|
Recent Findings on Automatically Maintained Self-Injurious Behavior |
Sunday, May 26, 2019 |
6:00 PM–6:50 PM |
Hyatt Regency West, Ballroom Level, Regency Ballroom C |
Area: DDA; Domain: Applied Research |
Chair: Michelle A. Frank-Crawford (Kennedy Krieger Institute; University of Maryland, Baltimore County) |
CE Instructor: Michelle A. Frank-Crawford, M.A. |
Abstract: Approximately 25% of self-injurious behavior is maintained by automatic reinforcement. Recent research has identified subtypes of automatically maintained self-injurious behavior (ASIB) based on levels of differentiation across play and no interaction conditions of functional analyses and the presence of self-restraint. Subtype classification and level of differentiation are highly predictive of response to treatment using reinforcement alone. The first presenter will provide an overview of results obtained during the course of a 5-year grant supported research project on subtypes of ASIB, summarizing data which replicate and extend earlier findings, as well as new findings with respect to injuries incurred from SIB, results of analyses examining sensitivity to contingencies on operant tasks, and the impact of procedures designed to promote alternative responses and disrupt SIB in the most treatment resistant subtypes. The second presenter will provide an in-depth review of findings from an augmented competing stimulus assessment that involves actively promoting engagement and blocking SIB to identify and establish competing stimuli. The third presenter will describe results from an assessment designed to examine differences in sensitivity to changing reinforcement parameters, which unexpectedly produced reductions SIB to uncharacteristically low levels. Each presenter will discuss potential implications of the findings. |
Instruction Level: Intermediate |
Keyword(s): Automatically maintained, competing stimulus, response competition, Self-injurious behavior |
Target Audience: Practitioners in applied settings; researchers |
Learning Objectives: 1. Understand the concept of sensitivity to disruption by alternative reinforcement and how it distinguishes the various subtypes of automatically maintained self-injurious behavior, 2. Understand the implications of findings for future research on ASIB, 3. Understand the rationale for and procedures of the augmented competing stimulus assessment and single operant task and their potential utility in treatment. |
|
Automatically-Maintained Self-Injury: A Summary of Findings From a Five Year study |
LOUIS P. HAGOPIAN (Kennedy Krieger Institute; Johns Hopkins University School of Medicine), Griffin Rooker (Kennedy Krieger Institute; Johns Hopkins University School of Medicine), Michelle A. Frank-Crawford (Kennedy Krieger Institute), Jennifer N. Haddock (Johns Hopkins School of Medicine, Kennedy Krieger Institute ), Alexander Rodolfo Arevalo (Kennedy Krieger Institute ), Christopher M Dillon (Kennedy Krieger Institute), Alyssa Fisher (Kennedy Krieger Institute), Noor Javed (Kennedy Kreiger Institute) |
Abstract: Results from a 5-year federally-funded research grant on automatically maintained self-injurious behavior (ASIB) will be reviewed. Subtypes are derived from the level of differentiation of SIB across play and no interaction conditions of functional analyses and the presence of self-restraint. Data replicating and extending earlier findings on subtypes of ASIB, and their differential responsiveness to treatment using reinforcement alone will be summarized. Findings related to self-restraint, injuries incurred from SIB, and behavioral sensitivity to contingencies on operant tasks across functional classes of SIB will be reviewed. New procedures designed to promote alternative responses and disrupt SIB in the most treatment resistant subtypes will be briefly discussed - and elaborated upon further by the other presenters. In addition to findings on ASIB, this work led to the refinement of methods for safely conducting research on SIB that may have clinical utility, the development of a preliminary model of injury production, and the application of methods and concepts used in precision medicine to define predictive behavioral markers. Implications of these findings for future research on ASIB will be discussed. |
|
Initial Results From an Augmented Competing Stimulus Assessment |
NOOR JAVED (Kennedy Kreiger Institute), Louis P. Hagopian (Kennedy Krieger Institute; Johns Hopkins University School of Medicine), Michelle A. Frank-Crawford (Kennedy Krieger Institute), Alyssa Fisher (Kennedy Krieger Institute), Christopher M Dillon (Kennedy Krieger Institute), Griffin Rooker (Kennedy Krieger Institute; Johns Hopkins University School of Medicine) |
Abstract: A competing stimulus assessment (CSA) is used to identify stimuli that, when made freely available, reduce problem behavior - presumably via reinforcer competition. Recent research suggests that competing stimuli are more frequently identified for subtype 1 automatically reinforced behavior than for more treatment-resistant subtypes 2 and 3. We developed and applied an augmented CSA (A-CSA) with six individuals with treatment resistant subtypes of automatically maintained behavior. The A-CSA involves first providing free access to the test stimuli, then repeating the assessment while prompting engagement and, when necessary, blocking problem behavior. Prompting and blocking are then removed and the free access condition is repeated to determine if outcomes are improved. Results demonstrated that the number of effective stimuli and duration of engagement increased across the initial and repeated free access condition for all participants. Additionally, for 3 of 4 participants, response blocking resulted in further increases in engagement relative to prompted engagement alone. Changes across the initial and repeated free access condition may be related to the prompting and/or blocking procedures interrupting reinforcement maintaining problem behavior and facilitating contact with reinforcement available through stimulus engagement. |
|
Reductions in Self-Injury Under Fixed Ratio Schedules in Treatment-Resistant Subtypes of Automatically Maintained Self-Injurious Behavior |
CHRISTOPHER M DILLON (Kennedy Krieger Institute), Griffin Rooker (Kennedy Krieger Institute; Johns Hopkins University School of Medicine), Jennifer N. Haddock (Johns Hopkins School of Medicine, Kennedy Krieger Institute ), Nabil Mezhoudi (New England Center for Children), Alexander Rodolfo Arevalo (Kennedy Krieger Institute ), Louis P. Hagopian (Kennedy Krieger Institute; Johns Hopkins University School of Medicine) |
Abstract: Recent research on automatically maintained SIB (ASIB) has shown a positive relation between level of differentiation in the functional analysis and response to treatment using reinforcement alone – a dimension that has been characterized as sensitivity to disruption by alternative reinforcement. Relative to subtype 1 ASIB and socially maintained SIB, subtypes 2 and 3 ASIB show decreased sensitivity to disruption by alternative reinforcement. To examine whether the insensitivity of ASIB is specific to that response class, or is a generalized response tendency among individuals with these subtypes, individuals performed a single operant task under changing schedules of reinforcement (i.e., fixed and progressive ratio schedules, and extinction). Individuals with subtypes 2 and 3 ASIB showed comparable levels of sensitivity to reinforcement schedule changes relative to individuals with socially maintained SIB. During this assessment, uncharacteristically low levels of SIB were observed with the majority of participants with ASIB. Specifically, near zero rates of SIB were observed for six of the 10 participants with ASIB, and an 80% reduction in SIB relative to the toy play condition of the functional analysis was achieved with eight participants. The implications of these findings for research are discussed. |
|
|