378380
BMO
The Effects of
Presession
Manipulations on
Automatically
Maintained Challenging
Behavior and Task
Responding
Behavior Modification
34(6) 479­–502
© The Author(s) 2010
Reprints and permission: http://www.
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DOI: 10.1177/0145445510378380
http://bmo.sagepub.com
Yi-Chieh Chung1 and Helen I. Cannella-Malone1
Abstract
This study examined the effects of presession exposure to attention, response
blocking, attention with response blocking, and noninteraction conditions on
subsequent engagement in automatically maintained challenging behavior and
correct responding in four individuals with significant intellectual disabilities.
Following a functional analysis, the effects of the four presession conditions
were examined using multielement designs. Results varied across the 4 participants (e.g., presession noninteraction acted as an abolishing operation for
2 participants, but as an establishing operation for the other 2 participants).
As such, both the results replicated and contradicted previous research examining the effects of motivating operations on automatically maintained challenging behavior. Although the results varied across participants, at least one
condition resulting in a decrease in challenging behavior and an increase in
correct responding were identified for each participant. These findings suggested that presession manipulations resulted in decreases in subsequent
automatically maintained challenging behavior and simultaneous increases in
correct responding might need to be individually identified when the maintaining contingencies cannot be identified.
1
The Ohio State University, Columbus, OH, USA
Corresponding Author:
Helen I. Malone, PhD, 348A PAES Building, 305 W 17th Avenue, Columbus OH 43210
Email: [email protected]
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Keywords
automatically maintained challenging behavior, motivating operations, presession
analyses, intervention, severe intellectual disability
Automatically maintained challenging behavior presents a unique challenge to
behavior analysts, because these behaviors are often difficult to assess and treat
due to the intrinsic reinforcement provided by the behavior (LeBlanc, Patel, &
Carr, 2000). Stereotypy has commonly been presumed to be maintained by
nonsocial or sensory reinforcement (Lovaas, Newsom, & Hickman, 1987;
Roantree & Kennedy, 2006) because the maintaining resource is generated
directly by the repetitive movement of the behavior itself and is independent
of social mediation (Rapp & Vollmer, 2005). Stereotypy has often been resistant
to intervention, however several studies have found that stereotypy might be
sensitive to motivating operations (MOs; e.g., Rapp, 2004, 2006, 2007; Roantree
& Kennedy, 2006). MOs have been defined by Michael (1982) as: (a) changes
in the environmental conditions that alter the extent to which a stimulus is
reinforcing or punishing (i.e., establishing [EO] vs. abolishing operations [AO]),
and (b) the frequencies of behavior pertaining to that stimulus (i.e., evocative
vs. abative effects). Manipulating MOs could provide an alternative approach
to treating automatically maintained challenging behavior, especially when
it is impractical to withhold the sensory consequence (Rapp, 2004).
Several studies have examined the effects of manipulating presession conditions and have noted that these conditions may act as either EOs or AOs for
stereotypic behavior. For example, Rapp (2004) demonstrated that previous
access to object twirling served as an AO for later engagement in that behavior
in a boy with Down syndrome by comparing the levels of stereotypic object
twirling during two daily sessions. During the first daily session (i.e., previous
access), the participant was alone in a room with cords and shirts that he could
twirl for 30 min. The second daily session was identical to the first, except it
was conducted 3 hr later. The results indicated that earlier access to stereotypic
object twirling during the first daily session produced lower levels of that
behavior during the second session. That is, earlier access to stereotypy served
as an AO for later object twirling.
In another example, Rapp (2006) found that presession response blocking
functioned as an EO for stereotypic object tapping in a boy with autism and
mental retardation. Rapp used a multiple schedule to evaluate the separate effects
of noncontingent matched stimulation and response blocking on the participant’s
stereotypic behavior. The results indicated that 15 min of presession noncontingent matched stimulation served as an AO and that response blocking served as
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an EO for the subsequent stereotypic object tapping. In other words, presession
noncontingent matched stimulation may have decreased the reinforcing value
of the stimulation that was generated by the participant’s engagement in object
tapping. On the other hand, presession response blocking may have increased
the reinforcing value of the stimulation generated by stereotypy, thus increasing
the later likelihood of engagement in that behavior.
Roantree and Kennedy (2006) evaluated the effects of social attention on
the repetitive full-body reflex in a 10-year-old boy with severe mental retardation. A combined reversal (ABA) and multielement design was used to
examine the participant’s stereotypy during analogue functional analyses. In
the first phase (A), a typical analogue functional analysis was conducted after
a 20 min noninteraction condition. The second phase (B) was identical to the
first, except that noncontingent attention—consisting of positive verbal comments—was provided every 30 s for 20 min earlier to each session. The results
of the functional analysis without presession attention (A) indicated undifferentiated results. When presession attention was provided (B), stereotypy
occurred most frequently in the attention condition. Unlike previous findings
that indicated that presession attention functioned as an AO when attention
acted as a positive reinforcer, Roantree & Kennedy found that presession
attention acted as an EO for the participant’s stereotypic behavior. This suggests that stereotypy might be influenced by socially mediated reinforces that
are provided during presession conditions.
In another example, Rapp (2007) examined the effects of auditory stimulation
on the vocal stereotypy of two boys with autism and mental retardation. Stereotypy was measured during the three successive components (i.e., preintervention,
intervention, and postintervention) within a reversal design to evaluate the
percentage of each participant’s stereotypy earlier to, during, and after access
to auditory stimulation. During the first and third components, the researchers
simply collected data on the occurrence of stereotypy. During the second component (i.e., intervention), 1 participant was given noncontingent access to toys
that made noise, whereas the other was given noncontingent access to chewing
gum and contingent brief verbal reprimands. The results demonstrated that access
to auditory stimulation served as an AO for 1 participant’s stereotypy and that
reprimands functioned as an EO for the other participant’s vocal stereotypy.
Nowadays, studies that have examined the effects of MOs on stereotypic
behavior are limited by their exclusion of an analogue functional analysis to
confirm function or by undifferentiated functional analysis results. For example,
Rapp (2004, 2006) stated in his studies that the behaviors he examined were
maintained by automatic reinforcement, but no analogue functional analyses
were conducted to confirm this, and in Roantree and Kennedy (2006), the
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functional analysis without presession attention had undifferentiated findings.
Even though providing earlier access to attention was used to discover an
attention-maintained function, it did not rule out the possibility of discrimination failure (Iwata, Duncan, Zarcone, Lerman, & Shore, 1994) or a multiplemaintained function.
In addition, MO manipulations have been limited to examine the isolated
effects of reprimands, positive attention, response blocking, or access to the
behavior. In clinical settings, when teaching new skills and simultaneously
targeting challenging behavior, a teacher may use both response blocking and
social attention. For example, contingent on a student’s correct response, positive comments may be provided; however, if the student engages in hand flapping during a task, response blocking may be used. Therefore, both the isolated
and combined effects of social attention and response blocking conditions warrant investigation.
On the basis of the aforementioned limitations, the purpose of this study
was to examine the separate and combined MO effects of presession conditions
following a functional analysis that identified the function of challenging
behavior as automatically maintained. The specific research questions addressed
were: (a) How does manipulating four presession conditions (i.e., attention,
response blocking, attention with response blocking, and noninteraction) contribute to the elimination of automatically maintained behavior?, and (b) Will
manipulating the duration (i.e., 5, 10, and 15 min) of the most effective preaccess condition contribute to the subsequent occurrence of challenging and
on-task behavior?
Method
Participants, Materials, and Setting
Four individuals, 3 girls and 1 boy, who engaged in automatically maintained
challenging behavior that interfered with their learning, participated in this
study. All participants were included in Experiments 1 and 2, and only three of
the four (i.e., all but Charlie) participated in Experiment 3. Anna was an 11-yearold girl with multiple disabilities. Charlie was a 14-year-old boy with multiple
disabilities. Lilly was an 11-year-old girl with autism and mental retardation.
Kellie was a 16-year-old girl with multiple disabilities. All students were nonverbal, but used several gestures or idiosyncratic vocalizations to communicate
their wants and needs.
Materials included preferred items identified by the participants’ teachers
including a ball and beads for Anna, a musical instrument and a toy with
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6 buttons to push for Charlie, a toy fish tank and a toy piano for Lilly, and a
ball and a keyboard for Kellie. All sessions were conducted in a small room
that contained a table and two chairs. The room was located at the participants’
school, which was a county funded school that served individuals with severe
to profound disabilities between the ages of 5 and 22.
Dependent Measures, Data Collection,
and Interobserver Agreement
The dependent measure for all 4 participants was stereotypic behavior. Anna’s
stereotypic behavior was chair scratching, defined as continuously scratching
her chair back with her fingernails. Charlie engaged in shirt biting, defined as
inserting his own shirt into his mouth and chewing on it. Lilly’s stereotypic
behavior was putting one or both of her hands into her pants, between her
pants and her diaper. Kellie engaged in teeth tapping, defined as tapping her
front teeth with the heel of her hand, and knuckle clapping, defined as bringing
the knuckles and the heels of her hands together. Data on the dependent measure
were collected using 10 s partial interval recording. In addition, data were
only collected during test conditions throughout the study and not during the
presession manipulations.
Interobserver agreement (IOA) was calculated on a session-by-session basis
using the formula: agreements divided by agreements plus disagreements,
multiplied by 100%. IOA for the functional analysis was collected during an
average of 38% (range, 36%-40%) of sessions and was calculated to be 99.3%
(range, 89.7%-100%). For the presession analysis, IOA was collected for an
average of 39% (range, 35%-44%) of sessions and was calculated to be 98.1%
(range, 91.3%-100%). Finally, for the treatment analysis, IOA was collected
for an average of 40% (range, 38%-43%) of sessions and was calculated to be
99.2% (range, 90.9%-100%).
Experimental Design
There were three experiments in this study, including a functional analysis
(Experiment 1), a presession access analysis (Experiment 2), and a treatment
analysis (Experiment 3). Multielement designs were used in Experiments 1
and 2. In the functional analysis, noninteraction, attention, play, demand, and
tangible conditions were alternated. In the presession analysis, presession access
to attention, noninteraction, response blocking, and attention with response
blocking were alternated. In Experiment 3, a combined alternating treatments
plus multiple-baseline across participants design was used to examine the
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effects of antecedent events on automatically maintained behavior and correct
task responding (Richards, Taylor, Ramasamy, & Richards, 1999).
Experiment 1: Functional Analysis
Experimental Procedures
Using methods similar to those described by Iwata, Dorsey, Slifer, Bauman,
and Richman (1982/1994), stereotypic behavior was assessed in attention,
tangible, demand, noninteraction, and play conditions to confirm that the behavior was automatically maintained. In the attention condition, no leisure items
were available and participants were given attention in the form of a brief negative statement (e.g., Don’t do that.) when they engaged in stereotypic behavior
and were ignored at all other times. In the tangible condition, participants were
given access to a preferred leisure item for 5 s when they engaged in the stereotypic behavior and were ignored at all other times. The tangible condition
was not assessed for Charlie, because he did not regularly engage with preferred
tangible items. In the demand condition, participants were given a task (e.g.,
folding towels or sorting objects) and were allowed to escape from the task
for 30 s when they engaged in stereotypic behavior. In the noninteraction condition, no items were available to the participant and the researcher did not interact
with the participant for the duration of the session. Finally, in the play condition,
participants were given noncontingent positive attention, allowed continuous
and noncontingent access to leisure items, and not presented with any tasks.
Each condition was run in random order for 5 min. Sessions were conducted 4
to 9 times based on participant availability, usually 1 day per week, until a stable
trend in the data were achieved. For all participants, extended noninteraction
conditions were conducted (Vollmer, Marcus, Ringdahl, & Roane, 1995) to
confirm that the behavior was maintained (at least in part) by automatic reinforcement. These conditions were identical to the noninteraction conditions.
Results
Results from the functional analysis are shown in Figure 1 for Anna (upper
left), Charlie (upper right), Lilly (lower left), and Kellie (lower right). Anna
engaged in the highest percentage of intervals of chair scratching in the noninteraction condition (mean = 86%, range, 60%-100%), though she still scratched
her chair in the demand (mean = 14.4%, range, 10%-23.3%), attention (mean =
7.7%, range, 3.3%-16.6%), play (mean = 13.3%, range, 3.3%-23.3%), and
tangible (mean = 15.5%, range, 10%-20%) conditions. When the extended
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Figure 1. Percentage of intervals with challenging behavior during the functional
analysis for Anna, Charlie, Lilly, and Kelly.
noninteraction conditions were run, she engaged in chair scratching during
100% of the intervals in each session.
Charlie engaged in moderate levels of shirt biting across the noninteraction
(mean = 67%, range, 1%-100%), attention (mean = 36.6%, range, 6.6%-73.3%),
and play (mean = 49.3%, range, 0%-83.3%), conditions. He engaged in the
lowest levels of shirt biting in the demand condition (mean = 5.9%, range,
0%-23%). When the extended noninteraction conditions were run, he engaged
in shirt biting during an average of 83.4% (range, 60%-100%) of intervals,
with an increasing trend.
Lilly put her hands in her pants in the noninteraction condition during an
average of 36.6% (range, 0%-66.6%) of intervals with an increasing trend.
She did not attempt to put her hands in her pants in any of the other conditions.
When the extended noninteraction conditions were run, she engaged in challenging behavior during an average of 54.4% (range, 33.3%-66.6%) of intervals
with an increasing trend.
Finally, Kellie engaged in the highest percentage of intervals of challenging
behavior in the noninteraction condition (mean = 47.3%, range, 26.6%-83.3%),
though she still engaged in challenging behavior in the demand (mean = 20%,
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Behavior Modification 34(6)
range, 10%-33.3%), attention (mean = 2.8%, range, 0%-10%), play (mean = 8.6%,
range, 0%-26.6%), and tangible (mean = 17.2%, range, 10%-26.6%) conditions.
When the extended noninteraction conditions were run, she engaged in challenging behavior during an average of 81.7% (range, 80%-83.3%) of intervals.
The results of Experiment 1 showed that for Anna, Lilly, and Kellie, challenging behavior occurred at the highest levels in the noninteraction condition
and maintained or increased in the extended noninteraction condition. For
Charlie, his levels of challenging behavior were high across all conditions
(except the demand condition). However, the data path of the attention condition was not elevated relative to the play condition and the behavior increased
in the extended noninteraction condition. These results of the functional analysis
for all participants supports that the behavior was maintained by automatic
reinforcement. On the basis of these results, subsequent MO analyses were
conducted in Experiment 2 to determine the effects of presession manipulations on behaviors maintained by automatic reinforcement.
Experiment 2: Presession Access Analysis
Experimental Procedures
In this phase, four presession manipulation conditions were evaluated: (a) noninteraction, (b) attention, (c) response blocking, and (d) attention with response
blocking. Each presession manipulation condition was 15 min in length and was
immediately followed by a 5 min noninteraction test condition. During the presession noninteraction manipulation condition, no social consequences were provided,
and the participant was free to engage in stereotypic behavior. In the presession
attention manipulation condition, noncontingent positive attention (e.g., I like
how you’re sitting.) was delivered approximately once every 30 s, and no consequences were provided for stereotypic behavior. In the presession response
blocking manipulation condition, no attention was provided, and the researcher
blocked stereotypic behavior by gently redirecting the participant’s hands back
to their lap before completion of the target behavior. Finally, in the presession
attention with response blocking manipulation condition, noncontingent positive
attention was provided approximately once every 30 s and all stereotypic behavior
was blocked. One session was conducted per day for each participants, usually
2 to 3 days per week, until a stable trend in the data were achieved.
Results
Results from the presession access analysis (compared with the functional analysis alone condition) are shown in Figures 2 through 5 for Anna, Charlie, Lilly,
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Figure 2. Percentage of intervals with challenging behavior across the functional
analysis alone condition and the presession analysis noninteraction (upper right),
response blocking (upper left), attention (lower right), and attention plus response
blocking (lower right) test conditions for Anna.
and Kellie. For Anna (Figure 2), all but the presession response blocking manipulation acted as an AO for challenging behavior when compared to the noninteraction condition from the functional analysis. Following the noninteraction condition
(upper left panel), she engaged in chair scratching during an average of 48%
(range, 10%-83.3%) of intervals in the subsequent test conditions, which was a
mean decrease of 38% from the noninteraction condition in the functional analysis.
In addition, these data indicated a steep decreasing trend. Following the presession response blocking manipulation (upper right panel), she engaged in chair
scratching during an average of 85% (range, 73.3%-96.6%) of intervals, which
was only a mean decrease of 1%. Following the presession attention manipulation (lower left panel), she engaged in stereotypic behavior during an average of
70% (range, 40%-100%) of intervals, which represents a mean decrease of 16%.
This data path indicates a slight decreasing trend. Finally, following the presession
attention with response blocking manipulation (lower right panel), she engaged
in chair scratching during an average of 62% (range, 6.6%-100%) of intervals.
This was a mean decrease of 24%, though the trend was fairly stable.
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Figure 3. Percentage of intervals with challenging behavior across the functional
analysis alone condition and the presession analysis noninteraction (upper right),
response blocking (upper left), attention (lower right), and attention plus response
blocking (lower right) test conditions for Charlie.
For Charlie (Figure 3), the presession response blocking, attention, and
noninteraction manipulations acted as AOs, and the presession attention with
response blocking manipulation had a negligible effect for shirt biting when
compared with the noninteraction condition in the functional analysis. Following the presession noninteraction manipulation (upper left panel), he engaged
in shirt biting during an average of 62% (range, 16.6%-96.6%) of the intervals,
which was a mean decrease of 5% from the functional analysis. Following the
presession response blocking manipulation (upper right panel), Charlie engaged
in shirt biting during an average of 33% (range, 13.3%-96%) of intervals in the
corresponding test conditions, which was a mean decrease of 34%. Following
the presession attention manipulation (lower left panel), he engaged in shirt
biting during an average of 57% (range, 40%-90%) of intervals, which represents
a mean decrease of 10%. Finally, following the presession attention with
response blocking manipulation (lower right panel), he engaged in shirt biting
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Figure 4. Percentage of intervals with challenging behavior across the functional
analysis alone condition and the presession analysis noninteraction (upper right),
response blocking (upper left), attention (lower right), and attention plus response
blocking (lower right) test conditions for Lilly.
during an average of 69% (range, 16.6%-100%) of intervals, which was a mean
increase of 2%.
When the presession analysis was conducted for Lilly (Figure 4), an AO
was observed with the presession response blocking manipulation, no effect
was observed in the presession attention with response blocking manipulation,
and an EO was observed with the attention and noninteraction manipulations.
Following the presession noninteraction manipulation (upper left panel), she
put her hands in her pants during an average of 41% (range, 30%-53.3%) of
intervals, which represents a mean increase of 4.4%. Following the presession
response blocking manipulation (upper right panel), she engaged in stereotypic
behavior during an average of 21% (range, 3.3%-43.3%) of intervals. This was
a mean decrease of 15.6% from the functional analysis and showed a decreasing
trend. Following the presession attention manipulation (lower left panel), she
put her hands in her pants during an average of 67% (range, 46.6%-86.6%) of
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Figure 5. Percentage of intervals with challenging behavior across the functional
analysis alone condition and the presession analysis noninteraction (upper right),
response blocking (upper left), attention (lower right), and attention plus response
blocking (lower right) test conditions for Kelly.
intervals, which represents a mean increase of 30.4%. Finally, following the
presession attention with response blocking manipulation (lower right panel),
she engaged in challenging behavior during an average of 37% (range, 26.6%53.3%) of intervals, which was almost the same as the functional analysis,
though it showed a stable pattern of responding.
Finally, for Kellie (Figure 5), the presession response blocking manipulation
acted as an AO, and the presession attention with response blocking, noninteraction, and attention manipulations acted as EOs for challenging behavior.
Following the presession noninteraction condition manipulation (upper left
panel), she engaged in challenging behavior during an average of 67% (range,
60%-80%) of intervals, which was a mean increase of 19.7%. Following the
presession response blocking manipulation (upper right panel), she engaged in
challenging behavior during an average of 29% (range, 3.3%-50%) of intervals
in the subsequent test conditions, which was a mean decrease of 18.3% from
the noninteraction condition in the functional analysis. Following the presession
attention manipulation (lower left panel), she engaged in stereotypic behavior
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during an average of 80% (range, 60%-100%) of intervals, which represents a
mean increase of 32.7%. Finally, following the presession attention with response
blocking manipulation (lower right panel), she engaged in challenging behavior
during an average of 53% (range, 23.3%-76.6%) of intervals, which was a mean
increase of 5.7%.
Results from the presession analysis were highly variable. Presession access
to the challenging behavior (i.e., noninteraction) acted as an AO for Anna and
Charlie, but as an EO for Lilly and Kellie. Presession response blocking may
have acted as AOs for Lilly, Kellie, and Charlie (see Discussion), but had no
effect for Anna. When the presession attention manipulation was provided,
stereotypic behavior significantly increased for Kellie and Lilly (i.e., EO), but
decreased for Charlie and Anna. Finally, the presession attention with response
blocking manipulations acted as an AO for Anna, as an EO for Kellie, and had
no effect for Charlie and Lilly.
Although the results varied across participants, at least one presession condition that acted as an AO was identified for each participant, suggesting that
presession manipulations resulting in decreases in subsequent challenging
behavior should be individually identified. On the basis of these results, extended
MO analyses were conducted in Experiment 3 to determine how much exposure
was needed to maintain the decreases in challenging behavior as well as to
determine whether increases in correct task responding would be observed
following the presession access to an effective AO.
Experiment 3: Treatment Analysis
Method
Tasks and experimental assignments. Two equivalent receptive object labeling
tasks were identified for each participant on the basis of their current individualized educational program (IEP) and teacher report that the skills had not yet
been mastered. For Lilly, the tasks involved matching a spoken word with a
real item from a group of 3. For Anna, the tasks included matching spoken
words to their corresponding picture. For Kellie, the tasks involved matching
spoken letters to the corresponding written capital letter. For each participant,
one task was assigned to the condition with presession access and a second
task was assigned to the condition without presession access.
Dependent measures and data collection. Stereotypic behavior was measured
and defined as in Experiments 1 and 2. Data on correct responding were also
collected and defined as any correct response emitted within 5 s of the presentation of the verbal stimulus. For Lilly, a correct response was defined as
making any physical contact with the real item (from a group of 3) named by
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the researcher. For Anna, a correct response was defined as making any physical contact with the picture the researcher named. A correct response was
scored for Kellie when she made a written mark on the written capital letter
named by the researcher. The percentage of correct responses was calculated
by dividing the number of correct responses by the total number of responses
and multiplying by 100%.
Experimental procedures. During baseline, data were collected on the percentage
of correct responding and challenging behavior during both tasks. Nonpresession
access was provided for either task. Each session was 5 min in length, and a new
instruction was delivered approximately once every 30 s. If a participant’s response
was correct, the researcher said, Good job. There was no contingency for other
responding (e.g., incorrect responding or challenging behavior).
Intervention was identical to baseline for one task (i.e., nonpresession access
provided). With the second task, the same in-session instructional procedures
were used as in baseline, but several different periods of presession access were
provided (i.e., 5 min for Lilly; 10 and 15 min for Anna; and 5, 10, and 15 min
for Kellie) from shorter to longer durations until differentiated responding
occurred. When differentiated patterns were not identified for Anna, a preferred
activity (i.e., short walk) was provided as her presession condition (rather than
presession noninteraction). Sessions in Experiment 3 were conducted 1 to 2 days
per week, and each session was conducted once per day for each participant.
Results
Results for Lilly are presented in the top tier of Figure 6 (challenging behavior)
and Figure 7 (correct responding). During baseline, Lilly put her hands in her
pants during an average of 20.8% (range, 0%-40%) and 31.2 (range, 23.3%46.6%) of the intervals in Tasks A and B, respectively, and did not respond
correctly on either task. During intervention with Task A, 5 min of presession
access to response blocking resulted in zero levels of challenging behavior,
and she responded correctly an average of 56% (range, 50%-60%) of the time.
When nonpresession access continued with Task B, Lilly did not engage in
any challenging behavior, but only responded correctly 16% (range, 10%-20%)
of the time.
Results for Anna are presented in the second tiers of Figure 6 (challenging
behavior) and Figure 7 (correct responding). During baseline, Anna engaged
in chair scratching during an average of 55% (range, 43.3%-66.6%) and 41.6%
(range, 30%-53.3%) of the intervals with Tasks A and B, respectively, and
correctly responded an average of 5% (range, 0%-10%) of the time across
both tasks. Both 10 and 15 min of presession access to noninteraction led to
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Figure 6. Percentage of intervals with challenging behavior during the treatment
analysis for Lilly, Anna, and Kellie.
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Figure 7. Percentage correct responding during the treatment analysis for Lilly,
Anna, and Kellie.
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decreases in challenging behavior, but the effects were undifferentiated across
the two task conditions (i.e., presession access vs. nonpresession access). Following 10 min of presession access, she responded correctly an average of
18.8% (range, 10%-25%) of the time versus 12.5% (range, 0%-20%) when
nonpresession access was provided. Following 15 min of presession access,
she responded correctly an average of 40% (range, 30%-50%) of the time
versus 34% (range, 20%-50%) when nonpresession access was provided. When
a preferred activity (i.e., short walk) was provided, she engaged in stereotypic
behavior during an average of 5.5% (range, 0%-16.6%) of intervals. She continued to engage in higher levels (mean = 32.7%, range, 6%-56%) of stereotypic
behavior when nonpresession walk was provided. She responded correctly
an average of 93.3% (range, 20%-100%) of the time when presession access
to a short walk was provided and 41.1% (range, 0%-80%) when nonpresession walk was provided.
Results for Kellie are presented in the bottom tiers of Figure 6 (challenging
behavior) and Figure 7 (correct responding). She engaged in stereotypic behavior
in an average of 60.5% (range, 16.6%-93.3%) and 63.3% (range, 50%-93.3%)
of the intervals in Tasks A and B, respectively, and she responded correctly an
average of 3.3% (range, 0%-20%) of the time with Task A and 8.3% (range,
0%-20%) for Task B. During intervention, both 5 min and 10 min of presession
access to response blocking led to decreases in stereotypic behavior (mean = 39%,
range, 23%-70%), but the effects were almost undifferentiated from Task B,
which had nonpresession access (mean = 47.6%, range, 20%-86.6%). Following 5 min of presession access to response blocking, she responded correctly
an average of 31.7% (range, 20%-40%) of the time versus provided and 20%
(range, 0%-30%) when nonpresession access was provided. Following 10 min
of presession access, she responded correctly an average of 32.5% (range,
0%-60%) of the time versus 22.5% (range, 0%-40%) when nonpresession
access was provided. However, when 15 min of presession access was provided,
she engaged in stereotypic behavior during an average of 30.6% (range, 23%46.6%) of intervals, and 78% (range, 20%-86.6%) of intervals when nonpresession access was provided. She responded correctly an average of 74%
(range, 0%-90%) of the time when presession access was provided and 28%
(range, 0%-50%) when nonpresession access was provided.
Results from Experiment 3 suggested that providing presession access to
the condition identified as an effective AO in Experiment 2 for 5, 10, or 15 min
was successful in reducing stereotypic behavior and increasing correct responding for two of the three participants. For Anna, the condition identified in
Experiment 2 was not effective, but providing access to a preferred activity
(i.e., a short walk) was successful in reducing challenging behavior and increasing correct responding.
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Discussion
This study examined the effects of presession exposure to four conditions on
subsequent engagement in automatically maintained challenging behavior and
correct responding. The results of the functional analysis for all participants
supports that the behavior was automatically maintained. Results from the presession analysis were highly variable, but at least one condition acting as an AO
was identified for each participant. In addition, when presession access to the
condition acting as an AO was provided, decreases were observed with the
challenging behavior and increases were observed with correct responding for
all participants. Even though the use of antecedent walking was not planned for
Anna, her results extend the literature by demonstrating that antecedent exercise
can be used to decrease stereotypic behavior (e.g., Elliot & Dobbin, 1994).
The results of this study both replicate and contradict previous findings.
There are at least three general reasons that might contribute to these results:
(a) individual differences, (b) the challenges and idiosyncrasies related to treating automatically maintained behavior, and (c) methodological differences
between this and previous studies. Given that different presession manipulations
were found to decrease subsequent automatically maintained challenging behavior and increase correct responding for different participants, it is likely that
presession manipulations may need to be individually identified. In other words,
what acts as an AO for 1 participant may not act as an AO for another participant.
Future studies should continue to examine the effects of different presession
conditions on automatically maintained challenging behavior and task responding across multiple participants to determine whether particular characteristics
suggest the effectiveness of a particular presession manipulation.
Second, the findings in this study add to the literature by demonstrating the
idiosyncratic nature of automatically maintained challenging behavior. For
example, although the functional analysis results suggested that each participant’s
challenging behavior was automatically maintained, their patterns of responding
were not identical (e.g., Anna had highly differentiated results, but Charlie had
undifferentiated and highly unstable results). Future studies may examine the
effects of the same presession condition on automatically maintained challenging
behavior with different functional analysis results (e.g., differentiated vs. undifferentiated). It is possible that this kind of examination may provide further
direction for selecting an appropriate presession condition.
Finally, methodological differences may be a potential reason for the different results across studies. For instance, Roantree and Kennedy (2006) conducted
a full functional analysis as their baseline, but Rapp (2004) used a 30 min free
operant condition. In the current study, the noninteraction condition from the
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analogue functional analysis (Experiment 1) was used as the baseline to evaluate
the effects of the presession manipulations on later engagement in automatically
maintained behavior. Given that the baselines varied across studies, idiosyncratic
EO and AO effects may be unsurprising. Future researchers should consider
replicating these studies to determine whether these findings would replicated
when the same methodologies were employed.
The following sections will discuss each condition and the possible reasons
for the findings as well as potential directions for future research. When presession noninteraction has been provided in previous research (e.g., Rapp, 2004),
it acted as an AO, which we replicated with 2 participants (range=5%-38%
decrease). For the other 2 participants, we found that the presession noninteraction condition acted as an EO (range = 4.4%-19.7% increase). Unlike this study,
Rapp used the first of two daily sessions as both the baseline and the earlier
access conditions and found that challenging behavior decreased during the
second daily session when compared to the first. He concluded that free access
to challenging behavior during the first daily session served as an AO for that
behavior. Given that the first and the second sessions were always 3 hr apart, it
is possible that there were other antecedent events that occurred between the
first and second daily sessions that produced the effects. In the current study,
each 15 min presession condition was immediately followed by a 5 min test
condition, thus focusing on the immediate effects of the MO manipulation.
Immediate and significant decreases in the challenging behavior were only noted
with Anna, though decreases were also observed with Charlie. It is possible that
15 min of access was not sufficient to produce satiation with the other participants
and that behaviors that occur at lower frequencies may require longer presession
access (e.g., 30 min preaccess in Rapp’s study) to demonstrate an effect in the
subsequent test condition. For example, in this study, during baseline, Anna
engaged in challenging behavior in an average of more than 80% of intervals,
whereas the other participants engaged in challenging behavior during an average percentage of intervals that was lower than 60%. Similarly, in Rapp’s study,
the participant engaged in object twirling around 64% of the time during baseline
(i.e., the first daily session). Therefore, it may be that longer presession conditions might function as an AO when the challenging behavior is less frequent.
Future studies should evaluate the effects of different periods of presession access
(i.e., shorter vs. longer sessions) on automatically maintained behavior that
occurs at different frequencies (i.e., low and high frequencies).
Previous research on presession response blocking (e.g., Rapp, 2006; Rapp,
Vollmer, Dozier, St. Peter, & Cotnoir, 2004) found that it acted as an EO, but
we found that it appeared to act as an AO for 3 participants and had no effect
with the fourth. In Rapp’s (2006) study, he used a multiple schedule that included
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three 15 min conditions (i.e., preintervention, intervention, and postintervention). During the pre and postintervention conditions, no interaction was provided to the participant. The intervention consisted of 15 min of response
blocking. He found that presession response blocking (i.e., intervention) functioned as an EO for later challenging behavior (i.e., postintervention). In this
study, 3 of the 4 participants engaged in less challenging behavior following
response blocking. There are at least three potential factors that might contribute
to the inconsistency.
First, it is possible that the effects of the presession manipulation were only
momentary (the defining feature of an MO). The participants may have started
to engage in increased levels of challenging behavior over time, but those
increases were not seen due to the short duration of our test conditions. In other
words, had the presession response blocking conditions been followed by longer
test conditions (i.e., greater than 5 min) or when the participants had been left
in the room alone (rather than in a room with the experimenter present but
providing no interaction), we may not have observed the decreases we did.
Future studies should exam the lasting effects of MO manipulations with respect
to the duration of presession response blocking.
Second, the experimenter may have become a conditioned stimulus delta
during the test condition by simply being present in the room, even though they
did not interact with the participants. In other words, the participants may have
come to expect that they would not be allowed to engage in the behavior (i.e.,
the reinforcer would be unavailable) when the experimenter was present (particularly following a 15 min session with response blocking), even during the
test condition when the experimenter did not block the behavior. If this were
the case, the effects of decreased challenging behavior during the test sessions
for the presession response blocking manipulation might be the results of signaled extinction, punishment, or discriminated inhibitory stimulus control (e.g.,
Doughty, Anderson, Doughty, Williams, & Saunders, 2007). To avoid this possible influence, a different person should be used in future studies to minimize
the effect (Rapp, 2006, 2007).
Finally, it is also possible that blocking procedure itself provided matched
stimulation for automatically maintained behavior. In Experiment 3, all participants’ target behaviors involved using hands to contact either a body part
(e.g., mouth) or an object (e.g., chair). The presession response blocking
involved using the researcher’s hands to redirect the participants’ automatically
maintained behavior. If the physical contact provided by the blocking procedure
produced stimulation that was functionally similar to the stimulation generated
by the automatically maintained behavior, these findings (i.e., presession blocking functioned as an AO for 3 participants) might be less surprising. However,
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this hypothesis should be direly tested in future studies. Although the potential
motivation to engage in stereotypy may not be very clear, low levels of stereotypic behavior following presession response blocking manipulation
were correlated with increased academic performance for 2 of 3 participants
(Lilly and Kelly).
In past research, when presession attention in the form of reprimands was
provided, it acted as an EO for stereotypic behavior (e.g., Rapp, 2007). In this
study, presession attention acted as a significant EO for 2 participants (i.e., Lilly
and Kellie), but as a moderate AO for the other 2 participants. Without knowing
the specific sensory reinforcers maintaining the challenging behavior, it is difficult to interpret these results. For Anna and Charlie, presession attention
resulted in a 10% to 16% decrease in challenging behavior with a decreasing
trend. In the play condition of the functional analysis, both participants engaged
in some challenging behavior. It is possible that provision of noncontingent
attention may have led to a state of satiation, thus demonstrating an AO. For
Lilly and Kellie, presession attention resulted in a 30.4% to 32.7% increase in
challenging behavior. It is possible that following the presession attention, some
aspect of the maintaining contingency may have been in a state of deprivation,
resulting in the increased challenging behavior. Unfortunately, this is only one
possible interpretation that cannot be confirmed without knowing the specific
maintaining contingencies of the challenging behavior.
Finally, when presession attention with response blocking was provided, it
acted as an AO for 1 participant, an EO for 1 participant, and had no effect for
the other 2 participants. It might be important to note that the effects of presession attention with response blocking was not the same as simply combining
the effects of the isolated presession attention and response blocking conditions,
suggesting that combining the two conditions results in a completely different
condition. Although the results for Anna demonstrated a significant AO, the
negligible results for the remaining 3 participants suggests that combining the
attention and response blocking conditions may be unlikely to improve the
effectiveness of the two presession conditions. In addition, although teachers
may intervene with challenging behavior using both attention and response
blocking, it does not appear to be an effective MO manipulation. These findings
should be replicated with additional participants. It might also be worthwhile
to compare the effects of attention with response blocking as an MO manipulation versus a consequence-based intervention.
The results of Experiment 3 demonstrate that providing varying durations
of the presession conditions can both maintain subsequent decreases in challenging behavior, but also increase correct responding. These results suggest
that manipulating MOs may be able to provide teaching personnel with a
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window of opportunity for increased instructional programming. In other
words, providing a presession “booster” session may allow a student to benefit
more from subsequent teaching. In Experiment 3, nonadditional teaching
strategies were implemented to increase correct responding, suggesting that
something about the MO manipulation set up the students to perform better
following presession access. Future research should examine at least two
questions. First, how long will the MO effects maintain the behavior changes
compared with various durations of the presession conditions? Second, when
presessions access is paired with other evidence-based teaching practices, can
students with severe disabilities be taught new skills more efficiently than
when they are not provided with the presession condition?
The results of the present studies extend and contribute to previous studies
in several ways, but there are several limitations that should be addressed. First,
although we were able to include 4 participants in this study—compared to
only one in previous studies (e.g., Rapp, 2004, 2006; Roantree & Kennedy,
2006—the results across the 4 participants were not consistent. It would be
meaningful to increase the sample size to produce more consistent and convincing results. Second, although we confirmed automatic reinforcement as the
maintaining contingency, we did not identify the specific aspects of the behavior
that were reinforcing (e.g., stimulation to the hand or mouth for hand mouthing), which makes the interpretation of the findings more difficult. Even though
the AO identified in Experiment 2 led to decreases in challenging behavior and
increases in correct responding in Experiment 3, knowing the specific maintaining variables might make the process of identifying the most effective AO more
efficient. Third, there is considerable overlapping of the data from baseline to
the test conditions in Experiment 2. It would have been meaningful to collect
additional data to demonstrate a clearer functional relationship. Fourth, the
durability of presession effects in Experiments 2 and 3 was not assessed. Future
research should evaluate how long the MO effects maintain as well as how
often a presession condition should be provided to lead to the most potent
changes in behavior? Finally, using 10 s partial interval recoding could generate
false-positive or false-negative effects for duration events (Meany-Daboul,
Roscoe, Bourrett, & Ahearn, 2007; Rapp, Colby-Dirksen, Michalski, Carroll,
& Lindenberg, 2008). Future studies may score duration in real time to prevent
this potential limitation (e.g., Rapp, 2006).
Unlike with socially maintained challenging behavior, multiple presession
MO analyses may be needed to determine the most effective and practical
intervention for each individual’s automatically maintained challenging
behavior. By identifying an effective MO manipulation, it may be possible
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to then use that manipulation to decrease challenging behavior and simultaneously increase correct responding in subsequent sessions with individuals with
severe disabilities who engage in automatically maintained challenging
behavior.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interests with respect to the authorship
and/or publication of this article.
Financial Disclosure/Funding
The authors received no financial support for the research and/or authorship of this
article.
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Bios
Yi-Cheih Chung, PhD, is recently graduated from The Ohio State University. Her
current research interests include the manipulation of motivating operations to effect
automatically maintained challenging behavior in individuals with severe to profound
intellectual disabilities.
Helen I. Cannella-Malone, PhD, is an assistant professor of special education and
applied behavior analysis at The Ohio State University. Her research interests include
working with individuals with severe to profound intellectual disabilities to teach new
skills using video technology, and to examine the effects of choice and preference, and
motivating operations on behavior.
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