Noncontingent reinforcement in the treatment of pediatric feeding disorder: A concise review.

This concise review summarizes the literature on noncontingent reinforcement in the treatment of pediatric feeding disorder from 2018 to 2022. We reviewed 15 published behavior-analytic feeding studies to identify how often the term noncontingent reinforcement is used, what form of noncontingent reinforcement is delivered, and what the effects of noncontingent reinforcement are on behavior when it is included in treatment. Implications and directions for future research are discussed.

A Continuum of Methods for Assessing Preference for Conversation Topics.

Among individuals with a diagnosis of autism spectrum disorders (ASD), conversation topic preference could influence social skills in many ways. For example, an individual with advanced vocal-verbal skills, but just learning to join a conversation, might be less inclined to participate if the topic chosen is not preferred. However, commonly used preference assessment procedures have not been applied to evaluating conversation-topic preferences. Therefore, the purpose of the current experiment was to conduct three different types of assessments that varied in efficiency, the degree of certainty they allow, and clients with whom they are likely to be applicable and acceptable. In particular, we conducted a self-report preference assessment, a multiple-stimulus-without-replacement (MSWO) preference assessment, and a response restriction conversation assessment (RRCA). Each assessment identified a preferred topic of conversation, but the RRCA was the only assessment that was able to differentiate which topics would maintain a conversation. Implications for assessment and intervention procedures related to complex social skills are discussed and directions for future research are proposed.

Reflections and Critical Directions for Toilet Training in Applied Behavior Analysis.

Achieving toileting independence is a critical skill that yields several benefits of pressing social, developmental, and health-related importance. The seminal behavioral approach to toilet training established the conceptualization of continence and framework for toileting research thereafter. Contemporary researchers continue to evaluate toilet training procedures that produce efficacious outcomes for young children that closely align with current applied behavior analysis (ABA) ethics and standards of practice. Despite the overall success of behavior-analytic toileting approaches, there are critical directions still worthy of consideration and investigation. In this paper, we acknowledge the seminal roots and many of the contemporary contributions. We also critically reflect on current practices while proposing necessary areas to advance behavior-analytic toilet training research.

Evaluation of schedule thinning following treatment for aggression maintained by access to higher level restrictive and repetitive behavior.

One of the diagnostic characteristics of individuals with autism spectrum disorders includes engaging in restricted and repetitive behavior. Research has shown that individuals will often display problem behavior when access to restricted and repetitive behavior is blocked. The purpose of the current study was to evaluate the use of functional communication training and schedule thinning to treat aggression displayed by three children diagnosed with autism spectrum disorders when higher level restrictive and repetitive behavior was blocked. Further, we assessed whether all steps in a schedule-thinning sequence were necessary as well as extended the practicality of these procedures by removing the continuous signal during the delay to reinforcement. The results indicated that functional communication with schedule thinning reduced aggression related to blocking access to engaging in higher level restrictive and repetitive behavior for all participants.

Recommendations Regarding Use of the Term "Ignore" in Applied Behavior Analysis.

Ignore is a common term used in behavioral assessment, behavior intervention plans, textbooks, and research articles. In the present article, we recommend against the typical usage of the term in most applications of behavior analysis. First, we briefly outline some history of the use of the term in behavior analysis. Then, we describe six main concerns about ignore and the implications for its continued use. Finally, we address each of these concerns with proposed solutions, such as alternatives to the use of ignore.

Verbal Behavior Analysis of Teaching Story Recall to Children with Autism: A Replication and Extension.

Children with autism spectrum disorder (ASD) may struggle with verbal behavior related to recall in various contexts. However, relatively little research has evaluated methods for improving recall among this population, and even fewer from a verbal behavior perspective. One socially important set of skills that relies upon a behavioral repertoire of recall is applied reading skills, such as reading comprehension and story recall. Valentino et al. (2015) designed an intervention package to teach children with ASD to recall short stories and conceptualized the behavior as an intraverbal chain. The present study replicated and extended that study with three school-aged children with ASD using a multiple baseline design across stories. For some participants and some stories, story recall was mastered under less intensive intervention conditions than in the previous study. When it was necessary to implement the full intervention package, the effects largely replicated previous research. Improvements in recall were correlated with increases in correct answers to comprehension questions. These data have important implications for clinicians and educators providing reading and recall interventions to children with ASD. Results also have theoretical implications for verbal behavior accounts of memory and recall, and suggest several possible avenues for future research. Supplementary Information: The online version contains supplementary material available at 10.1007/s40616-023-00183-2.

A Comparison of Baseline Procedures in Task Analyses.

Several methods for assessing baseline performance in chained tasks have been outlined in the literature, including the fixed-opportunity probe (FOP) and the multiple-opportunity probe (MOP). Concerns have been raised regarding how each of these methods might change the baseline performance of a task, affecting the interpretation of experimental control. The purpose of the current study was to conduct a within-subject comparison of both the FOP and MOP procedures for children with autism performing daily living and self-care skills. Results indicated that, for most participants, the MOP resulted in elevated performance during baseline compared to the FOP, and that for some participants the MOP resulted in acquisition prior to direct training. Because of the possibility that the FOP might result in suppressed baseline performance, it is recommended that in most cases clinicians and researchers use the MOP when assessing baseline performance in chained tasks in order to obtain the most accurate data.

An evaluation of methods for studying the effects of conditioned reinforcement on human choice.

Shahan et al. (2006) found that the relative rate of pigeons' pecking on two observing responses (i.e., responses that only produced an S+ or stimulus correlated with primary reinforcement) was well described by the relative rate of S+ delivery. Researchers have not evaluated the effects of S+ delivery rate in a concurrent observing response procedure with human subjects, so the necessary procedural modifications for studying the effects of conditioned reinforcement on human choice remain unclear. The purpose of the current study was to conduct an additive component analysis of modifications to the procedures of Shahan et al. (2006). We evaluated the additive effects of introducing response cost, a changeover response, and ordinal discriminative stimuli on correspondence with the results of Shahan et al. and the quality of fits of the generalized matching equation. When our procedures were most similar to those of Shahan et al., we observed low rates of observing and indifference between the two observing responses. For the group of subjects with whom all three additive components were included, we obtained the highest level of sensitivity to relative rate of S+ delivery, but the slope and R2 of our fits of the generalized matching equation were still much lower than those obtained by Shahan et al. Potential reasons for these discrepancies, methods of resolving them, and implications for future research are discussed.

A Brief Assessment to Identify Sensitivity to a Conversational Partner's Interest.

Individuals diagnosed with autism spectrum disorder (ASD) may seek professional assistance with social skills, such as identifying the function of social cues and responding appropriately to those cues. The purpose of the current study was to develop a brief assessment to determine participant sensitivity to social cues indicating uninterest in continuing a conversation. Results show that the assessment was successful in identifying contexts to address on an individual basis, related to social cues during conversation. Furthermore, the assessment fit within an hourly appointment appropriate for individuals with ASD (we used person-first or identify-first language based on caregiver and individual preference) who display sophisticated conversational repertoires. Future research should evaluate the content of the conversations and other nonvocal stimuli that might be beneficial in assisting with social interactions, in addition to using behavioral skills training to strengthen the specific social skills evaluated in the current study.

Commentary on Slocum et al. (2022): Additional Considerations for Evaluating Experimental Control.

In the target article, Slocum et al. (2022) suggested that nonconcurrent multiple baseline designs can provide internal validity comparable to concurrent multiple baseline designs. We provide further support for this assertion; however, we highlight additional considerations for determining the relative strength of each design. We advocate for a more nuanced approach to evaluating design strength and less reliance on strict adherence to a specific set of rules because the details of the design only matter insofar as they help researchers convince others that the results are valid and accurate. We provide further support for Slocum et al.'s argument by emphasizing the relatively low probability that within-tier comparisons would fail to identify confounds. We also extend this logic to suggest that staggering implementation of the independent variable across tiers may be an unnecessary design feature in certain cases. In addition, we provide an argument that nonconcurrent multiple baseline designs may provide verification within baseline logic contrary to arguments made by previous researchers. Despite our general support for Slocum et al.'s assertions and our advocacy for more nuanced approaches to determining the strength of experimental designs, we urge experimenters to consider the perspectives of researchers from other fields who may favor concurrent multiple-baseline designs and suggest that using concurrent multiple-baseline designs when feasible may foster dissemination of behavior analytic research.

Pediatric Pain and Neurodevelopmental Disorders: Implications for Research and Practice in Behavior Analysis.

Individuals diagnosed with a neurodevelopmental disorder also are commonly diagnosed with a medical comorbidity. Because of this, it is estimated that this population experiences nearly twice the incidence of pain or discomfort as their neurotypical peers. Although behavior analysts consider the effect of biological variables on a client's behavior, considerations of pain appear to be underdiscussed and understudied. The purpose of this article is to discuss how pain may interact with the efficacy of behavior analytic assessments and treatments, provide potential solutions to the barriers associated with pain states, and describe avenues to promote clinical research to improve our behavior analysis of pediatric pain while developing treatments for behavior problems such as aggression.

The matching law provides a quantitative description of social time allocation in children with autism.

Recent research has developed and evaluated assessments of sociability in which time allocation near or away from an adult who initiates social interactions is used to characterize the participant as social, indifferent, or avoidant of social interaction. Though these qualitative outcomes have been useful, no studies have evaluated methods of obtaining more quantitative measures of sociability. The matching law has been demonstrated to describe a wide range of human behavior and may also be useful in describing social time allocation. We adapted the matching law and assessment of sociability procedures with the aim of providing a more precise, quantitative measure of sociability. We fitted the matching equation to the social time allocation data of 8 children with autism spectrum disorder. The equation was effective in quantifying sociability, accounted for a large proportion of variance in participants' behavior, did so equally well for participants who were social and avoidant, and provided a more sensitive measure relative to those used in previous research. The implications of this methodology, its potential utility, and directions for future research are discussed.

Further evaluation of functional analysis screening methods in early autism intervention.

A goal of some functional analysis (FA) variations is to reduce assessment time while still maintaining efficacy. This may be especially important when conducting FAs in early intervention programs, where time is a crucial commodity. To that end, we evaluated a model for using the results of the no-interaction condition as a screening for behavioral function and to guide selection of FA test conditions with 20 participants (22 assessments) aged 3 to 7 years old. We used the no-interaction condition to develop hypotheses for both automatic reinforcement and socially mediated reinforcement. The outcome of the no-interaction condition guided the selection of test conditions for the remainder of the FA. We also incorporated methods from prior FA studies (e.g., divided attention) to modify the test conditions. We obtained differentiated results in 91% of assessments, all within 70 min and, as such, extended evidence that an FA can be completed in little time without sacrificing efficacy.

New (old) perspectives on self-injurious and aggressive biting.

Functional analyses and treatments of self-injurious behavior and aggression have shown that such behavior is often operant. In this paper, we will revisit evidence that a subset of self-injurious and aggressive biting may be controlled primarily by antecedent events and may have phylogenetic origins. We propose that there is a research gap of more than four decades, if one considers the wealth of basic research on biting that occurred prior to 1977. To our knowledge, that body of basic research was never fully translated or directly applied within behavior analysis. It is known that organisms (including humans) sometimes bite in the presence of aversive events (broadly defined as the presentation of aversive stimuli or the removal of reinforcers). Thus, the variables controlling biting in the context of behavioral assessment and treatment require further analysis.

Increasing social time allocation and concomitant effects on mands, item engagement, and rigid or repetitive behavior.

Recent research has developed methods of assessing the function of generic, nonindividualized social interactions. The purpose of this type of assessment is to provide a measure of how an individual may respond to the types of interactions readily available in the natural environment. To date, no research has evaluated how the social time allocation of individuals for whom generic interactions are neutral or aversive could be improved. Moreover, no research has included additional dependent variables that may be functionally related to social time allocation. In the current study, we evaluated the effects of initiating preferred, individualized social interactions on the social time allocation of 3 participants for whom generic interactions functioned as neutral or aversive stimuli. The intervention increased social time allocation for all 3 participants. Next, we evaluated the relation between social time allocation and the occurrence of mands, item engagement, and rigid or repetitive behavior using the intervention data as well as secondary analyses of previously published datasets. The occurrence of mands and rigid or repetitive behaviors changed with improvements in social time allocation and were strongly correlated with social time allocation across participants. Implications for future research on, and the clinical use of, this type of assessment and intervention are discussed.

Parents Are People Too: Implementing Empirically Based Strategies During Daily Interactions.

The outcomes of the COVID-19 pandemic have resulted in decision-making related to in-person versus remote behavior-analytic service delivery. For those service providers who shifted from delivering in-person therapy to remote consultation, parents have presumably, at least at times, assumed a role similar to a registered behavior technician (RBT). We suggest that behavior analysts recommend two empirically based strategies to parents that they could incorporate into their daily lives during service disruptions: environmental enrichment and differential reinforcement of alternative behavior. We provide examples of naturally occurring contexts during which parents could integrate these procedures: (1) self-care or daily living activities, (2) physical activity, and (3) preferred learning activities. We support selecting these strategies and their application during exemplar contexts under the premise that they do not result in additional time expenditure, afford parents opportunities to complete essential (household, work-related, or personal) tasks, and still result in therapeutic gains.

Training behavior analysts to conduct functional analyses using a remote group behavioral skills training package.

Behavioral skills training (BST) is a well-established procedure used to train individuals how to perform a variety of complex skills. Previous research has used BST to train parents, teachers, and clinicians how to conduct a variety of clinical procedures, including functional analysis of problem behavior. Although this procedure has been demonstrated to be very effective, it can be time consuming and resource intensive. In the present study, 13 behavior analysts were trained to conduct functional analyses of problem behavior. All participants were employees of a multistate early intervention clinic. This staff training was conducted fully remotely, and trainers acted as child role-play partners. Participants experienced baseline, an instruction/discussion component, a post-instruction probe, group BST, and a post-BST probe. For 5 participants, in-situ probes were also conducted. All participants achieved mastery and in-situ errors were low.

A comparison of re-presentation and modified chin prompt to treat different topographies of liquid expulsion.

Treatment of one behavior in the chain of consumption might be associated with the emergence of other problematic behaviors. For example, some children with feeding disorders expel liquid. Moreover, the form in which children expel liquid might vary and influence whether a treatment to reduce liquid expulsion will result in clinically meaningful outcomes. In the current investigation, we first identified topographies of liquid expulsion (e.g., forceful, run out) for each child. We then compared and evaluated the effects of 2 procedures, a modified chin prompt and re-presentation, on the liquid expulsion of 3 children with feeding disorders. For 2 participants, expulsion decreased to clinically meaningful levels with a modified chin prompt or re-presentation. However, for 1 participant, expulsion decreased to clinically meaningful levels only when we combined the modified chin prompt and re-presentation as part of a treatment package. We discuss possible mechanisms underlying the effects of a modified chin prompt and re-presentation, in addition to areas for future research.

Evaluating the function of social interaction for children with autism.

Several researchers have assessed whether or not social interaction is reinforcing; however, few studies have evaluated methods of assessing whether social interactions function as reinforcing, neutral, or aversive stimuli. We extend this research by evaluating a new method of assessing the function of social interaction. Twenty-one children diagnosed with Autism Spectrum Disorder (ASD) participated. Social interactions were found to function as reinforcers for 9 participants, neutral stimuli for 7 participants, and aversive stimuli for 5 participants. The method evaluated was found to be more efficient, may be more feasible, and was similarly as decisive as methods evaluated in previous research. Implications of this study and its methodology as well as future directions in this line of research are discussed.