khan, 2013 ontaba research poster presentation decreasing self-injury and aggression

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Embedding Prompting and Differential Reinforcement Contingencies

to Decrease Self-Injurious Behaviour and Aggression

Differential Reinforcement of Alternative Behavior has long been

utilized to help individuals reduce maladaptive behaviours, and increase

functionally equivalent behaviours to replace them (Vollmer et al., 2010).

Video Modeling has been shown to be an effective means of teaching

individuals with Autism Spectrum Disorders to engage in socially

significant desired behaviours ,i.e. social skills training (Charlop et al.,

1989).

Functional Behavioural Assessments have been shown to be effective

in determining likely maintaining contingencies of maladaptive behaviour

(Hanley et al., 2003).

Subject

10 year old male with a diagnosis of Autism.

Secondary diagnosis of PTSD

Design

Single Subject design.

Goal Attainment Scaling (GAS) was used to determine measureable decreases in

maladaptive behaviours as a goal.

Three different maladaptive behaviours targeted for decrease were operationalized

and tracked by Mediators (see Figure 2). These behaviours included physical

aggression, verbal aggression and self-injurious behaviour in the form of self-choking.

Several replacement behaviours were operationalized and tracked by Mediators (see

Figure 2.). Replacement behaviours included: taking deep breaths, walking away,

asking for a preferred item, and several others.

Baseline

Mediators tracked the frequency of all above-mentioned behaviours in baseline

conditions.

Treatment

Differential reinforcement of alternative behaviour (DRA) was utilized as the

primary behaviour modification approach.

Video modelling was utilized to prompt desired alternate responses (replacement

behaviours) in the presence of antecedent stimuli most often present when maladaptive

behaviours occurred (usually involving denial of access to tangible reinforcement).

Generalization

As access to tangible reinforcement began to occur more consistently, the subject

was increasingly less likely to require the video modeling to engage in target

responses.

BACKGROUND

PURPOSE

METHOD

RESULTS

DISCUSSION & LIMITATIONS

CONCLUSIONS

REFERENCES

During the course of this case, prompting from mediators as

well as the video modeling itself were faded very quickly.

It is difficult to say with certainty that the treatment modality

resulted in the establishing and strengthening of a functionally

equivalent appropriate behaviour as repeated exposure to tangible

reinforcement as a result of quick program success may have

resulted in satiation of tangible reinforcement.

Data suggests satiation may have occurred as both

maladaptive, as well as replacement behaviours seemed to

decrease in treatment and follow-up phases.

Results indicate that utilization of non-contingent access to

reinforcement to achieve satiation and weaken the operant

relationship between maladaptive behaviour and access to

reinforcement could be combined with video modelling of

differential reinforcement as another possible treatment model. Video modelling has been demonstrated as an effective tool that can be

utilized to teach life skills.

This study sought to determine if video modelling in combination with

DRA can be an effective means of facilitating reductions in challenging

behaviours when utilized as a prompt.

A Functional Behavioural Assessment (FBA) indicated that the

maintaining function of the maladaptive behaviour to be access to

tangible reinformcement.

Naturally reinforcing contingencies were hypothesized to be most

effective and relevant as a means of achieving generalization of desired

behaviour in settings significant to the participant (Stokes et al., 1989).

Utilizing video models through cellular phones and other

personal electronic devices may be an effective means of both

teaching and prompting desired behaviours and reducing

dangerous behaviours.

Combining Differential Reinforcement of Alternative

Behaviour (DRA) and Video Modeling strategies can be an

effective means of reducing maladaptive behaviour and

increasing functionally equivalent appropriate behaviours.

Natural contingencies of reinforcement can be embedded

effectively into differential reinforcement procedures.

Subject engaged in 55 incidences of maladaptive behaviour in a 12 day

baseline period (an average of 4.6 instances of challenging behaviour per

day).

Use of replacement strategies occurred across 0% of opportunities in

the baseline period; as these responses were not prompted in the baseline

period.

The subject engaged in 12 incidences of maladaptive behaviour in eight

days (an average of 1.6 incidences of maladaptive behaviour per day) in

the treatment period. Thus, a reduction in maladaptive behaviour of

65.2% was noted.

Four instances of use of replacement behaviour were noted in the eight

day treatment period.

There were 14 instances of maladaptive behaviour in an eight day

follow-up period. (an average of 1.75 incidences of maladaptive behaviour

per day).

Charlop, M.H., Milstein, J.P. (1989) Teaching Autistic Children

Conversational Speech Using Video Modeling. Journal of

Applied Behavior Analysis. 22(3), 275-285.

Hanley, G.P., Iwata, B.A., McCord, B.E. (2003) Functional

Analysis of Problem Behavior: A Review. Journal

of Applied Behavior Analysis. 36(2), 147-185.

Stokes, T.F., Osnes, P.G. (1989) An Operant Pursuit of

Generalization. Behavior Therapy. 20, 337-255.

Vollmer, T, & Athens, E. (2010). An Investigation of

Differential Reinforcement of Alternative Behavior

Without Extinction. Journal of Applied Behavior

Analysis, 43, 569-589.

FIGURE 2.

FIGURE 1.

Baseline ABA Program Plan Follow-Up

Baseline ABA Program Plan Follow-Up