|Function-Based Treatments: Implications for Treatment and Maintenance|
|Saturday, May 26, 2018|
|4:00 PM–5:50 PM |
|Manchester Grand Hyatt, Seaport Ballroom DE|
|Area: DDA/CBM; Domain: Applied Research|
|Chair: Madeleine Diane Keevy (University of Nebraska Medical Center's Munroe-Meyer Institute)|
|Discussant: Joel Eric Ringdahl (University of Georgia)|
Function-based treatments are widely used in behavior analysis. Practitioners are not only interested in developing effective treatments in clinical settings, but in developing treatments that generalize to caregivers and can be feasibly implemented over time. To this end, practitioners implementing function-based treatments must consider teaching methods (e.g. prompting procedures), schedule thinning methods, caregiver training procedures, and the prevalence of relapse of caregiver behavior. Four studies investigated the impact of these variables on the outcomes of function-based interventions including functional communication training (FCT) and noncontingent reinforcement (NCR). First, one study compared the effects of response-independent and response dependent progressive time delay during training of FCT. Second, an investigation evaluated the effects of multiple schedules to rapidly thin schedules of NCR. Third, a study investigated the transfer of FCT treatment effects to a caregiver. Fourth, one investigation evaluated relapse of undesirable caregiver behavior after training to implement FCT. The results of these studies indicate that function-based interventions such as FCT and NCR are effective in reducing problem behavior, but it may be necessary to explicitly program for maintenance of treatment results by training caregivers to adhere to treatment protocols.
|Instruction Level: Intermediate|
|Keyword(s): caregiver training, FCT, relapse, schedule thinning|
The Effects of Response Dependent and Response Independent Progressive Time Delay During Functional Communication Training
|KRISTINA GERENCSER (Marcus Autism Center; Emory University School of Medicine), Joanna Lomas Mevers (Marcus Autism Center; Emory University School of Medicine), Colin S. Muething (Marcus Autism Center; Emory University School of Medicine)|
Functional communication training is a well-established, reinforcement based treatment to reduce problem behavior for individuals with developmental disabilities. However, the specific prompting procedures to teach a functional communication response (FCR) vary across studies and often are not adequately described. Progressive time delay (PTD) is a prompting procedure that initially starts with the therapist providing the child with a prompt to ensure s/he is engaging in the FCR. Then, the therapist gradually increases the delay of the prompt to give the child time to respond independently. Typically in most PTD procedures, the delay is increased dependent on the child's lack of acquisition. An alternative approach is to increase the time delay independent of the child's acquisition. Thus, the purpose of this study was to evaluate the effects of two PTD procedures (i.e., response dependent and response independent) on the acquisition of the FCR. The study included eight participants that engaged in problem behavior maintained by access to preferred items or attention. All participants acquired the FCR regardless of which PTD procedure was implemented. These results suggest that increasing the delay based on acquisition may not be a critical component. Clinical implications regarding these outcomes and future directions will be discussed.
|Evaluation of Multiple Schedules for Rapidly Thinning Noncontingent Reinforcement|
|RONALD JOSEPH CLARK (The Scott Center for Autism Treatment; Florida Institute of Technology), Justine Henry (The Scott Center for Autism Treatment; Florida Institute of Technology), Theo Paul Robinson (The Scott Center for Autism Treatment; Florida Institute of Technology), Kacie McGarry (The Scott Center for Autism Treatment; Florida Institute of Technology), Michael E. Kelley (The Scott Center for Autism Treatment, Florida Institute of Technology)|
|Abstract: Prior studies have successfully demonstrated thinning of reinforcement schedules when utilizing multiple schedules with a salient discriminative stimulus during functional communication training (FCT) (Betz, Fisher, Roane, Mintz, & Owen, 2013; Fisher, Greer, Fuhrman, & Querim, 2015). Noncontingent reinforcement (NCR) is a common treatment for behavior maintained by social reinforcement; however, little research has evaluated the use or rapid thinning of NCR within a multiple schedule. The current study aimed to replicate and extend previous literature by evaluating the effects of multiple schedules to rapidly thin schedules of NCR as a treatment to decrease problem behavior in children diagnosed with autism. Experiment one consisted of a brief functional analysis to determine environmental variables that maintained problem behavior. Experiment two consisted of a NCR evaluation as well as a comparison between mixed and multiple schedules of reinforcement. In experiment three, we rapidly thinned the schedule of reinforcement from 60s NCR/60s extinction (Ext) to 60s/540s (i.e., 60s NCR/540s Ext). Results demonstrated that multiple schedules were successful in decreasing problem behavior even when rapidly shifting from a dense schedule to a lean schedule of noncontingent reinforcement.|
|Promoting Rapid Transfer of Treatment Effects to Caregivers During Functional Communication Training|
|LAUREN PHILLIPS (University of Nebraska Medical Center's Munroe-Meyer Institute), Brian D. Greer (University of Nebraska Medical Center's Munroe-Meyer Institute), Wayne W. Fisher (University of Nebraska Medical Center's Munroe-Meyer Institute), Katie Lichtblau (University of Nebraska Medical Center's Munroe-Meyer Institute), Daniel R. Mitteer (University of Nebraska Medical Center's Munroe-Meyer Institute ), Adam M. Briggs (University of Nebraska Medical Center's Munroe-Meyer Institute)|
|Abstract: Fisher, Greer, Fuhrman, and Querim (2015) found that bringing functional communication responses (FCRs) and destructive behavior under the discriminative control of schedule-correlated stimuli within a multiple schedule facilitates the rapid transfer of functional communication training (FCT) treatment effects to other therapists or other settings. Study 1 extended these findings by evaluating the transfer of FCT treatment effects to a caregiver using FCT with response restriction (RR). The caregiver conducted baseline sessions within both escape and attention contexts while therapists initiated FCT with schedule thinning. We then trained the caregiver to implement FCT with RR at each terminal schedule in both contexts according to a multiple-baseline-across-functions design and observed rapid transfer of FCT treatment effects, despite the caregiver’s unique and lengthy history of reinforcement of the child’s destructive behavior. Study 2 evaluated transfer of treatment effects to two caregivers trained to implement FCT at a terminal schedule in the tangible context following therapist initiated FCT schedule thinning. We compared mixed and multiple schedules to isolate the effects of extinction versus discriminative control of schedule correlated stimuli. The results of these two studies demonstrate a potential method of mitigating the renewal of previously extinguished behavior upon changes in context.|
Relapse of Undesirable Caregiver Behavior Following Behavioral Skills Training
|DANIEL R. MITTEER (University of Nebraska Medical Center's Munroe-Meyer Institute ), Brian D. Greer (University of Nebraska Medical Center's Munroe-Meyer Institute), Wayne W. Fisher (University of Nebraska Medical Center's Munroe-Meyer Institute), Adam M. Briggs (University of Nebraska Medical Center's Munroe-Meyer Institute), Ryan Kimball (University of Nebraska Medical Center's Munroe-Meyer Institute), Kayla Rechelle Randall (University of Nebraska Medical Center's Munroe-Meyer Institute), David P. Wacker (The University of Iowa)|
Treatment relapse may be the most ubiquitous challenge facing behavior-analytic interventions for destructive behavior, and failure of caregiver treatment adherence to those interventions represents a primary source of treatment relapse. Researchers have focused on the persistence of child destructive and alternative behavior as they relate to treatment relapse and have largely ignored the persistence of caregiver treatment adherence. In the current study, we examined relapse of undesirable caregiver behavior (e.g., reinforcing child destructive behavior) following behavioral skills training (BST) with three caregivers of children referred to our clinic for treatment of destructive behavior. First, we simulated conditions in which undesirable caregiver behavior terminated confederate destructive behavior in a home-like context. Second, the behavior analyst used BST to teach desirable caregiver behavior (i.e., how to implement functional communication training), after which the caregiver practiced these skills with the confederate in a clinic context. Third, we introduced a treatment-adherence challenge in which caregivers returned to the home-like context and confederates appeared inconsolable (i.e., neither desirable nor undesirable caregiver behavior terminated confederate destructive behavior). We observed relapse of undesirable caregiver behavior during 2 of 3 caregivers' treatment-adherence challenges. We discuss these findings along with prospective training enhancements for strengthening caregiver treatment adherence.