A Translational Evaluation of Renewal of Inappropriate Mealtime Behavior

The term renewal describes the recurrence of previously extinguished behavior that occurs when the intervention context changes. Renewal has important clinical relevance as a paradigm for studying treatment relapse because context changes are necessary for generalization and maintenance of most intervention outcomes (Podlesnik, Kelley, Jimenez-Gomez, & Bouton, 2017). The effect of context changes are particularly important during intervention for children with feeding disorders because children eat in a variety of contexts, and extinction is an empirically supported and often necessary intervention. Therefore, we used an ABA arrangement to test for renewal during intervention with 3 children diagnosed with a feeding disorder. The A phase was functional reinforcement of inappropriate mealtime behavior in a simulated home setting with the child’s caregiver as feeder; B was function-based extinction in a standard clinic setting with a therapist as feeder; and the return to the A phase was function-based extinction in a simulated home setting with caregiver as feeder. Returning to Context A resulted in renewal of inappropriate mealtime behavior across children, despite the caregivers’ continued implementation of function-based extinction with high levels of integrity

Effects of equal and unequal reinforcer duration during functional analysis.

In the functional analysis described by Iwata, Dorsey, Slifer, Bauman, and Richman (1982/1994), reinforcer duration varied across conditions (e.g., brief attention vs. 30 s of escape); this may result in unequal exposure to the establishing operations for aberrant behavior. In this study, we compared the effects of unequal and equal reinforcer duration during a functional analysis. The results showed that reinforcer duration affects the rate of aberrant behavior and may potentially alter functional analysis interpretation

Differential reinforcement of alternative behavior and demand fading in the treatment of escape-maintained destructive behavior.

The escape-maintained destructive behavior of a boy with autism was reduced during instructional sequences with differential reinforcement of compliance (DRA), escape extinction without physical guidance, and demand fading. The procedure decreased destructive behaviors to near-zero levels and greatly increased compliance

A water-prompting procedure for the treatment of urinary incontinence.

Based on clinical observations of a naturally occurring phenomenon, a water-prompting procedure was used to facilitate toilet training with a 9-year-old boy with profound mental retardation. Other frequently used toilet-training procedures were either ineffective or were associated with increased self-injury. The water-prompting treatment package may increase continence by eliciting and reinforcing urination under specific stimulus conditions

The effects of contingent and noncontingent attention on self-injury and self-restraint.

Self-restraint and self-injurious behavior (SIB) are two responses that can sometimes be members of the same functional response class (i.e., maintained by the same contingency). In such cases, a single treatment should be effective for both responses. In this investigation, we examined the effects of providing attention (the presumed reinforcer) both noncontingently and contingent upon either SIB or self-restraint. Results were consistent with our hypothesis that both responses were maintained by attention and suggested that noncontingent reinforcement was a potentially effective treatment

Using a choice assessment to predict reinforcer effectiveness.

A choice assessment has been found to be a more accurate method of identifying preferences than is single-item presentation. However, it is not clear whether the effectiveness of reinforcement varies positively with the degree of preference (i.e., whether the relative preference based on the results of a choice assessment predicts relative reinforcer effectiveness). In the current study, we attempted to address this question by categorizing stimuli as high, middle, and low preference based on the results of a choice assessment, and then comparing the reinforcing effectiveness of these stimuli using a concurrent operants paradigm. High-preference stimuli consistently functioned as reinforcers for all 4 clients. Middle-preference stimuli functioned as reinforcers for 2 clients, but only when compared with low-preference stimuli. Low-preference stimuli did not function as reinforcers when compared to high- and middle-preference stimuli. These results suggest that a choice assessment can be used to predict the relative reinforcing value of various stimuli, which, in turn, may help to improve programs for clients with severe to profound disabilities

An evaluation of two differential reinforcement procedures with escape extinction to treat food refusal.

Consumption of solids and liquids occurs as a chain of behaviors that may include accepting, swallowing, and retaining the food or drink. In the current investigation, we evaluated the relative effectiveness of differential reinforcement of the first behavior in the chain (acceptance) versus differential reinforcement for the terminal behavior in the chain (mouth clean). Three children who had been diagnosed with a feeding disorder participated. Acceptance remained at zero when differential reinforcement contingencies were implemented for acceptance or mouth clean. Acceptance and mouth clean increased for all 3 participants once escape extinction was added to the differential reinforcement procedures, independent of whether reinforcement was provided for acceptance or for mouth clean. Maintenance was observed in 2 children when escape extinction was removed from the treatment package. The mechanism by which consumption increased is discussed in relation to positive and negative reinforcement contingencies

An evaluation of food type and texture in the treatment of a feeding problem.

An evaluation of food type and texture indicated that both variables affected the expulsions of a 3-year-old with feeding problems. The results of the evaluation were used to prescribe a treatment (reducing the texture of one food type) that reduced expulsion