Griffin W. Rooker

Functional communication training with and without alternative reinforcement and punishment: An analysis of 58 applications

Functional communication training (FCT) is an empirically supported treatment for problem behavior displayed by individuals with intellectual disabilities. Hagopian, Fisher, Sullivan, Acquisto, and LeBlanc (1998) analyzed 25 applications of FCT and showed that extinction was a necessary component of FCT, but sometimes punishment was needed to maintain low levels of problem behavior. The current consecutive case series summarized data from 58 applications of FCT in more recent cases. This analysis extended and updated Hagopian et al. by examining FCT when used in combination with alternative reinforcement (noncontingent and differential reinforcement) and multiple schedules during schedule thinning. Although it is difficult to make direct comparisons with the 1998 study, the results of the current case series analysis suggest that FCT can be enhanced when used in combination with alternative reinforcement and when multiple schedules are used during schedule thinning.

INITIAL FUNCTIONAL ANALYSIS OUTCOMES AND MODIFICATIONS IN PURSUIT OF DIFFERENTIATION: A SUMMARY OF 176 INPATIENT CASES

The functional analysis (FA) described by Iwata, Dorsey, Slifer, Bauman, and Richman (1982/1994) delineated not only a set a specific procedures, but also a model that involves the use of analogue conditions wherein antecedent and consequent variables are systematically manipulated. This consecutive case-series analysis describes FAs of 176 individuals with intellectual disabilities who had been admitted to an inpatient unit for severe problem behavior. Following an initial standardized FA, additional modifications were performed in pursuit of differentiation. Ultimately, a function was identified in 86.9% of the 176 cases and in 93.3% of the 161 cases for which the FA, if necessary, was modified up to 2 times. All modifications were documented and classified as involving changes to antecedents, consequences, or design (or some combination of these). Outcomes for each type of modification are reported. The results support the utility of ongoing hypothesis testing through individualized modifications to FA procedures, and provide information regarding how each type of modification affected results.

IDIOSYNCRATIC VARIABLES THAT AFFECT FUNCTIONAL ANALYSIS OUTCOMES: A REVIEW (2001–2010)

Although typical functional analyses often produce clear outcomes, some studies have reported ambiguous results that cannot be interpreted. Such undifferentiated outcomes may occur if test conditions do not include relevant antecedent or consequent events. Clinicians then may try to modify the functional analysis conditions to include those events. Hanley, Iwata, and McCord (2003) reviewed the functional analysis literature through 2000 and described idiosyncratic variables included in modified functional analyses. The objective of the present review was to present a quantitative analysis of idiosyncratic antecedents and consequences in modified functional analyses during the past decade (2001 to 2010). We discuss the range of stimulus parameters tested and the assessment strategies used for informing the modified analysis conditions.

Identifying empirically supported treatments for pica in individuals with intellectual disabilities.

The purpose of the current study was to critically examine the existing literature on the treatment of pica displayed by individuals with intellectual disabilities. Criteria for empirically supported treatments as described by Divisions 12 and 16 of APA, and adapted for studies employing single-case designs were used to review this body of literature. A total of 34 treatment studies were identified, 25 of which were well designed and reported at least an 80% reduction in pica (21 studies reported 90% or greater reduction in pica). Results indicated that behavioral treatments in general, and treatments involving the combination of reinforcement and response reduction procedures in particular, can be designated as well-established treatments for pica exhibited by individuals with intellectual disabilities.

False-Positive Tangible Outcomes of Functional Analyses.

Functional analysis (FA) methodology is the most precise method for identifying variables that maintain problem behavior. Occasionally, however, results of an FA may be influenced by idiosyncratic sensitivity to aspects of the assessment conditions. For example, data from several studies suggest that inclusion of a tangible condition during an FA may be prone to a false-positive outcome, although the extent to which tangible reinforcement routinely produces such outcomes is unknown. We examined susceptibility to tangible reinforcement by determining whether a new response was acquired more readily when exposed to a tangible contingency relative to others commonly used in an FA (Study 1), and whether problem behavior known not to have a social function nevertheless emerged when exposed to tangible reinforcement (Study 2). Results indicated that inclusion of items in the tangible condition should be done with care and that selection should be based on those items typically found in the individuals environment.

ASSESSING THE UTILITY OF A DEMAND ASSESSMENT FOR FUNCTIONAL ANALYSIS

We evaluated the utility of an assessment for identifying tasks for the functional analysis demand condition with 4 individuals who had been diagnosed with autism. During the demand assessment, a therapist presented a variety of tasks, and observers measured problem behavior and compliance to identify demands associated with low levels of compliance or high levels of problem behavior (low-probability demands) and demands associated with high levels of compliance or low levels of problem behavior (high-probability demands). Results showed that clearer functional analysis outcomes were obtained for 3 of the 4 participants when low-probability rather than high-probability demands were used.

EFFECTS OF FIXED VERSUS RANDOM CONDITION SEQUENCING DURING MULTIELEMENT FUNCTIONAL ANALYSES

It has been suggested that a fixed condition sequence might facilitate differential responding during multielement functional analyses (FAs) by capitalizing on or limiting sequence effects (Iwata, Pace, et al., 1994); however, the effects of condition sequence have not been examined empirically. We conducted fixed- and random-sequence FAs for 7 individuals with developmental disabilities to determine the relative effects that sequence may have on assessment outcomes. Experimental conditions during the fixed sequence were conducted in the following order: ignore, attention, play, and demand; condition order during the random sequence was determined randomly. Results showed that sequence had no influence on the FA outcomes for 3 subjects, whereas differential responding emerged either faster (1 subject) or only (3 subjects) under the fixed sequence for the remaining subjects. These results suggest that the fixed sequence, a simple modification, should be used when conducting multielement FAs to accommodate the influence of establishing operations across assessment conditions.

Delineating subtypes of self‐injurious behavior maintained by automatic reinforcement

Self-injurious behavior (SIB) is maintained by automatic reinforcement in roughly 25% of cases. Automatically reinforced SIB typically has been considered a single functional category, and is less understood than socially reinforced SIB. Subtyping automatically reinforced SIB into functional categories has the potential to guide the development of more targeted interventions and increase our understanding of its biological underpinnings. The current study involved an analysis of 39 individuals with automatically reinforced SIB and a comparison group of 13 individuals with socially reinforced SIB. Automatically reinforced SIB was categorized into 3 subtypes based on patterns of responding in the functional analysis and the presence of self-restraint. These response features were selected as the basis for subtyping on the premise that they could reflect functional properties of SIB unique to each subtype. Analysis of treatment data revealed important differences across subtypes and provides preliminary support to warrant additional research on this proposed subtyping model.

ASSESSMENT OF PROBLEM BEHAVIOR EVOKED BY DISRUPTION OF RITUALISTIC TOY ARRANGEMENTS IN A CHILD WITH AUTISM

A functional analysis suggested that the problem behavior of a 9-year-old girl with autism was maintained by gaining the opportunity to restore ritualistic toy arrangements that had been disrupted. Functional communication training and extinction produced clear decreases in problem behavior in 2 contexts: 1 in which we removed a play item, and 1 in which we merely relocated the item and blocked its rearrangement.

Further analysis of subtypes of automatically reinforced SIB: A replication and quantitative analysis of published datasets

Hagopian, Rooker, and Zarcone (2015) evaluated a model for subtyping automatically reinforced self-injurious behavior (SIB) based on its sensitivity to changes in functional analysis conditions and the presence of self-restraint. The current study tested the generality of the model by applying it to all datasets of automatically reinforced SIB published from 1982 to 2015. We identified 49 datasets that included sufficient data to permit subtyping. Similar to the original study, Subtype-1 SIB was generally amenable to treatment using reinforcement alone, whereas Subtype-2 SIB was not. Conclusions could not be drawn about Subtype-3 SIB due to the small number of datasets. Nevertheless, the findings support the generality of the model and suggest that sensitivity of SIB to disruption by alternative reinforcement is an important dimension of automatically reinforced SIB. Findings also suggest that automatically reinforced SIB should no longer be considered a single category and that additional research is needed to better understand and treat Subtype-2 SIB.