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| Treatment Resistant Behavior: Procedures and Perceptions |
| Sunday, May 28, 2023 |
| 5:00 PM–5:50 PM |
| Convention Center Mile High Ballroom 1A/B |
| Area: DDA; Domain: Applied Research |
| Chair: Bethany Munden (University of Alaska Anchorage) |
| CE Instructor: Alexis Constantin Pavlov, Ph.D. |
| Abstract: This symposium will address procedures and perceptions related to the assessment and treatment of challenging behavior. The first presentation will focus on an augmented competing stimulus assessment for treatment resistant challenging behavior. The second presentation will focus on a consecutive controlled case series to determine the prevalence of masked social functions with the use of protective procedures. The final presentation will focus on how perceptions of behavioral severity impact the perceived acceptability and effectiveness of reinforcement- and punishment-based procedures for challenging behavior. |
| Instruction Level: Intermediate |
| Keyword(s): perception, protective equipment, stimulus avoidance, treatment-resistant behavior |
| Target Audience: Attendees should have a familiarity with the common functions of challenging behavior as well as some common assessment (e.g., competing stimulus assessments) and treatment (e.g., functional communication training) options for individuals who engage in challenging behavior. |
| Learning Objectives: At the conclusion of the presentation, participants will be able to: (1) identify at least one consideration for treatment resistant challenging behavior maintained by automatic reinforcement; (2) describe how the use of protective procedures might mask social functions during an functional analysis; and (3) identify at least one way perception can impact determinations of a treatment's acceptability and effectiveness. |
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Augmented Competing Stimulus Assessment for Treatment Resistant Challenging Behavior |
| ALEXIS CONSTANTIN PAVLOV (Marcus Autism Center), Sarah Slocum (Marcus Autism Center and Emory School of Medicine) |
| Abstract: Competing stimulus assessments (CSA) used to identify items or activities that compete with an identified reinforcer can be very effective for challenging behavior maintained by automatic reinforcement. While these assessments have been validated for the selection of competing items, engagement with said items is a necessary prerequisite. When individuals are lacking the skills to or interest in engaging with a potentially novel stimulus, prompting can serve to augment engagement allowing for a more throughout examination of a competing stimulus in assessment. This talk will examine an essential consideration for treatment resistant challenging behavior maintained by automatic reinforcement prior to considering more intrusive treatment evaluations. This talk will present data from participants admitted to an intensive outpatient program whose treatment involved an augmented CSAs that included the use of prompting and/or response interruption and redirection. Subsequent treatment data for challenging behavior maintained by automatic reinforcement will also be discussed. Results indicate that an augmented CSA can successful identify an effective competing stimulus to include in treatment for the reduction of automatically maintained challenging behavior. |
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| Unmasking Social Functions: A Consecutive Controlled Case Series |
| JASMEEN KAUR (Kennedy Krieger institute ), Michelle A. Frank-Crawford (Kennedy Krieger Institute), Nicole Hausman (Journey Autism & Behavioral Care Centers), Molly K Bednar (Little Leaves Behavioral Services) |
| Abstract: Procedural modifications are often required to clarify initially ambiguous functional analysis results. For example, some case reports suggest that the application of protective procedures may elucidate social functions when the initial functional analysis outcome indicated that problem behavior was only sensitive to automatic reinforcement. However, because prior research in this area included a small number of participants, it is unclear how often the application of protective procedures produces similar outcomes. The purpose of this study was to conduct a consecutive controlled case series to determine the prevalence of masked social functions with the use of protective procedures when the initial functional analysis indicated an automatic function. The study illustrated three general patterns of outcomes among the participants. These findings suggest that when an initial functional analysis indicates an automatic function, the addition of protective procedures may (a) unmask social functions; (b) elucidate multiply maintained results and; (c) suppress problem behavior via sensory extinction. The systematic use of protective procedures may aid in clarifying ambiguous functional analysis results. |
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| Severity of Challenging Behavior Effects on the Acceptability and Effectiveness of Reinforcement and Punishment Treatments |
| ABIGAIL LEIGH MARTINEZ (University of Alaska Anchorage), Mychal Machado (University of Alaska Anchorage), Kristin Riall (Alaska Association for Behavior Analysis) |
| Abstract: The challenging behaviors exhibited by individuals diagnosed with autism have been successfully treated using both reinforcement- and punishment-based procedures. Some studies have focused on identifying variables that impact a treatment’s perceived acceptability and effectiveness, but these studies have relied on textual descriptions of challenging behavior, treatments for challenging behavior, or both. The current study evaluated how severity impacts caregiver and child-care professional ratings of acceptability and effectiveness with respect to reinforcement- and punishment-based procedures using video vignettes of a confederate caregiver working with a confederate child with autism. Vignettes included the confederate child engaging in either low-severity and high-severity challenging behavior, and the confederate caregiver implementing one of six empirically-supported treatments (brief interruption, communication training, contingent noxious stimulation, differential reinforcement, timeout, and social disapproval). Following each vignette, caregivers and child-care professionals were asked to rate the severity of the behavior displayed as well as the acceptability and effectiveness of the treatment displayed. Results demonstrated reinforcement-based procedures were considered more acceptable and effective than punishment-based procedures, regardless of the perceived severity of the behavior. |
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