Reinforcers to Treat Escape-Maintained Behavior

Overview

• Functional and nonfunctional reinforcers are directly compared to treat escape-maintained behavior in 5 subjects.
• Compliance produced a break from instructions in the first treatment.
• Compliance produced a small edible item in the second treatment.
• Escape extinction was not included in either treatment.
• The delivery of a positive reinforcer for compliance was effective for all 5 subjects in treating escape-maintained problem behavior.
• The delivery of escape for compliance was ineffective for 3 of the 5 subjects.

Functional Analysis Methodology

• Applying functional analysis has resulted in an ↑ in function-based treatments use, as opposed to arbitrarily selected treatments.
• Functional analysis results give info to develop a treatment that weakens the relation between problem behavior and its maintaining consequences.
• Strengthens the relation between appropriate behavior and those same consequences.
• Function-based treatments have been developed for socially and automatically reinforced behavior.
• Treatments usually involve using the reinforcer to strengthen appropriate behaviour.

Escape-Maintained Problem Behavior

• Commonly the use of noncontingent escape (NCE), differential reinforcement (DR).
• Also escape extinction (EE) is used to deal with escape-maintained problem behavior
• EE is often used with other procedures.
• Extinction is sometimes necessary for maximally effective treatment of escape behavior.
• EE has limitations, including the necessity for physical guidance in the context of three-step prompting.
• Physical guidance might be undesirable, dangerous, or impossible when the subject is larger or stronger than practitioners.
• Alternative interventions have been sought that do not require physical interaction.

Competing Alternative Behavior

• Compliance might covary with problem behavior.
• Delivery of positive reinforcers for compliance and noncontingent delivery of positive reinforcers can ↓ problem behavior and ↑ levels of compliance.
• Problem behavior was likely influenced by multiple variables for a young boy with developmental delays - task introduction and removal of appetitive activities
• Treatment was most effective when experimenters delivered praise, toys, a break from demands, and social interaction contingent on compliance.
• Possible response allocation shifts, despite continued availability of escape for problem behavior.
• Maintaining the contingency for problem behavior while reinforcing compliance might treat negatively reinforced problem behavior

Piazza et al. (1997) Study Variables

• The effects of positive and negative reinforcement with and without extinction on escape-maintained behavior were compared
• Problem behavior was maintained by both negative and positive reinforcement for 3 individuals.
• The introduction of a break contingent on compliance (without extinction) ↑ compliance and ↓ problem behavior for one participant.
• The addition of positive reinforcement contingent on compliance resulted in a more immediate suppression of problem behavior for two participants.
• Extinction was necessary for high levels of compliance and low levels of problem behavior for the third participant.
• The addition of a tangible item during a period of escape was more effective than escape alone when EE was excluded.
• Positive reinforcers alone may be effective at reducing problem behavior.
• Lalli et al. (1999) and Carter (2010) have conducted the most direct comparisons of contingent positive and contingent negative reinforcement in the treatment of escape behavior without EE.
• Either an edible item or a break was provided contingent on compliance.
• Across subjects, positive reinforcement was more effective at ↓ problem behavior and ↑ compliance with task demands
• This was when compared to negative reinforcement.

Further Considerations

• Subjects experienced demands every 30s rather than continuously in the Piazza et al. (1997) and Lalli et al. (1999) studies
• Lalli et al. also used 10-s interprompt intervals in the least-to-most prompting hierarchy which might compromise interpretation of the data.
• The prompting strategies themselves included brief breaks which might have contributed to decreased motivation to access breaks and abated escape-related responding.
• Control of the intertrial intervals is a reasonable step when comparing positive and negative reinforcement for treating escape-maintained problem behavior
• Both Lalli et al. and Carter (2010) primarily used reversal designs.
• Negative reinforcement contingencies were effective for treating problem behavior only when the positive reinforcement condition preceded the negative reinforcement condition for Jay (Lalli et al.).

Benefits of Positive Reinforcement

• Positive reinforcement to treat problem behavior maintained offers potential benefits
• Delivery of positive reinforcers for appropriate behavior may be less disruptive than providing escape.
• Teachers/practitioners might prefer to deliver a small edible item/token rather than a break.
• Reinforcers also would influence the establishing operation for escape during aversive stimulation, likely for positive reinforcers to be more effective

Additional Research Needed

• Additional systematic research that directly compares positive and negative reinforcement for compliance while some of the previously discussed variables are controlled is warranted needed.
• Comparison of positive and negative reinforcement for compliance sans EE while treating escape from demands.

Method

Subjects and Setting

• Referred to a clinic or attended a local school.
• Five participants (four boys and one girl, ranging in age from 4 to 8 years) participated, problem behavior maintained by escape was shown in functional analyses
  • Braiden: a 4-year-old boy, diagnosed with ASD, communicated with gestures and a few modified words, and followed some single-step instructions
  • Ali: was a 7-year-old girl, diagnosed with ASD and ADHD, spoke in multiword sentences and followed complex instructions.
  • Nicholas: was an 8-year-old boy, diagnosed with pervasive developmental disorder, spoke in short sentences and followed two-step instructions.
  • Stephen: was a 7-year-old boy, diagnosed with ASD, could not speak vocally but used a few sign approximations, and followed some single-step instructions
  • Milo: was a 4-year-old boy, diagnosed with a developmental delay, no functional communication, and did not follow simple instructions

Other Variables

• Sessions conducted either in a small pullout room (2 m by 2 m) at a local school or in a session room (3 m by 4 m) in a clinic.
• Session rooms were equipped with an observation panel.
• Milo's sessions were conducted in an area (3 m by 3 m) of a larger room blocked off to mitigate high levels of loud vocal stereotypy.
• The session room (or area) was empty except for items needed to conduct the sessions.

Response Definitions and Interobserver Agreement

• The operational definitions for each subject's problem behavior are presented in Table 1
  • Braiden engaged in aggression and spitting.
  • Ali's target behavior consisted of vocal protests, a precursor behavior for more severe aggression.
  • Nicholas displayed aggression.
  • Stephen's aggression included grabbing, hair pulling, and pinching.
  • Milo's aggression took the form of pushing, climbing on others, and hitting.
• Experimenters attempted to block instances that might have harmed the experimenter due to severity of the aggression across subjects, but any blocked attempt was scored as problem behavior.
• Compliance was scored if the subject engaged in the correct response following either a vocal or a model prompt. Interobserver agreement using a proportional agreement method.

Functional analysis

• Before the treatment comparison, the analysis of behavior influenced the selection of conditions for each of the 5 subjects.
• Sessions lasted 5 min and were based on the procedures described by Iwata, Dorsey, Slifer, Bauman, and Richman (1982/1994).
• Not all subjects were exposed to all conditions and conditions were selected based on anecdotal evidence of behavioral function.
• Sessions were displayed in each subject's functional analysis graph.
• the subject and experimenter were in the session room with no other materials in the no interaction and the experimenter did not engage with the subject
• during attention the experimenter would sit in the session room with materials and the subject had continuous access to a moderately preferred tangible item as the subject proceeded to engage in behavior the experimenter provided attention

Tangible Condition

• Subjects briefly interacted with leisure or edible items before the start of the tangible sessions, the staff then removed anything from the subjects procession at the start of each secession

Demand Condition

• Finally, the subject was provided with specific instructions in the demand condition analysis based on direct observation of the subject

Comparison

• They compared two treatments using a reversal design embedded with a multielement design that was 5 min across sessions with discriminative stimuli that can assist in discrimination between conditions