Association for Behavior Analysis International

Previous research has found correlations between wound surface area (WSA, cm2) and rates of self-injurious behavior (SIB; Wilson, Iwata, & Bloom, 2012). Rooker et al. (2019) found a negative correlation between differentiation in the FA and a different injury characteristic (number of injuries). The purpose of this study was to replicate and extend both studies, and investigate whether response rate in, or percent differentiation based on, relevant FA conditions correlated with WSA across seven individuals with automatically maintained SIB (ASIB). That is, we investigated the generality of the finding from Wilson et al., using a combination of methods from both studies. Results suggest that percent differentiation in the FA tends to predict total WSA for ASIB; that is, lower differentiation in the FA predicts more total WSA. Further, when tested independently, rate of SIB in the play and rate of SIB in the test condition of the FA had a weaker correlation with total WSA. These findings are similar to those described by Rooker et al. in that the number of contexts in which an individual engages in SIB appears to be more predictive of injury characteristics than the rate of SIB in any given condition for individuals with ASIB.

Geophagia is the intentional consumption of dirt, soil, or clay. Dangerous health risks of geophagia include parasitic infections, metal poisoning, and gastrointestinal problems. In the current study, geophagia was assessed and treated in a 5-year-old male preschooler with developmental delays who was referred for outpatient behavioral treatment of pica. Primary items consumed were dirt, soil, and sand. Functional analyses results suggested geophagia was maintained by automatic reinforcement due to responses occurring almost exclusively in alone conditions, in the absence of social consequences. Additionally, preference and treatment analyses were conducted to identify stimuli that would compete with geophagia. Matched and unmatched stimuli were presented during baseline conditions to determine the role of oral stimulation in geophagia responses. Stimuli that best competed and yielded the lowest rates of geophagia were then provided noncontingently during treatment sessions, which has resulted in decreases in rates of geophagia.

A 12-year-old male was referred to a severe behavior applied behavior analysis (ABA) clinic for the assessment and treatment of self-injurious behavior (SIB). The client has a rare diagnosis, Bainbridge-Ropers Syndrome (BRPS). BRPS was first described in 2013, and has only been identified in approximately 30 individuals in the literature (Koboldt et al., 2018). BRPS is due to changes in function of the gene additional sex combs-like 3, ASXL3. This gene instructs cells in various organs at different stages of development (Bainbridge et al., 2013), and this mutation is problematic for growth and functioning. Due to the limited amount of individuals currently diagnosed with BRPS, there is a need for increased evidence to support appropriate and efficient assessment and intervention strategies. The client seen in the severe behavior clinic was considered an early learner and due to difficulties related to his diagnosis of BRPS, assessment and treatment of his SIB was challenging. Through various functional assessments tailored specifically to the client, the treatment team was able to identify an appropriate function of his SIB and behavioral interventions were found to be effective for the client based on visual analysis of the data.

Functional analysis (FA) is the most widely researched method for assessing problem behavior of individuals with developmental disabilities and is a vital component in developing treatments for these individuals (Beavers, Iwata, & Lerman, 2013; Hanley, Iwata, & McCord, 2003). This study compared results of two functional analyses, testing synthesized and single contingencies. Familiar staff members who worked with the participants completed the Open- Ended Functional Assessment Interview (Hanley, 2009). Both participants’ behavior was hypothesized to engage in challenging behaviors maintained by escape from demand and access to preferred tangible items. Test conditions for both participants included the following: control, escape, tangible and synthesized escape/tangible. Results of this study indicate that challenging behavior may at times be maintained by more than one single contingency without also occurring under synthesized contingencies while at other times may be maintained by both single and synthesized contingencies.

Disrobing is a socially stigmatizing behavior impacting people with developmental disabilities. It can be a difficult problem to manage in community settings which may lead to social isolation, poor integration with peers, or placement in restrictive settings (Carlson et al., 2011). Traditional functional analysis (FA) procedures rely on measuring repeatability of a behavior while testing isolated functions (Iwata et al., 1994). Disrobing poses a challenge for this methodology since repeated occurrence would require a therapist redressing the client, potentially providing additional attention, which may serve as a confounding variable (Thomason-Sassi et al., 2011). For disrobing, and other behaviors that cannot be repeated due to practical or ethical concerns (e.g.: elopement, vomiting, severe SIB), latency-based functional analyses can be used to identify function. However, latency-based FAs may take time for the participant to detect the contingencies, which uses additional time and resources and may fail to adequately identify automatically maintained behavior. The present study examined the use of an extended latency-based FA on disrobing for an adult in a residential setting. In test conditions, the participant was instructed to put on clothing. Following the initial disrobing, the participant contacted the contingency and was redressed. Latency to disrobing was measured for before and after the contingency. Results indicated that behavior is likely automatically maintained because behavior was evoked at approximately the same latency throughout all conditions, irrespective of the presence of the potentially reinforcing contingency.

Results of recent research identified subtypes of automatically reinforced self-injurious behavior (ASIB) that vary greatly in terms of their responsiveness to treatment. Subtype-2 ASIB has been shown to be one of the most treatment-resistant forms of behavior. As such, protective procedures (blocking and protective equipment) are sometimes used to treat this behavior. However, the collateral effects of these procedures on other forms of self-injurious behavior are unclear. We document the effects of these two procedures on the automatically reinforced self-injurious behavior of an individual who experienced theses protective procedures. Results provide preliminary evidence of response variation in automatically reinforced self-injurious behavior as a function of blocking and protective equipment. Potential implication of the current results will be discussed.

The purpose of this study was to examine the effect of pseudo self-monitoring on rule infraction behavior in a child with ADHD who showed rule infraction behavior in a teaching situation using a card game. Pseudo-self-monitoring is a procedure in which a participant monitors the behavior of another person imitating the participant (Wada and Takeuchi, 2019). The participant was a child with ADHD, 16 years old. As a method of this research, we created a video of the behavior of others imitating the participation behavior in a teaching situation using a card game. Several scenes in the video were presented to the participant in random order for evaluation. The frequency of rule infraction behavior was averaged 66.4% during the baseline, averaged 20% during the intervention phase, and averaged 24.8% during the probe phase. In other words, it was shown that pseudo self-monitoring was effective in reducing the rule infraction behavior of children with ADHD, and that the effect was maintained.

Self-injurious behavior (SIB) is a common topography among individuals diagnosed with developmental disabilities. Head directed self-injurious behavior can lead to significant and long-lasting injury and will typically require some form of intervention. Due to the dangerous nature of head directed self-injury, standard forms of assessment can put the individual at increased risk if allowed to engage in repeated instances of the behavior. In this study, a non-concurrent multiple baseline design across functions with latency as the dependent measure was utilized in order to establish experimental control. This approach limited repeated instances of SIB during baseline and eliminating the need for a return to baseline during treatment. Results indicated that latency to SIB increased when the Picture Exchange Communication System (PECS) was introduced across three identified functions: escape from demands, social avoidance, and access to tangible items. This study indicates that the use of latency as a dependent measure in combination with a multiple baseline design may offer clinicians an alternative to more traditional designs to decrease the risk of injury when SIB is the targeted behavior.

Pica, or the persistent ingestion of non-edible objects, is dangerous and may lead to various health implications such as gastrointestinal complications, lead poisoning, infections, and other dental health problems. Pica is challenging to treat, and is maintained in the absence of social consequences (Piazza, et. al. 1998). The identification and use of items that compete effectively with pica to reduce ingestion of inedible items has shown to work under very controlled conditions. However, the noncontingent delivery of items on a schedule rich enough to compete with pica may be difficult or even unethical to utilize over long periods of time. There is a small body of research has shown that utilizing differential reinforcement of an alternative behavior, i.e., the exchange of an inedible item, may reduce rates of pica, e.g., Kern, Starosta and Adelman, 2006, while circumventing some of these concerns. The current study demonstrates the efficacy of differentially reinforcing the exchange of edible items that had previously been identified to effectively compete with pica with the inedible items the individual encountered across sessions.

To better understand parent trainings on challenging behavior interventions for parents that speak a language other than English, we conducted a review of the existing literature. We conducted a database search and ancillary searches. Six studies evaluating parent training in challenging behavior interventions in a language other than English were identified. The articles identified were analyzed to determine the types of trainings that had been used and to determine the impact that these trainings had on the child’s challenging behaviors. Across the articles, there were 151 parent participants and 151 child participants. The most common language of parent training was Chinese. The existing literature shows that weekly group parent trainings were most commonly used. The scarcity of articles highlights the need for more research in this area. Specifically, future research should evaluate the efficacy and social validity of research supported challenging behavior interventions with parents who speak languages other than English. Implications and directions for future research will be discussed.

Leisure activities have been linked in providing an opportunity for individuals with developmental disabilities to acquire adaptive skills which are necessary for successful inclusion in the general public. Teaching individuals with developmental disabilities to engage in leisure activities is widely acknowledged in improving communication skills, social interaction skills and also providing an opportunity for behaving appropriately in society. Studies involving individuals with developmental disabilities have mainly focused on interventions on feeding and self-care and leisure activities have been somewhat an afterthought. Leisure activities for individuals with disabilities are often selected by their caregivers. This literature review analyzed studies that used video modeling, a non-intrusive behavioral antecedent intervention, to teach individuals with developmental disabilities to engage in leisure activities. Participants in the study were individuals 3 years and above with varying diagnosis that fell under the generic term developmental disabilities. The studies used single-case designs that were evaluated using guidelines of the What Works Clearing House (2017). Studies published from 2001 to 2018 (n =10) were identified. For individuals with severe developmental disabilities, preference assessments should be conducted to identify their preferred leisure activities so that they may engage in leisure activities of their choices.

Antecedent choice-making interventions involve offering an individual a choice in how to complete a task prior to the onset of that task. In order to better understand the possible relationship between antecedent choice making and challenging behavior, a review of the existing literature on the use of antecedent choice-making interventions to reduce challenging behavior was conducted. A systematic review of the literature identified 30 articles in which antecedent choice was implemented to reduce problem behavior. The studies were summarized according to characteristics of the participant, antecedent choice intervention, problem behavior, and other dependent variables such as task completion. In addition, the included studies were analyzed according to the What Works Clearinghouse (WWC; 2017) Single Case Research Design Standards. The literature indicate that antecedent choice-making interventions involve both within-activity choices such as choice of activity materials or setting as well as across-activity choices, such as the order of activities. Initial results indicate the effectiveness of choice-making interventions to reduce challenging behavior. Results will be further analyzed and discussed.

Current research has identified poor post-school outcomes for individuals with intellectual and developmental disabilities; in fact, poorer than any other disability group. Employment support such as vocational skill training can improve outcomes and increase opportunities for paid employment. With recent advances in technology, a myriad of technology devices and programs offer relatively inexpensive and portable forms of support to vocational training programs. Moreover, today’s ubiquitous use of technology allows for the use of technology supports in a way that may not be as stigmatizing in the work setting relative to more traditional forms of support. The purpose of this review is to summarize the literature regarding the use of technology in vocational skills training programs. Articles identified via a systematic search of the literature are summarized according to (a) participant characteristics, (b) vocational skills targeted, and (c) technology device characteristics. In addition, the included studies are analyzed according to the What Works Clearinghouse (WWC; 2017) Single Case Research Design Standards. Results will be further analyzed and discussed.

Functional Communication Training (FCT) is a well-known and often recommended intervention to treat problem behavior among individuals with developmental disabilities. FCT consists of teaching a functional, alternative communicative response to replace problem behavior in the individual’s repertoire to allow them to obtain functional reinforcers that previously maintained problem behavior. Despite a number of literature reviews on FCT, to date, no literature review has examined studies that have evaluated FCT as a treatment for negatively reinforced problem behavior. It may be beneficial to explore treatment related factors to inform practitioners and researchers on how to increase the social validity and generalization of FCT outcomes for negatively reinforced problem behavior(s). The primary purpose of this literature review was to evaluate factors that impact the effectiveness of FCT alone and/or in conjunction with other interventions to treat negatively reinforced problem behaviors. Results across 47 empirical studies supported and extended prior literature review findings. Some novel identified findings on factors that can affect FCT efficiency and generalizability were quality of reinforcement, variability of mands, and the exposure of problem behavior to establishing operations. Recommendations for clinicians and potential avenues for future research will be discussed.

Practitioners commonly test for generality of treatment effects during the end of patient admissions (Stokes & Baer, 1977). Tests may include conditions such as conducting treatment with a novel implementer, in a novel setting, or large decreases in reinforcement. Research suggests that tests for treatment generality often produce treatment relapse (Pritchard, Hoerger, & Mace, 2014). Treatment relapse is generally defined as the reemergence of undesirable behavior following successful treatment (Wathen & Podlesnik, 2018). The current study quantified the prevalence of treatment relapse during these common generality tests for 12 participants enrolled in an outpatient treatment program for severe destructive behavior. We retrieved information on the (a) child's age, (b) referral concerns, (c) diagnoses, (d) level of intellectual disability, (e) treatment duration, (f) undesirable behavior targeted, (g) function of behavior, (h) rates of behavior during assessments and treatment, (i) rates of behavior during tests for generality, and (j) generality test type. We compared mean rates of undesirable behavior during treatment to mean rates of undesirable behavior during tests for generality. Destructive behavior resurged in 18 of 24 applications and renewed in 9 of 14 applications. These findings are discussed in terms of clinical application for the treatment of destructive behavior.