Functional Behavioral Assessment, Diagnosis, and Treatment: A Complete System for Education and Mental Health Settings - Ennio Cipani PhD 2018

Functional Behavioral Treatment Protocols for SME 4.0: Problem Behaviors

In this chapter, the material presented in Chapter 4 is expanded to provide a treatment protocol for each replacement function option delineated for socially mediated escape (SME) target behaviors. The treatment protocols for direct escape (DE) are the same as the SME protocols except for some minor variations in the procedures for dealing with the occurrence of the target behaviors. These variations are explicated in each replacement function option.

For SME problem behaviors, the following protocols are presented in this chapter:

✵Premack Contingency Option

✵Tolerance Training Option (or Differential Negative Reinforcement of All Other Behaviors)

✵Escape Mand (Protest or Negotiation Behavior) Option

✵Alternate Direct Escape Form

✵Noncontingent Escape (NCE)

This chapter also contains a protocol for a treatment program called noncontingent reinforcement (NCR). This program was not delineated in Chapter 4 because it does not readily address the function of the target behavior or the development of the replacement function (not one specified). Rather, it works as a result of altering the motivational condition of the client in one of two ways. In the case of target behaviors maintained by negative reinforcement, the NCE program alters behavior by removing the aversive stimulus that generates escape behavior. In this case, it may also establish the conditions for extinction by disrupting the contingent pairing of the target behavior and the reinforcer.

All the protocols in this chapter, with the exception of NCE, contain a functional arrangement of treatment contingencies. The target behavior’s function is disabled, while the replacement behavior’s function to the relevant reinforcer is enabled.

SME FUNCTIONS: PREMACK CONTINGENCY OPTION

Brief Description

In a Premack contingency, the desired reinforcer is produced following the client’s successful compliance with a designated regimen of tasks or demands. This has also been referred to as Grandma’s rule, that is, you don’t get your dessert until you eat your vegetables. The more technical definition of the Premack principle is making access to a high-probability behavior contingent on performing a low-probability behavior (Premack & Bahwell, 1959).

To implement a Premack contingency for SME functions, the staff, parent, or teacher determines what negative reinforcer the target behavior is removing (what task, event, or person the unwanted behavior is escaping or avoiding). You would then determine a set of tasks that have to be performed before escape or avoidance is allowed. The reinforcing event (removal of the negative reinforcer) is withheld until the client performs the specified task.

The advantage of using a Premack contingency is that it still allows for escape of the aversive event to be used as a negative reinforcer. The requirement to perform a set of tasks will build in a delay of the removal of the negative reinforcer. The client subsequently learns to tolerate the aversive event or activity for longer periods of time. This replacement function option reduces some of the difficulties associated with extinction. It also usually reduces the overall rate of terminating or avoiding the negative reinforcer (similar to that produced in tolerance training). The Premack contingency can be used with any SME subcategory.

Apparatus

Data sheets—See Form 6.1 “Simple Frequency Data With Formulas”

Baseline Measurement

1.Identify the target behavior to be observed.

2.Operationally define or pinpoint the target behavior, with specific criteria for onset and offset of behavior (if not readily evident).

3.Determine the observation period, possibly reviewing scatter plot or A-B-C data to identify periods of time when behavior is highly likely.

4.Construct the data sheet to reflect the length of the observation period, trying to keep the length reasonably similar during all baseline sessions.

5.During observation, record either the occurrence of the target behavior, the duration of the target behavior, or the intensity of the behavior (which measure you select will depend on the target behavior).

6.Repeat step 5 until the observation period ends.

7.Conduct at least four more baseline sessions.

8.Graph or display the data across all baseline sessions.

Procedures for Premack Contingency

1.Either at specified times of the day or under antecedent conditions that occasion the target escape behavior, require the client to engage in a simple designated task determined by an analysis of client’s level of ability.

2.When the client completes the designated task, remove the aversive event allowing the client to escape the negative reinforcer.

3.Repeat steps 1 and 2 with each occurrence of the conditions that have in the past preceded escape behaviors.

4.As a function of success in ameliorating the target behavior, progressively increase the duration or quantity of the task required.

5.Ensure that the target behavior does not produce negative reinforcement. (escape extinction)

Procedures for Premack Contingency When Used as a Supplement for Requesting Program.

1.Contingent upon a request by the client to terminate an activity or event or have an item removed from the area, require the client to engage in a simple designated task, determined by an analysis of client’s level of ability.

2.When the client completes the designated task, remove the aversive event, allowing the client to escape the negative reinforcer.

3.Repeat steps 1 and 2 with each request.

4.As a function of success in ameliorating the target behavior, progressively increase the duration or quantity of the task required.

5.Ensure that the target behavior does not produce the desired reinforcer (escape extinction).

Thinning the Schedule of Delivery of Maintaining Reinforcer

Once the target behavior is reduced, the behavior analyst can increase the response effort or time to remove the undesired event or item. This can be done in two ways:

1.Increase the duration or complexity of each task.

2.Increase the number of tasks required to earn the reinforcer.

Progressively altering either or both of these factors will increase the length of time the client will have to tolerate the aversive condition (whether it be a task demand or social situation) before a request to remove the event is honored.

If utilizing this behavior option for direct escape (DE) behaviors: Utilize the same baseline and treatment procedures as above, except that chain interruption would occur instead of extinction when the target behavior is displayed.

How It Works

It is often the case that the social environment has made it too easy for the person to escape or avoid certain events. Therefore, escape or avoidance of such events occurs at unreasonable levels. To want to get out of an unpleasant event is not a sin! But it surely is tough to accommodate such a desire when it prevents learning of important life skills or endangers the person’s health. If a child cannot tolerate sitting in a group activity in early elementary school for longer than 30 seconds, such an inability will result in fewer learning opportunities and perhaps removal from the classroom.

A problem may also appear once a mand (request) for escape is taught and acquired. Requesting “out” may occur too often once developed, resulting in the person staying in the relatively aversive situation far too short a time compared to his or her peers. Hence, this Premack contingency program also is used as a supplement to the escape mand (requesting) program.

A Premack contingency is well suited to reduce the client’s desire to avoid a given event. Requiring the performance of a task as a condition for removal of a negative reinforcer is a strategy that will eventually wean the client off of frequent avoidance and increase the ability to tolerate a nonpreferred condition for longer periods of time.

Hypothetical Example

I Need a Break, My Brain Is Swelling

John was a mainstreamed fourth-grade student. The initial referral to the behavior analyst, Ms. White, stated that the staff needed help with John’s tantrum behavior. Ms. White went to the classroom and interviewed the teacher and teacher’s aide. She constructed Table 6.1 from the information they provided.

Ms. White observed John on several occasions and noticed that the target behavior occurred only during reading. John would read for about 5 to 10 minutes, as long as one of the special education personnel were looking at him. As soon as that person turned away, he would put down his book and very quietly take out one of his toys and start to play. When one of the aides looked at him, he would attempt to hide the toys by picking up his reading book. When the aide looked away, he would go back to playing with his toys. If the aide caught him and came over and attempted to direct him back to reading, he would begin to complain, yell, throw items off the desk, stomp his feet, and so forth. Following each outburst, the aide directed him to the quiet area in the classroom to allow him time to engage in his “self-calming” skills. He would then return to the class when “calm.” Ms. White noticed that with each self-calming session, the time it took him to calm usually lasted until the assignment changed from reading to math. In other words, as a result of the “self-calming” procedure, he missed the remainder of the reading period.

TABLE 6.1 ■ SUMMARY OF TOY PLAY A-B-C DATA

TABLE 6.2 ■ DIAGNOSTIC TABLE FOR TANTRUMS AND TOY PLAY

SMA, socially mediated access; SME, socially mediated escape.

Ms. White considered the function of such behaviors to possibly be socially mediated access (SMA) SMA 2.1: Staff Attention. However, she ruled this out as John was observed at other times to have very effective skills to start conversations and evoke attention from staff members during other times of the day. The critical piece of information was the timing of the end of the tantrum and self-calming behaviors. It was perfectly correlated with the end of the reading assignment. This left the most likely diagnosis to be SME 4.2: Lengthy Tasks, specifically the reading task (see Table 6.2). It appeared that John could read the material; however, he just ran out of steam at some point in the lengthy reading period.

Ms. White presented her hypothesis to the teacher. The teacher expressed some concern and disagreement with Ms. White’s analysis. She believed that the tantrum was just an effort to get her attention. Ms. White offered to test her hypothesis over the next 6 days. The test was a simple one.

A.Three days with a 1-hour period of coloring pictures; no reading during this time with no attention provided at this time.

B.Three days with a 1-hour period of reading with frequent attention.

For 1 hour each day, John would be alternately asked to engage in either a coloring activity or the usual reading assignments. The time period for these two activities would be the same each of the 6 days. During the coloring activity, he would receive no attention from any of the adults. If he displayed tantrums during this time, it would provide some evidence that the tantrums were functioning to access attention. During the reading period, he would receive frequent attention. If he had more tantrums during this typical reading activity, when compared to the coloring activity, escape motivated tantrum behavior seemed plausible.

The teacher agreed, and Ms. White implemented the procedure. It produced the data presented in Example Form 6.1.

From this data it was very clear that the tantrums were functioning to escape the reading assignments. Ms. White also found that John would engage in the reading assignment for an average of 5 minutes. Any attempts to direct him back to reading after 5 minutes would result in tantrum behaviors. This occurred in all of the reading periods. Ms. White reviewed the Individual Education Plan (IEP) and found there was no indication that John had visual impairments of any kind.

Example Form 6.1 ■ Frequency Count Data Sheet

✵Behavior: Tantrums

✵Total Observation Time: 360 min (1, 60-minute session/day)

✵Session Length 60 min

✵Number of Days: 6

✵Place an X on the appropriate day box each time the target behavior occurs

A.Total minutes observed: 180

B.Total occurrences observed: 10

C.Range (low) 2 to (high) 2, Avg = 2

A.Total minutes observed: 180

B.Total occurrences observed: 0

C.Range (low) 0 to (high) 0, Avg = 0

Ms. White could have simply set up a program that allowed a requesting behavior to escape reading (by asking to color instead). This clearly would have ended the tantrum behaviors. However, it would not be conducive to his continued learning and development. She decided that a Premack contingency would be better suited as it would reduce the level of tantrums while slightly increasing the amount of reading time during the beginning phase of intervention. The Premack contingency would also gradually alter John’s desire to escape reading activities over time, as the work requirement (to get out of reading and into coloring) increased. Ms. White had noticed during her observations that John would also play with Sudoku math puzzles during his free time.

Ms. White set up the following Premack contingency. John would be given access to Sudoku math puzzles or coloring activities following completion of a specified amount of reading. In the initial contingency, he could end the reading task and access 5 minutes of Sudoku or coloring by completing one page of reading (see Example Form 6.2).

Example Form 6.2 ■ Premack Contingency: Plan

✵Person served: John

✵Target Tantrums

✵Behavioral diagnostic category: SME 4.2: Lengthy Tasks/Chores/Assignments, reading task

✵Designated time period(s): Reading period

✵Rate of low-probability Baseline 0 pgs/period Target 10 pgs/period

✵Rate of high-probability Baseline 1/period Target 0

✵Initial standard for low-probability Upon request by the teacher to begin reading, John will be required to complete 1 page of reading.

✵Description of how high-probability behavior will be provided: (how much, how often etc.) Will be provided 5 minutes to play Sudoku or color in a book following each page of reading.

✵Criterion for Increasing the duration/complexity of the low-probability When John has gone 5 consecutive days with no tantrum behaviors, increase the low-probability behavior required by adding one additional paragraph to the reading requirement.

✵Criterion for decreasing the duration/complexity of the low-probability If John engages in tantrums for three consecutive reading periods, change the required response to three paragraphs.

✵Procedure for withholding/preventing the high-probability behavior if not earned: All toys will be removed from John and Sudoku puzzles/coloring will be available only from the teacher.

✵Special instructions for delivery of reinforcer(s): If John completes multiples of the reading task at one time, he can be given multiples of the reinforcer. That is, if he reads two pages in a row, he can earn 10 minutes of Sudoku, etc.

FIGURE 6.1 ■ Reading and tantrums.

The plan was implemented, and Ms. White graphed tantrums as well as pages read. The intervention had a clear effect on the rate of tantrums and increased the rate of reading. Ms. White also graphed the number of times John was earning access to Sudoku or coloring. As can be seen in Figure 6.1, the Premack contingency had an immediate effect on John’s tantrum behavior as well as his reading. John quickly progressed to an acceptable reading standard. During periods 22 thorough 30, he was exceeding the Premack requirement such that he was accessing Sudoku or coloring for a total of 15 minutes per reading period. His reading output remained relatively high, and as the reading requirement was increased, his total time doing math puzzles decreased. There were two occurrences of tantrum behavior during this intervention. One occurred during the first increase in the response requirement. The second occurred during a stable point in the intervention.

What If?

What if the person refuses to do the required behavior?

You must impose conditions that do not allow escape of the task via any behaviors except those you have specified in the plan, that is, completing tasks. If your analysis is correct, the person should, after some short period of time, engage in the low-probability behavior because it is the only way to escape or avoid the less preferred event.

You must be sure that the client can actually perform the low-probability behavior, that is, he or she does not have a skills deficit (or an inept repertoire diagnosis). You may want to reduce the difficulty of the low-probability behavior to make it more likely the client will contact the reinforcer.

Forms: Premack Contingency

6.1 Simple Frequency Data With Formulas

6.2 Premack Contingency: Simple Plan

Form 6.1 ■ Simple Frequency Data With Formulas

✵Behavior: __________________________________________________

✵Number of Days:

✵Place an X on the appropriate day box each time the target behavior occurs

A.Total minutes observed: _____

B.Total occurrences observed: _____

C.Range (low) _____ to (high) _____, Avg = _____

Form 6.2 ■ Premack Contingency: Simple Plan

✵Person served: ___________________________

✵Target 'margin-top:6.0pt;margin-right:5.0pt;margin-bottom: 0cm;margin-left:21.8pt;text-indent:-16.8pt;line-height:normal'>•Behavioral diagnostic category: _______________

✵Target rate: ___________________________

✵Designated time period(s): ___________________________

✵Initial standard for low-probability 'margin-top:6.0pt;margin-right:5.0pt;margin-bottom: 0cm;margin-left:21.8pt;text-indent:-16.8pt;line-height:normal'>•Description of how high-probability behavior will be provided: (how much, how often, etc.) __________________________________________

__________________________________________

✵Criterion for increasing the duration/complexity of the low-probability 'margin-top:6.0pt;margin-right:5.0pt;margin-bottom: 0cm;margin-left:21.8pt;text-indent:-16.8pt;line-height:normal'>•Criterion for decreasing the duration/complexity of the low-probability 'margin-top:6.0pt;margin-right:5.0pt;margin-bottom: 0cm;margin-left:21.8pt;text-indent:-16.8pt;line-height:normal'>•Procedure for withholding/preventing the high-probability behavior if not earned: __________________________________________

__________________________________________

✵Special instructions for delivery of reinforcer(s):

__________________________________________

__________________________________________

__________________________________________

ADDITIONAL RESOURCES

Allison, J. (1976). Contrast, induction, facilitation, suppression and conservation. Journal of the Experimental Analysis of Behavior, 25, 185—198.

Amari, A., Grace, N. C., & Fisher, W. W. (1995). Achieving and maintaining compliance with the ketogenic diet. Journal of Applied Behavior Analysis, 28, 341—342.

Hanley, G. P., Iwata, B. A., Roscoe, E. M., Thompson, R. H., & Lindberg, J. S. (2003). ­Responserestriction analysis: II. Alteration of activity preferences. Journal of Applied Behavior Analysis, 36, 59—76.

Hanley, G. P., Iwata, B. A., Thompson, R. H., & Lindberg, J. S. (2000). A component analysis of “stereotypy as reinforcement” for alternative behavior. Journal of Applied Behavior Analysis, 33, 285—297.

Homme, L. E., de Baca, P. C., Devine, J. V., Steinhorst, R., & Rickert, E. J. (1963). Use of the Premack principle in controlling the behavior of nursery school children. Journal of the Experimental Analysis of Behavior, 6, 544.

Konarski, E. A., Jr., Johnson, M. R., Crowell, C. R., & Whitman, T. L. (1980). Response deprivation and reinforcement in applied settings: A preliminary analysis. Journal of Applied Behavior Analysis, 13, 595—609.

Mitchell, W. S., & Stoffelmayr, B. E. (1973). Application of the Premack principle to the behavioral control of extremely inactive schizophrenics. Journal of Applied Behavior Analysis, 6, 419—423.

Mithaug, D. E., & Mar, D. K. (1980). The relation between choosing and working prevocational tasks in two severely retarded young adults. Journal of Applied Behavior Analysis, 13, 177—182.

Premack, D. (1963). Rate differential reinforcement in monkey manipulation. Journal of the Experimental Analysis of Behavior, 6, 81—89.

Premack, D. (1970). A functional analysis of language. Journal of the Experimental Analysis of Behavior, 14, 107—125.

Premack, D., & Bahwell, R. (1959). Operant-level lever pressing by a monkey as a function of interest interval. Journal of the Experimental Analysis of Behavior, 2, 127—131.

Premack, D., & Premack, A. J. (1963). Increased eating in rats deprived of running. Journal of the Experimental Analysis of Behavior, 6, 209—212.

Premack, D., & Schaeffer, R. W. (1962). Distributional properties of operant-level locomotion in the rat. Journal of the Experimental Analysis of Behavior, 5, 89—95.

Premack, D., & Schaeffer, R. W. (1963). Some parameters affecting the distributional properties of operant-level running in rats. Journal of the Experimental Analysis of Behavior, 6, 473—475.

Premack, D., Schaeffer, R. W., & Hundt, A. (1964). Reinforcement of drinking by running: Effect of fixed ratio and reinforcement time. Journal of the Experimental Analysis of Behavior, 7, 91—96.

SME FUNCTIONS: TOLERANCE TRAINING OPTION (OR DIFFERENTIAL NEGATIVE REINFORCEMENT OF ALL OTHER BEHAVIORS)

Brief Description

In tolerance training or differential negative reinforcement of other behavior (DNRO), the specific maintaining reinforcer is contingent on the absence of the target behavior in a given period of time. In this case, the maintaining reinforcer is the avoidance or termination of an event, item, or person that is aversive to the client. DNRO is one of the simplest of all behavior reduction procedures. One could also view a DNRO as a reinforcement system that allows the person to escape or avoid a specific negative reinforcer by engaging in a variety of behaviors, as long as the targeted behavior does not occur.

To implement a DNRO program, the staff, parent, or teacher determines if the target behavior occurred during a specified interval of time. If it occurred, escape or avoidance is prevented, and the interval is reset for the full DNRO period. If the target behavior did not occur, reinforcement in the form of termination of an unpleasant event or task is provided at the end of the designated interval. By providing reinforcement in this way, engaging in any behavior other than the targeted behavior pays off better. Concurrently, the target behavior’s functional relation to escape or avoidance of an aversive event is disabled.

The advantage of using a DNRO procedure is that it is easy to implement, and it specifically focuses on the reduction of the unwanted behavior. It is not designed to teach any new behavior or to target any specific behavior for an increase. Differential reinforcement has been one of the most widely used procedures for dealing with the reduction of unwanted behaviors.

Terms

Interbehavior interval: The length of time that passes between the end of one targeted behavior and the beginning of the next occurrence of the targeted behavior.

DNRO interval: The length of time the person must abstain from engaging in the target behavior in order to escape or avoid the aversive event.

Thinning the schedule of delivery of maintaining reinforcer: The process of gradually ­increasing the time that elapses before the negative reinforcer is removed.

Escape: Engaging in behavior that terminates the presence of an aversive task or event.

Avoidance: Engaging in behavior that prevents one from coming in contact with an aversive task or event.

Aversive stimulus: A task, event, or person that, when presented, evokes a response that avoids or escapes the stimulus.

Apparatus

Timing device—This can be a kitchen timer, alarm clock, computer with alarm feature, and so on. A tape recorder with beeps at designated intervals, or a calendar, depending on the length of the schedule of NCR. Its purpose is to prompt the staff person, teacher, or parent to remove the aversive event.

Data sheets—See Form 6.3 “Simple Frequency Data With Formulas”

Baseline Measurement

1.Identify the target behavior to be observed.

2.Operationally define or pinpoint the behavior being observed, with specific criteria for onset and offset of behavior (if not readily evident).

3.Determine the observation period, possibly reviewing scatter plot or A-B-C data to identify periods of time when behavior is highly likely.

4.Construct the data sheet to reflect the length of the observation period, trying to keep the length reasonably similar in multiple baseline sessions.

5.During observation, record the occurrence of the target behavior.

6.Repeat step 5 until the observation period ends.

7.Sum the total number of occurrences of the target behavior, and enter that number on the data sheet.

8.Divide the session length by the total frequency of target behavior (see following examples) to arrive at the interbehavior interval for that session.

9.Complete at least four more baseline sessions.

10.Graph or display the interbehavior interval across all baseline sessions, noting the range and mean.

Calculating the Interbehavior Interval. Suppose we had the data in Table 6.3 and wanted to determine the interbehavior interval.

TABLE 6.3 ■ INTERBEHAVIOR INTERVAL DATA

To calculate the interbehavior interval for the entire 5 days of observation, simply take the total number of minutes for observations, and divide the number by the total number of occurrences of the target behavior. In this case:

600 total minutes ÷ 18 total occurrences of behavior = an interbehavior interval of 33.33 minutes.

If we were to calculate the interbehavior interval for Day 1, it would be:

120 minutes ÷ 2 occurrences of behavior = an interbehavior interval of 60 minutes.

If we were to calculate the interbehavior interval for Day 5, it would be:

120 minutes ÷ 6 occurrences of behavior = an interbehavior interval of 20 minutes.

DNRO With Extinction Procedures

1.From baseline data, calculate the interbehavior interval.

2.Determine the schedule for the removal of the negative reinforcer. The initial schedule should be set so that removal of the negative reinforcer occurs at or more frequently than the average interbehavior interval; for example, initial interval set at 20% below the average interbehavior interval. (An average interbehavioral interval 33 minutes times 80% would equal 26.4 minutes.) This becomes the DNRO interval length.

3.Set the timing device to the initial removal schedule.

4.When the timer goes off, terminate the negative reinforcer if the person has not engaged in the target behavior for the entire time period, and then reset the timer.

5.As soon as the client engages in the target behavior during the interval, do not allow escape or avoidance of the aversive event; use extinction procedures as needed, and reset the timer for the full DNRO interval.

6.Thin the schedule of the negative reinforcement.

Thinning the Schedule of Removal of the Negative Reinforcer

When the target behavior goal is achieved, increase the length of the DNRO interval and set a new target behavior goal. The steps for thinning the schedule follow.

1.When the target behavior goal is achieved, increase the DNRO interval by 5% to 10%. For example, if the DNRO interval was 5 minutes, and the target behavior goal was met, then the new schedule for removal might be set at 5 minutes, 30 seconds.

2.With each week of success in achieving the target behavior goal, the schedule of removal is thinned by progressively increasing the DNRO interval by 10%.

3.If the target behavior occurs at a rate consistently higher than the established goal over a given week, consider returning to the previous DNRO interval.

4.If you have made several attempts at thinning the schedule but are unable to get past a particular DNRO interval, it may be best to keep the schedule at that level while incorporating another functional treatment program.

If utilizing this behavior option for direct escape (DE) behaviors: Utilize the same baseline and treatment procedures as above, except that chain interruption would occur instead of extinction when the target behavior is displayed.

How It Works

As with all differential reinforcement, DNRO works by altering the contingencies such that engaging in the target behavior reduces the frequency and magnitude of reinforcement. Prior to the DNRO contingency, the exhibition of the target behavior was functional. The social environment enabled such a behavior by frequently removing the negative reinforcer contingent upon its occurrence. The DNRO schedule disables this function by further postponing the removal of the aversive event contingent on an occurrence of the target behavior, that is, the DNRO interval is reset. Therefore, doing anything other than the target behavior is a more efficient path to escape or avoid the aversive event.

Hypothetical Example

The 20-Minute Child. Fred was an elementary school student in a regular education classroom. Mr. Delgadillo received a referral to develop a plan to reduce the disruptive desk hitting of Fred. Mr. Delgadillo was not sure what was maintaining the desk-hitting behavior, so he decided to set up an A-B-C chart, and he collected data for a 2-week period. A sample of the data collected is presented in Table 6.4.

TABLE 6.4 ■ SUMMARY OF DESK-HITTING A-B-C DATA

After examining the previous A-B-C descriptive data, Mr. Delgadillo set about answering the questions: “What are the common elements in the events involving desk hitting?” and “How do they differ from the events that did not produce desk hitting?” Mr. Delgadillo discovered Fred did not engage in desk hitting when he was working on tasks of his choice, even if no one interacted with him for periods as long as 45 minutes, which ruled out SMA 2.1: Adult Attention and SMA 2.2: Peer Attention as the likely maintaining function. Desk hitting was never followed by the presentation of a tangible item eliminating a hypothesis of SMA 2.3: Tangible Reinforcer as a maintaining function. Mr. Delgadillo noticed that desk hitting happened only if Fred worked on a task, not of his choosing, for greater than 15 minutes without a break. After an event of desk hitting was interrupted by the teacher, Fred would typically stop work on the undesired task for an average of 5 minutes while the teacher corrected his behavior. Fred would then sometimes be offered a different, more preferred task on which to work.

Mr. Delgadillo determined the most likely hypothesis is that desk hitting is being maintained by 4.2 SME: Relatively Lengthy Tasks/Chores/Assignments (see Table 6.5). Having formulated a hypothesis, Mr. Delgadillo collected data during a 4-hour session (240 minutes) each day for 5 days. The data indicated that Fred was hitting the desk at a rate of about three times per hour (see Example Form 6.3).

The interbehavior interval was calculated by determining

Total minutes observed (1,200 minutes) ÷ Total frequency target behavior occurred (58 occurrences) = Average interbehavior interval (20.7 minutes).

With this data in hand, and an understanding of the function of the desk-hitting behavior, Mr. Delgadillo formulated an intervention plan (see Example Form 6.4). Because the problem was not a skills deficit and really required just changing the contingencies to increase the length of time Fred was reading, Mr. Delgadillo settled on differential reinforcement. Because the target behavior was maintained by an escape function, Mr. Delgadillo decided to use tolerance training (DNRO). Having determined that the desk-hitting behavior occurred about every 20 minutes, he set the initial DNRO interval to 15 minutes to ensure that Fred was very likely to obtain reinforcement more often under this plan.

Prior to implementing the program, Mr. Delgadillo informed the staff that an extinction burst would probably occur and that they should be prepared for this event. He also made sure to be in the classroom during the implementation of the program so that he could support the teaching staff and assure them that the program was implemented correctly. The program was implemented, and the following data were collected and are presented in Figure 6.2.

As Mr. Delgadillo expected and as can be seen in the graph, the DNRO was successful in reducing the occurrence of desk-hitting behavior. It is interesting to note that as Mr. Delgadillo predicted, on 6/25, the desk hitting behavior worsened. This is a familiar and expected pattern when using extinction, called an extinction burst. Following this burst (increase in rate from prior level), the desk-hitting behavior steadily and quickly declined. Because Mr. Delgadillo had let the teaching staff know what to expect, they were prepared for this and stuck with the plan. By 7/14 the behavior had met the criteria for thinning the DNRO schedule, so Mr. Delgadillo increased the interbehavior interval by 10% such that reinforcement was now delivered every 17 minutes. Mr. Delgadillo continued this thinning process until the desk-hitting behavior was no longer occurring.

TABLE 6.5 ■ DIAGNOSTIC TABLE FOR DESK HITTING

SMA, socially mediated access; SME, socially mediated escape.

Example of From 6.3 ■ Frequency Count Data Sheet

✵Behavior: Desk Hitting

✵Number of Days: 5

A.Total minutes observed: 1,200 Interbehavior interval = A/B 1,200/58 = 20.69 min Rate/hour = (B/A)60 (58/1,200)60 = 2.9/hr

What If?

What if the behavior does not decrease (or gets worse) with DNRO?

When using DNRO with extinction, we often see an initial worsening of the target behavior. The technical term for this is an extinction burst. Just like its name implies, it is a brief and often intense increase in the target behavior that happens when the behavior no longer produces the reinforcer. You should see a dramatic decrease in the behavior within 3 sessions or days. If the behavior continues at a high rate for longer than that, you will need to confirm that the item or event you are removing contingently is actually reinforcing for the person. The other possibility is that the DNRO interval is simply too long for the person to contact the reinforcer at a high enough rate to reinforce other behaviors. In this case, shortening the DNRO interval is an option you should consider. If this is still ineffective, you should consider a more focused reinforcement strategy, perhaps starting with NCR.

What if I cannot ignore some of the target behaviors?

If the target behavior has life-threatening consequences or cannot be ignored, you can program a DNRO without extinction. In this case, all the elements of the DNRO would be the same with the exception that when the target behavior occurs, we will continue to respond to it as we have in the past. This will make the behavior change process somewhat slower because the difference in level of reinforcement will not be as great. This can be countered to some extent by shortening the DNRO interval, thus increasing the density of reinforcement for all other behaviors.

Example Form 6.4 ■ Tolerance Training Or Differential Negative Reinforcement With Extinction: Plan

✵Person served: Fred

✵Target Desk hitting

✵Behavioral diagnostic category: SME 4.2: Task Duration

✵Target rate: 0 events per week

✵Designated time period(s): All class periods

✵Intervals with no occurrence of desk hitting:

✵Initial schedule of differential negative reinforcement:

○X Fixed time schedule every 15 minutes/hours/days

OR

○__Variable time schedule on average every__minutes/hours/days

✵Reset timer: End of each interval

○X End of each interval AND if target behavior occurs

○Special instructions for delivery of reinforcer(s):

1.If desk hitting occurs, immediately reset the timer to 15 minutes and record data.

2.Reset timer to 15 minutes at the end of the earned 5-minute break.

✵Criterion for increasing amount of time between reinforcers: When desk-hitting behavior occurs in <1% of intervals observed for 3 consecutive days, increase time between delivery of reinforcement by 10%.

✵Criterion for decreasing amount of time between reinforcers: If desk-hitting behavior occurs in more than 5% of observed intervals for 3 consecutive days, decrease time between delivery of reinforcement by 1 minute.

✵Criterion for withholding the scheduled reinforcer delivery: Occurrence of desk hitting.

FIGURE 6.2 ■ Frequency of desk hitting.

Forms: DNRO

6.3Simple Frequency Data With Formulas

6.4DNRO With Extinction: Simple Plan

6.5Formulas for Calculating Percentage of Intervals of Targeted Behavior and Interbehavior Intervals

6.6Formulas for Determining Increases or Decreases in Frequency of Differential Negative Reinforcement

Form 6.3 ■ Simple Frequency Data With Formulas

✵Behavior:

✵Number of Days:

✵Place an X on the appropriate day box each time the target behavior occurs

A.Total minutes observed: Interbehavior interval = A/B / = ____

✵Rate/hour = (B/A)60 ( / ) 60 = ____

A.Total minutes observed:___Interbehavior interval = A/B / = ____

B.Total occurrences observed:____

C.Range (low) to (high)___, Avg = Rate/hour = (B/A)60 ( / )60 = ____

Form 6.4 ■ DNRO with Extinction: Simple Plan

✵Person served: _________________________

✵Target 'margin-top:6.0pt;margin-right:5.0pt;margin-bottom: 0cm;margin-left:21.8pt;text-indent:-16.8pt;line-height:normal'>•Behavioral diagnostic category: _________________________

✵Target rate: _________________________

✵Designated time period(s): _________________________

✵Initial schedule of differential negative reinforcement:

○____Fixed time schedule every____ minutes/hours/days

OR

○____Variable time schedule on average every _____ minutes/hours/days

✵Reset timer:

○____End of each interval

○____End of each interval AND if target behavior occurs

○Special instructions for delivery of reinforcer(s):

____________________________________________

____________________________________________

____________________________________________

✵Criterion for increasing amount of time between reinforcers:

_________________________________________________

✵Criterion for decreasing amount of time between reinforcers:

_________________________________________________

✵Criterion for withholding the scheduled reinforcer delivery:

_________________________________________________

Form 6.5 ■ Formulas for Calculating Percentage of Intervals of Targeted Behavior and Interbehavior Interval

✵Interbehavior interval: This formula will help you determine on average how much time passes between the occurrence of targeted behaviors (interbehavior interval). Use this information to help set the frequency of differential negative reinforcement.

○Total minutes observed ÷ Total behavior occurrences observed = Average interbehavior interval

✵Rate: This formula will help you to determine how often the behavior occurs in a given amount of time. Use this formula if you have different lengths of observation periods to allow for ongoing comparison of data.

○Number of occurrences of behavior ÷ Length of observation in minutes = Rate of behavior per minute

○Rate per hour = (rate per minute)60

○Rate per day = (rate per minute)1,440

Form 6.6 ■ Formulas for Determining Increases or Decreases in Frequency of Differential Negative Reinforcement

✵Formula for 10% increase in DNRO interval (time between negative reinforcement).

Current reinforcement interval × 1.10 = (10% increase in time).

✵Formula for 5% increase in DNRO interval.

Current reinforcement interval × 1.05 = (5% increase in time).

✵Formula for 10% decrease in DNRO interval.

Current reinforcement interval × 0.90 = (10% decrease in time).

✵Formula for 5% decrease in DNRO interval.

Current reinforcement interval × 0.95 = (5% decrease in time).

ADDITIONAL RESOURCES

Barton, L. E., Brulle, A. R., & Repp, A. C. (1986). Maintenance of therapeutic change by momentary DRO. Journal of Applied Behavior Analysis, 19, 277—282.

Conyers, C., Miltenberger, R., Maki, A., Barenz, R., Jurgens, M., Sailer, A., & Kopp, B. (2004). A comparison of response cost and differential reinforcement of other behavior to reduce disruptive behavior in a preschool classroom. Journal of Applied Behavior Analysis, 37, 411—415.

Cowdery, G. E., Iwata, B. A., & Pace, G. M. (1990). Effects and side effects of DRO as treatment for self-injurious behavior. Journal of Applied Behavior Analysis, 23, 497—506.

Goetz, E. M., Holmberg, M. C., & LeBlanc, J. M. (1975). Differential reinforcement of other behavior and noncontingent reinforcement as control procedures during the modification of a preschooler’s compliance. Journal of Applied Behavior Analysis, 8, 77—82.

Haring, T. G., & Kennedy, C. H. (1990). Contextual control of problem behavior in students with severe disabilities. Journal of Applied Behavior Analysis, 23, 235—243.

Harris, S. L., & Wolchik, S. A. (1979). Suppression of self-stimulation: Three alternative strategies. Journal of Applied Behavior Analysis, 12, 185—198.

Heard, K., & Watson, T. S. (1999). Reducing wandering by persons with dementia using differential reinforcement. Journal of Applied Behavior Analysis, 32, 381—384.

Lindberg, J. S., Iwata, B. A., Kahng, S., & DeLeon, I. G. (1999). DRO contingencies: An analysis of variable-momentary schedules. Journal of Applied Behavior Analysis, 32, 123—136.

Luce, S. C., Delquadri, J., & Hall, R. V. (1980). Contingent exercise: A mild but powerful procedure for suppressing inappropriate verbal and aggressive behavior. Journal of Applied Behavior Analysis, 13, 583—594.

Marcus, B. A., & Vollmer, T. R. (1996). Combining noncontingent reinforcement and differential reinforcement schedules as treatment for aberrant behavior. Journal of Applied Behavior Analysis, 29, 43—51.

Martinez, S. S. (1977). Comparison of extinction, DRO 0-sec, and DRO 6-sec in the elimination of imitative responding under discrete-trial paradigms. Journal of Applied Behavior Analysis, 10, 315.

Mazaleski, J. L., Iwata, B. A., Vollmer, T. R., Zarcone, J. R., & Smith, R. G. (1993). Analysis of the reinforcement and extinction components in DRO contingencies with self-injury. Journal of Applied Behavior Analysis, 26, 143—156.

McCord, B. E., Iwata, B. A., Galensky, T. L., Ellingson, S. A., & Thomson, R. J. (2001). Functional analysis and treatment of problem behavior evoked by noise. Journal of Applied Behavior Analysis, 34, 447—462.

Piazza, C. C., Fisher, W. W., Hanley, G. P., Hilker, K., & Derby, K. M. (1996). A preliminary procedure for predicting the positive and negative effects of reinforcement-based procedures. Journal of Applied Behavior Analysis, 29, 137—152.

Repp, A. C., Barton, L. E., & Brulle, A. R. (1983). A comparison of two procedures for programming the differential reinforcement of other behaviors. Journal of Applied Behavior Analysis, 16, 435—445.

Repp, A. C., & Deitz, S. M. (1974). Reducing aggressive and self-injurious behavior of institutionalized retarded children through reinforcement of other behaviors. Journal of Applied Behavior Analysis, 7, 313—325.

Rolider, A., & Van Houten, R. (1985). Movement suppression time-out for undesirable behavior in psychotic and severely developmentally delayed children. Journal of Applied Behavior Analysis, 18, 275—288.

Thompson, R. H., Iwata, B. A., Hanley, G. P., Dozier, C. L., & Samaha, A. L. (2003). The effects of extinction, noncontingent reinforcement, and differential reinforcement of other behavior as control procedures. Journal of Applied Behavior Analysis, 36, 221—238.

Vollmer, T. R. (1999). Noncontingent reinforcement: Some additional comments. Journal of Applied Behavior Analysis, 32, 239—240.

Vollmer, T. R., Iwata, B. A., Zarcone, J. R., Smith, R. G., & Mazaleski, J. L. (1993). The role of attention in the treatment of attention-maintained self-injurious Journal of Applied Behavior Analysis, 26, 9—21.

Woods, D. W., & Himle, M. B. (2004). Creating tic suppression: Comparing the effects of verbal instruction to differential reinforcement. Journal of Applied Behavior Analysis, 37, 417—420.

SME FUNCTIONS: ESCAPE MAND (PROTEST OR NEGOTIATING BEHAVIOR) OPTION

Brief Description

In this replacement function option, the removal of the negative reinforcer, whether it be aversive tasks, events, or people, occurs upon an appropriate mand (request) from the client. Concurrently, the target behavior no longer functions to efficiently escape the aversive event, that is, programmed extinction. This is an application of differential reinforcement, specifically differential negative reinforcement of an alternative behavior (DNRA). In this option, the alternative behavior is a request (mand) to terminate, or a protest of, the conditions that are aversive to the client.

To implement an escape mand replacement behavior program for a problem behavior that is diagnosed with an SME function, you determine what specific form the request or protest should take. Such a form will result in the contingent removal of a negative reinforcer (escape or avoidance). In the beginning part of this program, each time the new request or protest behavior occurs, it must result in removing the negative reinforcer. If the target behavior occurs, it should result in the loss of opportunity to escape or avoid the aversive event (extinction) until the protesting behavior is utilized. By removing the negative reinforcer only if the person uses the specified protesting behavior, the specified replacement behavior “pays off” better than the target behavior.

The advantage of using this procedure is that it teaches a specific behavior that will result in the removal of a negative reinforcer when the person is most motivated to escape or avoid that particular negative reinforcer. This makes the acquisition of the skill relatively rapid and generally results in a robust response that can be shaped and generalized to overcome other target behaviors. A disadvantage of this option involves an initial interruption in the client’s routine due to a parent or staff person immediately complying with the person’s request to escape or avoid the aversive stimulus. This option is a bit more labor intensive than DNRO and requires a higher level of expertise and interaction on the part of the people implementing the intervention.

Terms

Mand: A verbal operant behavior under the control of a specific motivating operation that produces a socially mediated specific reinforcer (in the case of a negative reinforcer, a request to escape or avoid).

Escape: Engaging in behavior that terminates the presence of an aversive task or event.

Avoidance: Engaging in behavior that prevents one from coming in contact with an aversive task or event.

Aversive stimulus: A task, event, or person to which the person will make a response that avoids or terminates the stimulus.

Apparatus

Data sheets—See Form 6.7 “Simple Frequency Data on Target and Replacement Behavior”

Baseline Measurement

It is important to first determine the form of the protesting behavior that will be developed or increased prior to baseline data collection. Next, you can collect baseline data on both the target behavior and the replacement behavior using Form 6.7.

If the frequency of the target behavior is low, you might consider using a trigger analysis, that is, contriving an antecedent condition that causes the person to encounter the aversive task, event, or person, and observe what behavior occurs (target or replacement behavior). See “trigger analysis” in Chapter 2 for greater detail on conducting this assessment. Realize that the conditions of aversive stimulation have to be present in order for either behavior to occur. Try to make sure that no one, in any way, removes or reduces the aversive conditions prior to the end of your assessment.

Procedures

1.Present the person with a nonpreferred task, object, or activity (e.g., a wash cloth, least preferred math task, or food item the person dislikes) with instruction (e.g., “Here, have this.” Or “Do this.”).

2.After a short time delay (0—2 seconds), provide a general prompt, “What’s wrong?”

3.Reinforce a desired protest response (either handing back object or saying or signaling “No!”).

4.If the identified form of the replacement response is vocal and a vocal protest response does not occur to the general prompt, or if the target behavior occurs, model vocal protest (e.g., “stop,” “no,” “I do not want to do that,” or “I don’t want that”).

5.If the identified form of the replacement response is nonvocal and a nonvocal protest response does not occur to general prompt, or if the target behavior occurs, physically guide the protest response, either handing back the object or manually signing “no” or “stop.”

6.Reinforce any approximation of the desired form of protest (vocal or nonvocal) by removing the nonpreferred object or stopping the activity and initiating a more preferred activity. Do not allow the target behavior to result in the removal of the nonpreferred item or activity (escape extinction).

7.During subsequent protest opportunities, provide less guidance (or modeling) of the protest response until it occurs independently and immediately at the presentation of the nonpreferred task, object, person, or activity.

8.Utilize many different nonpreferred activities and objects during structured training sessions to teach a generalized skill of protesting.

9.Consider developing a Requesting Behavior Option Plan in conjunction with this skill.

10.Provide opportunities for protesting behaviors in real life by occasionally handing the client a nonpreferred item or engaging the person in a nonpreferred activity. Reinforce protest with removal of nonpreferred item or activity.

Capturing Motivation—It is essential that the person being assessed is motivated to escape or avoid the task, event, or person. The judgment of when the person wants to avoid or escape the task, event, or person can generally be along the same conditions under which the SME target behavior occurred. Using this same level of aversive stimulation that existed as a motivating condition for the problem behavior, you now use the above procedures to develop the replacement behavior.

Modification for Use with DE Behaviors.

1.Utilize the same baseline measurement procedures.

2.When the target behavior occurs, use chain interruption procedures and follow the Escape Mand Replacement Behavior Option instructions starting with step 4 as listed previously.

How It Works

Teaching a protesting behavior (mand) works by establishing an alternate form of behavior that will allow the person to more effectively and efficiently escape or avoid the same maintaining negative reinforcer as the target behavior. By ensuring that the alternate behavior “pays off” better for the person, the function of alternative behavior is enabled and the function of the target behavior is disabled. Once the person has an alternative behavior in his or her repertoire that can function as a protest, you enable its function by making it more effective and efficient than the target behavior in removing the negative reinforcer. Once the mand is functional, the fading or thinning process allows for the natural contingencies in the environment to control the protesting behavior so that it will maintain over time.

Hypothetical Example

“I’m Bored”

As an example, let us look at how the Escape Mand Replacement Behavior Option might be applied to the case of the child who learned how to get a 5-minute break by throwing things in class.

Mr. Jones, a behavior analysis consultant, was told by the teaching staff that once or twice a day, for no apparent reason, Susan would get out of her seat, grab an item off of her desk or someone else’s desk, and throw it as hard as she could against the wall. Staff contended that the problem behaviors were occurring “for no good reason” and just came “out of the blue.” The staff commented that it was probably due to some mental illness. Given the variability and lack of specific information in staff reports, Mr. Jones needed to find a way to obtain reliable information. He decided to perform a descriptive functional assessment (A-B-C analysis) from his direct observations. Table 6.5 summarizes his findings.

Mr. Jones reviewed his observations. He noted that the behavior occurred only after Susan had been working on a task for over 20 minutes. Although Susan’s throwing behavior produced attention from the teacher, she engaged in other behaviors that were equally successful in getting teacher attention. Mr. Jones noted that throwing objects also resulted in Susan’s removal from the assignment for a period of time. This finding ruled out SMA 2.1: Staff Attention as the maintaining contingency for the throwing behavior. The sensory result of throwing items did not appear to be the purpose of the behavior, given the relative infrequency of such behavior and that it was more likely to occur when working on an assignment for relatively long periods of time. Further, Susan appeared happy or excited by the prospect of being sent to time-out. Mr. Jones also noticed that Susan was compliant with demands to complete short duration tasks.

Mr. Jones concluded that the most likely maintaining contingency was SME 4.2: Relatively Lengthy School Assignments (see Table 6.6). Currently, Susan’s throwing of items is frequently followed by being removed from the school work task for at least 5 minutes.

TABLE 6.5 ■ SUMMARY OF THROWING ITEMS A-B-C DATA

The SME 4.2 diagnosis made perfect sense in regards to why the behavior appeared to occur randomly and only once or twice per day. Susan was willing to engage in school work, but if it continued for too long, she found a way to get a break.

Mr. Jones considered using DNRO, tolerance training; however, this student could already stay on task for an acceptable length of time, and during his observations he had never observed Susan making a request of the teacher. Mr. Jones decided to train a requesting behavior using DNRA. This would result not only in a reduction of throwing things, but also would develop a skill that could be used to effectively escape many aversive situations in the school setting.

Prior to writing the plan, Mr. Jones requested that the teacher record baseline data on the frequency of throwing things and the frequency of requesting a break across 55-minute-long observation sessions over 6 days. The data was recorded on Example Form 6.7.

With this frequency data in hand and an understanding of the function of the throwing behavior, Mr. Jones formulated an intervention plan (see Example Form 6.8). He determined that throwing things occurred under the conditions of having been working continuously on a seat work task for over 20 minutes. His data also indicated that the student very rarely exhibited the replacement behavior of requesting a break, and when the request was made it did not result in getting a break.

Mr. Jones knew that the targeted behavior of throwing things was more likely around 11:00 a.m. each day, when the student was at her desk and had been doing school work for over 20 minutes. He decided the best way to capture a high level of motivation for the taking a break was to set up training for about 11:00 a.m. in the classroom at the student’s desk after she had been continuously working for at least 20 minutes.

Mr. Jones decided that the protesting behavior he would try to establish was having the student simply pull out a laminated break card, show it to the teacher, and wait for the teacher to acknowledge or approve the request. Susan would then set a timer for 5 minutes of break time. Subsequently, after the break, she would return to work.

Mr. Jones set the initial reinforcement schedule such that every presentation of a break card produced 5 minutes of break time. In order to limit the amount of break time used, Mr. Jones set an additional contingency that if in any period (morning or afternoon) Susan did not go over her allotted number of break cards, she earned five points toward a video of her choice at her parent’s home. She had to earn 30 points by Friday afternoon in order to earn the video (i.e., no more than two periods in the week where she took more than two breaks).

To increase the speed of this process, Mr. Jones also specified another contingency. Specifically, if the student engaged in throwing things, any break cards left were immediately removed for the remainder of the morning or afternoon session. If she continued throwing materials, she would be removed from the area for the protection of other students and placed in time-out until she “calmed down.” Following time-out, she would be told that she had extra work to do during recess at the principal’s office area (reverse Premack). Further, she would not earn five points and would have to return to the assignment during the class period.

TABLE 6.6 ■ DIAGNOSTIC TABLE FOR THROWING OBJECTS

SMA, socially mediated access; SME, socially mediated escape.

Mr. Jones specified that the following prompt sequence should be used in teaching Susan to request a break. The first prompt would be delivered vocally and progress to more helpful or intrusive prompts if the prompt card was not presented. The instructions to the staff were as follows:

1.After at least 20 minutes of seat work, provide the prompt, “Do you want a break?”

2.If no response, provide the same prompt with the addition of a gestural prompt of pointing to the break card.

3.Once the request via the break card occurs, allow Susan to take a break for 5 minutes.

Mr. Jones also wanted to make sure that Susan would eventually present a break card when she wanted a break from school work without anyone prompting her to do so. In order to accomplish this, he developed a plan for slowly decreasing the prompts that were provided. He determined that once Susan could present a break card with prompts for 3 consecutive days, the staff would be taught to reduce or fade the prompts.

The program was implemented and produced the data displayed in Figure 6.3. As Mr. Jones expected, this plan was successful in reducing the occurrence of throwing behavior and increasing the rate of protesting behavior (mand for a break). By 1/14 the protesting behavior had met the criteria for fading prompts. The prompts were gradually faded until Susan was requesting her break independently.

What If?

What if the behavior does not decrease or gets worse?

When using this option, which is DNRA with extinction, we often see an initial worsening of the target behavior. The technical term for this is an extinction burst. Just like its name implies, it is a brief and often intense increase in the target behavior that happens when the behavior no longer produces termination of the negative reinforcer. You should see a dramatic decrease in the behavior within 3 sessions or days. If the behavior continues at a high rate for longer than that, you will need to confirm that the behavior you have set up as the protesting behavior is actually resulting in termination of the negative reinforcer. You should also ensure that extinction is indeed occurring for the target behavior.

Example Form 6.7 ■ Frequency Count Data Sheet

✵Behavior: Throwing things

✵Total Observation Time: 330 min (2, 55-minute session/day) Session Length 55 min

✵Number of Days: 6

✵Place an X on the appropriate day box each time the behavior occurs

A.Total minutes observed: 330

B.Total target behavior occurrences observed: 6

C.Total replacement behavior occurrences observed: 1

Example Form 6.8 ■ Teaching Requesting Behavior: Simple Plan

✵Person served: Susan

✵Target Throwing items

✵Behavioral diagnostic category: SME 4.2: Lengthy School Assignments

✵Protesting/negotiating 'margin-top:6.0pt;margin-right:5.0pt;margin-bottom: 0cm;margin-left:48.2pt;text-align:justify;text-indent:-22.8pt;line-height:normal'>Requesting a break

A.Form of protest: vocal request; manual signed request; requesting by pointing to a communication board; use augmentative device to request; other:

Holding up of break card

B.Description of initial protest to be reinforced: Show one of her break cards to the teacher; wait for acknowledgment, and set the timer for five minutes.

✵Target rate: No more than four times per day.

✵Instructions to assure motivation:

○Train at Time and place that target behavior is most likely which is: Training in the classroom at her desk after at least 20 minutes of continuous seat work task.

○Ensure limited escape from the negatively reinforcing item at other times by: Redirecting back to task after throwing behaviors.

✵Initial schedule of differential negative reinforcement:

A.Remove/terminate the unwanted event/item after every 1 (number of) protests and with no more than a 5 sec delay.

✵Targeted final schedule of differential negative reinforcement:

A.No more than 2 (number of) protests in a half day (time period)

✵Replacement behavior is reinforced:

○If the protesting behavior occurs independently, terminate the negative reinforcer.

○If the protesting behavior does not occur under the targeted conditions, provide the following prompts (using Vocal):

1.Provide the prompt “Do you want a break?”

2.If no response, provide the prompt again with the item break card and timer within sight.

3.If no response, provide the prompt with the addition of a gestural prompt.

4.If no response, provide the prompt with the addition of modeling the response.

5.Once the protest occurs, set the timer and provide a 5-minute break.

6.Repeat up to four times per day (two in the a.m. and two in the p.m.)

✵If target behavior occurs:

○Specifically if Susan engaged in throwing things, any break cards left are immediately removed for the remainder of the morning or afternoon session. If she cannot be stopped from continuing to throw materials, she will be removed from the area for the protection of other students and placed in time-out until she “calms down.” Following time-out, she will be told that she has extra work to do during recess at the principal’s office area (Reverse Premack). Further, she does not earn five points and has to return to the assignment during the class period.

○Special instructions for delivery of small amount of reinforcer(s): Breaks are to last no longer than 5 minutes and a maximum of four times per day.

✵Criterion for fading prompts: When target rate for replacement behavior is reached on 3 consecutive days, reduce the level of helpfulness of the prompt first by waiting for 5 seconds before providing the prompt, and then by reducing the prompt from vocal to simple hand gestures, and eventually to the level of prompts that would usually be in place in the classroom.

FIGURE 6.3 ■ Breaks and throwing items.

What if the person is asking to escape all the time?

If the protesting behavior becomes too frequent, you can set up some limits and incentives as described in the example. That is, you can decrease the number of requests that will be honored over time. To do this, you will need to set up an additional contingency to differentially reinforce lower rates of requesting behavior. This is the same basic differential reinforcement process, but you provide reinforcement contingent on the target behavior occurring below a specific standard. You then progressively set the standard at a lower rate.

What if the person has never been observed to have exhibited a request or protest behavior?

In this case, you will have to first teach a behavior that can be used effectively to protest the presentation of some negative reinforcer. This generally involves a task analysis and some specific teaching procedures to ensure that the skill is well established in the client’s repertoire. Discrete Trial Training and Precision Teaching are specific teaching procedures that have been used effectively for this purpose.

Forms: DNRO

6.7 Simple Frequency Data on Target and Replacement Behavior

6.8 Teaching Requesting Behavior: Simple Plan

Form 6.7 ■ Simple Frequency Data on Target and Replacement Behaviors

✵Behavior: ________________________________________

✵Number of Days:___

✵Place an X on the appropriate day box each time the behavior occurs

A.Total minutes observed:

B.Total target behavior occurrences observed:

C.Total replacement behavior occurrences observed:

Form 6.8 ■ Teaching Requesting Behavior: Simple Plan

✵Person served: _________________________

✵Target 'margin-top:6.0pt;margin-right:5.0pt;margin-bottom: 0cm;margin-left:21.8pt;text-indent:-16.8pt;line-height:normal'>•Behavioral diagnostic category: _________________________

✵Protesting/negotiating 'margin-top:6.0pt;margin-right:5.0pt;margin-bottom: 0cm;margin-left:48.2pt;text-align:justify;text-indent:-22.8pt;line-height:normal'>A.Form of protest: vocal request; manual signed request; requesting by pointing to a communication board; use augmentative device to request; other:

__________________________________________________

B.Description of initial protest to be reinforced:

✵Target rate: ________________________

✵Instructions to ensure motivation:

○Train at time and place that target behavior is most likely, which is:

___________________________________________

○Ensure limited escape from the negatively reinforcing item at other times by:

___________________________________________

✵Designated time period(s) to implement: ___________________

✵Initial schedule of differential negative reinforcement:

✵Targeted final schedule of differential negative reinforcement:

✵No more than (number of ) protests in a (time period):

✵Replacement behavior is reinforced:

○If the requesting behavior occurs independently, terminate the negative reinforcer.

○If the protesting behavior does not occur under the targeted conditions, provide the following prompts (using Vocal Sign Gesture Visual):

1.Provide the prompt, “What do you want?”

2.If no response, provide the prompt with the addition of a gestural prompt.

3.If no response, provide the prompt with the addition of modeling the response.

4.If no response, provide the prompt with the addition of a physical prompt.

5.If no response, provide increasing physical prompt using least to most prompting.

6.Once the protest occurs, terminate the negative reinforcer.

7.Repeat for as long as the person is motivated to escape the negative reinforcer.

✵If target behavior occurs:

○Extinction (no escape from the negative reinforcer) for minutes, then begin prompt sequence for replacement behavior listed above.

○If replacement, protesting behavior occurs during this time period, provide escape from the negative reinforcer.

○Special instructions for delivery of small amount of reinforcer(s): __________

___________________________________________

✵Criterion for fading prompts: ________________________

________________________________________________

✵Criterion for increasing the amount of delay in the delivery of reinforcer:

________________________________________________

ADDITIONAL RESOURCES

Teaching Requesting Skills

Arntzen, E., & Almås, I. K. (2002). Effects of mand-tact versus tact-only training on the acquisition of tacts. Journal of Applied Behavior Analysis, 35, 419—422.

Bowman, L. G., Fisher, W. W., Thompson, R. H., & Piazza, C. C. (1997). On the relation of mands and the function of destructive behavior. Journal of Applied Behavior Analysis, 30, 251—265.

Brown, K. A., Wacker, D. P., Derby, K. M., Peck, S. M., Richman, D. M., Sasso, G. M., & Harding, J. W. (2000). Evaluating the effects of functional communication training in the presence and absence of establishing operations. Journal of Applied Behavior Analysis, 33, 53—71.

DeLeon, I. G., Fisher, W. W., Herman, K. M., & Crosland, K. C. (2000). Assessment of a response bias for aggression over functionally equivalent appropriate behavior. Journal of Applied Behavior Analysis, 33, 73—77.

Derby, K. M., Wacker, D. P., Berg, W., DeRaad, A., Ulrich, S., Asmus, J., & Stoner, E. A. (1997). The long-term effects of functional communication training in home settings. Journal of Applied Behavior Analysis, 30, 507—531.

Drasgow, E., Halle, J. W., & Ostrosky, M. M. (1998). Effects of differential reinforcement on the generalization of a replacement mand in three children with severe language delays. Journal of Applied Behavior Analysis, 31, 357—374.

Henry, L. M., & Horne, P. J. (2000). Partial remediation of speaker and listener behaviors in people with severe dementia. Journal of Applied Behavior Analysis, 33, 631—634.

Kahng, S., Hendrickson, D. J., & Vu, C. P. (2000). Comparison of single and multiple functional communication training responses for the treatment of problem behavior. Journal of Applied Behavior Analysis, 33, 321—324.

Lalli, J. S., Mauro, B. C., & Mace, F. C. (2000). Preference for unreliable reinforcement in children with mental retardation: The role of conditioned reinforcement. Journal of Applied Behavior Analysis, 33, 533—544.

Northup, J., Wacker, D., Sasso, G., Steege, M., Cigrand, K., Cook, J., DeRaad, A. (1991). A brief functional analysis of aggressive and alternative behavior in an outclinic setting. Journal of Applied Behavior Analysis, 24, 509—522.

Partington, J. W., Sundberg, M. L., Newhouse, L., & Spengler, S. M. (1994). Overcoming an autistic child’s failure to acquire a tact repertoire. Journal of Applied Behavior Analysis, 27, 733—734.

Peck, S. M., Wacker, D. P., Berg, W. K., Cooper, L. J., Brown, K. A., Richman, D., & Millard, T. (1996). Choice-making treatment of young children’s severe behavior problems. Journal of Applied Behavior Analysis, 29, 263—290.

Richman, D. M., Wacker, D. P., & Winborn, L. (2001). Response efficiency during functional communication training: Effects of effort on response allocation. Journal of Applied Behavior Analysis, 34, 73—76.

Sprague, J. R., & Horner, R. H. (1992). Covariation within functional response classes: Implications for treatment of severe problem behavior. Journal of Applied Behavior Analysis, 25, 735—745.

Vollmer, T. R., Borrero, J. C., Lalli, J. S., & Daniel, D. (1999). Evaluating self-control and impulsivity in children with severe behavior disorders. Journal of Applied Behavior Analysis, 32, 451—466.

Wallace, M. D., Iwata, B. A., & Hanley, G. P. (2006). Establishment of mands following tact training as a function of reinforcer strength. Journal of Applied Behavior Analysis, 39, 17—24.

Winborn, L., Wacker, D. P., Richman, D. M., Asmus, J., & Geier, D. (2002). Assessment of mand selection for functional communication training packages. Journal of Applied Behavior Analysis, 35, 295—298.

Yamamoto, J., & Mochizuki, A. (1988). Acquisition and functional analysis of manding with autistic students. Journal of Applied Behavior Analysis, 21, 57—64.

DIFFERENTIAL REINFORCEMENT OF ALTERNATIVE BEHAVIOR

Goh, H., Iwata, B. A., & DeLeon, I. G. (2000). Competition between noncontingent and contingent reinforcement schedules during response acquisition. Journal of Applied Behavior Analysis, 33, 195—205.

Lee, R., McComas, J. J., & Jawor, J. (2002). The effects of differential and lag reinforcement schedules on varied verbal responding by individuals with autism. Journal of Applied Behavior Analysis, 35, 391—402.

McCord, B. E., Thomson, R. J., & Iwata, B. A. (2001). Functional analysis and treatment of self-injury associated with transitions. Journal of Applied Behavior Analysis, 34, 195—210.

Piazza, C. C., Moes, D. R., & Fisher, W. W. (1996). Differential reinforcement of alternative behavior and demand fading in the treatment of escape-maintained destructive behavior. Journal of Applied Behavior Analysis, 29, 569—572.

Ringdahl, J. E., Kitsukawa, K., Andelman, M. S., Call, N., Winborn, L., Barretto, A., & Reed, G. K. (2002). Differential reinforcement with and without instructional fading. Journal of Applied Behavior Analysis, 35, 291—294.

Vollmer, T. R., Roane, H. S., Ringdahl, J. E., & Marcus, B. A. (1999). Evaluating treatment challenges with differential reinforcement of alternative behavior. Journal of Applied Behavior Analysis, 32, 9—23.

SME FUNCTIONS: ALTERNATE DIRECT ESCAPE FORM

Brief Description

In this replacement behavior option, the negative reinforcer is removed by the client engaging in a chain of behaviors that directly terminates or avoids the aversive item or event, independent of anyone else’s intervention.

To implement a DE program, you must determine what chain of behaviors can directly remove the aversive items or event. If the person can fluently perform the requisite chain of behaviors, a simple rearrangement of contingencies is all that is usually required. Performance of the chain of behaviors is allowed to remove the negative reinforcer. Concurrently, extinction of the target behavior (i.e., socially mediated) is programmed.

If the person does not currently possess the DE behavior, his or her behavior must be shaped to produce an effective response (see inept repertoire diagnosis in Chapter 4). In some cases, the entire chain of behaviors may have to be taught. In other cases, a few components of the chain may be lacking.

If the client can perform the chain of behaviors, but not fluently (i.e., with acceptable speed and accuracy), fluency training is required. Once the client has acquired fluent performance of the chain of behaviors, differential negative reinforcement as delineated in this program is implemented.

The advantage of this replacement behavior option is that it allows the client to independently escape or avoid aversive items or events without reliance on other people or having to use communication or social skills. The DE option develops a specific chain of behaviors that will continue to be functional for the client over time. Once these behaviors are acquired, they can be utilized in other situations through the process of shaping and generalization.

Terms

Trigger analysis: Setting up all the conditions hypothesized to occasion the target behavior, and documenting the occurrence (or lack thereof) of the target behavior and DE replacement behavior.

Apparatus

Data sheets—See Form 6.9 “Simple Frequency Data With Formulas”

Baseline Measurement

There are two different types of information you need to obtain. First, you need to determine how often the target behavior is occurring under relevant conditions. Additionally, you need the frequency of occurrence of the proposed alternate form of DE behavior under relevant conditions.

The frequency measure is simply a count of each time the person engages in the target behavior and a count of each time the person performs the alternate form DE behavior under the same conditions. This type of data is best collected via a trigger analysis. When considering this option, baseline rates for the direct access behavior are typically at or near zero.

Trigger Analysis (see Form 6.10)

1.Contrive or capture a situation in which escape or avoidance of the item or event is highly likely. To accomplish this, set up motivational conditions, usually through temporary exposure to the negatively reinforcing items or events.

2.Observe the person’s behavior relative to the chain of alternate form DE behaviors.

3.Record the time the person takes to initiate the response and terminate the negative reinforcer.

4.Record which steps were completed and any prompts required to facilitate the performance of the steps.

5.Record if the negative reinforcer was terminated.

6.Repeat steps 1 through 5 at least two more times.

7.Graph or display the data across all baseline sessions.

If the baseline trigger analysis data indicates that the person does not appear to have the designated alternate form of DE behaviors in his or her repertoire, you will first need to teach the specific chain of behaviors to fluent performance.

If the baseline data indicates that the person is not performing the DE behavior, start by teaching the behavior using discrete trials. If the baseline data indicates that the person is able to perform the behavior, then skip to incidental teaching.

Discrete Trials

1.Present the aversive item or event to the person.

2.Prompt the person to perform the first step in the alternate DE behavior.

3.Provide reinforcement contingent on completing the behavior or chain of behaviors.

4.If the person does not complete the chain of behaviors, provide an additional prompt to help complete the next step.

5.Provide reinforcement, preferably in the form of escape or avoidance of the aversive item or event you want the person to directly escape with this behavior.

6.If the person engages in the target behavior, extinction in the form of blocking escape or avoidance should occur until the target behavior has been absent for some short period of time. Then resume prompts to engage in the identified alternate form of the DE behavior.

7.Record data.

8.On each successive trial, shape more independent responding by reducing the level of prompt provided.

9.Once the person is performing the task without the need for additional prompts, change to incidental teaching method.

Incidental Teaching

1.Observe for conditions under which the person would usually engage in the target behavior.

2.If the person directly escapes or avoids an item or event without engaging in a target behavior, allow him or her to do so.

3.If the person does not escape or avoid the item or event, provide a prompt to engage in the DE behavior.

4.If the person does not complete the task, provide an additional prompt to help him or her complete the next step.

5.On each successive trial, shape more independent responding by reducing the level of prompt provided.

6.If the person engages in the target behavior, extinction in the form of blocking escape or avoidance should occur until the target behavior has been absent for some short period of time. Then resume prompts to engage in the identified alternate form of the DE behavior.

7.Record data.

If utilizing this behavior option for DE behaviors: Utilize the same baseline and treatment procedures as above, except that chain interruption would occur instead of extinction when the target behavior is displayed.

Ensure Escape or Avoidance of the Negative Reinforcer!

It is critical that, during the time that the person is learning to perform the alternate form DE chain of behaviors, the negative reinforcer be terminated every time the alternate form DE behavior occurs. If the rate of the alternate form DE replacement behaviors becomes too high with ad lib escape, you may consider setting up a DNRO or Premack contingency as an additional replacement behavior option to gradually reduce the rate of escape.

How It Works

When the person is motivated to escape a particular item or event and can do so directly, it will become functional very quickly. The alternate DE form behavior will probably remove the negative reinforcer at a higher rate and more reliably than the target behavior that required other people to be involved. There is no reliance on ancillary skills such as initiating a social interaction or making a request.

Hypothetical Example

I Want to Change, Please

John is a person diagnosed with schizophrenia living in a locked psychiatric facility who was referred for services due to “stripping off his clothes.” Mr. Clay was assigned the case and began the assessment process by reviewing the data the facility was keeping. He then proceeded to interview the staff of the facility to understand the definitions of the targeted behaviors and gain information about the conditions under which the behavior occurs.

The data Mr. Clay obtained from the records for the previous week are presented in Example Form 6.9A.

Example Form 6.9A ■ Simple Frequency Data

✵Behavior: stripping

✵Number of Days: 7

✵Place an X on the appropriate day box each time the behavior occurs

Mr. Clay asked the staff to describe what the behavior looked like the last time it happened and if there was much variation across occurrences. The staff reported that it was typically the same each time. John would walk up to the nurses station and remain there briefly. He would then walk around the facility and begin to slowly unbutton his clothing. He would often be in a moderate state of undress. He would then return to the nurses’ station and tell the staff that “animals don’t wear clothes.” The staff indicated that, if they talked with him, he would briefly stop disrobing. However, after a short period of time, he would resume saying “animals don’t wear clothes” and proceed to remove his clothing one piece at a time. The staff told Mr. Clay they believed his behavior was the result of some traumatic experience he had while wearing a wool sweater. Mr. Clay was interested in their rationale for such an inference and asked why they hypothesized this. One staff member said, “He seems to make more delusional statements and strip more often when he is wearing a wool sweater.”

Mr. Clay suspected that the odd repetitive statements and the wool sweater might have something to do with the function of the behavior. He asked the staff a series of questions:

Because John was not likely to strip if no one else was there to see it, Mr. Clay was fairly certain that the behavior did not function to access sensory stimulation secondary to being naked. Further questioning revealed that the behavior happened only when John had on clothing he did not pick out himself and that the “stripping” behaviors stopped as soon as he changed into more preferred clothing. With this information, Mr. Clay was reasonably sure that the behavior served an escape function and that the diagnosis would be SME 4.4: Aversive Physical Stimuli or Event (see Table 6.7).

Mr. Clay wondered why John would make delusional statements and strip as a way to get a change of clothes. Why would he not just go to his room and change? He asked the staff if they had ever seen John change into preferred clothing independent of staff. The staff replied “No, if we let him change once, he would keep changing all day, and if we let him choose his own clothes, he will wear the same dirty clothes day after day. Clothes changing is just a part of his delusional system around being an animal. His delusions are so bad that we had to put all his clothes in a locked closet to stop him from changing all the time.”

TABLE 6.7 ■ DIAGNOSTIC TABLE FOR STRIPPING BEHAVIOR

SMA, socially mediated access; SME, socially mediated escape. DA, direct access.

Now the delusional statements made sense to Mr. Clay, as did the stripping behavior. The only way to get out of wearing uncomfortable clothing was through staff mediation. Staff would provide the change of clothes only if John stripped off his other clothing. The delusional statements were an attempt to tell the staff what he wanted.

Mr. Clay could have simply instructed the staff to follow the current procedure of blocking access to clothing and added an extinction component by instructing staff to have John put on the same clothes each time he stripped. However, John would probably have developed a new set of behaviors that made the clothing unwearable. He decided that staff will simply teach John to change into preferred clothing when he was uncomfortable. Mr. Clay found out from the staff that John’s favorite outfit was light-weight sweat pants and a loose-fitting cotton t-shirt. The staff objected to this plan saying that they had tried that before, and he would just wear the same clothes every day. When they took away the clothes he wore every day, he would change clothing constantly all day long.

In order to test the staff members’ hypothesis, Mr. Clay set up a simple analysis to find out what John might do given free access to choose and change his own clothes. Mr. Clay asked the staff to dress John in clothing that they reported he was very likely to strip off. Mr. Clay asked that they also provide him with the key to John’s room and clothing closet (recall that access to his clothes had been prevented by placing them in a locked closet, which he could access only with staff assistance). Mr. Clay then waited at the nurses’ station for John to stop by and make the statement that “animals don’t wear clothes.” When this occurred, Mr. Clay provided a simple prompt of “Would you like to change into some different clothes?” The instructions for this trigger analysis and the data are presented on Example Form 6.10.

Mr. Clay also observed that John wore the clothing items for the rest of the day. John did not engage in multiple changes of clothing, indicating that it was indeed most likely the aversive stimulation from particular clothes that was establishing the value of stripping behavior.

Mr. Clay now could develop a simple contingency plan that he knew would eliminate the “stripping.” If John had not been able to complete the task, Mr. Clay would have completed a Task Analysis and developed a plan to teach him the skill using a combination of Discrete Trial Training, Incidental Teaching, Chaining, and behavioral fluency.

Mr. Clay developed a simple DE plan (see Example Form 6.11). If John “strips,” he will be required to dress in the clothes he had just removed until the target behaviors had been absent for 10 minutes. If John goes to his room and changes into preferred clothing, he is free to wear them. John is to have free access to preferred clothing at all times. Staff will continue take data on “stripping” and also record the number of times John changes his clothing per shift.

Example Form 6.9B ■ Simple Frequency Data

✵Target Behavior: Stripping

✵DE Behavior: Changing clothes in discrete area

✵Number of Days: 7

✵Place an X on the appropriate day box each time the behavior occurs

A.Total minutes observed: ___

B.Total occurrences observed: 3

C.Range (low) 0 to (high) 2, Avg = 0.43

A.Total minutes observed: ___

B.Total occurrences observed: 16

C.Range (low) 2 to (high) 3, Avg = 2

Example Form 6.10 ■ Trigger Analysis Instruction and Data

✵Client name: John

✵Antecedent set up: _________________________

✵Motivation for the reinforcing item will be assured by: Dressing him in clothing items that have previously occasioned stripping behavior

✵Availability of the reinforcing item will be indicated by: A verbal prompt and alternative clothing items available in his room

✵Type and sequence of prompts to be used: Verbal then gestural

✵Preferred response: Chooses and puts on preferred clothing items. No more than one clothing change in an 8-hour period of time

✵Conditions regarding access to the reinforcing item:

○How much: 1 clothing change

○How long: N/A

✵I = Independent P = prompted N = did not complete

✵Independent completion rate: Whole task: 0/6

✵Prompted completion rate: Whole task: 6/6

✵Time to complete task:

○Longest 30 min

○Shortest 10 min

○Average 15.83 min

Example Form 6.11 ■ Direct Escape: Plan

✵Person served: John

✵Target Stripping

✵Behavioral diagnostic category: SME 4.4: Aversive Physical Stimuli/Event

✵Direct access Changing into preferred clothing

✵Designated time period(s): Any

✵Initial form or task analysis of direct access Choose preferred clothing items and dress himself in a discrete location (bedroom/bathroom), changing clothes no more than once per 8-hour time period.

✵Reinforcing item/event to be directly escaped: Nonpreferred clothing.

✵When and how will it be made available: Initially preferred clothing items will simply be available in his now unlocked closet.

✵How to respond to the target Have John get redressed in the clothing he just stripped off. After 10 minutes of no stripping behavior, prompt him to go to his room to choose and change clothes to more preferred clothing items.

✵Types of prompts to be used:

Visual Vocal Gestural Written Touch Graduated Guidance

✵When to use prompts: Vocal prompt to change into preferred clothing items should be made when John stops by the nurses’ station and makes the statement that “animals do not wear clothes.”

The plan was implemented and produced the data presented on Example Form 6.9B.

As can be seen in the data, the program was very successful in disabling the function of the stripping behavior and enabling the function of choosing and discretely changing into more comfortable clothing. It is also interesting to note that clothes changing did not occur at an excessive rate. One further note of interest is that there were no more delusional statements regarding animals not wearing clothes.

The next phase in the training process would be to teach John to independently identify the general fabrics and styles of clothing he prefers so that he can pick them out when he is shopping for new clothing.

What If?

What if the person refuses or is unable to complete the DE behavior?

This would require teaching the person the skill first. If the person was unable to acquire the skill, then some environmental set-up would be needed to allow him or her a way to escape the negative reinforcer directly. If that were still not possible, an alternative might be to use noncontingent negative reinforcement.

What if the DE behavior results in the person escaping the negative reinforcer at too high a rate?

If this occurs, the simplest solution would be to implement a DNRO or Premack contingency option such that the person could still directly escape the negative reinforcer, but the complexity or duration of the behavior required prior to escape could be increased and thereby reduce the frequency of escape.

What if the person can do the DE behavior but is too slow?

If the person is simply taking too long to complete the task, you should consider fluency training or differential reinforcement of higher rates (DRH) of behavior. In fluency training, the focus is on breaking down each component step of the overall task to be completed and increasing the speed of movement of each component rather than focusing on accurate performance of the entire task. Accuracy of the entire task develops as each component can be performed fluently. DRH focuses on differentially reinforcing the person performing the behavior faster. So the faster they do the behavior, the greater the pay off. Both methods are effective at speeding up slow performances.

Forms: DE

6.9 Simple Frequency Data With Formulas

6.10 DE Trigger Analysis Trial Data Sheet

6.11 DE: Simple Plan

Form 6.9 ■ Simple Frequency Data With Formulas

✵Behavior: ____________________________

✵Number of Days: _____

✵Place an X on the appropriate day box each time the behavior occurs

A.Total minutes observed: ___

B.Total occurrences observed: ___

C.Range (low) ____ to (high) ___, Avg = ___

A.Total minutes observed: ____

B.Total occurrences observed: ____

C.Range (low) ___ to (high) ___, Avg = ____

Form 6.10 ■ DE Trigger Analysis Trial Data Sheet

✵Client name: _________________________

✵Antecedent set up: _________________________

✵Motivation for the escape from the negatively reinforcing item will be ensured by:

__________________________________________________

✵Availability of escape from the negative reinforcer will be indicated by:

__________________________________________________

✵Type and sequence of prompts to be used: _________________________

✵Preferred response: _________________________

✵Conditions regarding escape from the negatively reinforcing item:

○How much: _________________________

○How long: _________________________

✵I = Independent P = prompted N = did not complete

✵Independent completion rate: Whole task: __________

✵Prompted completion rate: Whole task: __________

✵Time to complete task:

○Longest: __________

○Shortest: __________

○Average: __________

Form 6.11 ■ DE: Simple Plan

✵Person served: _________________________

✵Target 'margin-top:6.0pt;margin-right:5.0pt;margin-bottom: 0cm;margin-left:21.8pt;text-indent:-16.8pt;line-height:normal'>•Behavioral diagnostic category: _________________________

✵Designated time period(s): _________________________

✵Initial form or task analysis of DE 'margin-top:6.0pt;margin-right:5.0pt;margin-bottom: 0cm;margin-left:21.8pt;text-indent:-16.8pt;line-height:normal'>•Negatively reinforcing item/event to be directly escaped: ________

__________________________________________________

✵When and how escape will be made possible: ________________

__________________________________________________

✵How to respond to the target 'margin-top:6.0pt;margin-right:5.0pt;margin-bottom: 0cm;margin-left:21.8pt;text-indent:-16.8pt;line-height:normal'>•Types of prompts to be used:

Visual Vocal Written Touch Graduated Guidance

✵When to use prompts: _________________________

ADDITIONAL RESOURCES

Bosch, S., & Fuqua, R. W. (2001). Behavioral cusps: A model for selecting target behaviors. Journal of Applied Behavior Analysis, 34, 123—125.

Dattilo, J., & Camarata, S. (1991). Facilitating conversation through self-initiated augmentative communication treatment. Journal of Applied Behavior Analysis, 24, 369—378.

Mithaug, D. K., & Mithaug, D. E. (2003). Effects of teacher-directed versus student-directed instruction on self-management of young children with disabilities. Journal of Applied Behavior Analysis, 36, 133—136.

Thompson, R. H., & Iwata, B. A. (2000). Response acquisition under direct and indirect contingencies of reinforcement. Journal of Applied Behavior Analysis, 33, 1—11.

Vaughn, B. J., & Horner, R. H. (1997). Identifying instructional tasks that occasion problem behaviors and assessing the effects of student versus teacher choice among these tasks. Journal of Applied Behavior Analysis, 30, 299—312.

SME FUNCTIONS: NONCONTINGENT ESCAPE (NCE) OPTION

Brief Description

In noncontingent escape (NCE), the specific maintaining negative reinforcer is removed following a given period of time. The negative reinforcer is removed even if the target behavior has or is occurring. One could view an NCE as a reinforcement system that reduces the rate of behavior by removing the motivation to engage in the target behavior or that operates by disrupting the contingent relationship between the behavior and the removal of the negative reinforcer.

To implement this option, you would determine how frequently to remove the negative reinforcer. You would then remove the negatively reinforcing item based on that schedule.

The advantage of using an NCE procedure is that it is easy to implement and generally will rapidly reduce the occurrence of target behaviors. NCE procedures generally do not teach or strengthen any new replacement behaviors. They alter the rate of the target behavior initially by removing the motivation underlying the targeted behavior. Generally, NCE will be used in conjunction with other replacement function options that are designed to strengthen specific replacement functions, DNRA, or tolerance, DNRO. NCE may not be useful in situations where frequent escape from the maintaining reinforcer is impractical, not feasible, or dangerous.

Terms

Schedule of reinforcement: The interval schedule of noncontingent removal of the ­maintaining negative reinforcer.

Interbehavior interval: The length of time that passes between the end of one targeted behavior and the beginning of the next occurrence of the targeted behavior.

Thinning schedule of removal of the maintaining negative reinforcer: The process of gradually increasing the amount of elapsed time between removal of the negative reinforcer.

Apparatus

Timing device—This can be a kitchen timer, alarm clock, computer with alarm feature, tape recorder with beeps at designated intervals, or a calendar, depending on the length of the schedule of NCR. Its purpose is to prompt the staff person, teacher, or parent to provide the reinforcer.

Data sheets—See Form 6.12 “Partial Interval Data, 30-Minute Intervals”

Baseline Measurement

Baseline measurement consists of determining the interbehavior interval for the target behavior. To accomplish this, a partial interval method is used for recording the occurrence of the target behavior. Partial interval methods of recording are useful when dealing with behaviors that may be difficult to keep track of or when staff persons have many other duties besides collecting data.

Steps to Collect Baseline Data Using Partial Interval Recording

1.Identify the target behavior to be observed.

2.Operationally define or pinpoint the behavior being observed.

3.Determine the observation period, possibly reviewing scatter plot or A-B-C data to identify periods of time when behavior is highly likely.

4.Determine the length of the observation period, and divide the observation period into equal interval blocks (keeping these the same across baseline sessions).

5.Construct the data sheet.

6.During observation, enter date and time of day on data sheet and set timing device for interval length.

7.At the end of each interval, if the target behavior occurred at all, place an X in the corresponding interval on the data sheet.

8.Repeat step 7 until the observation period ends.

9.Sum the total number of intervals in which a target behavior occurred, and enter that number on the data sheet.

10.Continue observing client and target behavior for at least four more baseline sessions.

For example, the staff person records partial interval data on the rate of occurrence of the targeted behavior on the data sheet found in Table 6.8. Observations are made five times per day, for 10 minutes. If the behavior occurs within a given 2-minute interval, an X is placed on that respective interval. Therefore, the data sheet in Table 6.8 for 1 day of observation reveals a grid, involving five intervals per observation across five observation sessions.

As you can see, in the first observation period (column marked Day 1), the client engaged in the target behavior only during the second and fourth interval during the entire 10-minute observation. During the next observation period, the client engaged in the target behavior in intervals 1, 2, 3, and 5. The totals at the bottom of each column are out of a possible of 5 intervals in which the behavior can be recorded. Summing across the row labeled “total” yields 16 intervals in which the target behavior was recorded as having occurred (against a total of 25 intervals for 5 days of observation). With this ratio 16/25, one can compute the percentage of occurrence, in this case 64% of intervals.

The interbehavior interval can also be calculated by dividing the number of minutes of observation for the week (50) by the number of intervals on which the target behavior occurred (16), which yields an average interbehavior interval of 3.125 minutes. In other words, the target behavior occurs about every 3 minutes. In this example, it is important to note that the rate of target behavior is relatively stable across the five observation periods. If it were more varied, one should examine what factors were different at each observation to account for the variability in rate of occurrence.

TABLE 6.8 ■ BASELINE INTERBEHAVIOR INTERVAL

Condition: Baseline

Recording Method: Partial interval

Interval Length: 2 minutes

Client: Arthur

Chart Started: 2-1-08

Day/Month/Year

Behavior: XXX

Day of the month/Start time

NCE Procedures

1.From baseline data, calculate the interbehavior interval.

2.Determine your schedule of escape from the maintaining negative reinforcer. (The initial schedule should be set so that reinforcement occurs at or more frequently than the shortest interbehavior interval, e.g., initial interval set at 80% of the average interbehavior interval.)

3.Identify conditions under which the client will be exposed to the negative reinforcer.

4.During the identified time periods, set the timing device to the initial escape schedule.

5.When the timer goes off, remove the negative reinforcer for a prespecified period of time. The duration of escape will depend on the specific negative reinforcer. If possible, do not let the target behavior produce escape.

6.Reset the timer.

7.Record data on data sheet.

Thinning the Schedule of Delivery of Maintaining Reinforcer

The schedule is thinned when the target behavior goal is achieved. When the goal is achieved, increase the length of time between the removal of the negative reinforcer, and set a new target behavior goal. The steps for thinning the schedule follow.

1.When the target behavior goal is achieved with the program, increase the length of the interval between NCE by 5% to 10%. For example, if the length of time between NCE was 5 minutes and the target behavior goal was met, the new schedule for escape might be set at 5 minutes, 30 seconds.

2.With each week of success in achieving the target behavior goal, the schedule of delivery is increased progressively by 10%.

3.If the target behavior occurs at a rate higher than the target behavior goal consistently over a given week, consider returning to the previous schedule of reinforcement.

4.If you have made several attempts at thinning the schedule but are unable to get past a particular rate of escape, it may be best to keep the schedule at that level while incorporating another functional treatment option.

How It Works

1.By eliminating the client’s motivation for escape from a particular negatively reinforcing item or event: When there is no motivation to escape the item or event, there is no reason for the person to engage any behaviors that previously removed that negative reinforcer.

2.By disrupting the learned contingency between the client’s target behavior and the removal of the negatively reinforcing event: That is, the negative reinforcing event is removed on some time schedule regardless of occurrence of the target behavior, so the person may learn that the unwanted behavior is no longer correlated with the removal of the negative reinforcer (extinction by unpairing).

Hypothetical Example

Enough Is Enough

Kalena, a third-grade student in a special education classroom, hits herself in the head and face when she is pressed to continue a task (SME 4.2: Lengthy Task/Chore/Assignment). In the past, when she engaged in this behavior, she was moved to another activity, whereupon such self-injury ceased. Dr. Stengel was asked to assess this child and find a way to reduce the self-injury. After obtaining a general description of the behavior, Dr. Stengel observed Kalena in her classroom over the course of 5 days. Using partial interval data collection, Dr. Stengel obtained the data presented in Example Form 6.13A.

In graphing the data recorded on Form 6.13A, it appeared that there was an increasing trend in the occurrence of the target behavior (2, 3, 4, and 5 intervals on consecutive days). (See Figure 6.4.)

Dr. Stengel could have calculated the interbehavior interval on the cumulated data, and it would have looked like this:

100 minutes ÷ 18 intervals with aggression = 5.56 minutes

In order to increase the likelihood of getting a positive effect quickly, Dr. Stengel calculated the interbehavior interval based on the session with the most occurrences, thus ensuring that the rate of NCE was higher than the rate of escape she was currently receiving for self-injurious behaviors (SIB).

Example Form 6.13A ■ Partial Interval Data

Day of the month

FIGURE 6.4 ■ Baseline self-injury data.

Dr. Stengel counted the total number of minutes of the observation (20) and divided it by the total number of intervals in which SIB occurred (5). This gave her an average interbehavior interval of 4 minutes.

20 minutes ÷ 5 intervals with self-injury = 4 minutes

Dr. Stengel now knew the rate of the target behavior but did not yet know the function. She determined that the behavior was probably socially mediated as it never occurred when Kalena was alone and had been observed only when adults and students were in close proximity. From her observations, Dr. Stengel had noticed that the SIB seemed to occur only when Kalena was working on math assignments and stopped when the math assignment was removed. This information made it less likely that the SIB functioned to access attention. If SIB was maintained by attention, it should happen at times other than when math work was given to Kalena. The target behavior stopped after math was removed, indicating the behavior likely functioned to produce escape. Kalena would, however, start to work on math for a period of time prior to engaging in SIB. Dr. Stengel hypothesized that SIB probably served to terminate relatively lengthy math tasks (SME 4.2: Relatively Lengthy Tasks/Chores/Assignments see Table 6.9).

To test this hypothesis, Dr. Stengel set up the following conditions. For 8 days during math class, she would present math work to Kalena. On 4 days she would present assignments that lasted an entire 15 minutes (full = F), that is, the student keeps working until 15 minutes is up. On the other 4 days, she would present short assignments that would last only 3 to 5 minutes (short = S). Once the assignment was finished, the session would end and Kalena could go to an entertaining activity for 30 seconds. After the 30-second break, Kalena was asked to do another math assignment of 3 to 5 minutes. This cycle was repeated three times so that the total time on task was equivalent to the 15-minute full condition. The only difference in instructions for the short condition was that Dr. Stengel provided the prompt, “Let’s do just this one task before we take a break.” Each time SIB occurred in either short or full sessions, Dr. Stengel gave Kalena a 1- to 2-minute break from the assignment. The assessment produced the data listed in Table 6.10.

Dr. Stengel now was fairly certain that her hypothesis was correct and that she could probably reduce the rate of SIB using a simple NCE contingency.

Dr. Stengel decided to start with an NCE schedule that required the aide to remove the task from Kalena every 4 minutes. She provided the staff with a simple plan to deliver NCE (see Example Form 6.14).

She started the intervention on the 12th. The staff were very excited by the results of their intervention. The data are presented on Example Form 6.13B.

We can present the same data in graphical format to more easily see the trends (see Figure 6.5).

TABLE 6.9 ■ DIAGNOSTIC TABLE FOR SELF-INJURY

SMA, socially mediated access; SME, socially mediated escape.

TABLE 6.10 ■ SIB HYPOTHESIS TEST

Based on the data that no aggression had occurred for 3 consecutive days, Dr. Stengel changed the schedule of escape to every 3.5 minutes.

3 minutes (current schedule) × 1.10 (10 percent increase) = 3.3 minutes

(Note: Because the time frames were relatively short, and Dr. Stengel knew that her timing device would make it difficult to track anything smaller than half a minute, she rounded up to 3.5 minutes.)

There was one event of self-injury on the first day of the new schedule but no further occurrences for 3 days after that. Dr. Stengel continued this process until the schedule had been thinned to every 10 minutes. After consultation with the teacher and teacher’s aide as to the feasibility, Dr. Stengel decided to keep the NCE schedule at this level while they taught Kalena some new behaviors that she could use to request a break. Kalena continued to have no events of self-injury. During the acquisition, a simple request for a break, in this case signing “break,” it was noted that Kalena could make the request quite well during training but was not using it during seat work in class. Dr. Stengel surmised that the NCE that was keeping the self-injury from occurring did so by eliminating the motivation to do any behavior that functioned to produce adult attention. She therefore began thinning the schedule of NCE. Upon reducing the NCE, Kalena began to use the requesting behavior she had learned. Dr. Stengel continued to collect data and thin the schedule of NCE until reaching the targeted interbehavior interval of 15 minutes. Dr. Stengel then discontinued the NCE but continued to take data for 1 month to ensure that the replacement behavior would continue to be effective in escaping lengthy seat work tasks.

Example Form 6.13B ■ Partial Interval Data

FIGURE 6.5 ■ Self-injury data.

Example Form 6.14

✵Person served: Kalena

✵Target Self-injury

✵Target behavior goal: Self-injury in less than 1% of observed intervals

✵Designated time period(s): Math time 25 minutes per day

✵Initial schedule of noncontingent escape:

○X Fixed time schedule every 3 minutes/hours/days

OR

○_____ Variable time schedule on average every _____ minutes/hours/days

✵Special instructions for removal of negative reinforcer(s): Remove all school work and allow Kalena to engage in any desk activity of her choosing during the 30 seconds. Following the 30 seconds, place the work in front of her and direct her to begin working.

✵Criterion for increasing amount of time between removal of negative reinforcers: When self-injurious behavior occurs in <1% of intervals observed for 3 consecutive days, increase time between NCE escape by 10.

✵Criterion for decreasing the amount of time between removal of negative reinforcers: If self-injurious behavior occurs in more than 5% of observed intervals for 3 consecutive days, decrease time between noncontingent escape by 1 minute.

What If?

What if the behavior does not decrease (or gets worse) with NCE?

This may happen, although it is less likely with this program than with others. When the target behavior is no longer effective in escaping the negative reinforcer, it may occur more frequently (called an extinction burst). If it occurs during NCE, it is possible the schedule of delivery is not dense enough. Try shortening the time between allowing escape. If there is still no effect, it is very likely that your functional assessment was incorrect and that there is a different reinforcer maintaining the target behavior. It would be best to return to taking A-B-C data and repeat the functional assessment.

Forms: NCE

6.12Partial Interval Data, 30-Minute Intervals

6.13Partial Interval Data, 2-Minute Intervals

6.14NCE: Simple Plan

6.15Formulas for Calculating Percentage of Intervals of Targeted Behavior and ­Interbehavior Interval

6.16Formulas for Determining Increases or Decreases in Frequency of NCE

Form 6.12 ■ Partial Interval Data, 30-Minute Intervals

✵Condition: Baseline or Treatment Recording Method: Partial Interval

✵Client: ____________________ Chart Started: _____________

Day/Month/Year

✵Behavior: __________________________________

✵Interval Length: 30 minutesTotal Observation Time: __Session Length: __

Behavior did NOT occur Behavior DID occur

Day of the month/Start time

Form 6.13 ■ Partial Interval Data, 2-Minute Intervals

Day/Month/Year

✵Behavior: __________________________________

✵Interval Length: 2 minutesTotal Observation Time: __Session Length: __

Behavior did NOT occur Behavior DID occur

Day of the month/Start time

Form 6.14 ■ NCE: Simple Plan

✵Person served: ____________________

✵Target 'margin-top:6.0pt;margin-right:5.0pt;margin-bottom: 0cm;margin-left:21.8pt;text-indent:-16.8pt;line-height:normal'>•Behavioral diagnostic category: ____________________

✵Target rate: ____________________

✵Designated time period(s): ____________________

✵Initial schedule of noncontingent escape:

✵_____ Fixed time schedule every _____ minutes/hours/days

OR

✵_____ Variable time schedule on average every _____ minutes/hours/days

✵Special instructions for removal of negative reinforcer(s):

_________________________________

_________________________________

_________________________________

✵Criterion for increasing amount of time between removal of negative reinforcers:

_________________________________

✵Criterion for decreasing the amount of time between removal of negative reinforcers: _________________________________

_________________________________

Form 6.15 ■ Formulas for Calculating Percentage of Intervals of Targeted Behavior and Interbehavior Interval

✵% of occurrence: This formula will help you determine how often a behavior is occurring. Use this information to assess treatment effects.

○(Total intervals target behavior occurred ÷ Total intervals observed) × 100 = % of intervals of target behavior

✵Rate: This formula will help you determine on average how much time passes between the occurrence of targeted behaviors (interbehavior interval). Use this information to help set the frequency of noncontingent escape.

○Total minutes observed ÷ Total intervals target behavior occurred = Rate or average interbehavior interval

Form 6.16 ■ Formulas for Determining Increases or Decreases in Frequency of NCE

✵Formula for 10% increase in time between negative reinforcement.

✵Current reinforcement interval × 1.10 = (10% increase in time)

✵Formula for 5% increase in time between negative reinforcement.

✵Current reinforcement interval × 1.05 = (5% increase in time)

✵Formula for 10% decrease in time between negative reinforcement.

✵Current reinforcement interval × 0.90 = (10% decrease in time)

✵Formula for 5% decrease in time between negative reinforcement.

✵Current reinforcement interval × 0.95 = (5% decrease in time)

ADDITIONAL RESOURCES

Coleman, C. L., & Holmes, P. A. (1998). The use of non-contingent escape to reduce disruptive behaviors in children with speech delays. Journal of Applied Behavior Analysis, 310, 687—690.

Kodak, T., Miltenberger, R. G., & Romaniuk, C. (2003). The effects of differential negative reinforcement of other behavior and non-contingent escape on compliance. Journal of Applied Behavior Analysis, 36, 379—382.

O’Callaghan, P. M., Allen, K. D., Powell, S., & Salama, F. (2006). The efficacy of non-contingent escape for decreasing children’s disruptive behavior during restorative dental treatment. Journal of Applied Behavior Analysis, 39, 161—171.

Vollmer, T. R., Marcus, B. A., & Ringdahl, J. E. (1995). Non-contingent escape as ­treatment for self-injurious behavior maintained by negative reinforcement. Journal of Applied Behavior Analysis, 28, 15—26.