Punishment-Based Procedures

• Numerous punishment-based procedures are effective for treating problem behavior.

Positive Punishment

• Contingent presentation of a stimulus decreases the likelihood of a behavior in the future.
• Examples include verbal reprimands, brief physical restraint, and demands.

Negative Punishment

• Contingent removal of a stimulus decreases the future likelihood of a behavior.
• Includes response cost, which is the removal of a positive reinforcer, and time out, which is contingent loss of access to reinforcement.

Basic Research

• It has been instrumental in developing an effective technology of punishment.
• Applied literature has demonstrated advantages and disadvantages.
• Research goal: develop safe, effective punishers for individuals with intellectual developmental disorder.

Concerns About Punishment

• Basic and applied research on punishment is declining.
• The decrease is attributed to advances in functional analysis and greater use of function-based treatment.
• Punishment remains important for severe cases of problem behavior.
• Punishment may be indicated when reinforcers maintaining problem behavior can’t be identified or controlled.
• Punishment also may be the treatment of choice for life-threatening behavior.

Function-Based Punishment

• Clinicians should prescribe punishment with some knowledge of relevant vs. irrelevant consequences to maintain problem behavior.
• Function-based punishers are likely to be effective, given available information.

Chapter Objectives

• Provide an overview of punishment procedures
• Provide approaches for selecting procedures
• List of factors that influence punishment effects
• Provide strategies for using punishment effectively

When To Use Punishment

• When initial interventions based on reinforcement and extinction do not produce acceptable decreases in problem behavior.
• When the problem behavior warrants immediate intervention with procedures likely to produce rapid decreases in responding.

Types of Punishment

• Procedures are classified by form (overcorrection), function (time out), or both.
• Many include multiple potential punishing stimuli.
• Classification done by its effects on behavior.
• Some procedures function as punishment while others have different functions.

Positive-Punishment Procedures

• These involve the presentation of an aversive stimulus contingent on behavior.

Verbal Reprimands

• Brief statements of disapproval or instruction may function as an effective punisher.
• Effective for: self-injurious behavior, aggression, pica, rumination, and stereotypy.
• Stern "No," or "Don't do that, you'll hurt yourself," contingent on problem behavior.
• Reprimands can be established as effective conditioned punishers.
• More effective when paired with eye contact and physical contact, when delivered nearby, and contingent on the problem behavior of other individuals.

Response Blocking and Physical Restraint

• Response blocking involves brief physical contact to prevent a response.
• Physical restraint restricts or limits an individual's movement.
• Restraint procedures: hands down, baskethold, and movement suppression time out.
• Used briefly (30-60 seconds) and with other potential punishers.
• Time out from positive reinforcement may be a component of any physical-restraint procedure.

Overcorrection and Contingent Effort

• Several variations involve requiring the individual to engage in an effortful response following problem behavior.
• Overcorrection: contingent response is topographically like or related to the problem behavior.
  • Restitutional overcorrection: individual restores the physical environment to a better state.
  • Positive-practice overcorrection: repeatedly practice an appropriate, related behavior.
• Contingent demands: complete tasks unrelated to the problem behavior.
• Negative practice: exhibit the problem behavior repeatedly.
• Contingent exercise: perform motor movements unrelated to the problem behavior.
• Response interruption and redirection: deliver questions or instructions requiring vocal responses contingent on occurrences of vocal stereotypy.

Water Mist

• Used contingent water mist to decrease problem behavior.
• Deliver one mist of water for each instance.

Aversive Tastes and Smells

• Aversive tastes (vinegar, lemon juice) and smells (aromatic ammonia) successfully treat problem behavior.
• Therapist squirts a small amount of lemon juice/vinegar into the mouth or applies aromatic ammonia under the nose.
• Used for: self-stimulatory behavior, chronic rumination, public masturbation, pica, aggression, and breath holding/hyperventilation.

Noise

• Contingent presentation of noise can be a punisher.
• Used for finger/thumb sucking, hair pulling, and auditory hallucinations.
• Device producing a tone when hand moves toward the mouth reduced thumb sucking.

Shock

• Most intrusive and controversial, but produces rapid and durable reductions in severe SIB and aggression.
• Researchers delivered brief, moderate intensity electric shock to an extremity via electrodes activated by a movement detection device.
• It does not increase the risk of undesirable side effects and can be a safe alternative.

Negative-Punishment Procedures

• Involves the contingent loss of access to positive reinforcers as a punishment.

Time Out from Positive Reinforcement

• Contingent loss of access to positive reinforcers or withdrawal.
• This is one of the most common forms of punishment.
• Removing someone to a less reinforcing environment (exclusionary time out), or discontinuing reinforcement in the current environment (nonexclusionary time out).
• Studies have examined durations from 15 seconds to 30 minutes; outcome is inconsistent.
• Contingent release: fixed durations compared the absence of problem behavior during time out, suggests that the latter does not confer any additional benefits.
• Nonexclusionary time-out: visual screen, the time-out ribbon, contingent observation, and item removal.
• Researchers commonly combine physical restraint while placing someone in time out e.g. basket hold

Response Cost

• Contingent removal of a specific amount of reinforcement can function as an effective punisher.
• Participant obtains reinforcement via appropriate behavior or independently, and loses these reinforcers contingent on problem behavior.
• Research conducted in the context of token-economy systems; participants lost books, audiotapes and money.
• Methods for determining the appropriate reinforcers to remove in a response cost intervention have not been evaluated.

Selecting Punishment Procedures

• Ethical guidelines mandate prioritizing the least restrictive procedure that is clinically effective.
• Procedures should be arranged hierarchically by restrictiveness or aversiveness.
• Less restrictive: nonexclusionary time out and response cost.
• More restrictive: exclusionary time out, overcorrection, and other physical punishers.
• This hierarchy can be used as a levels system

Concerns About The Least Restrictive Model

• Attempts to apply the least restrictive treatment model may raise ethical concerns.
• Clinicians using a hierarchical system typically evaluate punishment procedures on a trial basis
• Can be time-consuming, delay the onset of treatment, and produce prolonged exposure to multiple intrusive procedures.
• Claims that a more restrictive procedure has a higher likelihood of success lacks empirical support.
• The approach emphasizes topography of an intervention, ignores other considerations, such as whether the behavior could be used as a reinforcer.
• Exposure to progressively intrusive interventions could promote habituation.
• Additional factors to considerate are immediacy of effects, relevance to behavioral function and caregivers’ willingness to implement the procedure.

Functional Analysis

• Knowing the function of problem behavior is crucial.
• Punishment more effective if clinician combines it with extinction and differential reinforcement of alternative behavior.
• Clinicians should withhold identified functional reinforcers for problem behavior and deliver those reinforcers for appropriate behavior whenever possible.
• Examination of assessment outcomes may indicate whether a procedure is likely to be effective, unlikely to be effective, or specifically contraindicated for the problem behavior.

Types of Analysis

• Verbal reprimands and physical contact: may have no effect on problem behavior, exclude them as punishment.
• Can also yield lower levels of problem behavior, indicating that this consequence may be an effective intervention
• Results may show sensitivity to attention as reinforcer, increases verbal/physical attention in blocking and overcorrection may be contraindicated
• Can also yield sensitivity the demand condition which tests the removal of interaction and instructional materials
• Additional assessment needed to identify the most appropriate intervention in the following sections.
• Further research is needed on the predictive validity and clinical utility of the assessments; only 8.5% of studies reported how researchers selected the punisher.

Stimulus Avoidance Assessment

• Involves researchers evaluating participants’ responses to various punishment procedures to determine which one they should apply.
• Researcher should evaluate participants' responses to various punishment procedures.
• Each potential punisher presented independently of needing to respond.
• Observers measured avoidance responses, negative and positive vocalizations, procedures associated with the highest rates of avoidance responses and negative vocalizations more likely to function as punishers.
• An advantage is that it empirically evaluates multiple potential punishers in a short time.

Brief Punisher Assessment

• Brief assessments of punishers have been useful for identifying effective interventions.
• Used in conjunction with or instead of avoidance assessments.
• Results showed that the assessment had good predictive validity when they evaluated the punisher throughout the day in an intervention package.
• Evaluate one or more potential punishers to predict the effectiveness
• Researchers evaluate 1 to 2 punishers during each of 3 to 6 sessions, alternating in a multielement deisng

Activity Assessment

• Baseline observations determined the relative lengths of time for which participants engaged in various freely avaliable activiites Results ofsome studies predicted activity associated with low probably of engagement would function as punisher
• Arrange the contingency and require participant to engage in the activity from (hibh->low)
• Other researchers have predicted than any activity may function, suggest that even all levels of engagement relative Krivacek and Powell required 3 students withintellectuals engage with activiets for activities that clients rarely engaged spontaneously

Choice Assessments

• Behavior analysis can use additional assessment of care giver, of client preerence for intervemtiion
• Behaviour analyses can assess caregibver or opinion about properness to implemented
• There are many factors include experiencer with intervention,
• Client can be the preffered type

Using Punishment Effectively

• Can be effective for many Behaviour disorder, treatment, renforcements can be highly ineffective to
• Difficult to predicts , clinical outcomes,
• Findings suggest clinical ways can undernine effective intervensitons
• Punishment, ,ay not poduce immediate subsatnal in provlem

Contiguty Of the Punishher

• Im applied study therpaist delivered the consequcene immediatley fter the
• Studies dicate for suppress the responding that a given has no effect

Schedule of Punishments

• Reulst of basics studie that the punishment for delivers for target for
• Intermittent with punishing schedule

Magnitude Of Punishers

• Basic Resesrach conducted wlectirc and intensity of puinshment will produce relar reductions
• magnitude when increase gradient the reduction of Bheaviour
• The limited magntidue for the limited clincia utile
• Can enahnce the restisan of puinshers

Alibilty of Alternative Source of Renforcement

• Apliealies and resesrahc may be indicated for alterntaivley respondign
• Increased depravations reduces effeveitnss if behaviour

Reinforcements of the Punishee Response

• Applied studies indicated in the absce of exction

Altecende Control of the Pinshiee Response

• Reulst indicated that three appliied studies over the estibaling criminaltiy
• Study over ofter the deleyed to stimimulied with the effectivenss
• Mcknezile had some restraaitn

Use of Conditiioned Purhs

• Analyst may enanve effeicient of intermilutent anverssing
• Reulst indicated that neurtulized innfeictven

Had some reulst for exampel conditned pursooner with a given intervensiiton

Maiintenaces of Punismnet Effects

• Severla APplide had reported the efifccay
• Physicl restraints repiramns with wattwe er misjht ans onther
• Reseeaches tyiclaly collects data from 1=12 the time

Stimulus Generilaiztioions of Pinisjemt

• In unlited research had been the genatied of 1110116

Interet effect of Punsh

• In general resposnen of exctied

Conlusiois

• Mumerous varations