Association for Behavior Analysis International

Function-based treatments are widely used in behavior analysis. Practitioners are not only interested in developing effective treatments in clinical settings, but in developing treatments that generalize to caregivers and can be feasibly implemented over time. To this end, practitioners implementing function-based treatments must consider teaching methods (e.g. prompting procedures), schedule thinning methods, caregiver training procedures, and the prevalence of relapse of caregiver behavior. Four studies investigated the impact of these variables on the outcomes of function-based interventions including functional communication training (FCT) and noncontingent reinforcement (NCR). First, one study compared the effects of response-independent and response dependent progressive time delay during training of FCT. Second, an investigation evaluated the effects of multiple schedules to rapidly thin schedules of NCR. Third, a study investigated the transfer of FCT treatment effects to a caregiver. Fourth, one investigation evaluated relapse of undesirable caregiver behavior after training to implement FCT. The results of these studies indicate that function-based interventions such as FCT and NCR are effective in reducing problem behavior, but it may be necessary to explicitly program for maintenance of treatment results by training caregivers to adhere to treatment protocols.

Functional communication training is a well-established, reinforcement based treatment to reduce problem behavior for individuals with developmental disabilities. However, the specific prompting procedures to teach a functional communication response (FCR) vary across studies and often are not adequately described. Progressive time delay (PTD) is a prompting procedure that initially starts with the therapist providing the child with a prompt to ensure s/he is engaging in the FCR. Then, the therapist gradually increases the delay of the prompt to give the child time to respond independently. Typically in most PTD procedures, the delay is increased dependent on the child's lack of acquisition. An alternative approach is to increase the time delay independent of the child's acquisition. Thus, the purpose of this study was to evaluate the effects of two PTD procedures (i.e., response dependent and response independent) on the acquisition of the FCR. The study included eight participants that engaged in problem behavior maintained by access to preferred items or attention. All participants acquired the FCR regardless of which PTD procedure was implemented. These results suggest that increasing the delay based on acquisition may not be a critical component. Clinical implications regarding these outcomes and future directions will be discussed.

Treatment relapse may be the most ubiquitous challenge facing behavior-analytic interventions for destructive behavior, and failure of caregiver treatment adherence to those interventions represents a primary source of treatment relapse. Researchers have focused on the persistence of child destructive and alternative behavior as they relate to treatment relapse and have largely ignored the persistence of caregiver treatment adherence. In the current study, we examined relapse of undesirable caregiver behavior (e.g., reinforcing child destructive behavior) following behavioral skills training (BST) with three caregivers of children referred to our clinic for treatment of destructive behavior. First, we simulated conditions in which undesirable caregiver behavior terminated confederate destructive behavior in a home-like context. Second, the behavior analyst used BST to teach desirable caregiver behavior (i.e., how to implement functional communication training), after which the caregiver practiced these skills with the confederate in a clinic context. Third, we introduced a treatment-adherence challenge in which caregivers returned to the home-like context and confederates appeared inconsolable (i.e., neither desirable nor undesirable caregiver behavior terminated confederate destructive behavior). We observed relapse of undesirable caregiver behavior during 2 of 3 caregivers' treatment-adherence challenges. We discuss these findings along with prospective training enhancements for strengthening caregiver treatment adherence.