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| Assessment and Treatment of Automatically Maintained Self-Injurious Behavior |
| Sunday, May 27, 2018 |
| 10:00 AM–10:50 AM |
| Manchester Grand Hyatt, Seaport Ballroom G |
| Area: AUT; Domain: Applied Research |
| Chair: Eileen M. Roscoe (The New England Center for Children) |
| CE Instructor: Samantha Russo, M.Ed. |
| Abstract: Approximately 25 % of self-injurious behavior is maintained by automatic reinforcement. This function of self- injurious behavior is significantly less understood than self-injury maintained by social reinforcement (Hagopian, Rooker & Zarcone, 2015). In 2015, Hagopian, Rooker & Zarcone conceptualized various subtypes of self injurious behavior based on patterns of responding during functional analyses and the presence of self restraint behavior. The current symposium will incorporate these seminal findings into applied research regarding the assessment and treatment of self- injurious behavior. |
| Instruction Level: Advanced |
| Keyword(s): "Automatically maintained", "Competing stimulus", "Self-Injury", "Self-restraint" |
| Target Audience: Practitioners in applied settings. |
| Learning Objectives: 1. Understand the conceptualization of the subtypes of automatically reinforced self injurious behavior 2. Understand in greater depth the subtype 3 conceptualization of self-injurious behavior 3. Analyze differences in self- restraint reduction methodology |
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Decreasing Self-Injurious Behavior and Self-Restraint in an Adult With Autism |
| SAMANTHA RUSSO (Endicott College; Eden Autism), Christopher Tallmadge (Eden Autism) |
| Abstract: Self- injurious behavior that is maintained by automatic reinforcement can be categorized into three different subtypes. These subtypes are conceptualized based on the presence of self-restraint and patterns of responding during functional analysis (Hagopian, Rooker & Zarcone, 2015). In this conceptual framework, subtype 3 is the presence of self-restraint behavior. This specific subtype is often most resistant to treatment. Hagopain, Rooker & Zarcone (2015) found that of the 39 individuals with automatically reinforced self-injurious behavior, only 20.5% met the criteria for subtype 3. Banda, McAfee & Hart (2012) published a single case study in which an ABAB design was used to establish that rates of self-injury were significantly lower when self-restraint was allowed. Systematic fading of the self-restraint materials resulted in low rates of self-injury and no self-restraint. The current study replicates and extends on the work of Banda et al., (2012) in order to decrease severe self-injurious behavior and the use of self-restraint materials in an adult male. |
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| Reduction of Automatically Maintained Self-Injurious Behavior Using Combined Differential and Noncontingent Reinforcement |
| CHRISTOPHER M DILLON (Kennedy Krieger Institute), Griffin Rooker (Kennedy Krieger Institute), Jennifer R. Zarcone (Kennedy Krieger Institute), Michelle A. Frank-Crawford (Kennedy Krieger Institute), Erica Lozy (Louisiana State University), Alexander Rodolfo Arevalo (Kennedy Krieger Institute), Louis P. Hagopian (Kennedy Krieger Institute) |
| Abstract: Self-injurious behavior (SIB) maintained by non-social (automatic) reinforcement is an especially pernicious form of maladaptive behavior because the reinforcement obtained by the individual cannot be directly withheld. Hagopian, Zarcone, and Rooker (2015) described a model for subtyping automatically reinforced SIB (ASIB) based on unique response patterns in the functional analysis (FA). They determined that Subtype-3 ASIB, characterized by the presence of self-restraint, appears highly resistant to treatment. Recent research we conducted examining the performance of participants with ASIB on a human operant task targeting an arbitrary response using contingent reinforcement produced unexpected reductions in SIB. When this differential reinforcement of alternative behavior (DRA) component was combined with other treatment components in the context of a treatment evaluation targeting SIB, further reductions in SIB were observed. We speculate that the mechanism for response suppression involved both response competition (as a function of the DRA component), reinforcer competition (as a function of the NCR schedule), and sensory extinction or punishment (via response blocking and arm splints). Although the findings are preliminary and require further replication and refinement, they point to the potential for including additional schedule components aimed at increasing responses that may be incompatible with or disrupt the occurrence of SIB. |
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Identifying Stimuli That Compete With Self-Restraint and Automatically Reinforced Self-Injurious Behavior |
| MICHELLE A. FRANK-CRAWFORD (Kennedy Krieger Institute), Louis P. Hagopian (Kennedy Krieger Institute), Jennifer R. Zarcone (Kennedy Krieger Institute), Griffin Rooker (Kennedy Krieger Institute), Alyssa Fisher (Kennedy Krieger Institute), Erica Lozy (Louisiana State University) |
| Abstract: Competing stimulus assessments (CSAs) have been used for nearly two decades to identify stimuli that effectively compete with automatically reinforced self-injurious behavior (ASIB; Fisher, O'Connor, Kurtz, DeLeon, & Gotjen, 2000; Jennett, Jann, & Hagopian, 2011). Competing stimuli are identified by comparing the rate or percentage of occurrence of ASIB in a control condition absent of any external sources of stimulation to conditions in which a stimulus is present. Stimuli that reduce ASIB to clinically significant levels are then characterized as competing stimuli. Some individuals who engage in ASIB also engage in self-restraint (SR), behavior that is incompatible with or prevents SIB (e.g., sitting on one's hands; Oliver, Murphy, Hall, Arron, & Leggett, 2003). If SR effectively eliminates ASIB, the identification of competing stimuli for ASIB becomes difficult. In those cases, measuring SR as the dependent variable and observing how stimuli alter both its occurrence and the occurrence of ASIB may be a viable option. The current study describes the use of a CSA to identify stimuli that compete with both SR and ASIB, and will discuss how covariation in SR and ASIB in a CSA might inform us about the relation between these responses. |
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