An analysis of reinstatement of appropriate behavior

Transcription

1 University of Iowa Iowa Research Online Theses and Dissertations Summer 2017 An analysis of reinstatement of appropriate behavior Stephen Edward Ryan University of Iowa Copyright 2017 Stephen Edward Ryan This dissertation is available at Iowa Research Online: Recommended Citation Ryan, Stephen Edward. "An analysis of reinstatement of appropriate behavior." PhD (Doctor of Philosophy) thesis, University of Iowa, Follow this and additional works at: Part of the Educational Psychology Commons

2 AN ANALYSIS OF REINSTATEMENT OF APPROPRIATE BEHAVIOR by Stephen Edward Ryan A thesis submitted in partial fulfillment of the requirements for the Doctor of Philosophy degree in Psychological and Quantitative Foundations in the Graduate College of The University of Iowa August 2017 Thesis Supervisors: Professor Stewart W. Ehly Wendy K. Berg

3 Graduate College The University of Iowa Iowa City, Iowa CERTIFICATE OF APPROVAL This is to certify that the Ph.D. thesis of PH.D. THESIS Stephen Edward Ryan has been approved by the Examining Committee for the thesis requirement for the Doctor of Philosophy degree in Psychological and Quantitative Foundations at the August 2017 graduation. Thesis Committee: Stewart W. Ehly, Thesis Supervisor Wendy K. Berg, Thesis Supervisor David P. Wacker Scott D. Lindgren Joel E. Ringdahl David K. Duys

4 To those who taught me the value of the details, to be patient, and to persist. ii

5 The good life is one inspired by love and guided by knowledge. Bertrand Russell iii

6 ACKNOWLEDGEMENTS It wasn t until I made the turn toward finishing my dissertation that I began to reflect in earnest on how fortunate I have been over the past 10 years. I am forever indebted to my family, friends, colleagues, and mentors who have supported me throughout this entire process. You have supported me during times of great difficulty, guided me when I had lost my path, and encouraged me to continue raising the bar to new levels as I have continued to build confidence in myself. Without this invaluable support network, this would not have been possible. I can never thank you all enough. To my dissertation committee: Dr. Stewart Ehly, Wendy Berg, Dr. David Wacker, Dr. Scott Lindgren, Dr. David Duys, and Dr. Joel Ringdahl. Thank you for all your effort and time that you ve spent providing me with valuable feedback for my dissertation project. Your thoughtful insights have been extremely valuable during the formulation and implementation of my project, and it would not have been as successful without you all. To Dr. John Northup, thank you for giving me my very first introduction to behavior analysis, and for doing such inspiring and creative research. It was your work on ADHD that first inspired me to apply to the University of Iowa. Your commitment during our revival of the ADHD Summer Treatment and Research program was inspiring, and I will never forget the support that you provided as a mentor. To Dr. Yaniz Padilla, you took a green graduate student under your wing during your last year at Iowa, and established a footing and a clinical home for me for the rest of my time in graduate school. Thank you for your patience, and always for your enthusiasm. iv

7 To Drs. Patrick Romani and Alyssa Suess, thank you for helping me while we worked to get this grant project off the ground. Whether it was navigating through some memorable situations in participants homes, or engaging in interesting discussions around the back table, I will always be thankful for your willingness to help. I would also like to thank Dr. Nicole Lustig for sharing her time and talents on this grant project. To Todd Kopelman, thank you for being a paragon of professionalism and commitment with children and families. I learned so much while we worked together, and I valued our time together during the many cancellations in Friday clinic more than you know. I find myself trying to emulate many aspects of your clinical skillset, and I thank you for always being there whenever I just needed to talk about life. To Stewart Ehly, I have always valued our conversations. You have always been supportive and available to provide guidance and direction when I needed it. I hope to be as thoughtful and knowledgeable about so many things one day. To Joel Ringdahl, thank you for providing me with an opportunity to let my interest in behavioral research grow. You have always been generous with your time, and I have grown as a researcher because of our interactions working on relapse and persistence studies. To Dave Wacker, I am so grateful for the training opportunities that I have had with you over the past 5 years. You always had time to talk about unique clinical or research ideas, and encouraged me to think creatively about how to approach each issue. Our meetings and conversations at the back table in 251 were some of the most formative experiences of my graduate training, as a 30-minute meeting could (and did) routinely v

8 turn into a 2-hour conceptual discussion. Over my time at Iowa, I realized just how many of these conversations applied to life outside of clinic. Thank you for everything. Wendy Berg, I will never be able to thank you enough for everything you have done for me. You have spent countless hours working on clinical cases and research projects with me, and provided me with valuable insight through all of it. You were gracious enough to take in a junior clinician and start from the beginning in behavior analysis. You have provided me with necessary feedback when I needed to hear it, and pointed me toward opportunities that have altered my career path. You have given me so much over the past 5 years, and you have done so while embodying selflessness and professionalism. Our interactions over the years have meant more to me than you will ever know, and yes, it is about stimulus control (most of the time). It has truly been a pleasure to work with you, and I hope that my career continues to make you proud. To my family, you all have been so supportive of this long journey that I ve been on. To my mother and father, this degree is as much yours as it is mine. You have provided nothing but unconditional love and support across this journey. Iowa City to Springfield, and back home to Iowa City again, I would never be where I am today without you. You inspired me to pursue my aspirations, and I am forever grateful for that. I hope that this makes you proud. To Lee, Robin, and Maureen, thank you for all your support, and your never-ending patience with me. To my classmate, partner in persistence, and of course wife, Anna- we finally did it! When I started my Ph.D., there was no way that I could know just what I was getting myself into when I came back to Iowa City. It was exciting enough to know that I would be completing a degree in an area of study about which I was passionate. But I could vi

9 never have known that I would also be making the best decision of my life. You have been there with me, every step of the way, through all of graduate school s challenges: early morning research meetings, tough clinic cases, conferences, stats exams, internship applications, and cross-country moves. But you have also been there through all of the weekend trips, spending time with our families and friends, beer quests, and of course, starting our own family together. We are a team, and we will continue to tackle everything life throws at us with the same approach that we ve perfected over the last 5 years. I m so proud of you for your accomplishments, and I love you to the moon and back. I couldn t be more excited to find the next great adventure with you! vii

10 ABSTRACT Behavioral momentum theory provides a conceptual framework for the study of the recurrence of previously extinguished operant behavior. Commonly referred to as treatment relapse, this is the failure to maintain treatment gains (e.g., reductions in challenging behavior) when there is a change in conditions under which these gains were achieved. One treatment relapse paradigm previously examined in basic and applied research is reinstatement. Reinstatement of challenging behavior has been shown to occur when functional reinforcers are delivered on a fixed-time schedule following extinction of challenging behavior. Although examinations appropriate behavior possess applied value, analyses of reinstatement have been conducted almost exclusively with challenging behavior. During the current study, a reinstatement methodology was applied to communicative responses with five children diagnosed with developmental disabilities who exhibited comorbid communication deficits, as well as challenging behavior maintained by positive reinforcement. In the first phase of the reinstatement evaluation, each child received functional communication training (FCT) within a positive reinforcement context within a two-component multiple schedule design with each schedule paired with a distinct communicative response. After achieving steady-state responding in the first phase, in which all participants were independently emitting both communicative responses, all appropriate communication was placed on extinction in the second phase. Extinction continued until rates of appropriate communication were at or near zero. In the third phase, positive reinforcement was delivered and the recurrence of appropriate communication was evaluated. For two of five participants, communicative viii

11 responding recurred following the fixed-time delivery of the functional reinforcer, indicating a successful demonstration of reinstatement. For three of five participants, communicative responding recurred prior to the delivery of fixed-time reinforcement, indicating that an alternative recurrence phenomenon likely occurred. These results suggest that reinstatement methodologies can be applied to cases in which FCT treatment failures have occurred to efficiently restore clinical gains for some participants. Implications for clinical practice and future directions of this line of research are discussed. ix

12 PUBLIC ABSTRACT The maintenance of clinical gains in any treatment context is a primary goal for practicing clinicians of any discipline. However, failures or regressions in treatment gains often occur to some degree, and clinicians are charged with re-establishing treatment efficacy. Recent behavioral research has focused on addressing treatment failures as they relate to reducing the recurrence of once-treated challenging behaviors. However, a growing area of research has shifted this focus toward the study of methods that encourage the return of positive behaviors once they have faded. This represents a novel approach to addressing this clinical issue, and needs further research as an avenue for restoring clinically significant gains. This study evaluated the use of a method previously demonstrated to evoke the return of challenging behavior to encourage the return of appropriate communication. Using a behavioral intervention shown to replace challenging behavior with appropriate communication, five children with developmental disabilities and communication difficulties were taught to communicate for preferred items/activities using two different modes of communication. After demonstrating sufficient skill with the two modes of communication, all access to preferred items/activities was suspended regardless of their use of communication. Once communication ceased to occur (i.e., treatment had failed ), scheduled deliveries of the preferred item/activity that were not contingent on communication were provided. For two of the children, these scheduled deliveries produced a return in communication following the delivery of the item/activity. For three children, communication recurred before the delivery of the item/activity. These results show that these methods are a promising alternative to restore clinical gains. x

13 TABLE OF CONTENTS LIST OF TABLES... xiii LIST OF FIGURES... xiv CHAPTER I. INTRODUCTION... 1 The Framework of Behavioral Momentum Theory... 6 Translating Behavioral Momentum Theory and Treatment Relapse... 8 Resurgence Renewal Reinstatement Clinical Relevance of Reinstatement Purpose of the Study II. LITERATURE REVIEW The Translational Process from Basic Laboratories to Applied Settings Behavioral Momentum Theory as a Basic Model for Response Strength Application of Behavioral Momentum Theory and Resistance to Change to Naturalistic Contexts Behavioral Momentum Theory as a Model for the Recurrence of Behavior Resurgence Renewal Reinstatement Recurrence of Novel Topographies of Behavior Statement of Purpose III. METHODOLOGY Participants Setting and Materials Preference Assessment Communicative Responses/Devices Stimulus Poster Boards Design and Analysis Dependent Variables Response Definitions Data Collection and Inter-Observer Agreement (IOA) Procedures Consent and Initial Interview Phase 1: Functional Communication Training xi

14 Phase 2: Extinction Phase 3: Reinstatement Test Phase Data Evaluation IV. RESULTS Functional Communication Training Baseline Phase Extinction Phase Reinstatement Test Phase V. DISCUSSION Defining Recurrence through Patterns of Responding Applied Implications Limitations and Future Directions Conclusion REFERENCES xii

15 LIST OF TABLES Table 1. Summary of Methodologies Employed to Evaluate Recurrence Phenomena Table 2. Summary of Demographic and Relevant Behavioral Information Across Participants xiii

16 LIST OF FIGURES Figure 1. Communicative response data from Phase 1 FCT (left-hand phase), Phase 2 Extinction (center phase), and Phase 3 Reinstatement Test Phase (right-hand phase) for Sheldon. All data are presented as a rate per minute. Open squares represent the microswitch response, and closed diamonds represent the card touch response Figure 2. Rate of reinforcement data from Phase 1 FCT (left-hand phase), Phase 2 Extinction (center phase), and Phase 3 Reinstatement Test Phase (right-hand phase) for Sheldon. All data are presented as a rate per minute. Open squares represent the microswitch response, and closed diamonds represent the card touch response Figure 3. Communicative response data from Phase 1 FCT (left-hand phase), Phase 2 Extinction (center phase), and Phase 3 Reinstatement Test Phase (right-hand phase) for Samuel. All data are presented as a rate per minute. Closed diamonds represent the card touch response, while the asterisks represent the vocal response Figure 4. Rate of reinforcement data from Phase 1 FCT (left-hand phase), Phase 2 Extinction (center phase), and Phase 3 Reinstatement Test Phase (right-hand phase) for Samuel. All data are presented as a rate per minute. Closed diamonds represent the card touch response, while the asterisks represent the vocal response Figure 5. Communicative response data from Phase 1 FCT (left-hand phase), Phase 2 Extinction (center phase), and Phase 3 Reinstatement Test Phase (right-hand phase) for Randall. All data are presented as a rate per minute. Open triangles represent the manual sign response, and the closed diamonds represent the card exchange response.. 83 Figure 6. Rate of reinforcement data from Phase 1 FCT (left-hand phase), Phase 2 Extinction (center phase), and Phase 3 Reinstatement Test Phase (right-hand phase) for Randall. All data are presented as a rate per minute. Open triangles represent the manual sign response, and the closed diamonds represent the card exchange response.. 84 Figure 7. Communicative response data from Phase 1 FCT (left-hand phase), Phase 2 Extinction (center phase), and Phase 3 Reinstatement Test Phase (right-hand phase) for William. All data are presented as a rate per minute. Closed diamonds represent the card exchange response, and the open squares represent the ipad response Figure 8. Rate of reinforcement data from Phase 1 FCT (left-hand phase), Phase 2 Extinction (center phase), and Phase 3 Reinstatement Test Phase (right-hand phase) for William. All data are presented as a rate per minute. Closed diamonds represent the card exchange response, and the open squares represent the ipad response Figure 9. Communicative response data from Phase 1 FCT (left-hand phase), Phase 2 Extinction (center phase), and Phase 3 Reinstatement Test Phase (right-hand phase) xiv

17 for Scarlett. All data are presented as a rate per minute. Closed diamonds represent the ipad response, and open squares represent the microswitch response Figure 10. Rate of reinforcement data from Phase 1 FCT (left-hand phase), Phase 2 Extinction (center phase), and Phase 3 Reinstatement Test (right-hand phase) for Scarlett. All data are presented as a rate per minute. Closed diamonds represent the ipad response, and open squares represent the microswitch response Figure 11. A sample of the temporal sequence of responding during the first session of the reinstatement test phase for Sheldon. Red bars represent times when reinforcement is absent, and green bars represent times when reinforcement is present Figure 12. A sample of the temporal sequence of responding during the first session of the reinstatement test phase for Samuel. Red bars represent times when reinforcement is absent, and green bars represent times when reinforcement is present Figure 13. A sample of the temporal sequence of responding during the first session of the reinstatement test phase for Randall. Red bars represent times when reinforcement is absent, and green bars represent times when reinforcement is present Figure 14. A sample of the temporal sequence of responding during the first session of the reinstatement test phase for William. Red bars represent times when reinforcement is absent, and green bars represent times when reinforcement is present Figure 15. A sample of the temporal sequence of responding during the first session of the reinstatement test phase for Scarlett. Red bars represent times when reinforcement is absent, and green bars represent times when reinforcement is present xv

18 CHAPTER I INTRODUCTION Applied Behavior Analysis (ABA) has long been concerned with the reduction of challenging behaviors and replacement of these behaviors with those deemed more prosocial (Mace et al., 2010). One potential barrier encountered by those implementing treatment programs for challenging behavior is the recurrence of unwanted behaviors once they have been successfully reduced. The recurrence of unwanted behavior has been termed treatment relapse, and refers to the failure to maintain effects when the treatment conditions under which these reductions were achieved are challenged (Nevin & Wacker, 2013; Osnes & Lieblein, 2003; Stokes & Osnes, 1989). Treatment relapse has been an obstacle encountered across both medical and mental health fields (Pritchard, Hoerger, & Mace, 2014a; Pritchard, Hoerger, Mace, Penney, & Harris, 2014b). Within ABA, several environmental factors have been shown to increase the likelihood that treatment relapse will occur, including poor treatment integrity (e.g., St. Peter-Pipkin, Vollmer, & Sloman, 2010), exposing replacement behaviors to extinction (Doughty & Oken, 2008; Lieving, Hagopian, Long, & O Connor, 2004; Volkert, Lerman, Call, & Trosclair-Lasserre, 2009; Wacker et al., 2013), returning to a context previously associated with reinforcement for challenging behavior from a treatment context (Kelley, Liddon, Ribeiro, Greif, & Podlesnik, 2015), or the noncontingent delivery of a reinforcer that was previously associated with challenging behavior (DeLeon, Williams, Gregory, & Hagopian, 2005; Falcomata, Hoffman, Gainey, Muething, & Fienup, 2013). The likelihood that a behavior will recur once it has been reduced has been thought to be tied to the underlying strength of the behavior. Behavioral momentum 1

19 theory has been used as a framework for conceptualizing response strength and its relation to treatment relapse (Nevin & Shahan, 2011; Nevin & Wacker, 2013). Response strength has been previously associated with the rate in which a response occurs (Catania, 1998; Skinner, 1938). However, more recently within behavioral momentum studies, response strength has been measured by evaluating the extent to which a response is resistant to change (Nevin & Grace, 2000; Nevin & Wacker, 2013). This resistance to change, also referred to as persistence, is defined by the continued occurrence of a behavior despite the challenge that it encounters (e.g., extinction; Nevin, 1974). At its most basic level, behavioral momentum theory hypothesizes that a behavior s strength is dependent upon the density of the reinforcement history for the behavior. A behavior will gain comparatively greater strength if it has been exposed to a greater rate of reinforcement than another behavior. A traditional methodology for examining resistance to change within a behavioral momentum framework is to utilize a two-phase model (Pritchard et al., 2014a). In the first phase, a baseline rate of responding is established by correlating two separate responses with two separate discriminative stimuli, each of which signals a different reinforcement schedule. Both responses are reinforced in the context of their designated discriminative stimulus according to the specified reinforcement schedule until both responses occur at steady rates (e.g., Nevin, 1974; Nevin, Mandell, & Atak, 1983). After the response rates become stable, a disruptor is introduced during the second phase to decrease the rate of responding. Several disruptors have been used to suppress responding, including extinction (e.g., Nevin et al., 1990; Podlesnik & Shahn, 2010), presession feeding (i.e., prefeeding; Shahan & Podlesnik, 2008), and distraction (e.g., 2

20 Mace et al., 1990). The magnitude of decrement in rate of responding when disrupted is indicative of how resistant a response is to change. The effect of disruption is most often expressed via proportion of baseline, because of differing rates of responding during baseline (Nevin et al., 1983). Proportion of baseline is typically derived by dividing the response rate for a particular disruption session by the average rate of responding during baseline. A smaller proportional decrease in behavior during disruption as compared to each individual s baseline behavior is indicative of greater resistance to change. The use of proportion of baseline thus allows for a comparison of data across subjects by removing the individual differences in rates of responding during baseline (Dube, Ahearn, Lionello-DeNolf, & McIlvane, 2009; Nevin & Shahan, 2011). Many demonstrations exist that show that relatively greater response strength is observed for behaviors exposed to richer schedules of reinforcement in comparison to behaviors exposed to leaner schedules of reinforcement (e.g., Nevin, 1992; Nevin et al., 1983). For example, Podlesnik and Shahan (2009), within a two-component multiple schedule design, provided different rates of reinforcement to two distinct responses two responses in a sequential fashion. After training a target response, that response was placed on extinction and an alternative response was then reinforced. Both responses were then placed on extinction, and a greater magnitude of recurrence was observed in the response associated with a denser schedule of reinforcement. The results of this study suggest that recurrence phenomena such as recurrence of a previously extinguished response function within a behavioral momentum framework. Three types of recurrence have been described in the literature. Resurgence is one recurrence type, and has been defined as the recurrence of a previously extinguished 3

21 behavior when a replacement behavior contacts extinction (Shahan & Sweeney, 2011). For example, this may occur when challenging behavior recurs after an appropriate replacement response contacts extinction. A second recurrence type is renewal, and refers to the return of previously extinguished behavior following a change in the context in which the behavior contacted extinction (Bouton, Winterbauer, & Todd, 2012). For example, a return of challenging behavior may occur when a child returns home (i.e., context in which challenging behavior was reinforced) from a clinical admission where challenging behavior was on extinction. Finally, the third type of recurrence is reinstatement. Reinstatement is defined as the recurrence of previously extinguished behavior in response to the delivery of response-independent stimuli that were used as reinforcement during training (Doughty, Reed, & Lattal, 2004). This may be exemplified by the return of previously extinguished attention-maintained challenging behavior in a classroom after the teacher delivers noncontingent praise to the student. Resurgence, renewal, and reinstatement have typically been studied evaluating the return of unwanted or neutral responses. Although all three types of recurrence pose distinct challenges for clinicians, reinstatement may potentially be the most difficult to combat from a practical standpoint. Within ABA, both contingent and noncontingent reinforcement-based strategies are among the most commonly employed strategies for the treatment of challenging behavior (Lennox, Miltenberger, Spengler, & Efanian, 1988; Matson et al., 2011; Petscher, Rey, & Bailey, 2009). Therefore, the inclusion of reinforcement into clinical treatment for the purposes of establishing an appropriate alternative response and reducing challenging behavior is a likely course of action. However, previous studies on reinstatement suggest 4

22 that the inclusion of the reinforcer that was previously maintaining challenging behavior following the application of treatment may evoke a recurrence of challenging behavior. This can be illustrated by the classroom example provided in the preceding paragraph. In this situation, the inclusion of attention as a treatment component may have the unintended side effect of increasing the likelihood that delivery of attention following the extinction of attention-maintained challenging behavior, regardless of the contingency, will evoke a recurrence of challenging behavior. This creates a very difficult obstacle for clinicians, as they may have to rely on treatment components with less empirical support to avoid the reinstatement of challenging behavior. Within the spectrum of recurrence phenomena, there have been fewer published studies examining reinstatement. Reinstatement is often examined using a three-phase experimental analysis: (a) reinforcement of a target response, (b) the reduction of the target response through disruption (e.g., extinction), and (c) delivering responseindependent stimuli that previously functioned as reinforcement for the target response (Falcomata, Hoffman, Gainey, Muething, & Fienup, 2013). Similar to alternative relapse paradigms, basic studies suggest that reinstatement operates within the parameters of behavioral momentum theory in that rate of reinforcement appears to be predictive of the magnitude of recurrence of the target behavior trained during Phase 1 (e.g., Podlesnik & Shahan, 2009; Pyszczynski & Shahan, 2011). In addition to the relative paucity of applied studies examining reinstatement, investigations that explore whether reinstatement extends to the behaviors selected to replace the target behavior are rare. With this in mind, this study evaluated if alternative operant behaviors (i.e., appropriate behavior) show patterns of reinstatement similar to 5

23 those observed in demonstrations with arbitrary or challenging behavior. Three children with histories of challenging behavior maintained by positive or negative reinforcement are proposed to participate in this study. The remainder of Chapter I is comprised of four sections. First, I provide further discussion on the basic principles of behavioral momentum theory and review initial behavioral momentum studies that were conducted in basic operant laboratories with nonhuman animals. Second, I provide a brief overview of early translations of behavioral momentum theory and its relevance to two types of recurrence phenomena. Third, I narrow the focus specifically to the recurrence phenomenon of reinstatement and demonstrations of the effect and its utility. Finally, I will provide a more in-depth outline of the aims for the current study. The Framework of Behavioral Momentum Theory Behavioral momentum theory was based on a metaphor for Newton s second law of motion (Nevin, 1992; Nevin & Grace, 2000). As it relates to physical motion, Newton s second law states that an object s momentum is a function of the object s mass and velocity (Nevin et al., 1983). That is, a heavier object moving at great velocity will possess more momentum than a lighter object traveling at the same velocity. Thus, the object with greater momentum will require a greater external force to alter the object s velocity. Translating this metaphor to behavioral concepts, a behavior s momentum is directly related to its response rate (i.e., velocity) and history of reinforcement (i.e., mass). The decrease in response rate is directly related to the magnitude of the disruptor (i.e., external force), and inversely related to the reinforcement history (Nevin & Shahan, 2011). 6

24 As previously discussed, early studies examining behavioral momentum have typically employed an arrangement that utilized multiple schedules that define two or more discriminated operants (Dube et al., 2009; Nevin & Grace, 2000). During the first phase, each response is differentially reinforced according to the signaled schedule until steady state responding is achieved. In the second phase, responding is disrupted, commonly with extinction, pre-feeding, or distraction. In an early behavioral momentum study, Nevin (1974) trained three pigeons to peck keys for grain using a multiple variable interval (VI) 60s VI 180s schedule. This multiple VI schedule of reinforcement produced greater rates of responding and reinforcement in the VI 60s schedule, as compared to the VI 180s schedule. To disrupt responding, Nevin (1974) introduced response-independent food between sessions (i.e., prefeeding). Results of this disruption showed that the response on the leaner schedule of reinforcement (VI 180s) was less resistant to change, and thus possessed less response strength than the response on the denser schedule of reinforcement (VI 60s). Nevin (1974) reported that the rate of reinforcement for a specific response was predictive of the resistance to change and response strength for that response. Many studies since Nevin s (1974) initial finding have replicated the role of reinforcer rate for building response strength in nonhuman animals (e.g., Cohen, 1986; Cohen, Riley, & Weigle, 1993; Fath, Fields, Malott, & Grossett, 1983; McLean, Campbell-Tie, & Nevin, 1996; Nevin et al., 1983; Nevin et al., 1990). In an extension of Nevin s (1974) earlier work, Nevin and colleagues (Experiment I; 1990) conducted a study that evaluated the role of overall rate of reinforcement under different stimulus conditions in predicting response strength. This study utilized a two-component multiple 7

25 schedule, in which one component was on a VI 60s schedule, while the other was on a VI 60s schedule with a superimposed variable time (VT) 30s schedule. The result of this programmed reinforcement was a multiple schedule with identical rates of contingent reinforcement across components, but unequal rates of overall reinforcement. Once steady-state responding was achieved in baseline, prefeeding and extinction were used as disruptors for both responses to test response strength. During disruption, the response associated with the richer overall rate of reinforcement (VI+VT) was more resistant to change. These results suggest that the overall rate of reinforcement associated with a given stimulus context will be predictive of the strength of a response. Translating Behavioral Momentum Theory and Treatment Relapse Early demonstrations in basic laboratories with nonhuman animals provided evidence that certain experimental arrangements produced robust behavioral momentum effects (Dube et al., 2009). These effects have since been translated into human populations using behaviors of social significance. In one of the first demonstrations of behavioral momentum theory with socially significant behavior, Mace and colleagues (1990) conducted a two-experiment study with two participants with intellectual disability to assess behavioral momentum in a group home setting. In Experiment I, a two-component VI 60s VI 240s multiple schedule was implemented to train each participant to sort plastic dinner utensils. Each schedule was signaled by either red or green utensils, and either popcorn (Subject 1) or coffee (Subject 2) was delivered contingently as reinforcement. Once steady-state responding was achieved during baseline reinforcement, responding was disrupted with the use of distraction during task presentation (television program during task performance). Response rates decreased for 8

26 each subject, but less so in the schedule associated with the richer schedule of reinforcement. This finding successfully translated Nevin s (1974) initial findings, and extended them to a novel applied context with novel behaviors. In Experiment II, a similar two-component multiple schedule was again used; however, lean and dense schedules were defined differently. One schedule was reinforced according to a VI 60s schedule, while the other was reinforced with a VI 60s + VT 30s schedule. This resulted in a greater overall rate of reinforcement in the VI 60s + VT 30s schedule. Distraction was again used as a disruptor for the utensil sorting behavior. Replicating the arrangement and results of Nevin et al. s (1990) study, this study found that responding was more resistant to change in the schedule associated with a greater overall rate of reinforcement (VI 60s + VT 30s). The results of both experiments demonstrated that the principles of behavioral momentum theory as first shown in basic laboratories could hold relevance for socially significant behaviors in applied contexts. Although previous behavioral momentum studies have documented the relation between strong responses and their resistance to change, an alternative application of behavioral momentum is the study of strong responses and their recurrence once they have been reduced (Podlesnik & Shahan, 2009). The recurrence of behavior once it has been extinguished is thought to be a product of the underlying behavioral mass of the behavior (Pritchard et al., 2014a). Several different experimental arrangements have been used to observe and categorize relapse phenomena. Therefore, the remainder of this section is devoted to resurgence, renewal, and reinstatement as conceptualized by behavioral momentum theory. Please refer to Table 1 for a brief overview of the procedures for each recurrence phenomenon. 9

27 Resurgence One obstacle to the treatment of challenging behavior is the return of challenging behavior when using procedures that often include extinction as a treatment component, such as differential reinforcement of alternative behavior (DRA plus extinction; Lattal & St. Peter Pipkin, 2009). In DRA treatments, reinforcement is provided for replacement behaviors while target challenging behavior is placed on extinction. The recurrence of a previously extinguished response after an alternatively reinforced response is placed on extinction is referred to as resurgence of the response (Cançado & Lattal, 2011; Epstein, 1983, 1985; Leitenberg, Rawson, & Bath, 1970). Studies of resurgence are partly defined by their three-phase experimental arrangement (Nevin & Wacker, 2013). During the first phase, a baseline is established by reinforcing a target response. During the second phase, the target response is placed on extinction and reinforcement is provided for an alternative response (i.e., replacement response). After the target behavior has decreased to very low frequencies and the alternative response occurs consistently in Phase 2, reinforcement is withheld (i.e., extinction) for the alternative response and the target response. Any recurrence of the target response is described as resurgence. In an early seminal study of resurgence, Epstein (1985) first trained six pigeons to peck keys for food using a VI schedule (Phase 1). Key pecking was then placed on extinction while an alternative response (i.e., wing raising or turning) was reinforced (Phase 2). All reinforcement was then subsequently withheld (Phase 3). A recurrence of the previously reinforced key pecking response was observed despite being on extinction since the Phase 1. Epstein s (1985) demonstration illuminated one mechanism for resurgence within a basic laboratory setting. 10

28 Renewal Renewal has been defined as the recurrence of a behavior that was reinforced in one context, extinguished via treatment in an entirely separate stimulus context, and recurs when the behavior contacts the original context even though the treatment components remain in place (Nakajima, Tanaka, Urushihara, & Imada, 2000; Shahan & Sweeney, 2011). A three-phase experimental arrangement is commonly used to study renewal (Bouton, Todd, Vurbic, & Winterbauer, 2011). In the first phase, a response is trained in one context (i.e., context A). Extinction is then implemented to eliminate the trained response in an alternative context (i.e., context B). Finally, the subject is returned to context A where exposure to the original training context results in response recurrence despite the extinction contingencies still in place. In an examination that occurred in a basic laboratory, Nakajima et al. (2000) evaluated the renewal phenomenon by assessing the role of context change on recurrence of responding using the aforementioned three-phase model with 24 rats. Each context was defined by different visual, auditory, and tactile cues. In the first context, rats were trained to press a lever by delivering food pellets on a VI schedule. Extinction for the lever pressing was then conducted in a separate context until responding decreased to zero. In the third phase, the rats were returned to the original context in which training had occurred. The lever pressing response recurred when the rats were returned to the original context. These results demonstrated the potential control that the stimulus context can have over responding, and how this control can relate to the generalization of treatment effects across contexts. 11

29 Reinstatement Reinstatement has been defined as a recurrence of previously extinguished responding when the reinforcer is delivered independent of behavior (Franks & Lattal, 1976; Reid, 1958). Similar to previously discussed treatment relapse phenomena, threephase arrangements have been used to study reinstatement in both basic (e.g., Doughty et al., 2004; Franks & Lattal, 1976; Podlesnik & Shahan, 2009) and applied (e.g., DeLeon et al., 2005; Falcomata et al., 2013) settings. The three-phase model is as follows: (1) a target response is reinforced, (2) the target response is reduced via extinction, and (3) The reinforcer used in Phase 1 is delivered on a response-independent schedule. The recurrence of behavior during the response-independent delivery of reinforcement is defined as reinstatement. The reinstatement effect was initially demonstrated in studies utilizing non-human species and/or human behaviors lacking social significance. In the first account of reinstatement, Reid (1958) conducted a series of experiments on rats, pigeons, and humans. Across species, responding was established and stabilized using responsedependent reinforcement during the first phase. Responding was then disrupted using extinction to reduce response rates to zero. Finally, response-independent (termed free reinforcers ) reinforcers were delivered. Results were uniform across species, in that a return of the previously trained and extinguished response was observed. The majority of early investigations into reinstatement as a clinical phenomenon have been primarily in the substance abuse literature. For example, Bienkowski, Kostowski, and Koros (1999) examined reinstatement of alcohol-seeking behavior by contingently delivering an ethanol solution to rats for pressing a lever. Responding was 12

30 reinforced on a fixed-ratio (FR) schedule. Once response rates had stabilized, reinforcement was discontinued and lever pressing was placed on extinction. Responseindependent presentations of a dipper filled with ethanol were then initiated, and reinstatement of lever pressing was observed. Bienkowski and colleagues (1999) provided an animal model for the relapse in drug-seeking behavior as consistent with the reinstatement paradigm. Clinical Relevance of Reinstatement Almost all previous studies of reinstatement have been conducted with nonhuman animals; however, the findings from these studies have direct application to treatments that reduce challenging behavior in young children. Relating the previous basic demonstration of reinstatement to the relapse of challenging behavior in children, one example of reinstatement may involve the contingencies used in clinical assessment and treatment of challenging behavior. Following the three-phase reinstatement paradigm, Phase 1 would include reinforcement of a target response. In a clinical analog to Phase 1, a functional analysis (Iwata, Dorsey, Slifer, Bauman, & Richman, 1994) may be conducted during which challenging behavior (i.e., the target response) is reinforced to assess the social conditions in which the response is most likely to occur. Phase 2 of the reinstatement paradigm then requires the target response to be reduced. Clinically, treatment would likely include the implementation of a differential reinforcement program that would then place challenging behavior on extinction (analogous to placing the target response on extinction in Phase 2). Phase 3 of the reinstatement paradigm would require the delivery of reinforcement independent of behavior. Clinically, this may occur in the natural environment following treatment once challenging behavior has been 13

31 extinguished. The child will likely contact a response-independent reinforcer previously associated with challenging behavior, which may in turn occasion a recurrence of the previously treated challenging behavior. As predicted by the reinstatement paradigm, this clinical sequence would create an arrangement that may increase the likelihood of a recurrence challenging behavior. Of note, very few if any studies of the summarized recurrence phenomena have described the nature of response patterns in the test phase of each arrangement in a nuanced fashion. Studies examining these phenomena evaluate the absolute presence or absence of responding within the test phase following disruption when determining whether the phenomenon occurred. However, little empirical guidance is available to direct our understanding of how differences in response patterns within the test phase may alter our determination or identification of the recurrence phenomenon. For example, response dimensions such as the temporal sequence of responding may be important for making a determination of whether the recurrence phenomenon was observed, particularly with phenomena that postulate that the mechanism for a return of responding is governed by the return of environmental stimuli (i.e., return to the original context in the case of renewal, return of reinforcement in the case of reinstatement). This limitation of the literature would benefit from further analysis. In summary, a great deal of the study of response recurrence, including reinstatement, has been limited to avenues outside of applied behavior analysis. Early examinations have focused on arbitrary behaviors in nonhuman animals, and extant studies have concentrated on the relapse of treatment for challenging behaviors (e.g., substance abuse, challenging behavior). Applied treatment relapse studies investigating 14

32 the relapse of alternative behavioral topographies, such as appropriate behavior in children, have been rare (e.g., Berg et al., 2015). Additionally, nuanced analysis of response patterns within recurrence studies, and especially reinstatement, has been limited. Purpose of the Study In the current examination, I translated previous basic findings on reinstatement by evaluating a novel application of the reinstatement paradigm to evoke the recurrence of appropriate communicative behavior after the behavior was disrupted. A functional analysis of problem behavior (Iwata et al., 1994) was conducted prior to the start of the study to identify the functional reinforcer maintaining problem behavior. Consistent with previous examinations of reinstatement, a three-component sequential schedule design was used. In Phase 1, functional communication training (FCT; Carr & Durand, 1985) was implemented to replace challenging behavior with two appropriate communicative responses by reinforcing these responses with the identified functional reinforcer for challenging behavior. These communicative responses were on identical FR1 reinforcement schedules. In Phase 2, all communicative responses were then placed on extinction until response rates reduced to zero or near-zero levels. In Phase 3, the reinforcers used in Phase 1 were provided on a fixed-time schedule to evaluate whether appropriate communicative responses recurred similarly to the topographies of behavior used in previous investigations. Finally, an in-depth analysis of response patterns within sessions conducted in Phase 3 was conducted to further evaluate the importance of temporal sequence as it relates to determination and identification of the reinstatement phenomenon. 15

33 Table 1: Summary of Methodologies Employed to Evaluate Recurrence Phenomena Recurrence Phenomenon Phase 1 Phase 2 Phase 3 Resurgence Contingent reinforcement for Behavior A Contingent reinforcement for Behavior B, extinction for Behavior A Extinction for both Behavior A and Behavior B Renewal (i.e., ABA Renewal) Contingent reinforcement for Behavior A in original context (Context A) Extinction for Behavior A in a different context (Context B) Continuation of extinction for Behavior A upon returning to the original context (Context A) Reinstatement Contingent reinforcement for Behavior A Extinction for Behavior A Response-independent reinforcement delivered on a fixed-time schedule 16

34 CHAPTER II LITERATURE REVIEW The Translational Process from Basic Laboratories to Applied Settings Translational research has been defined as uniting findings in the study of fundamental science or mechanisms with concerns encountered in everyday life (Mace & Critchfield, 2010). Hake (1982) suggested that studies within behavior analysis lie on a continuum comprised of basic and applied research at opposing ends of the spectrum. Thus, basic and applied research studies are not divorced from one another; rather, all studies are linked along this translational bridge and can have reciprocal interaction with one another (Wacker, 2003). This bridge has already had an immense impact on the applied behavioral field, and provides avenues for more effective assessments (e.g., choice assessments; Fisher & Mazur, 1997) and treatments for challenging behaviors such as noncompliance (e.g., Mace et al., 1988). Mace (1994) suggested a general three-step methodology for translating findings from basic research to methods that address behavioral concerns of social importance in humans. In the first step of this process, questions are raised about basic behavioral processes and typically investigated with non-human populations (e.g., rats or pigeons). Second, findings are replicated in a human population in human operant research using behaviors that allow study of the research question with minimal confounds. This second step verifies the generalization of previously studied animal behavior in humans, and provides support for the notion that behavioral effects can be detected in a more naturalistic setting (Baron, Perone, & Galizio, 1991). Finally, these findings are replicated in humans with behaviors of social significance. This methodology has served 17

35 as an outline for bridging knowledge gained about behavioral mechanisms to issues of social importance. The aforementioned model for conducting translational science has been applied to behavioral momentum theory and treatment relapse. For example, in the case of resurgence, studies were first conducted with non-human animals to explore the underlying mechanism for the recurrence of previously reinforced behavior once alternative responses were placed on extinction (e.g., Epstein, 1983, 1985; Leitenberg et al., 1970). Later studies demonstrated this phenomenon with humans using arbitrary behaviors (e.g., key strokes on a keyboard; Mechner, Hyten, Field, & Madden, 1997). These fundamental findings have since been applied to explore variables that contribute to a lack of maintenance in the behavioral treatment of challenging behavior after reinforcement programs are withdrawn (e.g., Lieving et al., 2004; Wacker et al., 2013). Studies of behavioral momentum theory began in basic research with non-human animals, have been translated into human operant studies and applied studies for the past 45 years, and relatively recently have been extended to encompass treatment relapse. In the following sections, basic, translational, and applied studies on behavioral momentum theory will be discussed. Additionally, treatment relapse will be reviewed within this same framework. Behavioral Momentum Theory as a Basic Model for Response Strength The science of behavior has defined operant behavior as operating within a threeterm contingency (DeLeon, Bullock, & Catania, 2013; Skinner, 1969). First, an antecedent stimulus is presented within an environment. Second, the antecedent stimulus occasions a response from an organism. Third, the response results in a consequence that 18