior analysis for the purpose of automating data collection. Although they can potentially improve practicality of data collection for applied researchers and clinicians, program features of existing computerized programs do not include graphs and data interpretation generated in real time. We developed the Problem Behavior Multilevel Interpreter (PB.MI), which is designed to (a) allow for ongoing visual analysis of data displayed in real time and (b) support visual analysis with a computerized interpretation of functional control. The program was intended to be used during the functional analysis of problem behavior, specifically the single-session, interview-informed synthesized contingency analysis. In this article, we describe the program's functioning abilities and how we validated those abilities. In addition, we discuss the PB.MI program's practical utility. Supplementary Information: The online version contains supplementary material available at 10.1007/s40617-021-00656-7.

On the Occurrence of Dangerous Problem Behavior during Functional Analysis: An Evaluation of 30 Applications.

Functional analyses are often conducted by behavior analysts to understand the environmental variables contributing to an individual's problem behavior to better inform treatment implementation. While functional analyses are integral for designing function-based interventions, they often arrange contingencies to evoke and reinforce dangerous problem behavior. In Study 1 we reviewed 22 functional analyses with open-contingency classes including non-dangerous topographies of problem behavior and we found that participants were more likely to exhibit the non-dangerous behavior in 82% of the applications. We then conducted a single-subject comparison of closed and open-contingency classes with four additional participants in Study 2. Our results suggest that the functional analyses with the open-contingency class reduced the likelihood of observing dangerous problem behavior.

Contingency-based delay to reinforcement following functional communication training for autistic individuals: A multilevel meta-analysis.

LAY ABSTRACT: Functional communication training, an intervention for challenging behavior rooted in principles of applied behavior analysis, has copious empirical support dating back to the mid-1980s for autistic individuals. Recently, there has been a concerted effort to thin reinforcement delivery during functional communication training using contingency-based delays that, in turn, are designed to enhance practicality and feasibility while not compromising efficacy. In this synthesis, we meta-analyzed the literature base with the goal of investigating both combined and across type effectiveness of contingency-based delays. We also aimed to investigate moderating variables that might impact intervention outcomes. Findings showed that contingency-based delays were effective for individuals with an autism spectrum disorder diagnosis and most effective when the delay incorporated some form of positive reinforcement. In addition, differential reinforcement of alternative-based delays was overall more effective when compared to differential reinforcement of other behavior-based delays. Noteworthy moderating variables found to impact contingency-based delay efficacy included the intervention dosage and the topography of behavior. We discuss these findings and highlight directions where additional empirical research is warranted to improve our understanding about contingency-based delays for individuals diagnosed with autism spectrum disorder.

Structured visual analysis of single-case experimental design data: Developments and technological advancements.

Visual analysis is the primary method used to interpret single-case experimental design (SCED) data in applied behavior analysis. Research shows that agreement between visual analysts can be suboptimal at times. To address the inconsistent interpretations of SCED data, recent structured visual-analysis technological advancements have been developed. To assess the extent to which structured visual analysis is used to guide or supplement applied behavior analysts' interpretation of SCED graphs, a systematic review between the years of 2015 to 2020 in the Journal of Applied Behavior Analysis was conducted. Findings showed that despite recent efforts to develop structured visual-analysis tools and criteria, these methods are rarely used to analyze SCED data. An overview of structured visual-analysis tools is shared, their utility is delineated, common characteristics are brought to light, and future directions for both research and their clinical use are highlighted.

On the role of operant contingencies in the maintenance of inappropriate mealtime behavior: An epidemiological analysis.

Functional analysis is the primary assessment used to determine the function of inappropriate mealtime behavior in children with feeding disorders. Based on single-case experimental design studies and recent reviews, the prevalence of negative reinforcement alone in the maintenance of inappropriate mealtime behavior appears to be much greater than positive reinforcement alone. We conducted a retrospective consecutive-controlled case series to determine the generality of previous findings. Results of the epidemiological analysis support prior research in that negative reinforcement in the form of escape (44.8%), and multiple control (i.e., positive and negative reinforcement) in the forms of escape and attention (37.2%), are considerably more prevalent than positive reinforcement alone (2.5%). We discuss the relationship between functional analysis of inappropriate mealtime behavior and treatment utility. Further, we describe avenues of future research designed to advance the application of functional analysis in feeding disorders beyond inappropriate mealtime behavior.

Functional communication training: From efficacy to effectiveness.

Functional communication training (FCT; Carr & Durand, 1985) is a common function-based treatment in which an alternative form of communication is taught to reduce problem behavior. FCT has been shown to result in substantial reductions of a variety of topographically and functionally different types of problem behavior in children and adults (efficacy). The extent to which these reductions maintain in relevant contexts and result in meaningful changes in the lives of those impacted (effectiveness) is the focus of this paper. This review evaluates the degree to which FCT has been established as an evidence-based practice in psychology (EBPP) according to the definition set out by the American Psychological Association's 2005 Presidential Task Force on Evidence-Based Practice. Our review finds overwhelming evidence in support of FCT as an efficacious treatment but highlights significant limitations in support of its effectiveness. In order to also be recognized as an EBPP, future research on FCT will need to focus more closely on issues related to home, school, and community application, feasibility, consumer satisfaction, and more general and global changes for the individual.

A translational comparison of contingency-based progressive delay procedures and their effects on contextually appropriate behavior.

Schedule thinning is an essential step in treating problem behavior, yet little research has been conducted to determine the method associated with sustained treatment effects. A frequently used method for thinning reinforcement is contingency-based progressive delay, which requires the individual to meet some criteria before the reinforcers are returned. The response requirement could be dependent on (a) contextually appropriate behavior (differential reinforcement of alternative behavior-based thinning) or (b) absence of problem behavior (differential reinforcement of other behavior-based thinning). A translational arrangement with college students was implemented to determine the effects of these 2 response requirements. Tolerance was observed regardless of thinning method and was indicated by low rates of responding to the analogue problem behavior; however, more contextually appropriate behavior occurred during differential reinforcement of alternative behavior-based thinning. These results support the use of response requirements for behaviors that are expected of the individual when reinforcement is not immediately forthcoming.

Reducing an Adolescent's Destructive Behavior during Bathroom Visits in a Residential Setting: Brief Report.

As individuals with autism spectrum disorder (ASD) transition to adulthood, problem behavior may present restrictions to an independent lifestyle. In addition, problem behavior may interfere with performance of daily routines necessary for independent living. We developed a successful treatment for automatically reinforced toilet lid destruction of an adolescent with ASD during routine bathroom visits. The treatment was informed by a competing stimulus assessment (CSA) that identifies a preferred stimulus, the presentation of which is intended to compete with automatic reinforcement of problem behavior. Results indicated that access to the competing stimulus reduced the participant's toilet lid destruction while in the bathroom, and these treatment gains maintained during long term follow-up visits.

Interview-Informed Synthesized Contingency Analysis (IISCA): Novel Interpretations and Future Directions.

The functional analysis (FA) methodology was developed to provide an empirical basis for understanding the reinforcers contributing to the maintenance of problem behavior. Previous research has demonstrated that multiple formats have been established to address some areas, such as practicality, efficiency, and safety. We reviewed the research on a new replication and extension of the standard FA format, the interview-informed synthesized contingency analysis (IISCA) and its subsequent treatment. We discuss the efficiency and effectiveness of the IISCA across various populations, settings, topographies of problem behaviors, and maintaining functions across 17 studies. Common treatment trends, novel developments, and other critical intervention components are also reviewed. We provide suggestions for future directions and guidelines for practitioners when considering the use of the IISCA.

On the Standardization of the Functional Analysis.

The functional analysis procedures described in the seminal Iwata et al. (1982/1994) study are prominent in the applied behavior analytic literature, having been replicated hundreds of times over the past 30 years (Beavers, Iwata, & Lerman, 2013; Hanley, McCord, Iwata, 2003). However, the extent to which particular components of this functional analysis model have become more or less prominent over time is not clear from these literature reviews. We therefore conducted a review of the functional analysis literature between the years of 1965 and 2016 to determine the trends in the usage of particular components over time and to determine if the published literature reflects a standardization of the manner in which functional analyses of problem behavior are conducted. Furthermore, we discuss whether or not this standardization of a functional analysis model is currently necessary.

Transitioning from rich to lean reinforcement as a form of error correction.

Discrete trial instruction (DTI) is a ubiquitous tool used by practitioners in early intervention programs. A common approach to correcting errors during DTI involves providing a single prompt of the target response when a mistake is made (i.e., single-response repetition). Modifications to the single-response repetition approach have been developed to improve acquisition; however, these modifications are often aversive techniques (e.g., increased effort, response cost) and may not be preferred by the children or considered socially acceptable by caregivers. We conducted this study to evaluate the use of a transition from rich to lean reinforcement as a form of error correction. We compared the rich-lean condition to the single-response repetition approach during DTI for 4 boys diagnosed with autism. The rich-lean condition was (a) more efficient in improving accuracy in 6 out of 9 tasks, (b) more preferred by all participants, and (c) socially validated by caregivers.

Comparing the effects of varied and constant preferred items on improving tummy time for typically developing infants.

Tummy time involves placing an infant in a prone position to help build muscle strength. Pediatricians recommend tummy time because it helps with infant development related to milestones such as crawling, rolling over, and sitting up. However, parents sometimes avoid tummy time due to whining or crying when the infant is placed in the prone position. The current study compared two interventions incorporating preferred leisure items (i.e., varied or constant) for five typically developing infants to increase head elevation and decrease negative vocalizations during tummy time. Improvements occurred in infant performance regardless of the preferred items used. In addition, the mothers who implemented the tummy time procedures found the treatment to be socially valid and were more likely to select the use of the constant item when given the opportunity to choose.

Evaluating the boundaries of analytic efficiency and control: A consecutive controlled case series of 26 functional analyses.

We conducted this study to determine if the efficiency of the functional analysis could be improved without detrimental effects on control. In Experiment 1, we reanalyzed functional analyses conducted for the problem behavior of 18 children. We analyzed rates of problem behavior during the first 5 min and first 3 min of the original 10-min sessions and evaluated if changes in the level of control over problem behavior by the programmed contingency were evident from the analyses of shorter session duration. In Experiment 2, we conducted 8 consecutive functional analyses with 3-min sessions to further evaluate the utility of brief session durations. We found that control over problem behavior was demonstrated when conducting functional analyses with sessions as brief as 3 min.

Shaping complex functional communication responses.

Response efficiency plays an important role in the initial success of functional communication training (FCT). Although low-effort functional communication responses (FCRs) have been shown to be most effective in replacing problem behavior; more developmentally advanced FCRs are favored later in the treatment process. Attempts to teach these more complex FCRs, however, often lead to the resurgence of problem behavior. In this study, we provide a detailed description of an effective shaping process applied within a changing criterion design to develop complex FCRs from simple FCRs without resurgence of problem behavior. Four children with various language and intellectual abilities participated in this study. A practical shaping procedure, suitable for typical teaching contexts, is described for two participants in Experiment 1. The necessity and efficacy of the shaping process are demonstrated with the participants in Experiment 2. Implications for practice and research are discussed.

Achieving socially significant reductions in problem behavior following the interview-informed synthesized contingency analysis: A summary of 25 outpatient applications.

Jessel, Hanley, and Ghaemmaghami (2016) reported the results of 30 interview-informed, synthesized contingency analyses (IISCAs) and found the IISCAs to be an effective tool for identifying the functions of problem behavior across a variety of topographies, participants, and settings. Jessel et al. did not, however, include data on the effectiveness of the corresponding treatments. In the current study, we collected and summarized 25 additional applications, from analysis to treatment, in which the IISCA was applied in an outpatient clinic. The IISCA identified various social functions of problem behavior, which informed personalized treatments of functional communication training with contingency-based reinforcement thinning. A 90% or greater reduction in problem behavior was obtained for every participant by the end of the treatment evaluation. The assessment and treatment process was socially validated by caregivers who rated the procedures highly acceptable and helpful, and the improvement in their child's behavior highly satisfactory.

Using progressive ratio schedules to evaluate tokens as generalized conditioned reinforcers.

The properties of operant reinforcers are dynamic and dependent on a number of variables, such as schedule and effort. There has been sparse research on the generalized conditioned properties of token reinforcement. We evaluated leisure items, edible items, and tokens using a progressive ratio schedule with three children with diagnoses of ASD and developmental delays. The highest break points occurred during the token reinforcement condition for two out of three participants, but response rates tended to be higher with edibles. We then evaluated the effects of presession access to edibles on the break points of edible items and tokens with two participants. Break points decreased only in the edible reinforcement condition, and the participants chose to work for leisure items rather than edibles when presession access to edibles was in place. These findings suggest that the tokens functioned as generalized conditioned reinforcers.