Khan, 2013 ONTABA Research Poster Presentation Decreasing Self-Injury and Aggression
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Transcript of 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