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Treating problem behaviors maintained by negative reinforcement
Pergamon
Research in DevelopmentalDisabilities,Vol. 18, No. 5, pp. 329-342, 1997 Copyright © 1997 Elsevier Science Ltd Printed in the USA. All rights reserved 0891-4222/97 $17.00 + .00
PlI S0891-4222(97)00014-0
Treating Problem Behaviors Maintained by Negative Reinforcement Ennio Cipani California School of Professional Psychology
Fred Spooner University of North Carolina at Charlotte
The examination of controlling contingencies in an analysis of problem behavior has been an important clinical topic of discussion in the field of developmental disabilitiesfor many years. We know that problem behavior may be maintained by positive reinforcement or by negative reinforcement. From a clinical perspective, we seem to know more about behavioral techniques that are used when the problem behavior is maintained by positive reinforcement than we understand about those techniques that may be applied when a problem behavior is maintained by negative reinforcement. In this paper, we identify, four treatment techniques that may be applied when problem behavior is maintained by negative reinforcement: (a) functional communication training; (b) behavioral momentum: (c) differential reinforcement or an alternative escape behavior; and (d) errorless learning. Each of the four techniques will be defined, applications and guidelines .for use delineated. © 1997 Elsevier Science Ltd
T h e h i s t o r y a n d e m p i r i c a l b a s i s for b e h a v i o r a l t e c h n i q u e s p r o c e d u r e s is e x t e n sive (see J o u r n a l o f A p p l i e d B e h a v i o r A n a l y s i s , R e s e a r c h a n d I n t e r v e n t i o n in D e v e l o p m e n t a l Disabilities, B e h a v i o r T h e r a p y a n d o t h e r p r o f e s s i o n a l j o u r n a l s ) . Requests for reprints should be sent to Fred Spooner, Department of Counseling, Special Education, and Child Development, The University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223-0001; E-mail: [email protected]. 329
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In many earlier studies, behavior was changed through a manipulation of consequences. The programming of contingencies was largely arbitrary, with the functional aspects of problem behavior(s) often ignored. Subsequently, treatment procedures that were prescribed may have had little relation to the reinforcement contingencies maintaining the undesirable level of the problem behavior (Carr, Robinson, & Palumbo, 1990). For example, the prescription of a differential reinforcement strategy often involved the provision of a tangible reinforcer (e.g., edible, drink, etc.) as a contingency for a selected, alternate, acceptable behavior to the problem behavior (e.g., Deitz & Repp, 1973). However, the baseline relation between problem behavior and access to edibles (contingently) was usually not demonstrated or hypothesized. Therefore, it was unclear as to whether the systematic development of an alternate behavior that consistently produces edibles addressed the functional properties of the problem target behavior. A hypothetical example better illustrates the contrast between a functional and an arbitrary contingency. Let's say a target child engages in self-injurious behavior (SIB). If the function of SIB was to access food (when the child was hungry), the strategy of reinforcing an alternative behavior with food while not providing food when SIB occurs, would be effective (i.e., functional contingency). However, if the individual's SIB serves to escape "aversive" tasks or demands (e.g., within an instructional condition), one can clearly see that providing edibles for an alternative behavior does not address the function of SIB under these instructional conditions (arbitrary contingency). It is possible that one might see an increase in the alternative behavior. On the other hand, at a point when the task or demand is exceedingly aversive to the individual, and the child desires escape from the task more than receiving food, the unavailability of edibles for a period of time will not produce the desired effect on SIB. The child's desire to escape the task (via SIB) is greater than the desire to receive food. The contingency of interest in this scenario is between some behavior and its environmental ability to escape an aversive task or demand. A functionally derived contingency would be the occurrence of an alternate appropriate behavior and the contingent removal of the task. Functional analyses attempt to determine which of two reinforcement paradigms seem to be operable in the development and/or maintenance of heightened levels of problem behavior (Bailey & Pyles, 1989; Carr et al., 1990; Cipani, 1990a, 1994). Of the two possible maintaining contingencies, positive and negative reinforcement, the latter has been the least understood, both conceptually and technologically (Iwata, 1988). Behaviors maintained by negative reinforcement have often been misdiagnosed in clinical and applied settings. Subsequently, practitioner's prescribe ineffective treatments (e.g., social reinforcement for absence of problem behavior) on the basis of an incorrect (positive reinforcement) hypothesis. Techniques suited for behaviors maintained by negative reinforcement should be delineated and made distinct from those clinically indicated for treating behaviors maintained by positive reinforcement.
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Further, research reviews should be separate via these two different variables (i.e., positive vs. negative reinforcement operations). Behavior problems that are maintained by negative reinforcement operations involve escape and/or avoidance functions. The antecedent conditions that are present for negative reinforcement to be operable can be considered "aversive" to the individual client (Iwata, Pace, Kalsher, Cowdery, & Cataldo, 1990; Iwata, Vollmer, & Zarcone, 1990; Weeks & Gaylord-Ross, 1981 ). One must remember the term aversive is used here in the relative sense (i.e., what is aversive to one individual may not be considered aversive to another individual). Subsequently, the specific antecedent conditions for the shaping and maintenance of escape and/or avoidance behavior varies across each individual. This paper will identify four treatment techniques one can consider when treating a client for a problem behavior(s) maintained by negative reinforcement. All four of the techniques involve extinction of the escape/avoidance function of the current problem behavior while reinforcing a more acceptable escape/avoidance behavior, given the presence of the aversive event. The following techniques are suited to treat problem behaviors that are maintained via negative reinforcement operations: (a) functional communication training; (b) behavioral momentum for compliance situations; (c) differential reinforcement of an alternative escape behavior; and (d) errorless learning. Each technique will be reviewed using three parameters: (a) definitions and conceptualization, (b) applications, and (c) guidelines for use. FUNCTIONAL COMMUNICATION TRAINING One technique that has received considerable research attention is termed functional communication training (Carr & Durand, 1985; Durand & Carr, 1991; LaVigna, Willis, & Donnellan, 1989). Functional communication training can be used to assess the antecedent conditions that evoke escape or avoidance behavior. Concurrently, the function of the problem behavior(s), through a functional analysis is determined (Carr, 1988; Carr & Durand, 1985; Cipani, 1988b, 1990a, 1993, 1994; Doss & Reichle, 1989). Finally, a functional communicative behavior(s) is derived and taught to the client under the identified escape and/or avoidance conditions (Cipani, 1990b, 1994).
Definitions and Conceptualization A conceptual analysis of this type of deficit skill is well presented in Skinner's analysis of verbal behavior (see Skinner, 1957; Sundberg, 1983). A behavior that achieves a specific effect through the mediation of another person is termed a mand (Michael, 1982; Skinner, 1957; Sundberg, 1983). A mand can occur under two general establishing antecedent conditions; (a) a state of deprivation (with respect to some item or activity), or (b) a state of aversive stimulation. Such establishing conditions or operations (called EOs) alter the reinforcing effec-
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tiveness of certain consequent events that have been linked to those establishing operations in the past (Michael, 1982). Behaviors that occur under those EOs that become functional in removing either the aversive stimulation or state of deprivation (i.e., negative reinforcement paradigm) become strengthened in terms of their probability of occurrence. If such behavior produces this result under a given EO through the mediation of another person, it is termed a mand (Cipani, 1988a; Sundberg, 1983). Those mands that produce access to positive reinforcement via the behavior of another person can be termed access mands (Cipani, 1991). Those that indirectly escape or avoid aversive conditions can be termed escape/avoidance mands (Cipani, 1991). It is the latter that are of concern here. In functional communication training, escape/avoidance mands that are socially acceptable are derived from a functional analysis. These mands are then targeted to replace current (socially unacceptable) mands for the client. Applications
A potential acceptable escape response that can replace the function of the current mand (problem behavior) can be protesting skills (Dyer & Kohland, 1991). Protest skills can be taught to replace current aberrant behaviors, which currently serve the function of terminating (eventually) an unpleasant task or activity. If the protest is negatively reinforced with object or task removal, it will increase in frequency. Dyer and Kohland (1991) have developed an instructional program for training these skills, starting with a structured discrete trial format in which the aversive event, object, or activity is presented to the client, and some response (either a vocal response, manual sign "no," or gesture, such as giving the item back) is reinforced with the removal of that event and the presentation of a more preferred object or activity. Research has begun to identify effective procedures for developing protesting skills. As an example, teaching the response "no" to terminate a training activity with a short break was empirically demonstrated to be effective in reducing problem behaviors (Day, Rea, Schussler, Larsen, & Johnson, 1988). Escape from difficult tasks or instruction can also be achieved via a communicative response that obtains help on the task. Getting help on a difficult task makes the task less difficult and, therefore, less aversive to the client (thereby terminating an undesirable event--difficult items with no instructional help). A case in point is an initial study that taught a child to respond to the presentation of difficult items saying, "I don't understand!", thereby evoking teacher assistance (Carr & Durand, 1985). Developing this communicative behavior was successful in reducing high rates of problem disruptive behaviors (Carr & Durand, 1985). This research has since been replicated with similar results (Doss & Reichle, 1989; Durand & Carr, 1991; Repp, Felce, & Barton, 1988). Note that in developing a "help" response, the aversive nature of the instruc-
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tional condition is altered by the communicative response. The difficulty of the items is moderated via the enlistment of help from the teacher. Such a functional communicative response thus serves an escape function by having the teacher alter the level of "avesiveness" of the antecedent instructional condition.
Guidelines for Use In many circumstances, persons with disabilities lack the desirable communicative behaviors that can produce escape from demands or difficult task conditions as a result of their inability to produce reinforceable vocal behavior. Their escape/avoidance mand repertoire is weak, with the exception of the aberrant behavior that currently serves that function. In many cases, a nonvocal response (whether it be a manual sign, picture, communication board, or gesture) must be shaped. A methodology for developing nonvocal communicative behaviors has been described elsewhere (Cipani, 1990b, 1991; Dyer & Kohland, 1991; Sundberg, 1987). Functional "escape/avoidance" mand training involves the following: (a) presentation of the aversive condition, (b) prompting of the desirable mand (e.g., "Can I take a break? . . . . Help" or "stop work?"), and (c) termination of the aversive condition contingent upon the mand for escape or avoidance. Discrete trial training formats (Cipani, 1991 ; Dyer & Kohland, 1991; Tirapelle & Cipani, 1992) seems suited for quicker acquisition. However, across time, the natural opportunity for escape mands should be systematically programmed so that the mand will generalize from the training trials format to the natural context. For further delineation of these types of language training programs, the reader is enjoined to consult Cipani (1991) and/or Sundberg (1987).
BEHAVIORAL M O M E N T U M
Definition and Conceptualization One promising new method to obtain compliance to request or demands receiving research attention is behavioral momentum (Mace & Belfiore, 1990; Mace et al., 1988) or pretask instructions (Singer, Singer, & Horner, 1987). This technique relies more heavily on antecedent stimulus manipulation than strictly consequent manipulation of reinforcement contingencies. The focus of behavioral momentum is to provide an antecedent condition that controls initial compliance in the client (currently), in addition to reinforcing compliance when it occurs. By providing a series of requests that have a high probability of obtaining compliance (through a prior history of those compliant behaviors being reinforced), a "momentum" (Nevin, Mandell, & Atak, 1983) is established prior to the delivery of the target commands, previously occasioning noncompliance. The momentum of compliance increases the probability of compliance to the target request, which results in reinforcement for compliance
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to the target commands (both socially and through the termination of the request). Mace and Belfiore (1990) indicate that behavioral momentum may be well suited under conditions where the client is unlikely to perform the behavior at all (thus not allowing for its reinforcement) and when the physical stature of the client makes physical guidance prohibitive.
Applications This technology was used to treat a 36-year-old man, Bart, with severe mental retardation who resided in state institutions for most of his life (Mace et al., 1988). Bart had a long history of noncompliance and aggression. The researchers needed to identify two sets of relations: (a) the "do" and "don't" commands in which compliance was low (called low-p commands); and (b) the "do" and "don't" commands in which compliance was high (called high-p commands). After collecting baseline data on the percentage of compliance to low-p commands and evaluating the effectiveness of 10 mg of Haldol (twice a day) to control aggression (beneficial effect of Haldol noncompliance not evidenced in data), the behavioral momentum procedure was implemented. The researchers arranged the following relationship between low-p and high-p commands: Any low-p command was preceded by three to four high-p commands. Experimental control of this intervention was demonstrated for both "do" and "don't" commands singly and then together in the last treatment condition. The results of the behavioral momentum technique were replicated with a second subject's noncompliance as well. Mace and Belfiore (1990) have also used behavioral momentum successfully in the treatment of escape motivated stereotypic behavior. This technology for manipulating the antecedent condition to make compliance more probable was also used for the compliance to teacher requests for four elementary-age students with severe disabilities (Singer et al., 1987). Pretask requests were those requests that required less than 3 s to complete and had a high probability of being followed with compliance (termed high p-commands in Mace et al., 1988). These three to five requests were given in rapid succession (and compliance was praised), and then followed immediately by the target request (low-p command). The target request involved a request to transition from play to work. The pretask request condition produced higher compliance to target requests than the baseline condition, providing an additional replication of the Mace et al. (1988) research study.
Guidelines for Use Reinforcement of compliance is obviously a must for any treatment program for noncompliance or other behaviors maintained by escape or avoidance. In addition, the practitioner utilizes two sets of antecedent conditions: low probability commands, and high probability commands. Before presenting a low-p
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command, three to four high-p commands are presented, thus building a momentum of compliance.
DIFFERENTIAL REINFORCEMENT OF AN ALTERNATE ESCAPE BEHAVIOR
Definition Differentially reinforcing an alternate escape behavior involves identifying a replacement behavior that can serve the same escape or avoidance function as the problem behavior (Cipani, 1990a; Cipani & Morrow, 1992; Iwata, Vollmer, & Zarcone, 1990). As discussed earlier, functional communication training involves the shaping and reinforcement of a behavior that indirectly escapes or avoids the negative reinforcer, either by temporarily terminating the task or accessing help for difficult tasks, or temporarily avoiding the instruction or task by choosing an alternate activity. In this section, techniques that produce escape of the task or demand by successful completion of the task will be discussed. Many aberrant behaviors function to produce a more preferred event and escape an aversive event, such as an instructional task (Day et al., 1988; Iwata, Pace et al., 1990; Steege, Wacker, Berg, Cigrand, & Cooper, 1989). For example, a child dislikes daily addition math facts and currently exhibits escape and/or avoidance behaviors (e.g., disruptive behavior, off-task behavior, running away) to terminate or postpone this activity. All those escape and/or avoidance behaviors are successful in temporarily escaping or completely avoiding math practice each day. By reprogramming the escape contingencies (for task termination) by reinforcing an acceptable replacement behavior (such as task completion) with escape from an aversive task and subsequent access to a more preferred activity, one has developed a competing response to the problem behaviors. If task completion is more functional in terminating the aversive task (than disruptive behavior, then the child's behavior will change).
Applications One example of manipulating negative reinforcement contingencies to increase appropriate escape behavior can be found in the treatment of nocturnal enuresis (Hansen, 1979). Keeping the bed dry avoided a 95-decibel tone (replacement avoidance response). The escape paradigm was operable when the child did have an accident at night. Contingent upon an accident, the child could get out of the bed and turn off the tone, thus negatively reinforcing this chain of behaviors and also facilitating his waking up contingent upon accidents. Escape from additional practice during dental visits, in addition to positive reinforcement program components, produced decreases in disruptive behavior (such as kicking, screaming, hitting, noncompliance) and subsequent increases in cooperative behavior over baseline conditions during dental visits (Allen &
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Stokes, 1987). The contingencies designed were two-fold. During periods of uncooperative behavior, positive attention was discontinued, but practice continued. With the occurrence of cooperative behavior during the visit, at increasing levels, dental treatment was contingently discontinued for a short time. For example, during practice, the drill was turned on by the dental assistant and moved close to the child. If the child demonstrated cooperative behavior at the required level and length of time, the drill was turned off. After a short reprieve, another trial was implemented and practice proceeded under the same contingencies. Over several dental sessions, cooperative behavior increased until the response criterion for cooperative behavior was obtained across several dental procedures. The use of reinforcing task completion with task termination is often used in clinical cases. A child who demonstrated severe classroom problem behaviors and was referred to the first author illustrates the utility of building task completion behavior as the alternate escape behavior. The initial plan reduced the amount of work required in math, reading, and self-esteem classes to a minimal amount. Performing discrete target skills (e.g., reading one page and answering the question in reading) would result in termination of instruction in that class period and access to a number of preferred activities (including video games, outside activities, etc.). However, the behavioral program also designated time-out, contingent upon disruptive and noncompliant behavior. This last component, unfortunately, still left those undesirable behaviors as an efficient competing response to escape instruction. As a result, these undesirable behaviors persisted for the first day of intervention. Due to a lack of effectiveness, the author decided to revise the program on the second day. The time-out contingency was dropped, with the remainder of the program still in effect. Across time, the student was more successful in completing the assigned tasks and terminating instruction, and the amount required for completion was gradually increased to approximate a "reasonable" amount of work for him.
Guidelines for Use In order to utilize negative reinforcement of alternate behavior, one must identify the negative reinforcer currently maintaining the problem behavior. The alternate replacement behavior can then be identified, either through observation of same-aged peers in those conditions or consultation with experts in that area.
ERRORLESS LEARNING TECHNIQUES Definition and Conceptualization When aberrant behavior serves the function of escape under difficult or aversive task demands of instruction, a teaching technology that can lead to quick and accurate acquisition of the behaviors being required can produce a change in the
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rate of the aberrant escape behaviors. Teaching the child to perform the skill to criterion in a fluent manner can reduce the "aversiveness" of the task, and, thus eliminate, or at least ameliorate the need to escape. Errorless learning is a methodology in which discriminated behavior is achieved immediately by altering the discriminative stimulus (or stimuli) from its criterion level presentation (Cipani, 1987; Cipani & Madigan, 1987; Terrace, 1963b). With the program change in one or more of the target discriminative stimuli, successful discriminative responding is achieved immediately. Once the discriminated behavior reaches a criterion level of performance under the altered stimulus conditions, the stimulus (stimuli) is altered progressively, more closely approximating the target criterion level presentation while maintaining high rates of correct responding. This "errorless transfer" of stimulus control is achieved by small changes made in the stimulus presentation at each stage of the instructional program (Schilmoeller & Etzel, 1977; Sidman & Stoddard, 1967; Terrace, 1963a, 1963b). The discriminative response is eventually transferred to the target criterion level stimulus presentation, while keeping error rates low. An effective technique to utilize in building a discriminated set of behaviors errorlessly is to initially present one of the discriminative stimuli and obtain the correct response, but not present the other (usually the nondiscriminative stimulus or S - ) . Once the discriminative stimulus gains control over the desired response, the S - is gradually faded back into the instructional program, obtaining control over another response. Given that the S+ control over the initial response has been developed and strengthened, that response is less likely to occur to the S - , especially if the S - is designed to not "encourage" generalization. Subsequently, the S-can more effectively achieve control over a different response. In this manner. the S+ and S - are able to gain stimulus control more effectively over the individual desired responses (Terrace, 1963a; Schreibman, 1975).
Applications The purpose of errorless learning techniques in the present discussion is to illustrate its use as a technique for controlling problem aberrant behavior serving an escape or avoidance function. In a manner similar to the communicative function of the "help" response delineated earlier, these techniques serve to decrease escape or avoidance motivated aberrant behavior by reducing the aversiveness of the instruction (by making the performance required well within the repertoire of the client). Errorless learning or stimulus control techniques, can be used as treatment in regards to two aspects: (a) developing the alternate replacement behavior under demand conditions, using errorless learning techniques, or (b) as a method of transferring stimulus control by initially removing the antecedent conditions occasioning aberrant behavior and subsequently fading these back into the client's life to allow nonaberrant behaviors to occur in their presence. Errorless learning strategies can be used to build the required skill(s) needed
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under instructional or demand conditions. Using errorless learning techniques, discrimination tasks can be presented in a manner that allow the client to acquire correct discriminative capabilities immediately. Acquiring these skills produces two behavioral effects: (a) client receives social reinforcement for correct performance; and (b) tasks or instruction becomes less aversive to the client over time. As correct performance occurs, it can be reinforced by escape from instruction (for a period of time). The use of errorless learning techniques, including effective response prompting strategies, has been shown to produce a reduction in aberrant behavior during instruction (Iwata, Pace et al., 1990; Weeks & Gaylord-Ross, 1981). In a two-phase study by Weeks and Gaylord-Ross (1981), easy and difficult tasks were presented to students with severe handicaps and measurement of aberrant behavior and errors was recorded. For example, Heather, a 13-year-old female with severe mental retardation, bit her finger at higher rates when presented with a difficult two-choice discrimination task involving two-line figure drawings. Errors during the training of the difficult task were frequent. The easy task generated no biting and few errors. Following the presentation of these conditions, an errorless learning procedure was used to teach her to discriminate between the two-line figure drawings by gradually fading in the S - . The effect on finger biting was dramatic, and errors were markedly reduced. This finding was replicated across the other subjects in the research. A second manner in which errorless learning methods can be used to treat problem behavior is through an analysis of stimulus control relations. If one could identify the conditions that occasion high rates of problem behavior and the antecedent conditions that occasion low or zero rates of problem behavior, then it is possible to use this data in the treatment design. Identifying these two sets of relations from gathered data allows one to rearrange environmental conditions that generate low levels of problem behavior simply by eliminating the antecedent condition to high rates of problem behavior. Once these two sets of stimulus control relationships have been identified, one can begin rearranging the antecedent environment to completely eliminate or greatly reduce the presence of the antecedent conditions, stimuli, or setting events that evoke a high probability of target behavior. This stimulus control technique first received research attention with a 14-year-old girl (Joan) who had a history of serious aggression dating back to the age of 4 (Touchette, MacDonald, & Langer, 1985). A scatter plot was used to determine when aggressive incidence were occurring along 30-min intervals throughout the day. Assaults were most frequent between the hours of 1:00 and 4:00 PM, Monday through Thursday. Assaults were rare on Friday, Saturday, and Sunday and after 4:00 PM on weekdays, as well as early morning. As a result of this scatter plot data, activities that seemed to occasion a high incidence of assaults were identified, that being group prevocational and community living classes, and such eliminated. A new afternoon schedule was designed to approximate the weekend conditions with staff, including several informal activi-
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ties. These activities were changed every 15 min. When the number of assaults dropped dramatically following the revised program, elements of her original afternoon program were gradually reintroduced. By the fifth month, Joan was spending 30 min with each of her several teachers and was in a group instruction setting for brief periods without occasioning assaults. Eventually her original training program was gradually reintroduced without further assaults. This stimulus control technique, in which antecedents to problem behaviors are initially eliminated and then subsequently gradually reintroduced, was also successful in reducing SIB in two other clients (Touchette et al., 1985). One should note the similarity of the above technique for treating Joan's aggressive behavior with the errorless learning strategy identified earlier (i.e., initially removing the S - , obtaining correct responding to the S + immediately, and subsequently fading in the S - while maintaining correct responding ;obin this case appropriate behavior;cb).
Guidelines for Use To utilize errorless learning techniques, one should be familiar with behavioral terms and principles involving stimulus-response relations. Generating minimal to no errors during acquisition is achieved by altering the S - initially so that the response to be controlled by the discriminative stimulus can occur in its presence alone and be strengthened. Gradually, the S - is presented in a progressive manner, with few or no errors occurring. When the S - is presented in its criterion level form, the discrimination training is complete. To utilize stimulus control techniques, stimulus control of the problem behavior and the alternate replacement behavior needs to be identified. Consequently, the setting events and stimuli are altered to immediately increase the level of appropriate behavior (by altering the stimulus conditions) and then progressively changing those conditions to approximate the environmental arrangements that were in effect prior to the treatment being implemented. The reader is enjoined to consult additional references in that regard (see Cipani, 1987; Cipani & Madigan, 1987; Touchette et al., 1985; Weisberg, 1990). As more researchers and practitioners begin to study the application of this methodology to solving severe learning and behavioral problems, its utility will surely be demonstrated across many problems, settings, and situations. SUMMARY
The use of a "behavioral technique" can no longer be selected in ignorance of the controlling variables for the current problem behavior. The nature of the operable reinforcement variables must be understood to functionally address the problem behavior. Addressing all problem behaviors as if they are a function of positive reinforcement omits a vast array of behavioral strategies that can potentially control behavior that is maintained by negative reinforcement. This
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paper has presented techniques that are clinically indicated for behavior problems maintained by negative reinforcement. REFERENCES Allen, K. D., & Stokes, T. E (1987). Use of escape and reward in the management of young children during dental treatment. Journal of Applied Behavior Analysis, 12, 381-390. Bailey, J. S., & Pyles, D. A. M. (1989). Behavioral diagnostics. In E. Cipani (Ed.), The treatment of severe behavior disorders: Behavior analysis approaches (pp. 85-107). Washington, DC: American Association on Mental Retardation. Can-, E. G. (1988). Functional equivalence as a mechanism of response generalization. In R. H. Homer, G. Dunlap, & R. L. Koegel (Eds.), Generalization and maintenance: Life-style changes in applied settings (pp. 221-241). Baltimore: Paul Brookes. Cart, E. G., & Durand, V. M. (1985). Reducing behavior problems through functional communication training. Journal of Applied Behavior Analysis, 18, 11-126. Can:, E. G., Robinson, S., & Palumbo, L. W. (1990). The wrong issue: Aversive vs. nonaversive treatment. The right issue: Functional vs. nonfunctional treatment. In A. C. Repp & N. N. Singh (Eds.), Perspective on the use of nonaversive and aversive intervention for persons with developmental disabilities (pp. 361-380). Sycamore, IL: Sycamore Publishing Co. Cipani, E. (1987). Errorless learning technology: Theory, research and practice. In R. R Barrett & J. L. Matson (Eds.), Advances in developmental disorders (Vol. 1, pp. 237-275). Greenwich, CT: JAI Press. CipanJ, E. (1988a). Behavior analysis language program. Bellevue, WA: Edmark Publishers. Cipani, E. (1988b). The missing item format. TEACHING Exceptional ChiMren, 21, 25-27. Cipani, E. (1990a). The communicative function hypothesis: An operant behavior perspective. Journal of Behavior Therapy and Experimental Psychiatry, 21,239-247. Cipani, E. (1990b). "Excuse me: I'll have...": Teaching appropriate attention getting behavior to young children with severe handicaps. Mental Retardation, 28, 29-33. Cipani, E. (1991). Developing functional sign language capability in nonvocal children. In E. Cipani (Ed.), A guide to developing language competence in preschool children with severe and moderate handicaps (pp. 94-110). Springfield, 1L: Charles C Thomas. Cipani, E. (1993). The Cipani behavioral assessment and diagnostic (C-BAD) system. Visalia, CA: Cipani and Associates. Cipani, E. (1994). Treating children's severe behavior disorders: A behavioral diagnostic system. Journal of Behavior Therapy and Experimental Psychiatry, 25, 293-300. Cipani, E., & Madigan, K. (1987). Errorless learning: Research and application for "'difficult to teach" children. Canadian Journal for Exceptional Children, 3, 3943. Cipani, E., & Morrow, R. (1992). Educational assessment. In N. N. Singb & L. Beale (Eds.), Learning disabilities: Nature, theory and treatment (pp. 61-95). New York: Springer-Verlag. Day, R. M., Rea, J. A., Schussler, N. G., Larsen, S. E., & Johnson, W. L. (1988). A functionally based approach to the treatment of self-injurious behavior. Behavior Modification, 12, 565-589. Deitz, S. M., & Repp, A. C. (1973). Decreasing classroom misbehavior through the use of DRL schedules of reinforcement. Journal of Applied Behavior Analysis, 6, 4574-463. Doss, S., & Reichle, J. (1989). Establishing communicative alternatives to the emission of socially motivated excess behavior: A review. Journal of the Association for persons with Severe Handicaps, 14, 101-112. Durand, V. M., & Carr, E. G. (1991). Functional communication training to reduce challenging behavior: Maintenance and appfication in new settings. Journal of Applied Behavior Analysis, 24, 251-264. Dyer, K., & Kohland, K. A. (1991). Communication training at the May Center's integrated preschool: Assessment, structural teaching, and naturalistic generalization strategies. In E. Cipani (Ed.), A guide to developing language competence in preschool children with severe and moderate handicaps (pp. 167-200). Springfield, IL: Charles C Thomas.
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Hansen, G. D. (1979). Enuresis control through feeling, escape and avoidance training. Journal of Applied Behavior Analysis, 12, 303-307. Iwata, B. A. (1988). The development and adoption of controversial default technologies. The Behavior Analyst. 11, 149-157. Iwata, B. A., Pace, G. M., Kalsher, M. J., Cowdery, G. E., & Cataldo, M. E (1990). Experimental analysis and extinction of self-injurious escape behavior. Journal of Applied Behavior Analysis, 23, 11-27. Iwata, B. A., Vollmer, T. R., & Zarcone, J. R. (19901). The experimental (functional) analysis of behavior disorder: Methodology, application, and limitations. In A. C. Repp & N. N. Singh (Ects.), Perspectives an the use of nonaversive and aversive interventions for persons with developmental disabilities (pp. 303-330). Sycamore, IL: Sycamore Publishing Co. LaVigna, G. W., Willis, T. J., & Donnellan, A. M. (1989). The role of positive programming in behavioral treatment. In E. Cipani (Ed.), The treatment of severe behavior disonters: Behavior analysis approaches (pp. 55-84). Washington, DC: American Association on Mental Retardation. Mace, E C., & Belfiore, E (1990). Behavioral momentum in the treatment of escape-motivated stereotypy. Journal of Applied Behavior Analysis, 23, 507-514. Mace, E C., Hock, M. L., Lalli, J. S., West, B. J., Belfiore, P., Pinter, E., & Brown, D. K. (1988). Behavioral momentum in the treatment of noncompliance. Journal of Applied Behavior Analysis. 2l, 12.3-141. Michael, J. L. (1982). Distinguishing between the discriminative and motivational functions of stimuli. Journal of the Experimental Analysis of Behavior, 37, 149-155. Nevin, J. A., Mandell, C., & Atak, J. R. (1983). The analysis of behavioral momentum. Journal of the Experimental Analysis of Behavior, 39, 49-59. Repp, A. C., Felce, D., & Barton, L. E. (1988). Basing the treatment of stereotypic and self-injurious behaviors on hypotheses of their causes. Journal of Applied Behavior Analysis, 21,281-289. Schilmoeller, K. J., & Etzel, B. C. (1977). A review of errorless stimulus control: Implications for a technology of errorless programming. Unpublished working manuscript, Department of Human Development, University of Kansas, Lawrence. Schreibman, L. (1975). Effects of within-stimulus and extra-stimulus prompting on discrimination learning in autistic children. Journal of Applied Behavior Analysis, 8, 92-112. Sidman, M., & Stoddard, L. T. (1967). The effectiveness of fading in programming a simultaneous form discrimination for retarded children. Journal of the Experimental Analysis of Behavior, 10, 3-15. Singer, G. H. S., Singer, J., & Homer, R. H. (1987). Using pretask requests to increase the probability of compliance for students with severe disabilities. Journal of the Association fi)r Persons with Severe Handicaps', 12, 287-291. Skinner, B. E (1957). Verbal behavior. New York: Appleton-Century-Crofts. Steege, M. W., Wacker, D. E, Berg, W. K., Cigrand, K. K., & Cooper, L. J. (1989). The use of behavioral assessment to prescribe and evaluate treatments for severely handicapped children. Journal of Applied Behavior Analysis, 22, 23-33. Sundberg, M. (1983). Language. In J. L. Matson & S. E. Breuning (Eds.), Assessing the mentally retarded (pp. 285-310). New York: Grune & Stratton. Sundberg, M. L. (1987). Teaching language to the developmentally disabled: A course manual. Prince George, B.C.: New Caladonia Press. Terrace, H. S. (1963a). Discrimination learning with and without errors. Journal of the Experimental Analysis of Behavior, 6, 1-27. Terrace, H. S. (1963b). Errorless transfer of a discrimination across two continua. Journal of the Experimental Analysis of Behavior, 6, 223-232. Tirapelle, L., & Cipani, E. (1992). Developing functional requesting: Acquisition, dualability, and generalization of effects. Exceptional Children, 58, 260-269. Touchette, P E., MacDonald, R. E, & Langer, S. N. (1985). A scatter plot for identifying stimulus control of problem behavior. Journal of Applied Behavior Analysis, 18. 343-351.
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Weeks, M., & Gaylord-Ross, R. (1981). Task ditliculty and aberrant behavior in severely handicapped students. Journal of Applied Behavior Analysis, 14, 449--463. Weisberg, P. (1990). Academic training. In J. L. Matson (Ed.), Handbook of behavior modification with the mentally retarded (2rid ed., pp. 467-501). New York: Plenum Press.
Research in DevelopmentalDisabilities,Vol. 18, No. 5, pp. 329-342, 1997 Copyright © 1997 Elsevier Science Ltd Printed in the USA. All rights reserved 0891-4222/97 $17.00 + .00
PlI S0891-4222(97)00014-0
Treating Problem Behaviors Maintained by Negative Reinforcement Ennio Cipani California School of Professional Psychology
Fred Spooner University of North Carolina at Charlotte
The examination of controlling contingencies in an analysis of problem behavior has been an important clinical topic of discussion in the field of developmental disabilitiesfor many years. We know that problem behavior may be maintained by positive reinforcement or by negative reinforcement. From a clinical perspective, we seem to know more about behavioral techniques that are used when the problem behavior is maintained by positive reinforcement than we understand about those techniques that may be applied when a problem behavior is maintained by negative reinforcement. In this paper, we identify, four treatment techniques that may be applied when problem behavior is maintained by negative reinforcement: (a) functional communication training; (b) behavioral momentum: (c) differential reinforcement or an alternative escape behavior; and (d) errorless learning. Each of the four techniques will be defined, applications and guidelines .for use delineated. © 1997 Elsevier Science Ltd
T h e h i s t o r y a n d e m p i r i c a l b a s i s for b e h a v i o r a l t e c h n i q u e s p r o c e d u r e s is e x t e n sive (see J o u r n a l o f A p p l i e d B e h a v i o r A n a l y s i s , R e s e a r c h a n d I n t e r v e n t i o n in D e v e l o p m e n t a l Disabilities, B e h a v i o r T h e r a p y a n d o t h e r p r o f e s s i o n a l j o u r n a l s ) . Requests for reprints should be sent to Fred Spooner, Department of Counseling, Special Education, and Child Development, The University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223-0001; E-mail: [email protected]. 329
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In many earlier studies, behavior was changed through a manipulation of consequences. The programming of contingencies was largely arbitrary, with the functional aspects of problem behavior(s) often ignored. Subsequently, treatment procedures that were prescribed may have had little relation to the reinforcement contingencies maintaining the undesirable level of the problem behavior (Carr, Robinson, & Palumbo, 1990). For example, the prescription of a differential reinforcement strategy often involved the provision of a tangible reinforcer (e.g., edible, drink, etc.) as a contingency for a selected, alternate, acceptable behavior to the problem behavior (e.g., Deitz & Repp, 1973). However, the baseline relation between problem behavior and access to edibles (contingently) was usually not demonstrated or hypothesized. Therefore, it was unclear as to whether the systematic development of an alternate behavior that consistently produces edibles addressed the functional properties of the problem target behavior. A hypothetical example better illustrates the contrast between a functional and an arbitrary contingency. Let's say a target child engages in self-injurious behavior (SIB). If the function of SIB was to access food (when the child was hungry), the strategy of reinforcing an alternative behavior with food while not providing food when SIB occurs, would be effective (i.e., functional contingency). However, if the individual's SIB serves to escape "aversive" tasks or demands (e.g., within an instructional condition), one can clearly see that providing edibles for an alternative behavior does not address the function of SIB under these instructional conditions (arbitrary contingency). It is possible that one might see an increase in the alternative behavior. On the other hand, at a point when the task or demand is exceedingly aversive to the individual, and the child desires escape from the task more than receiving food, the unavailability of edibles for a period of time will not produce the desired effect on SIB. The child's desire to escape the task (via SIB) is greater than the desire to receive food. The contingency of interest in this scenario is between some behavior and its environmental ability to escape an aversive task or demand. A functionally derived contingency would be the occurrence of an alternate appropriate behavior and the contingent removal of the task. Functional analyses attempt to determine which of two reinforcement paradigms seem to be operable in the development and/or maintenance of heightened levels of problem behavior (Bailey & Pyles, 1989; Carr et al., 1990; Cipani, 1990a, 1994). Of the two possible maintaining contingencies, positive and negative reinforcement, the latter has been the least understood, both conceptually and technologically (Iwata, 1988). Behaviors maintained by negative reinforcement have often been misdiagnosed in clinical and applied settings. Subsequently, practitioner's prescribe ineffective treatments (e.g., social reinforcement for absence of problem behavior) on the basis of an incorrect (positive reinforcement) hypothesis. Techniques suited for behaviors maintained by negative reinforcement should be delineated and made distinct from those clinically indicated for treating behaviors maintained by positive reinforcement.
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Further, research reviews should be separate via these two different variables (i.e., positive vs. negative reinforcement operations). Behavior problems that are maintained by negative reinforcement operations involve escape and/or avoidance functions. The antecedent conditions that are present for negative reinforcement to be operable can be considered "aversive" to the individual client (Iwata, Pace, Kalsher, Cowdery, & Cataldo, 1990; Iwata, Vollmer, & Zarcone, 1990; Weeks & Gaylord-Ross, 1981 ). One must remember the term aversive is used here in the relative sense (i.e., what is aversive to one individual may not be considered aversive to another individual). Subsequently, the specific antecedent conditions for the shaping and maintenance of escape and/or avoidance behavior varies across each individual. This paper will identify four treatment techniques one can consider when treating a client for a problem behavior(s) maintained by negative reinforcement. All four of the techniques involve extinction of the escape/avoidance function of the current problem behavior while reinforcing a more acceptable escape/avoidance behavior, given the presence of the aversive event. The following techniques are suited to treat problem behaviors that are maintained via negative reinforcement operations: (a) functional communication training; (b) behavioral momentum for compliance situations; (c) differential reinforcement of an alternative escape behavior; and (d) errorless learning. Each technique will be reviewed using three parameters: (a) definitions and conceptualization, (b) applications, and (c) guidelines for use. FUNCTIONAL COMMUNICATION TRAINING One technique that has received considerable research attention is termed functional communication training (Carr & Durand, 1985; Durand & Carr, 1991; LaVigna, Willis, & Donnellan, 1989). Functional communication training can be used to assess the antecedent conditions that evoke escape or avoidance behavior. Concurrently, the function of the problem behavior(s), through a functional analysis is determined (Carr, 1988; Carr & Durand, 1985; Cipani, 1988b, 1990a, 1993, 1994; Doss & Reichle, 1989). Finally, a functional communicative behavior(s) is derived and taught to the client under the identified escape and/or avoidance conditions (Cipani, 1990b, 1994).
Definitions and Conceptualization A conceptual analysis of this type of deficit skill is well presented in Skinner's analysis of verbal behavior (see Skinner, 1957; Sundberg, 1983). A behavior that achieves a specific effect through the mediation of another person is termed a mand (Michael, 1982; Skinner, 1957; Sundberg, 1983). A mand can occur under two general establishing antecedent conditions; (a) a state of deprivation (with respect to some item or activity), or (b) a state of aversive stimulation. Such establishing conditions or operations (called EOs) alter the reinforcing effec-
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tiveness of certain consequent events that have been linked to those establishing operations in the past (Michael, 1982). Behaviors that occur under those EOs that become functional in removing either the aversive stimulation or state of deprivation (i.e., negative reinforcement paradigm) become strengthened in terms of their probability of occurrence. If such behavior produces this result under a given EO through the mediation of another person, it is termed a mand (Cipani, 1988a; Sundberg, 1983). Those mands that produce access to positive reinforcement via the behavior of another person can be termed access mands (Cipani, 1991). Those that indirectly escape or avoid aversive conditions can be termed escape/avoidance mands (Cipani, 1991). It is the latter that are of concern here. In functional communication training, escape/avoidance mands that are socially acceptable are derived from a functional analysis. These mands are then targeted to replace current (socially unacceptable) mands for the client. Applications
A potential acceptable escape response that can replace the function of the current mand (problem behavior) can be protesting skills (Dyer & Kohland, 1991). Protest skills can be taught to replace current aberrant behaviors, which currently serve the function of terminating (eventually) an unpleasant task or activity. If the protest is negatively reinforced with object or task removal, it will increase in frequency. Dyer and Kohland (1991) have developed an instructional program for training these skills, starting with a structured discrete trial format in which the aversive event, object, or activity is presented to the client, and some response (either a vocal response, manual sign "no," or gesture, such as giving the item back) is reinforced with the removal of that event and the presentation of a more preferred object or activity. Research has begun to identify effective procedures for developing protesting skills. As an example, teaching the response "no" to terminate a training activity with a short break was empirically demonstrated to be effective in reducing problem behaviors (Day, Rea, Schussler, Larsen, & Johnson, 1988). Escape from difficult tasks or instruction can also be achieved via a communicative response that obtains help on the task. Getting help on a difficult task makes the task less difficult and, therefore, less aversive to the client (thereby terminating an undesirable event--difficult items with no instructional help). A case in point is an initial study that taught a child to respond to the presentation of difficult items saying, "I don't understand!", thereby evoking teacher assistance (Carr & Durand, 1985). Developing this communicative behavior was successful in reducing high rates of problem disruptive behaviors (Carr & Durand, 1985). This research has since been replicated with similar results (Doss & Reichle, 1989; Durand & Carr, 1991; Repp, Felce, & Barton, 1988). Note that in developing a "help" response, the aversive nature of the instruc-
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tional condition is altered by the communicative response. The difficulty of the items is moderated via the enlistment of help from the teacher. Such a functional communicative response thus serves an escape function by having the teacher alter the level of "avesiveness" of the antecedent instructional condition.
Guidelines for Use In many circumstances, persons with disabilities lack the desirable communicative behaviors that can produce escape from demands or difficult task conditions as a result of their inability to produce reinforceable vocal behavior. Their escape/avoidance mand repertoire is weak, with the exception of the aberrant behavior that currently serves that function. In many cases, a nonvocal response (whether it be a manual sign, picture, communication board, or gesture) must be shaped. A methodology for developing nonvocal communicative behaviors has been described elsewhere (Cipani, 1990b, 1991; Dyer & Kohland, 1991; Sundberg, 1987). Functional "escape/avoidance" mand training involves the following: (a) presentation of the aversive condition, (b) prompting of the desirable mand (e.g., "Can I take a break? . . . . Help" or "stop work?"), and (c) termination of the aversive condition contingent upon the mand for escape or avoidance. Discrete trial training formats (Cipani, 1991 ; Dyer & Kohland, 1991; Tirapelle & Cipani, 1992) seems suited for quicker acquisition. However, across time, the natural opportunity for escape mands should be systematically programmed so that the mand will generalize from the training trials format to the natural context. For further delineation of these types of language training programs, the reader is enjoined to consult Cipani (1991) and/or Sundberg (1987).
BEHAVIORAL M O M E N T U M
Definition and Conceptualization One promising new method to obtain compliance to request or demands receiving research attention is behavioral momentum (Mace & Belfiore, 1990; Mace et al., 1988) or pretask instructions (Singer, Singer, & Horner, 1987). This technique relies more heavily on antecedent stimulus manipulation than strictly consequent manipulation of reinforcement contingencies. The focus of behavioral momentum is to provide an antecedent condition that controls initial compliance in the client (currently), in addition to reinforcing compliance when it occurs. By providing a series of requests that have a high probability of obtaining compliance (through a prior history of those compliant behaviors being reinforced), a "momentum" (Nevin, Mandell, & Atak, 1983) is established prior to the delivery of the target commands, previously occasioning noncompliance. The momentum of compliance increases the probability of compliance to the target request, which results in reinforcement for compliance
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to the target commands (both socially and through the termination of the request). Mace and Belfiore (1990) indicate that behavioral momentum may be well suited under conditions where the client is unlikely to perform the behavior at all (thus not allowing for its reinforcement) and when the physical stature of the client makes physical guidance prohibitive.
Applications This technology was used to treat a 36-year-old man, Bart, with severe mental retardation who resided in state institutions for most of his life (Mace et al., 1988). Bart had a long history of noncompliance and aggression. The researchers needed to identify two sets of relations: (a) the "do" and "don't" commands in which compliance was low (called low-p commands); and (b) the "do" and "don't" commands in which compliance was high (called high-p commands). After collecting baseline data on the percentage of compliance to low-p commands and evaluating the effectiveness of 10 mg of Haldol (twice a day) to control aggression (beneficial effect of Haldol noncompliance not evidenced in data), the behavioral momentum procedure was implemented. The researchers arranged the following relationship between low-p and high-p commands: Any low-p command was preceded by three to four high-p commands. Experimental control of this intervention was demonstrated for both "do" and "don't" commands singly and then together in the last treatment condition. The results of the behavioral momentum technique were replicated with a second subject's noncompliance as well. Mace and Belfiore (1990) have also used behavioral momentum successfully in the treatment of escape motivated stereotypic behavior. This technology for manipulating the antecedent condition to make compliance more probable was also used for the compliance to teacher requests for four elementary-age students with severe disabilities (Singer et al., 1987). Pretask requests were those requests that required less than 3 s to complete and had a high probability of being followed with compliance (termed high p-commands in Mace et al., 1988). These three to five requests were given in rapid succession (and compliance was praised), and then followed immediately by the target request (low-p command). The target request involved a request to transition from play to work. The pretask request condition produced higher compliance to target requests than the baseline condition, providing an additional replication of the Mace et al. (1988) research study.
Guidelines for Use Reinforcement of compliance is obviously a must for any treatment program for noncompliance or other behaviors maintained by escape or avoidance. In addition, the practitioner utilizes two sets of antecedent conditions: low probability commands, and high probability commands. Before presenting a low-p
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command, three to four high-p commands are presented, thus building a momentum of compliance.
DIFFERENTIAL REINFORCEMENT OF AN ALTERNATE ESCAPE BEHAVIOR
Definition Differentially reinforcing an alternate escape behavior involves identifying a replacement behavior that can serve the same escape or avoidance function as the problem behavior (Cipani, 1990a; Cipani & Morrow, 1992; Iwata, Vollmer, & Zarcone, 1990). As discussed earlier, functional communication training involves the shaping and reinforcement of a behavior that indirectly escapes or avoids the negative reinforcer, either by temporarily terminating the task or accessing help for difficult tasks, or temporarily avoiding the instruction or task by choosing an alternate activity. In this section, techniques that produce escape of the task or demand by successful completion of the task will be discussed. Many aberrant behaviors function to produce a more preferred event and escape an aversive event, such as an instructional task (Day et al., 1988; Iwata, Pace et al., 1990; Steege, Wacker, Berg, Cigrand, & Cooper, 1989). For example, a child dislikes daily addition math facts and currently exhibits escape and/or avoidance behaviors (e.g., disruptive behavior, off-task behavior, running away) to terminate or postpone this activity. All those escape and/or avoidance behaviors are successful in temporarily escaping or completely avoiding math practice each day. By reprogramming the escape contingencies (for task termination) by reinforcing an acceptable replacement behavior (such as task completion) with escape from an aversive task and subsequent access to a more preferred activity, one has developed a competing response to the problem behaviors. If task completion is more functional in terminating the aversive task (than disruptive behavior, then the child's behavior will change).
Applications One example of manipulating negative reinforcement contingencies to increase appropriate escape behavior can be found in the treatment of nocturnal enuresis (Hansen, 1979). Keeping the bed dry avoided a 95-decibel tone (replacement avoidance response). The escape paradigm was operable when the child did have an accident at night. Contingent upon an accident, the child could get out of the bed and turn off the tone, thus negatively reinforcing this chain of behaviors and also facilitating his waking up contingent upon accidents. Escape from additional practice during dental visits, in addition to positive reinforcement program components, produced decreases in disruptive behavior (such as kicking, screaming, hitting, noncompliance) and subsequent increases in cooperative behavior over baseline conditions during dental visits (Allen &
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Stokes, 1987). The contingencies designed were two-fold. During periods of uncooperative behavior, positive attention was discontinued, but practice continued. With the occurrence of cooperative behavior during the visit, at increasing levels, dental treatment was contingently discontinued for a short time. For example, during practice, the drill was turned on by the dental assistant and moved close to the child. If the child demonstrated cooperative behavior at the required level and length of time, the drill was turned off. After a short reprieve, another trial was implemented and practice proceeded under the same contingencies. Over several dental sessions, cooperative behavior increased until the response criterion for cooperative behavior was obtained across several dental procedures. The use of reinforcing task completion with task termination is often used in clinical cases. A child who demonstrated severe classroom problem behaviors and was referred to the first author illustrates the utility of building task completion behavior as the alternate escape behavior. The initial plan reduced the amount of work required in math, reading, and self-esteem classes to a minimal amount. Performing discrete target skills (e.g., reading one page and answering the question in reading) would result in termination of instruction in that class period and access to a number of preferred activities (including video games, outside activities, etc.). However, the behavioral program also designated time-out, contingent upon disruptive and noncompliant behavior. This last component, unfortunately, still left those undesirable behaviors as an efficient competing response to escape instruction. As a result, these undesirable behaviors persisted for the first day of intervention. Due to a lack of effectiveness, the author decided to revise the program on the second day. The time-out contingency was dropped, with the remainder of the program still in effect. Across time, the student was more successful in completing the assigned tasks and terminating instruction, and the amount required for completion was gradually increased to approximate a "reasonable" amount of work for him.
Guidelines for Use In order to utilize negative reinforcement of alternate behavior, one must identify the negative reinforcer currently maintaining the problem behavior. The alternate replacement behavior can then be identified, either through observation of same-aged peers in those conditions or consultation with experts in that area.
ERRORLESS LEARNING TECHNIQUES Definition and Conceptualization When aberrant behavior serves the function of escape under difficult or aversive task demands of instruction, a teaching technology that can lead to quick and accurate acquisition of the behaviors being required can produce a change in the
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rate of the aberrant escape behaviors. Teaching the child to perform the skill to criterion in a fluent manner can reduce the "aversiveness" of the task, and, thus eliminate, or at least ameliorate the need to escape. Errorless learning is a methodology in which discriminated behavior is achieved immediately by altering the discriminative stimulus (or stimuli) from its criterion level presentation (Cipani, 1987; Cipani & Madigan, 1987; Terrace, 1963b). With the program change in one or more of the target discriminative stimuli, successful discriminative responding is achieved immediately. Once the discriminated behavior reaches a criterion level of performance under the altered stimulus conditions, the stimulus (stimuli) is altered progressively, more closely approximating the target criterion level presentation while maintaining high rates of correct responding. This "errorless transfer" of stimulus control is achieved by small changes made in the stimulus presentation at each stage of the instructional program (Schilmoeller & Etzel, 1977; Sidman & Stoddard, 1967; Terrace, 1963a, 1963b). The discriminative response is eventually transferred to the target criterion level stimulus presentation, while keeping error rates low. An effective technique to utilize in building a discriminated set of behaviors errorlessly is to initially present one of the discriminative stimuli and obtain the correct response, but not present the other (usually the nondiscriminative stimulus or S - ) . Once the discriminative stimulus gains control over the desired response, the S - is gradually faded back into the instructional program, obtaining control over another response. Given that the S+ control over the initial response has been developed and strengthened, that response is less likely to occur to the S - , especially if the S - is designed to not "encourage" generalization. Subsequently, the S-can more effectively achieve control over a different response. In this manner. the S+ and S - are able to gain stimulus control more effectively over the individual desired responses (Terrace, 1963a; Schreibman, 1975).
Applications The purpose of errorless learning techniques in the present discussion is to illustrate its use as a technique for controlling problem aberrant behavior serving an escape or avoidance function. In a manner similar to the communicative function of the "help" response delineated earlier, these techniques serve to decrease escape or avoidance motivated aberrant behavior by reducing the aversiveness of the instruction (by making the performance required well within the repertoire of the client). Errorless learning or stimulus control techniques, can be used as treatment in regards to two aspects: (a) developing the alternate replacement behavior under demand conditions, using errorless learning techniques, or (b) as a method of transferring stimulus control by initially removing the antecedent conditions occasioning aberrant behavior and subsequently fading these back into the client's life to allow nonaberrant behaviors to occur in their presence. Errorless learning strategies can be used to build the required skill(s) needed
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under instructional or demand conditions. Using errorless learning techniques, discrimination tasks can be presented in a manner that allow the client to acquire correct discriminative capabilities immediately. Acquiring these skills produces two behavioral effects: (a) client receives social reinforcement for correct performance; and (b) tasks or instruction becomes less aversive to the client over time. As correct performance occurs, it can be reinforced by escape from instruction (for a period of time). The use of errorless learning techniques, including effective response prompting strategies, has been shown to produce a reduction in aberrant behavior during instruction (Iwata, Pace et al., 1990; Weeks & Gaylord-Ross, 1981). In a two-phase study by Weeks and Gaylord-Ross (1981), easy and difficult tasks were presented to students with severe handicaps and measurement of aberrant behavior and errors was recorded. For example, Heather, a 13-year-old female with severe mental retardation, bit her finger at higher rates when presented with a difficult two-choice discrimination task involving two-line figure drawings. Errors during the training of the difficult task were frequent. The easy task generated no biting and few errors. Following the presentation of these conditions, an errorless learning procedure was used to teach her to discriminate between the two-line figure drawings by gradually fading in the S - . The effect on finger biting was dramatic, and errors were markedly reduced. This finding was replicated across the other subjects in the research. A second manner in which errorless learning methods can be used to treat problem behavior is through an analysis of stimulus control relations. If one could identify the conditions that occasion high rates of problem behavior and the antecedent conditions that occasion low or zero rates of problem behavior, then it is possible to use this data in the treatment design. Identifying these two sets of relations from gathered data allows one to rearrange environmental conditions that generate low levels of problem behavior simply by eliminating the antecedent condition to high rates of problem behavior. Once these two sets of stimulus control relationships have been identified, one can begin rearranging the antecedent environment to completely eliminate or greatly reduce the presence of the antecedent conditions, stimuli, or setting events that evoke a high probability of target behavior. This stimulus control technique first received research attention with a 14-year-old girl (Joan) who had a history of serious aggression dating back to the age of 4 (Touchette, MacDonald, & Langer, 1985). A scatter plot was used to determine when aggressive incidence were occurring along 30-min intervals throughout the day. Assaults were most frequent between the hours of 1:00 and 4:00 PM, Monday through Thursday. Assaults were rare on Friday, Saturday, and Sunday and after 4:00 PM on weekdays, as well as early morning. As a result of this scatter plot data, activities that seemed to occasion a high incidence of assaults were identified, that being group prevocational and community living classes, and such eliminated. A new afternoon schedule was designed to approximate the weekend conditions with staff, including several informal activi-
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ties. These activities were changed every 15 min. When the number of assaults dropped dramatically following the revised program, elements of her original afternoon program were gradually reintroduced. By the fifth month, Joan was spending 30 min with each of her several teachers and was in a group instruction setting for brief periods without occasioning assaults. Eventually her original training program was gradually reintroduced without further assaults. This stimulus control technique, in which antecedents to problem behaviors are initially eliminated and then subsequently gradually reintroduced, was also successful in reducing SIB in two other clients (Touchette et al., 1985). One should note the similarity of the above technique for treating Joan's aggressive behavior with the errorless learning strategy identified earlier (i.e., initially removing the S - , obtaining correct responding to the S + immediately, and subsequently fading in the S - while maintaining correct responding ;obin this case appropriate behavior;cb).
Guidelines for Use To utilize errorless learning techniques, one should be familiar with behavioral terms and principles involving stimulus-response relations. Generating minimal to no errors during acquisition is achieved by altering the S - initially so that the response to be controlled by the discriminative stimulus can occur in its presence alone and be strengthened. Gradually, the S - is presented in a progressive manner, with few or no errors occurring. When the S - is presented in its criterion level form, the discrimination training is complete. To utilize stimulus control techniques, stimulus control of the problem behavior and the alternate replacement behavior needs to be identified. Consequently, the setting events and stimuli are altered to immediately increase the level of appropriate behavior (by altering the stimulus conditions) and then progressively changing those conditions to approximate the environmental arrangements that were in effect prior to the treatment being implemented. The reader is enjoined to consult additional references in that regard (see Cipani, 1987; Cipani & Madigan, 1987; Touchette et al., 1985; Weisberg, 1990). As more researchers and practitioners begin to study the application of this methodology to solving severe learning and behavioral problems, its utility will surely be demonstrated across many problems, settings, and situations. SUMMARY
The use of a "behavioral technique" can no longer be selected in ignorance of the controlling variables for the current problem behavior. The nature of the operable reinforcement variables must be understood to functionally address the problem behavior. Addressing all problem behaviors as if they are a function of positive reinforcement omits a vast array of behavioral strategies that can potentially control behavior that is maintained by negative reinforcement. This
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