7/31/11. Problems in technology transfer EXT DOES WORK!!! What is extinction (EXT)? EXT doesn t work means what?

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1 Problems in technology transfer Common refrain from teachers and parents I ve tried that behavior mod* stuff; it doesn t work *Insert EXT (or any other procedure) here Our typical response Perhaps there was a detail you missed (Translated: I suspect you have no idea what you did ) Does extinction involve a special case of not working? Brian A. Iwata Professor, Psychology & Psychiatry University of Florida What is extinction (EXT)? Not any one procedure per se Reversal of a fundamental principle of learning Termination of a reinforcement contingency Procedural variations PB maintained by Sr+: Do not attend to PB PB maintained by Sr-: Do not allow escape PB maintained by automatic Sr: Attenuate stimulation produced by PB Effects Direct: Decrease in response frequency Indirect: Increase in response variability EXT DOES WORK!!! Over 3,000 clinical studies Simple mechanism (contingency termination) Rapid, large, and enduring decreases in behavior Effects more reliable than with NCR, DRO, and DRA Enhances effects of NCR, DRO, and DRA Important component of shaping procedures Conclusion: EXT is the most direct and efficient method for reducing the frequency of behavior EXT doesn t work means what? EXT ( planned ignoring ) does not decrease behavior EXT produces inadequate therapeutic outcome EXT produces undesirable effects EXT cannot be implemented 1. EXT (planned ignoring) is ineffective Timeout may not decrease behavior Plummer, Baer, & LeBlanc (1977) Solnick, Rincover, & Peterson (1977) PB maintained by Sr-? Some forms of EXT do not decrease behavior Iwata, Pace, Cowdery, & Miltenberger (1994) PB (Sr+): EXT (sensory) ineffective PB ( Sr-): EXT (sensory) and EXT (attn) ineffective PB (automatic Sr): EXT (escape) and EXT (attn) ineffective Kuhn, DeLeon, Fisher, & Wilke (1999) Conclusions: Planned ignoring EXT EXT procedures are function specific 1

2 Elopement as an Example Potential reinforcing consequences Social Sr+ Attention from teacher ( the chase ) Interaction with peers in other area Access to tangible items in other area Social Sr- Escape from work Escape from social interaction Automatic Sr Running around outside 2. EXT produces inadequate therapeutic effects EXT produces gradual decrease in response frequency Responding during EXT influenced by many factors: Reinforcement history, response characteristics, stimulus change, session length, etc. (Lerman & Iwata, 1996) EXT does not strengthen appropriate behavior True, but EXT a critical component of: NCR (Reed et al., 2004; Vollmer et al., 1997) DRO (Mazaleski et al., 1993) DRA (Hagopian et al., 1998; Kelley et al., 2002; Zarcone et al., 1994) EXT promotes response variability (Lalli et al., 1994) Conclusions: EXT can produce rapid, widespread effects Alternatives: No EXT? Punishment? EXT burst 3. EXT produces undesirable effects Lerman & Iwata (1995) examined 113 sets of EXT data EXT alone: Bursting in 36% of data EXT + Sr: Bursting in 12% of data Other potential negative effects Aggression (Goh & Iwata, 1994) Behavioral contrast (maybe, Magee & Ellis, 2000) Spontaneous recovery (Lerman et al., 1999) Disinhibition (maybe, no published data) Conclusions: Undesirable effects are minimal Alternatives: No EXT? Punishment? 4. EXT cannot be implemented (Practical constraints prevent the use of EXT) Maintenance by social Sr+ (e.g., attention) Dangerous problem behavior requires attention Maintenance by social Sr- (escape from task demands) Large or combative clients often escape Maintenance by automatic Sr+ (sensory stimulation) Self-stimulation may be unpreventable Reinforcement-Based Approaches for Decreasing Behavior Eliminate the behavior s establishing operation (EO) Noncontingent reinforcement (NCR) Eliminate the behavior s maintaining contingency Extinction Strengthen a competing response Differential reinforcement (DRO, DRA) Can we eliminate problem behavior without extinguishing it? Strategy #1: Minimize the reinforcing aspects of social consequences Strategy #2: Maximize the effects of interventions that make responding less susceptible to ongoing reinforcement 2

3 Maintenance by Social Sr+ PB Access to attention or tangible items EXT: No consequence (NO attention or tangible) Difficulty: Severe PB requires response interruption An evaluation of the types of attention that maintain problem behavior (Kodak et al., 2007) What forms of attention are most reinforcing for PB? N=2 (DD), multiple PB FA: Maintenance by attention Attention Evaluation (consequences for PB) Reprimands Unrelated comments Tickles Eye contact Praise Physical attention Kodak et al. (2007) An evaluation of the properties of attention as reinforcement for destructive and appropriate behavior (Piazza et al., 1999) What consequences compete with reprimands as consequences for problem behavior? N=2 (DD), multiple PB FA: Maintenance by attention Paul PB Reprimands Alt R #1 Tickles Alt R #2 Praise Piazza et al. (1999) Effects of continuous and intermittent reinforcement for problem behavior during functional communication training (Worsdell et al., 2000) What happens if problem behavior is inadvertently reinforced? N=5 (DD), SIB or AGG FA: Maintenance by Sr+ (n=2), Sr- (n=3) BL: PB Sr (FR1) Phase 1: DRA (No EXT) Alt R Sr+ (FR 1) SIB Sr+ (FR 1) Phase 2: DRA (Inconsistent EXT) Alt R Sr+ (FR 1) SIB Sr+ (FR 2, FR 3, FR 5, FR 20) 3

4 Worsdell et al. (2000) Effects of response blocking on attentionmaintained problem behavior (Dempsey et al., in prep) Does response blocking: Serve as reinforcement for PB maintained by attention? Interfere with attempts to establish alternative behavior? N=3 (DD), SIB or AGG FA: Maintenance by attention Phase 1:Response Blocking PB Block (No eye contact, no words) Phase 2: Response Blocking + DRA PB Block (No eye contact, no words) Alt R Attention (eye contact, praise) Dempsey et al. (in prep) Maintenance by Social Sr+ Strategy #1: Minimize the reinforcing aspects of social consequences Intermittent Sr for PB: Intervene only when PB is clearly dangerous (Vollmer et al., 1999; Worsdell et al., 2000) Analysis of reinforcing aspects of attention (Kodak et al., 2007) Reprimand for PB (Piazza et al., 1999) Response block w/ minimal attention (Dempsey et al., in prep) The effects of noncontingent delivery of high- and low-preference stimuli on attention-maintained destructive behavior (Fisher et al., 2000) Would free access to preferred items make PB less sensitive to attention? N=1 (DD), multiple PB FA: Maintenance by attention Preference assessment: HP and LP leisure items FR-1: PB attention NCR (HP): Free access to HP leisure NCR (LP): Free access to LP leisure Fisher et al. (2000) 4

5 Comparison of single and multiple functional communication training responses for the treatment of problem behavior (Kahng et al., 2000) Does multiple-mand training compete more effectively than single-mand training with reinforcement for PB? N=1 (DD), multiple PB FA: Maintenance by attention Preference assessment: 6 HP items BL: PB 1 of 6 items (random) FCT single: PB 1 of 6 items (random) I want treats 1 of 6 items (random) FCT multiple: PB 1 of 6 items (random) I want X 1 of 6 items (specific item) Kahng et al. (2000) Maintenance by Social Sr+ Strategy #2: Maximize the effects of interventions that make responding less susceptible to ongoing reinforcement Noncontingent reinforcement (NCR): Free access to alternative reinforcers, but applies only to dense schedules of NCR [NC food v. attention or tangible for PB (Fischer et al., 1997), NC tangible v. attention for PB (Hanley et al., 1997; Fisher et al., 2000), NCR tangible vs. tangible for PB (Lalli,et al, 1997)] Teach multiple mands for Sr+ (Kahng et al., 2000) Maintenance by Social Sr- PB Escape from or avoidance of task demands or social interaction EXT: Prevention of escape (continuation of demands or interaction) Difficulty: Severe SIB terminates ongoing activity Highly aggressive clients often escape Competing contingencies for escape behavior and compliance (Hammond, Study 2, in prep) Hammond et al. (in prep) Will low-quality Sr- for PB produce EXT-like effects? N=4 (DD), SIB, AGG, PD FA: Maintenance by escape BL: Compliance praise, PB break Sr- / Sr-: Compliance break, PB break Sr- / LQ Sr-: Compliance break, PB response block 5

6 Maintenance by Social Sr- Strategy #1: Minimize the reinforcing aspects of social consequences (escape) Escape to no activity: No data Response blocking & return to task (Hammond et al., in prep) Antecedent interventions for problem behavior maintained by escape (Rolider et al., in prep) How well do antecedent interventions compete with Sr- for PB? Subjects: N=6 (DD), SIB or PD FA: Maintenance by escape BL: FT low-p demands (30-s schedule) Antecedent interventions: Demand fading: 1 low-p demand BL rate of low-p demands High-p sequence: 3 high-p demands : 1 low-p demand Rolider et al. (cont d)! Antecedent interventions (cont d) Fading + high-p sequence:1 high-p sequence X high-p sequences High-p Fading: FT high-p demands + 1 low-p demand BL rate of low-p demands NCR (food): Low-p demands + continuous edibles Consequent-based interventions S r+ (compliance)/ S r- (PB) : Compliance HP edible item S r+ / EXT: Compliance HP edible item, PB Physical prompt to complete task Hi-p Sequence Effective NCR (food) Effective S r+ / S r- Effective 6

7 Summary DF HiP DF+HiP HiP DF NCR Sr+/Sr- Sr+/Ext Does Sr- for compliance compete with Sr- for problem behavior? (see partial evaluation in other studies) Competing contingencies for escape behavior and compliance (Hammond, Study 1, in prep) Hammond et al. (in prep) Will longer a longer duration of Sr- for compliance compete with Sr- for PB? N=7 (DD), SIB, AGG, PD FA: Maintenance by escape BL: Compliance praise, PB 30-s break Sr- / Sr-: Compliance 30-s break, PB 30-s break Enhanced Sr- / Sr-: Compliance 120-s break, PB 30-s or 5-s break Sr+ / Sr-: Compliance Sr+, PB 30-s break Concurrent reinforcement schedules: Behavior change and maintenance without extinction (Hoch et al., 2002) Does high-quality Sr+ for compliance compete with escape for PB? N=3 (autism or DD), SIB, AGG, disruption FA: Maintenance by escape Preference assessment: HP leisure items No Sr: PB break; compliance Sr-/PA: PB break; compliance preferred activity Sr-/Sr-: PB break; compliance break Maintenance: Same as Sr-/PA, but task requirement increased (FR 2, 34, 102) Hoch et al. (2002) (FR 34) 7

8 Maintenance by Social Sr- Strategy #2: Maximize the effects of interventions that make responding less susceptible to ongoing reinforcement NCR (escape): Noncontingent breaks from work (No data when used w/o EXT) Other antecedent interventions: Easier tasks, shorter sessions, Hi-P sequence, demand fading, etc. (generally negative findings) Sr- for compliance (DRA) (generally negative findings) Hi-quality Sr+for compliance (DeLeon et al., 2001; Hoch et al., 2002; Lalli et al., 1999; Piazza et al., 1997) Maintenance by Automatic Sr PB Sensory stimulation EXT: Attenuation of response-produced stimulation Difficulty: Some responses difficult to stop (echolalia) Distinguishing between extinction and punishment effects of response blocking: A replication (Smith et al., 1999) What is the effect of intermittent blocking of PB maintained by automatic Sr? N=1 (DD), SIB FA: Maintenance by automatic Sr BL: SIB no consequences Continuous block: SIB attempts block Intermittent block: SIB attempts proportional block (.5,.67,.8) Smith et al. (1999) The use of wrist weights to reduce self-injury maintained by sensory reinforcement (Van Houten, 1993) Will increased response effort produce EXT-like effects? N=1 (DD), SIB FA: Maintenance by automatic Sr No weights: SIB no consequences Weights: Same as BL except that S wore 1.5 lb weights on each wrist Van Houten (1993) 8

9 Effects of increased response effort on self-injury and object manipulation as competing responses (Zhou et al., 2000) Would devices that make SIB more effortful have detrimental effects on leisure-item interaction? N=4 (DD), SIB (all hand mouthing) FA: Maintenance by automatic Sr BL: SIB no consequences Arm sleeves: Same as BL except that S wore flexible sleeves (3 lb required to bend 90º) Zhou et al. (2000) Maintenance by Automatic Sr Strategy #1: Minimize the reinforcing aspects of social consequences Not generally a problem; social consequences irrelevant Response blocking (Lerman & Iwata, 1996; Reid et al., 1993; Smith et al., 1999; Tarbox et al., 2007; and lots more) BUT, PB may acquire social function if blocking paired with attention or escape (no published data) Response effort: Increased effort for PB produces EXTlike effects (Van Houten, 1993; Zhou et al., 2000) A comparison of noncontingent reinforcement and sensory extinction as treatments for self-injurious behavior (Roscoe et al., 1998) Does noncontingent access to preferred items compete with SIB maintained by automatic reinforcement? N=3 (DD), SIB FA: Maintenance by automatic Sr BL: SIB no consequences NCR: Same as BL except that S had continuous access to highly preferred item Sensory EXT: Same as BL except that S wore device to attenuate stimulation (foam sleeves, gloves) Roscoe et al. (1998) On the relation between object manipulation and stereotypic self-injurious behavior (Lindberg et al., 1999) Does noncontingent access to preferred items compete with SIB maintained by automatic reinforcement? N=2 (DD), SIB FA: Maintenance by automatic Sr BL: SIB no consequences Prompts: Same as BL except that S prompted to contact preferred leisure item every 30 s Prompts + Sr+: Same as previous except that S received edible for increased duration of item contact Block: Same as previous except that SIB blocked (but counted) 9

10 Lindberg et al. (199) Maintenance by Automatic Sr Strategy #2: Maximize the effects of interventions that make responding less susceptible to ongoing reinforcement NCR: Free access to alt preferred items (Piazza et al., 2000; Roscoe et al., 1998; Shore et al., 1997; Vollmer et al., 1994) Establish a response that produces direct access to sensory Sr (Lindberg et al., 2003; Singh & Millichamp, 1987) So... Can we eliminate problem behavior without extinguishing it? Strategy #1: Minimize the reinforcing aspects of response interruption Maintenance by social Sr+ and social Sr-: Unsure Maintenance by automatic Sr+: Yes Strategy #2: Maximize the effects of interventions that make responding less susceptible to reinforcement NCR: Maybe, with dense NCR schedules DRA: Maybe, if parameters favor Alt R over PB Suggestions for Clinicians Continue to emphasize the importance of EXT EXT can be implemented with most problem behaviors Minimal social consequences might be reinforcing Interruption could introduce new contingencies *Response remains functional unless extinguished When EXT cannot be implemented #1: Minimal reactive strategy # 2: Deliver NCR (attention, escape, preferred items) on a dense schedule #3: Thin NCR and transition to DRA whose parameters favor Alt R Suggestions for Researchers Identify qualitative and quantitative limits of reinforcement for problem behavior Evaluate NCR schedule thinning w/o EXT Identify factors that compete with ongoing reinforcement Qualitative characteristics of consequences Parametric values (schedule, magnitude, delay, effort) Competing contingencies (Sr+ v. Sr-, social v. automatic Sr) Combined interventions Evaluate intervention effects in the absence of EXT Overall Goals Response-interruption strategies that are environmentally neutral Technology of indirect response suppression 59 10

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