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Further Examination of Response Blocking and Redirection to Reduce Automatically Maintained Problem Behavior |
Monday, May 28, 2018 |
9:00 AM–10:50 AM |
Manchester Grand Hyatt, Seaport Ballroom G |
Area: AUT/DDA; Domain: Applied Research |
Chair: Seth B. Clark (Marcus Autism Center) |
Discussant: John T. Rapp (Auburn University) |
CE Instructor: Seth B. Clark, M.A. |
Abstract: Response blocking and redirection can be effective in decreasing unwanted behavior, to include treatment resistant topographies, such as automatically maintained pica and self-injury. This symposium will present the results of four studies that utilized response blocking and redirection as part of a behavior intervention. Fisher et al., analyzed the effectiveness of competing items with and without response blocking and redirection in reducing treatment-resistant automatically-maintained self-injurious behavior. Priehs, Kishbaugh, Steinhauser, Cividini-Motta, and Ahearn examined the effectiveness of response blocking as compared to an overcorrection procedure when trying to treat public masturbation. Rettig, Fritz, Campbell, Williams, Smith, and Dawson examined whether blocking pica related behaviors earlier in a response hierarchy would be more effective than blocking only pica attempts. Finally, Clark, Muething, and Call sought to increase the ecological validity of response blocking and redirection procedures by examining if reductions in pica behaviors could be maintained when the discriminative stimulus associated with response blocking (i.e., caregiver or therapist) was absent. Together, these studies provide potential methods for reducing automatically-maintained behaviors through the use of response blocking and redirection procedures. Additionally, challenges associated with using response blocking and redirection will be discussed. |
Instruction Level: Intermediate |
Keyword(s): Pica, Redirection, Response Blocking, SIB |
Target Audience: Professionals, practitioners, BCBAs, and clinicians. |
Learning Objectives: At the conclusion of the presentation, participants will be able to: 1. Identify instances in which response blocking and redirection procedures may be useful. 2. Identify the challenges associated with using response blocking and redirection. 3. Identify methods of increasing the social validity and utility of response blocking and redirection procedures. |
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Reducing Public Masturbation in Individuals With Autism Spectrum Disorder: An Assessment of Overcorrection and Response Blocking |
Jonathan Priehs (The New England Center for Children, Inc), Adelyn Kishbaugh (The New England Center for Children, Inc), HALEY STEINHAUSER (The New England Center for Children, Inc; Western New England University), Catia Cividini-Motta (The New England Center for Children, Inc), William H. Ahearn (The New England Center for Children, Inc) |
Abstract: Behavior such as masturbation is considered a part of normal sexual development and should be expected in adolescents and adults with autism (American Academy of Pediatrics, 1996). However, this behavior can be problematic when individuals engage in masturbation in public. The current study investigated the effects of overcorrection and response blocking on public masturbation (PM) of children and adolescents with autism. Initial assessments showed that PM was not sensitive to social consequences. During the treatment evaluation phase we compared overcorrection and response blocking to determine whether either procedure was successful in decreasing PM. In the overcorrection condition, the participant completed physical activities involving both hands (e.g., moving chairs, touching toes) contingent on the occurrence of any PM. In the response blocking condition, the therapist blocked all PM using physical and verbal prompts (e.g., neutrally saying, "Stop that," and moving hands away). Both procedures were effective in decreasing public masturbation but response blocking required fewer resources and time. Interobserver agreement was collected for a minimum of 30% of sessions and was 85% or greater. Clinical implications and suggestions for future research are reviewed. |
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Using Precursor Assessment to Inform Treatment of Pica Maintained by Automatic Reinforcement |
LISA RETTIG (University of Houston-Clear Lake), Jennifer N. Fritz (University of Houston-Clear Lake), Kelsey Campbell (University of Houston-Clear Lake), Sarah Williams (University of Houston-Clear Lake), Leah Smith (University of Houston-Clear Lake), Kyle Dawson (University of Houston-Clear Lake) |
Abstract: Pica produces unique challenges during assessment because of risk posed by the behavior, and it often is maintained by automatic reinforcement. Blocking has been shown to effectively reduce pica. We conducted a latency FA for pica to determine the function of pica (Study 1). Next, we determined the response hierarchies leading to pica through a probability analysis and the effectiveness of a blocking treatment for participants’ whose pica appeared in both the alone condition and the attention condition of the functional analysis (Study 2). Finally, we compared the effects of blocking precursors to pica, touching an inedible item, and the pica itself (Study 3). Results showed that five of the six participants’ pica was maintained by automatic reinforcement (Study 1), and blocking decreased the rate of pica for three of four participants (Study 2). Results of Study 3 showed that blocking behaviors earlier in a response hierarchy is more effective than blocking only pica attempts. |
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Evaluating a Prompted Engagement and Response Blocking Competing Stimulus Assessment With Children With Automatically Reinforced Self-Injurious Behavior |
ALYSSA FISHER (Kennedy Krieger Institute), Louis P. Hagopian (Johns Hopkins School of Medicine; Kennedy Krieger Institute), Jennifer R. Zarcone (Johns Hopkins School of Medicine; Kennedy Krieger Institute), Erica Lozy (Louisiana State University), Griffin Rooker (Johns Hopkins School of Medicine; Kennedy Krieger Institute), Christopher M Dillon (Kennedy Krieger Institute; University of Maryland, Baltimore County), Alexander Rodolfo Arevalo (Kennedy Krieger Institute) |
Abstract: Competing Stimulus Assessments (CSA) are designed to identify stimuli that when freely available, are associated with reductions in problem behavior. In addition, treatments involving noncontingent delivery of stimuli identified by CSAs are more likely to be successful in reducing automatically reinforced behavior than those involving stimuli were selected based on other methods (Rooker, Bonner, Dillon, & Zarcone, in press). Beyond simply providing free accesses to stimuli during the CSA, one approach involves examining additional procedures aimed at promoting exposure to the potential reinforcement provided by the test stimuli through prompting, and interfering with problem behavior (through response blocking; Jennet, Jann, & Hagopian, 2011). The purpose of the current study is to extend earlier research on these methods, by prompting engagement with the test stimulus, and if necessary blocking of SIB during CSA trials. The CSA was conducted under three conditions: a) stimuli were freely available, b) engagement with test stimuli was prompted, and c) engagement was prompted and SIB was blocked. Following these manipulations, we repeated the free access condition to determine increased engagement and suppression of SIB persisted in the absence of prompting and response blocking |
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Increasing the Ecological Validity of Treatment for Pica: An Evaluation of Differential Reinforcement |
SETH B. CLARK (Marcus Autism Center), Colin S. Muething (Marcus Autism Center; Emory University School of Medicine), Nathan Call (Marcus Autism Center; Emory University School of Medicine) |
Abstract: Pica presents a serious health risk among individuals with developmental disabilities (Matson et. al. 2013; Stiegler 2005). Constant supervision and environmental manipulation are often required to effectively reduce pica. Response blocking, competing stimuli, redirection, and differential reinforcement have been shown to be effective interventions for pica (Goh, Iwata, & Kahng, 1999; Hagopian et. al., 2011; Schmidt et al., 2017). The current investigation sought to replicate and extend the results of Hagopian et al. by evaluating the effectiveness of their procedures to decrease the frequency of pica for two participants with developmental disabilities. Specifically, after utilizing response blocking and differential reinforcement to reduce pica behavior, the durability of the intervention was then assessed in a context in which the caregiver or therapist left the participant alone for periods of time in both contrived and naturalist settings. The combination of differential reinforcement of disposal behavior and response blocking were successful in decreasing pica behavior for both participants. The addition of differential reinforcement of other behavior (DRO) and proximity fading resulted in treatment sustaining under periods of time when the participants were unsupervised. Finally, the effects of treatment were successfully generalized to naturalistic contexts during periods of no-supervision or limited supervision. |
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