Association for Behavior Analysis International

Competing stimulus assessments (CSAs) are frequently used to identify items associated with high engagement and reduce automatically maintained challenging behavior. The present symposium will explore four studies evaluating novel modifications and their impact on challenging behavior in adults, adolescents, and children with autism spectrum disorder (ASD). The first two studies evaluate adaptions to traditional CSA methods. One explores the use of clothing items to compete with subtype one and three automatically maintained self-injurious behavior (SIB) and provides preliminary evidence of clothing effectively competing with self-injury. Another study compares the effectiveness of a latency-based CSA to traditional CSA methods and discusses the limited agreement between the two methodologies. The second two studies evaluate modifications to augmented CSA (A-CSA). One study evaluates the utility A-CSA for respondent biting and inappropriate sexual behavior (ISB) and discusses the maintenance of A-CSA findings outside of the intensive clinical context. The last study explores subtyping stereotypy based on functional analysis results as well as A-CSA procedures across training and generalization stimuli to determine maintenance effects. Overall, these studies highlight the importance of evaluating methodological adaptations to CSAs to ultimately enhance clinical practice and research.

Audience should be familiar with the design and implementation of competing stimulus assessments and the functional assessment of automatically maintained behavior.

Previous research establishes competing stimulus assessments (CSAs) as effective tools to identify stimuli associated with a reduction in challenging behavior in individuals with autism spectrum disorder (ASD) and related disabilities (Haddock & Hagopian, 2020). Research on CSAs, however, is limited within (1) the adult population and (2) subtype three automatically reinforced self-injurious behavior (SIB). The purpose of the present study was to evaluate the use of a competing stimulus assessment of clothing items to decrease automatically maintained self-injury in three applications. Two applications were conducted with a 27-year-old male, Myles, diagnosed with ASD demonstrating two separate topographies of subtype three automatically reinforced SIB. One application was conducted with a 24-year-old male, Tucker, diagnosed with ASD demonstrating subtype one automatically reinforced SIB. A CSA was conducted for each application in which levels of SIB, self-restraint, item engagement, and item avoidance were tracked when wearing various clothing items. Overall, at least one effective competing stimulus (defined by an 80% reduction from baseline) was identified for two of the three applications. Future researchers should continue to evaluate the efficacy of clothing items as competing stimuli for individuals demonstrating automatically reinforced SIB.

Competing stimulus assessments are one technology that aids in developing treatment for behaviors maintained by automatic reinforcement. However, these assessments do not always yield robust results. Stereotypic behaviors of different subtypes may require particular procedural modifications to identify competing items successfully. The current investigation recruited children and adolescents with autism spectrum disorder and included functional analyses to determine whether participant responding aligned with proposed stereotypy subtypes. Next, we implemented augmented competing stimulus assessment (A-CSA) procedures across training and generalization stimuli to determine whether (a) responding across either subtype was more likely to require intensive modifications and (b) the A-CSA procedures promoted generalized item engagement within a stimulus class. Lastly, an extended treatment evaluation was conducted to determine the durability of these findings and the generalization of the reduced target behavior to other settings. While participant responding fell into two subtype patterns, the general applicability of the subtyping model remains unclear. Generalized item engagement within stimulus classes was observed across participants, as well as maintenance of target behavior reductions across locations.