47th Annual Convention; Online; 2021
All times listed are Eastern time (GMT-4 at the time of the convention in May).
|Understanding Intrusive and Restrictive Procedures and Their Alternatives|
|Monday, May 31, 2021|
|4:00 PM–4:50 PM |
|Area: DDA; Domain: Applied Research|
|Chair: Carolyn Trump (University of Northern Colorado)|
|CE Instructor: Jennifer Ledford, Ph.D.|
The use of intrusive and restrictive interventions, especially for the treatment of intense and persistent challenging behavior, is sometimes warranted. Translational research and contemporary research synthesis practices may help researchers and practitioners identify the extent to which the use of restrictive or intrusive interventions is advisable under certain conditions. In this symposium, two systematic reviews of applied research conducted in relation to escape-maintained challenging behaviors (Presentation 1) and response interruption and redirection (Presentation 2) and one translational study assessing extinction bursts in low-stakes contexts (Presentation 3) are discussed in relation to the provision of supports for individuals who engage in challenging behavior or stereotypy. These studies have the potential to provide information to the field about the contexts under which certain interventions should be used and/or are most likely to be effective.
|Instruction Level: Advanced|
|Keyword(s): challenging behavior, escape extinction, extinction burst, RIRD|
|Target Audience: |
|Learning Objectives: At the conclusion of the presentation, participants will be able to (1) characterize the evidence base for interventions for escape-maintained behavior that do not include escape extinction (EE) and describe the ethical considerations for choosing EE and non-EE interventions, (2) describe the evidence base for RIRD and ethical considerations for choosing to use RIRD for vocal stereotypy, and (3) explain the value of parametric analysis of extinction bursts in relation to escape-maintained challenging behavior.|
Interventions Without Escape Extinction to Reduce Escape-Maintained Challenging Behaviors: A Meta-Analysis
|KATE TYGIELSKI CHAZIN (Vanderbilt University), Marina Velez (Vanderbilt University), Jennifer Ledford (Vanderbilt University)|
Individuals sometimes engage in challenging behavior to escape aversive stimuli. Interventions to reduce escape-maintained behaviors often use escape extinction (EE; e.g., physically prompting a student to complete an academic task, even if aggression occurs). Use of EE can increase risk of injury, escalate challenging behavior, restrict autonomy, and impact relationships between clients and implementers. To mitigate collateral effects, we can employ interventions without EE (i.e., non-EE)—that is, implementers can provide escape contingent on challenging behavior during intervention, in conjunction with other intervention components. No comprehensive syntheses of non-EE interventions have been conducted. In this systematic review, we identified 39 manuscripts that included non-EE interventions, with 273 separate single case designs. Non-EE interventions were associated with lower levels of challenging behavior and higher levels of alternative behavior than baseline conditions. Interventions that were effective included (a) antecedent modifications to decrease the value of escape as a reinforcer and (b) concurrent reinforcement schedules with more favorable reinforcement for alternative behavior relative to challenging behavior. Most comparisons between non-EE and EE interventions showed no functional relation, indicating that EE may not add substantial benefit to intervention efficacy in some situations.
|Systematic Literature Review for Response Interruption and Redirection: Outcomes and Limitations|
|JENNIFER LEDFORD (Vanderbilt University), Carolyn Trump (University of Northern Colorado), Kate Tygielski Chazin (Vanderbilt University), Kara L. Wunderlich (Rollins College)|
|Abstract: Response interruption and redirection (RIRD) has been evaluated in a number of single case intervention studies, especially for treatment of stereotypy for individuals with autism. In some reviews, RIRD was evaluated alongside response blocking (cf., Steinbrenner et al., 2020); indeed, RIRD sometimes includes similar components included in other interventions (e.g., physical prompting of completion of a competing task). RIRD is intrusive and may capitalize on punishment contingencies, and thus a review of its use and effectiveness is especially important. In this systematic review, we evaluate outcomes from RIRD studies using the Single Case Analysis and Review Framework (SCARF). We evaluate outcomes, using visual analysis, in relation to study quality and measurement practices. We also evaluate the extent to which authors report that reinforcement-based procedures were previously attempted; the extent to which authors report that the behavior was serious enough to warrant an intrusive intervention; and whether maintenance, generalization, or social validity data were reported.|
|Parametric Analysis of Extinction Bursts|
|BAILEY COPELAND (Vanderbilt University), Joseph Michael Lambert (Vanderbilt University), Jessica Lee Paranczak (Vanderbilt University)|
|Abstract: Extinction involves discontinuing delivery of reinforcement and results in a decrease in some measurable dimension of target behavior (e.g., rate, duration). Treatments of challenging behavior are less effective when they do not include extinction. However, when problem behavior is dangerous, practitioners may avoid using extinction. Using extinction temporarily increases the rate or intensity of the target behavior relative to baseline (i.e., extinction burst). Although the prevalence of extinction bursts has been estimated through post-hoc analysis, no method exists to control their occurrence. Thus, extinction is often omitted in the service of safety (and at the cost of efficacy). If we understood why bursts occurred, we could proactively work to mitigate their occurrence; thereby making extinction a viable treatment option in more settings. Available evidence suggests baseline reinforcement parameters influence responding during extinction. This study examined the relationship between participant specific baseline schedules of reinforcement and the presence or absence of extinction bursts.|
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