Association for Behavior Analysis International

Subtype-2 automatically maintained self-injurious behavior (ASIB) presents one of the most significant clinical challenges for behavior analysts due to its insensitivity to changes in environmental stimuli and social contingencies, and is often more resistant to treatment (Hagopian et al., 2015). Competing stimulus assessments (CSAs) are a pretreatment assessment used to measure stimulus engagement and SIB across various stimuli with the goal of identifying stimuli that may reduce SIB by promoting alternative engagement (e.g., Fisher et al., 2000; Ringdahl et al., 1997; Gover et al., 2019). While CSAs have demonstrated utility in identifying stimuli that compete with the reinforcement obtained from SIB, less is known about how durable the findings are across repeated applications. In this case study, an individual with Subtype 2 ASIB, receiving treatment at an intensive outpatient behavioral clinic participating in two CSAs over 10 days. These results suggest that CSA outcomes may change over time, even within a stable clinical setting. This underscores the importance of repeated CSAs to inform the most effective treatments for Subtype 2 ASIB. Implications for the clinical application of repeated CSAs and their use in the development of robust and effective behavioral interventions will be discussed.

The behavior analytic research base for interventions targeting severe behavior is substantial, particularly within single-case design (SCD); however, further replication and extension are needed to solidify the evidence base (Walker & Carr, 2021). The use of “assent-based intervention” (Breaux & Smith, 2023) and a collaborative approach (Choy et al., 2025) resulted in a positive response to intervention, reducing all behaviors of concern and decreasing the use of protective holds for a 12-year-old male with autism who engaged in head-directed self-injurious behavior (SIB), aggression, and property destruction. A functional behavior assessment (FBA) was conducted using both direct and indirect methods, with collaboration from the student (Shillingsburg et al., 2019). A compound schedule of differential reinforcement of other and alternative behaviors (DRO/DRA) was used during academic activities, with tokens exchanged for self-reported reinforcers (degli Espinosa & Hackenberg, 2024). The intervention goals were acceptable to the student before implementation, ensuring social validity in advance of the intervention (Carter & Wheeler, 2019). Educators were trained to criteria with behavioral skills training (BST) and a direct observation checklist. Interobserver agreement (IOA) was collected for 59.3% of occurrences using video recordings. The intervention followed an AB design, and social validity measures showed high student acceptance.

This study investigated the effects of Virtual Face Conditioning on children with developmental disabilities. The participants were four preschool males who attended a self-contained classroom. The study aimed to determine if conditioning children with virtual faces could increase their attention to faces and whether this attention would transfer to live, in-person faces. Researchers measured participants' gaze responses to both virtual and live faces, as well as their orientation to adults' faces and voices in real-world settings. The researchers implemented a structured Virtual Face Conditioning protocol using iPad-based technology. Participants were reinforced with edible treats and praised for maintaining eye contact with virtual faces displayed on the screen. Researchers gradually reduced reinforcement as participants progressed through the next phases of the study. Results showed an increase in participants’ observed responses to both virtual and live faces post-intervention. These findings suggest that virtual face conditioning with iPad-based technology can effectively improve preferential attention to adult faces that can be transferred to live faces and other generalized real-life situations. Future research should explore the use of more salient stimuli, such as caregivers' faces, and investigate longer intervention durations to further strengthen the intervention process.

Individuals with intellectual and developmental disabilities often engage in challenging behavior (Crocker etal., 2006). If left without intervention, challenging behavior can lead to many negative impacts on the individual’s life such as, higher caregiver turnover rates, higher abuse rates, and higher rates of arrest (Friedman, 2021; McCauley, 20217). The purpose of the present review is to examine the current body of literature regarding challenging behavior in adults to identify interventions implemented with this population, their effectiveness, and social validity. The literature search encompassed the following databases: PsychInfo, Education Research Complete (ERC), Academic Search Complete (ASC), Education Resources Information Center (ERIC), Medline, and Psychology and Behavioral Sciences Collection. Search Terms were entered in three search fields. The first used terms associated with intellectual or developmental disabilities using “OR” inbwteen terms. The second field used terms associated with challenging behavior, and the third field used the terms (intervention* OR “behavior modif*” OR treatment). Inclusion criteria included (a) ID or DD diagnosis; (b) participant 18+ years old; (c) challenging behavior as a dependent variable. Search results across all the databases returned 6,947 results. Initial abstract screening excluded 6,611 studies. 335 studies were screend in full-text.