Marguerite Hoerger

Treatment relapse and behavioral momentum theory.

The relapse of problem behavior after apparently successful treatment is an enduring problem for the field of applied behavior analysis. Several theoretical accounts of treatment relapse have emerged over the years. However, one account that has received considerable recent attention is based on behavioral momentum theory (BMT). BMT has shown that behavior is more persistent in contexts that are correlated with higher rates of reinforcers after disruption of the response-reinforcer relation. Accordingly, relapse after successful treatment can be viewed as the persistence of behavior when treatment is compromised in some manner. We review basic BMT research, alternative accounts of treatment relapse, and translational research studies derived from BMT research. The implications for applied behavior analysis in practice are discussed along with potential solutions to the problem of treatment relapse.

Clinical translation of animal models of treatment relapse

Behavioral Momentum Theory (BMT) has inspired animal models of treatment relapse. We translated the models of reinstatement and resurgence into clinical procedures to test whether relapse tests would replicate behavior pattern found in basic research. Following multiple schedule baseline reinforcement of a 16-year-old males problem behavior at equal rates by two therapists, treatment was introduced using a variable-interval, variable-time (VI VT) schedule arrangement with therapists delivering reinforcers at different rates. Despite the differing rates of VI VT reinforcers, the treatment produced comparable reductions in problem behavior. Following successful treatment, the two therapists discontinued treatment and resumed reinforcement of problem behavior at equal rates that constituted a reinstatement of baseline conditions. As predicted by BMT, reinstatement resulted in an immediate return of high rates of problem behavior but was 2.6 times higher for the therapist using the higher rate VI VT treatment. A second treatment phase was implemented followed by a test of resurgence in a single extended extinction session conducted separately for each therapist. The unequal VI VT treatment rates by therapists resulted in 2.1 times greater responding in the resurgence test for the therapist who implemented the higher rate VI VT procedure. These results are consistent with basic research studies and BMT.

Brief report: establishing ABA programs in a Welsh context: cross cultural considerations

The application of behavior analytic principles as an effective therapy for children with autism has been repeatedly demonstrated in the literature. Intensive Behaviour Intervention (IBI) has been successfully utilized intensively with children with autism (e.g. Lovaas, 1987). ABA has been increasingly utilized in a diverse range of other linguistic and cultural contexts over the past twenty years. Gwynedd Local Education Authority (LEA) in North West Wales, UK, is funding a small-scale autism-specific specialist education service using ABA methodology, available through the medium of Welsh. This unique service is illustrated by a case example demonstrating the success of an ABA program in this novel cultural and linguistic environment. Issues arising from delivering ABA interventions in a non-English context are discussed. It is argued that there is a role for a cross-cultural, multi-lingual network discussion forum to compare learning with other linguistic and cultural contexts where ABA is being utilized.

Clinical translation of the ABA renewal model of treatment relapse

ABSTRACT An 18-year-old male’s attention-maintained problem behavior was treated with an alternative (ALT) variable-interval, variable-time (VI VT) schedule arrangement with two therapists each delivering attention at different rates in a multiple schedule of reinforcement. Despite the differing rates of VI VT attention, the procedures resulted in similar rates of problem behavior in the last three treatment sessions reducing problem behavior by an average of 45%. Following treatment, the two therapists conducted separate extinction sessions, initially in a different context until problem behavior extinguished and then returning to the original treatment context (i.e., the ABA renewal test). Extinction took 4.4 times longer in the renewal test for the therapist who implemented the high-rate VI VT treatment compared with the therapist who implemented the low-rate VI VT treatment. Although these results are preliminary, the implications for clinicians is that treatment designs that use low-rate treatment may be more effective than high-rate treatment in preventing relapse.

A Methodology for Maintaining Low Levels of Attention-Maintained Problem Behaviors Following Variable-Time Schedule Thinning

Variable-time (VT) schedules of reinforcement deliver reinforcers contingent on the passage of a specified average amount of time. VT schedules that arrange for frequent reinforcer deliveries have been effective in producing immediate suppression of elevated levels of target behaviors. However, dense schedules may not be practical for caregivers and staff and a systematic methodology for thinning VT schedules is needed. This study employed VT schedules of attention to reduce attention-maintained problem behavior in a 14-year-old male. Following reduction in attention-maintained problem behaviors, the VT schedule was thinned. Results showed that a return to continuous attention following re-emergence of behaviors during schedule thinning resulted in maintenance of low levels of these behaviors and high levels of activity engagement.

Using applied behaviour analysis as standard practice in a UK special needs school

This article describes how applied behaviour analysis can be implemented effectively and affordably in a maintained special needs school in the UK. Behaviour analysts collaborate with classroom teachers to provide early intensive behaviour education for young children with autism spectrum disorders (ASD), and function based behavioural interventions for children between the ages of three and 18 years. Data are presented that show how the model is effective. Children with ASD under the age of seven made significant gains on intelligence quotient and on a range of skills including language, social and play, and academic skills following three academic terms of intervention. Case study data for two children reveal a marked decrease in challenging behaviour following a function based behavioural intervention. These interventions have led to greater independence, integration and access to curricular activities. These data show that children are making significant gains within this cost-effective model.

An Evaluation of Three Methods of Denying Access to Computers to a Person With Learning Disabilities

Parents and carers frequently report that individuals with learning disabilities who demand access to preferred activities present challenging behavior when they are denied access to these activities. The present research systematically replicated a pilot study by Mace, Pratt, Prager and Pritchard (in press) demonstrating that an escalating response class hierarchy of challenging behaviors could be reliably avoided if a child’s demands for access to a computer game were denied by either: (a) denying the child access to the computer game while at the same time offering an alternative activity; or (b) denying the child access to the computer game until the child had completed an academic task. The current study extended the pilot research by demonstrating the effectiveness of the two interventions with a 17 year-old male of large stature who engaged in dangerous challenging behavior when his demands for access to computers were denied.

Conditioned suppression of compulsive behavior in an adolescent diagnosed with obsessive-compulsive disorder

ABSTRACT Obsessive-compulsive disorder (OCD) is characterized by recurrent and ritualized acts that often have no social behavioral function. These behaviors commonly co-occur with anxiety. We used a mild punisher to suppress compulsive behaviors in a 16-year-old male diagnosed with OCD. We paired a “hands down” instruction with red paper and systematically reduced paper size and added a red wristband while continuing to reduce paper size. Conditioned suppression by the wristband was then generalized to a novel setting and staff.