Richard M. Foxx

Restitution: a method of eliminating aggressive-disruptive behavior of retarded and brain damaged patients.

Abstract Current methods of penalizing aggressive and disruptive behaviors have elements of retribution that discourage general usage. A procedure was developed that provided disruptive offenders with re-education, removal of the reinforcement for the offense, time-out from general positive reinforcement, and an effort requirement. The offender was required by instructions or physical guidance to overcorrect the general psychological and physical disturbance created by the offense. The procedure was applied to one brain-damaged and two retarded patients, who displayed one or more of the following types of behavior: physical assault, property destruction, tantrums, continuous screaming, and biting, all of which had resisted other treatments such as time-out, punishment and social disapproval. The procedure reduced the disturbed behaviors of all patients to a near-zero level within one or two weeks and maintained this therapeutic effect with minimal staff attention. This method appears to be a rapid and effective treatment procedure for disruptive behavior and emphasizes the individuals responsibility for his actions.

Dry-bed training: rapid elimination of childhood enuresis.

Abstract Enuresis has been treated with moderate effectiveness by the urine-alarm method which requires many weeks of training. The present procedure used a urine-alarm apparatus but added such features as training in inhibiting urination, positive reinforcement for correct urinations, training in rapid awakening, increased fluid intake, increased social motivation to be nonenuretic, self-correction of accidents, and practice in toileting. After one all-night training session, the 24 enuretic children averaged only two bedwettings before achieving fourteen consecutive dry nights and had no major relapses. Little or no reduction in bedwetting occurred within the first two weeks for matched-control enuretics who were given the standard urine-alarm training. The results of a control-procedure showed that the new procedure did not involve Pavlovian conditioning. The new method appears to be a more rapid, effective and different type of treatment for enuresis.

Treatment of scavenging behavior (coprophagy and pica) by overcorrection

Abstract Scavenging behavior such as pica (ingesting non-nutritive substances) and coprophagy (ingesting fecal matter) represents a serious health hazard in the care of the institutionalized retarded. The Overcorrection rationale was used to develop procedures for eliminating scavenging. The procedures were applied to 4 profoundly retarded adults who rumaged for and ate: paper, trash, garbage, cigarette butts, bits of cloth and feces. The 3 residents who habitually ate feces were chronically infested with intestinal parasites (Trichuris trichiura). The procedures emphasized correction of the scavenging act. as well as practice in alternative appropriate behavior in the situations in which scavenging normally occurred. The Overcorrection procedures reduced the scavenging of all 4 retardates to a near zero level within 1 week where it remained for the duration of the study. The results of biweekly stool specimens showed that all three coprophagic residents were free of parasites during the Overcorrection condition. The Overcorrection procedures were rapid, easily implemented, enduring and effective methods of reducing pica and coprophagic behavior.

Dry pants: a rapid method of toilet training children.

Abstract Toilet training sometimes requires considerable time. An intensive learning procedure was devised for shortening this training time and tested with 34 children who were experiencing toilet training problems. The procedure had the following major characteristics: (1) a distraction-free environment, (2) an increased frequency of urination by increased fluid intake, (3) continuous practice and reinforcement of the necessary dressing skills, (4) continuous practice and reinforcement in approaching the toilet, (5) detailed and continuing instruction for each act required in toileting, (6) gradual elimination of the need for reminders to toilet, (7) immediate detection of accidents, (8) a period of required practice in toilet-approach after accidents as well as (9) negative reinforcement for the accident, (10) immediate detection of correct toileting, (11) immediacy of reinforcement for correct toiletings, (12) a multiple reinforcement system including imagined social benefits as well as actual praise, hugging and sweets, (13) continuing reinforcement for having dry pants, (14) learning by imitation, (15) gradual reduction of the need for immediate reinforcement and (16) post-training attention to cleanliness. All 34 children were trained and in an average of 4 hr; children over 26 months old required an average of 2 hr of training. After training, accidents decreased to a near-zero level and remained near zero during 4 months of follow-up. The results suggest that virtually all healthy children who have reached 20 months of age can be toilet trained and within a few hours.

Dry bed: A rapid method of eliminating bedwetting (enuresis) of the retarded☆

Abstract Bedwetting has been a major and unsolved problem for the severely retarded. To solve this problem, an intensive training program was designed similar to a recently developed program for daytime toilet training of the retarded. Some distinctive features of the new procedure were frequent positive reinforcement for correct toileting, a negative reinforcer for accidents, positive practice in night time toileting, increased level of urination by forcing drinking, immediate detection of correct and incorrect toileting, and Positive Practice for accidents. Of twelve retarded adult bedwetters, the average bedwetter required only one night of intensive training. Several days of apparatus monitoring were used following the training but proved unnecessary for two-thirds of the trainees. Accidents were reduced by about 85 % during the first week after training, and almost entirely (95%) during the fifth week with no relapse during a 3 month follow-up. No reduction of accidents resulted when the same bedwetters were given a control procedure that provided no positive or negative reactions other than the sounding of an alarm upon bedwetting. The Dry-Bed procedure appears to be a very rapid solution to the problem of enuresis among the retarded and may be applicable to other difficult populations and also to normals.

Applied Behavior Analysis Treatment of Autism: The State of the Art

The treatment of individuals with autism is associated with fad, controversial, unsupported, disproven, and unvalidated treatments. Eclecticism is not the best approach for treating and educating children and adolescents who have autism. Applied behavior analysis (ABA) uses methods derived from scientifically established principles of behavior and incorporates all of the factors identified by the US National Research Council as characteristic of effective interventions in educational and treatment programs for children who have autism. ABA is a primary method of treating aberrant behavior in individuals who have autism. The only interventions that have been shown to produce comprehensive, lasting results in autism have been based on the principles of ABA.

Positive behavior support and applied behavior analysis.

This article reviews the origins and characteristics of the positive behavior support (PBS) movement and examines those features in the context of the field of applied behavior analysis (ABA). We raise a number of concerns about PBS as an approach to delivery of behavioral services and its impact on how ABA is viewed by those in human services. We also consider the features of PBS that have facilitated its broad dissemination and how ABA might benefit from emulating certain practices of the PBS movement.

A Remediation Program for Increasing the Spelling Achievement of Elementary and Junior High School Students

The present study evaluated four procedures designed to help poor spellers improve their achievement on weekly tests: (1) a pretest over the weeks spelling words followed in two days by the regular weekly test; (2) a positive practice procedure in which students were required to correct any misspelled word on the weekly test by writing out its (a) correct spelling, (b) part of speech, (c) phonetic spelling, (d) complete definition, and (e) correct usage in five different sentences; (3) a pretest, positive practice of the pretest, and the weekly test; and (4) a pretest, positive practice of the pretest, weekly test, and positive practice of the weekly test. The pretest/positive practice/test/positive practice procedure was the most effective, producing a 14 percentage point increase in spelling achievement. The pretest/positive practice/test (11 percentage point increase) and positive practice (10 percentage point increase) procedures were of near equal effectiveness. The pretest procedure produced no increase.

The use of overcorrection to eliminate the public disrobing (stripping) of retarded women.

Abstract Institutionalized retarded persons who disrobe publicly or ‘strip’ are a source of great concern to administrators, treatment staff and visitors. Common institutional approaches to public disrobing have been to dress strippers in restrictive clothing or cloister them from public view. Although behavior modification techniques have sometimes been used successfully to eliminate stripping, none has received widespread usage. The present study compared the effectiveness of an Overcorrection procedure that was designed to eliminate stripping with two behavioral treatments for stripping: time-out and physical restraint. The procedures were applied to two profoundly retarded female strippers. The key components of the Overcorrection procedure were: (1) a Restitutional Overcorrection procedure that consisted of a required dressing in panties, bra, slip, panty hose and tie shoes in addition to the womans normal ward clothing that consisted solely of a dress and (2) a Positive Practice Overcorrection procedure that required the stripper to attend to the clothing needs and personal appearance of other ward residents by buttoning or zipping their unfastened clothing, straightening rumpled or twisted clothing, furnishing footwear to those in bare feet and combing tousled hair. The Overcorrection procedure eliminated the womens stripping within 2 weeks and was more effective than the alternative procedures. The Overcorrection procedure appears to be a rapid, effective, and enduring method of eliminating the public disrobing of retarded adult females.

Twenty years of applied behavior analysis in treating the most severe problem behavior: Lessons learned.

This paper reviews some of the author’s experiences during the past 20 years of treating severe problem behavior. Factors that represent barriers to success are identified and discussed, as are factors that contribute to the development of successful treatment programs. Barriers to success include the inherent reactive nature of human services and educational systems, expertise problems, systems problems, information gaps, programming problems, characteristics of problem behavior, and maintenance problems. Some new programmatic directions are suggested for overcoming the various treatment barriers. The paper concludes with strategies and factors to consider that will ensure long-term success in the treatment of severe problem behavior.