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| Built to Last: Considerations for Designing and Implementing Durable Interventions for Socially Mediated Challenging Behavior |
| Sunday, May 28, 2017 |
| 8:00 AM–9:50 AM |
| Convention Center Mile High Ballroom 2A |
| Area: PRA; Domain: Applied Research |
| Chair: Audrey N. Hoffmann (Utah State University) |
| Discussant: Tyra P. Sellers (Utah State University; Utah Behavior Support Clinic) |
| Abstract: Although practitioners can and do replicate interventions published in behavioral journals, they are often required to lean on their scientific training in order to deduce what adaptations to published protocols might be appropriate or necessary for their own clients. They must also be prepared to contact failure and, when they do, to embark on an iterative evaluation process before finally achieving, a) short-term therapeutic gains, b) generality of treatment effects across relevant contexts, and c) long-term maintenance of observed progress. The purpose of this symposium is to highlight variables and techniques that practitioners may wish to consider when designing intervention in the service of the above-mentioned goals. The first presenter will present data validating a recently published treatment-selection guide for escape-maintained challenging behavior. The second presenter will highlight a technique intended to decrease the probability of relapse when care providers fail to reinforce the mands of individuals with extensive histories of challenging behavior. The third and fourth presenters will highlight multi-component function-based interventions designed to produce socially valid outcomes when fidelity to extinction procedures is either unsafe, or impossible. |
| Instruction Level: Basic |
| Keyword(s): Escape, Intervention, Levels Systems, Resurgence |
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| An Evaluation of a Published Treatment Selection Guide for Escape Maintained Problem Behavior |
| Bistra Bogoev (Utah State University), AUDREY N. HOFFMANN (Utah State University), Tyra P. Sellers (Utah State University) |
| Abstract: In recent years, researchers have published a treatment selection guide to aid practitioners in selecting function-based interventions for escape maintained problem behavior (Geiger et al. 2010). The purpose of this study was to validate the utility of a published treatment selection guide on the outcomes of function-based interventions for escape maintained problem behavior in five children with disabilities in a school setting. We first conducted a functional analysis (FA) to determine the function of problem behavior. We then had two BCBA’s independently use the treatment selection guide to select an intervention. We subsequently implemented the intervention selected by the BCBA’s with each participant. Results demonstrated decreases in problem behavior for all participants and increases in appropriate behavior for four participants in which functional communication training (FCT) was implemented. We conducted a differential reinforcement of other behavior (DRO) procedure with the fifth participant and his results demonstrated a decrease in problem behavior and an increase in the duration of time not engaging in problem behavior. We determined that for five students with disabilities in an elementary setting, using a published treatment selection guide led to identification of effective function based interventions leading to reductions in problem behavior for all participants. |
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| An Applied Examination of Training Multiple Mands During Functional Communication Training |
| Audrey N. Hoffmann (Utah State University), Bistra Bogoev (Utah State University), CHASE CALLARD (Utah State University), Tyra P. Sellers (Utah State University) |
| Abstract: The present study examined training multiple alternative responses during functional communication training (FCT) to examine the effects on alternative response persistence and problem behavior resurgence. Participants included four children with mild/moderate disabilities who engaged in severe problem behavior. During Phase I we conducted baseline, implemented traditional FCT (i.e., taught one alternative response), and then implemented extinction to examine alternative response persistence and problem behavior resurgence. During Phase II we again conducted baseline, implemented FCT training three new alternative responses, and then implemented extinction. We compared alternative response persistence and problem behavior resurgence during both Phase I and Phase II extinction components. Three participants demonstrated more alternative response persistence following training of multiple responses compared to training one response. Three participant also demonstrated less resurgence of problem behavior following training of multiple responses. These results provide preliminary applied evidence that when working with children with mild/moderate disabilities who engage in severe problem behavior, training multiple responses (i.e., a response class) during FCT may create more durable intervention effects in the face of disruptors such as extinction. |
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| Stimulus Fading and Levels System as Alternative to Extinction for Severe Aggression |
| KAYLA RECHELLE RANDALL (Vanderbilt University), Mary Matthews (Vanderbilt University), Joseph Michael Lambert (Vanderbilt University), Nealetta Houchins-Juarez (Vanderbilt University) |
| Abstract: Extinction is often necessary during differential reinforcement procedures in order to adequately suppress challenging behavior. However, when aggression is severe, fidelity to extinction is likely to be low and therapists may accidentally reinforce extinction-induced escalations. Related, when challenging behavior is multiply controlled, it is challenging to ascertain which establishing operations are influencing challenging behavior from moment to moment and it may not be readily apparent how, exactly, to implement extinction during any given behavioral episode. Function-based punishment procedures embedded into individualized levels systems may represent viable alternatives to extinction when addressing multiply controlled challenging behavior. In our study, we designed an individualized levels system for an 11-year old female diagnosed with autism whose severe aggression was maintained by access to attention, tangible items, and escape from demands. Systematic stimulus fading was employed to safely introduce multiple therapists across successive intervention sessions. Therapists were initially fully covered with protective gear and never conducted sessions independently. Following the fading procedure, single therapists conducted intervention sessions alone without wearing any protective gear. Data indicate an individualized levels system with stimulus fading could be used to treat severe aggression when safety is a concern. |
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Individualized Levels System as Intervention for Socially Mediated Self-Injurious Behavior |
| SOMER WIGGINS (Vanderbilt University), Mary Matthews (Vanderbilt University), Joseph Michael Lambert (Vanderbilt University), Nealetta Houchins-Juarez (Vanderbilt University) |
| Abstract: Behavior analysts are frequently employed to reduce or eliminate harmful forms of self-injurious behavior (SIB) emitted by their clients. However, when SIB is dangerous or life threatening, common approaches to intervention (e.g., response extinction) are neither feasible nor safe. Our participant was diagnosed with autism spectrum disorder (ASD) and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and engaged in frequent bouts of high intensity and multiply controlled but socially mediated SIB, including swallowing inedible objects (e.g., batteries, pens, etc.), self-choking, self-biting, head banging, and vomiting. This talk highlights an iterative approach to intervention in which multiple techniques were attempted before socially valid outcomes could be achieved. Intervention ultimately incorporated DRO, DRA, FCT, NCR, response interruption and redirection, and negative punishment procedures that were organized into an individualized levels system and embedded into a structured daily activity schedule. Results indicate that the major components of this intervention were ineffective in isolation and support some data suggesting that SIB is often most effectively addressed through multi-component interventions. |
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