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| Considerations for Treating Automatically Maintained Challenging Behaviors |
| Monday, May 29, 2023 |
| 9:00 AM–9:50 AM |
| Convention Center Mile High Ballroom 1C/D |
| Area: DDA/AUT; Domain: Applied Research |
| Chair: Changzhi Wu (University of Nevada, Reno) |
| CE Instructor: Christy Ho, M.A. |
| Abstract: Children with autism and other developmental disabilities engage in challenging behaviors that are maintained by automatic reinforcers. Automatically reinforced behaviors are difficult to deal with because of its inherent risk to the person who emits the behavior. Behavior analysts have been working on risk reduction in both the assessments and interventions of automatically reinforced behaviors. In this symposium, Kyle Dawson will first present a case study which provides clinical support for the utility of three classifications for automatically reinforced self-injurious behavior based on patterns of responding in the functional analysis (Hagopian, et al., 2020) in that the assessments were critical in developing an effective treatment package. Second, Changzhi Wu will present a literature review about safety precautions taken during functional behavior assessment of Pica, a dangerous behavior common in children with developmental disabilities. Last but not least, Christy Ho will present their work which replicates the protective equipment procedure used by Mazaleski et al. (1994) to reduce self-injurious hand mouthing in a 7-year-old participant diagnosed with autism and cerebral palsy. The result shows that protective equipment combined with response interruption and redirection (RIRD) of precursor responses and object manipulation gradually decreased the frequency of hand-mouthing to near zero level. |
| Instruction Level: Intermediate |
| Keyword(s): ASIB, efficiency, pica, FBA, RIRD, hand-mouthing |
| Target Audience: The audience should be familiar with FBA procedures, automatic reinforcement and the assessments and treatments of automatically reinforced behaviors. |
| Learning Objectives: understand the utility of three classifications for automatically reinforced self-injurious behaviors;
understand the importance of FBA modifications to accommodate the risk of self-injurious behaviors;
understand the utility of response interruption and redirection with object manipulation and protective equipments |
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| Identifying Alternative Responses to Replace Self-Restraint in an Adolescent with Subtype-3 ASIB |
| KYLE DAWSON (Munroe-Meyer Institute), Tara A. Fahmie (University of Nebraska Medical Center), Amanda Mae Morris (University of Nebraska Medical Center Munroe-Meyer Institute ), Kortlyn ktawney (Munroe-Meyer Institute, University of Nebraska Medical Center
), Thomas Freetly (University of Kansas) |
| Abstract: Recent research on the classification and treatment of automatically reinforced self-injurious behavior (ASIB) has found three classifications for ASIB based on patterns of responding in the functional analysis (Hagopian et al., 2015). Following the classification of the subtypes, the authors identified differences across subtypes based on resistance to treatment. Subtype-3 ASIB, marked by self-restraint, is one subtype of ASIB that is particularly resistant to treatment. Recently, researchers have developed assessments that can be used to better inform treatment procedures to be used with treatment-resistant ASIB. Hagopian and colleagues (2020) recently developed an augmented competing stimulus assessment (A-CSA) that can be used to identify competing stimuli for individuals with treatment-resistant ASIB. The study's results suggested that the A-CSA effectively identified and established competing stimuli. These results highlight the importance of pre-treatment assessments and potential modifications to empirically validated assessments in treating treatment-resistant ASIB. The current case study examined the efficacy of a matched-stimulus CSA, reinforcer assessment, and self-control assessment to develop a treatment package for an adolescent with Subtype-3 ASIB. The results of this case study provide clinical support for research conducted by Hagopian et al. (2020) in that the assessments were critical in developing an effective treatment package. |
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| A Review of Safety Precautions Taken During Functional Behavior Assessment of Pica |
| CHANGZHI WU (University of Nevada, Reno), Swathi Ragulan (University of Nevada, Reno), Bethany P. Contreras Young (University of Nevada, Reno) |
| Abstract: Self-injurious behavior (SIB) is a common problem behavior among people who are diagnosed with developmental disabilities. Pica is a common form of SIB (Ali, 2001) and the consequences of pica are often dangerous. Functional behavior assessments (FBA) are widely used to measure the functions of target behaviors and intervention plans are designed accordingly. However, limitations of FBA hinder its application in some circumstances. Behavior analysts must modify FBA to accommodate the potential risks of pica. The current literature review identified participant characteristics, procedures used, modifications of functional analysis (FA), and maintaining factors of pica. Results indicated that FA has been dominantly used to identify the function of pica. Indirect or descriptive assessments were not reported to facilitate FA. Behavior analysts have modified FA procedures to accommodate the danger to some extent. For most participants, pica was maintained by automatic reinforcers; others’ pica was maintained by attention. Suggestions and recommendations were made according to the results of the literature review. |
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Contingent Equipment Combined With Response Interruption and Redirection and Object-Manipulation to Reduce Stereotypic Hand-Mouthing |
| Michelle Lesser (Central Texas Autism Center), Aarti Haresh Thakore (Central Texas Autism Center), Anna I. Petursdottir (Texas Christian University), CHRISTY HO (Central Texas Autism Center) |
| Abstract: We replicated the protective equipment procedure used by Mazaleski et al. (1994) to reduce self-injurious hand mouthing in a 7-year-old participant diagnosed with autism and cerebral palsy. The hand-mouthing occurred at a very high frequency throughout the session. The functional analysis results suggested that her hand mouthing was maintained by automatic reinforcement rather than social reinforcement. We implemented non-contingent arm-bands as part of sensory extinction protocol. The result of the non-contingent arm-bands showed immediate decrease in hand mouthing to zero. However, the hand-mouthing increased to high levels in the return to baseline phase. Thus, the response interruption and redirection with object manipulation was introduced. The results showed no decrease in hand-mouthing. The frequency of hand-mouthing also remained high in the return to baseline phase. Consequently, contingent placement of protective equipment was combined with RIRD of precursor responses and object manipulation. The result showed gradual decrease in the frequency of hand-mouthing to near zero level. This intervention was effective in reducing the hand-mouthing to near zero level as well as the frequency remained near zero level when returned to the baseline condition. |
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