This lesson covers:
BCAT D-4: Functional behavior assessment
BCAT D-15: Escape extinction
BCAT D-16: Attention extinction
BCAT D-17: Access to tangible extinction
BCAT D-18: Extinction burst
BCAT D-21: Differential reinforcement of alternative behavior
BCAT D-22: Differential reinforcement of incompatible behavior
BCAT D-23: Differential reinforcement of other behavior
BCAT D-24: Response blocking
BCAT D-25: Redirection
BCAT D-26: Overcorrection
BCAT D-28: Time-out from reinforcement
BCAT D-29: Spontaneous recovery
RBT D-4: Implement differential reinforcement procedures (e.g., DRA, DRO).
RBT D-5: Implement extinction procedures.
Extinction is denial of the reinforcer for a previously reinforced behavior. Once the behavior no longer leads to the maintaining reinforcement, the patient will decrease future frequency of that behavior.
Extinction can be used for every function of behavior. It looks different depending on the function. This will be identified in the BIP.
Let's explore what extinction looks like for different functions of behavior.
Attention extinction procedure includes the following:
|The Wrong Way (Reinforcement)|
|Behavior technician is not paying attention to Adam.||⇨||Adam screams.||⇨||Behavior technician tells Adam to be quiet.|
|The Right Way (Extinction)|
|Behavior technician is not paying attention to Adam.||⇨||Adam screams.||⇨||Behavior technician still does not pay attention to Adam.|
In the wrong way example, the behavior technician is still giving attention to Adam when he tells him to be quiet.
In the right way example, the behavior technician does not deliver the reinforcer (attention). Of course, we would also combine this with an intervention to teach Adam how to appropriately gain attention, such as asking the behavior technician to play with him.
What cartoons do you watch?
We'll work on this.
We're working for this, remember? We need to pay attention. Pay attention.
So ask Hugh again. I don't think he heard you.
Tangible extinction procedure entails no longer providing access to the tangible item or activity the patient is attempting to obtain by engaging in problem behavior.
|The Wrong Way (Reinforcement)|
|Steven is given a piece of a cracker.||⇨||Steven cries.||⇨||Steven gets whole cracker.|
|The Right Way (Extinction)|
|Steven is given a piece of a cracker.||⇨||Steven cries.||⇨||Steven has a piece of a cracker.|
In the wrong way example, Steven is given the whole cracker (reinforcer).
In the right way example, Steven does not receive the whole cracker (reinforcer not delivered). We would also combine this with an intervention to teach Steven how to appropriately ask for a cracker, for example, using his PECS cards.
From a procedural standpoint, escape extinction is the continued presentation of a demand when the problem behavior occurs. It involves no longer allowing the patient to escape or “get out of” complying with demands contingent on problem behavior. Essentially, the patient is learning that engaging in inappropriate behavior doesn’t get them out of non-preferred tasks or situations.
|The Wrong Way (Reinforcement)|
|Yulia is given a math worksheet.||⇨||Yulia tears up her math worksheet.||⇨||Yulia does not have to do her math worksheet.|
|The Right Way (Extinction)|
|Yulia is given a math worksheet.||⇨||Yulia tears up her math worksheet.||⇨||Another math sheet is presented.|
In the wrong way example, Yulia is allowed to escape from doing the math worksheet (reinforcer).
In the right way example, Yulia is not allowed to escape doing the math worksheet (reinforcer not delivered). We would also combine this with an intervention to teach Yulia how to ask for a break from or help with completing the task, possibly using a break or help card.
|Mom says "Put on your shoes."||⇨||Steven hits his mom.||⇨||???|
This should only be used when instructed by the BCBA and using the least amount of physical contact as possible. We should never block the patient’s body parts or senses (hold their arms, cover their ears or eyes, etc.).
Response blocking can also be identified as a positive punishment procedure if not withholding the functional reinforcer; the BCBA should carefully consider the risks and benefits of this procedure and closely monitor its implementation. Sensory extinction only occurs if the patient can engage in the behavior without contacting the sensory stimulation.
Automatic extinction procedure involves blocking the source of automatic reinforcement hypothesized to be maintaining the problem behavior. A more common term you might see in the BIP is response blocking.
Depending on the patient’s problem behavior, response blocking could involve requiring the patient to wear a helmet, gloves, or other device. It could also involve physically blocking the patient from engaging in the response (e.g., blocking a patient from mouthing objects).
It is important to note that we never completely block a patient from being able to move or sense something.
EXAMPLEElan flips the light switch in the living room on and off for visual stimulation. This has created problems because the change in lighting causes severe migraines for his caregiver. The BCBA implements sensory extinction by removing the light bulb in the living room. Elan switches the light on and off, but there is no change in the environment, so he stops playing with the light switch in the living room. Of course, Elan is taught that he can switch the lights on and off in a different room during specific times when he requests "lights."
When beginning to implement extinction, we may see an extinction burst, which is an initial increase in the frequency or intensity of the behavior.
EXAMPLEIn the past, people gave Trent tangible reinforcers such as candy when he cried. When the behavior technician and caregivers begin to implement extinction, initially, Trent cries louder and begins to throw tantrums, falling on the floor and kicking. Nevertheless, if they continue to consistently use extinction, Trent will stop crying in these kinds of situations.
After extinction has occurred, we may see a spontaneous recovery, which is when a behavior reappears after it was successfully placed on extinction.
EXAMPLEJan used to throw items to gain attention from his caregiver. Extinction was implemented and Jan no longer threw items to get attention. A few months passed and when Jan’s caregiver was on the phone, Jan began throwing items. If Jan’s caregiver continues to place throwing on extinction, the throwing will stop occurring in these types of situations.
Differential reinforcement provides different levels of reinforcement for different behaviors. Reinforce desired behavior and do not reinforce (place on extinction) undesired behavior. Behaviors that receive reinforcement will increase and behaviors that receive no reinforcement will decrease.
There are three types of differential reinforcement that we will cover in this challenge:
The BIP will specify the time interval that the patient has to go without engaging in the problem behavior to receive a reinforcer. At the end of the time interval, the reinforcer is delivered for any other behavior occurring besides the problem behavior.
An interval of time is selected that is reasonable for the patient to refrain from the behavior. If the challenging behavior occurs, reinforcement is not given at the end of the interval:
EXAMPLEA patient who engages in object mouthing could be on a DRO. The BCBA may say if the patient goes five minutes without mouthing an object, the patient should get access to a reinforcer, such as iPad time.
EXAMPLEif a behavior occurs every fifteen minutes, the DRO interval would be set for every ten minutes. If the patient engaged in the challenging behavior (hitting) during the ten-minute interval, they would not receive the reinforcer (candy) at the end.
You're doing so good.
You sure did, Max. Would you like a Chex? Awesome. Nice job. Now get one Chex. One chex. Nice job. Is it good?
He got two.
It is best when the new appropriate response produces the same reinforcing outcome that the old inappropriate response produced. Sometimes the replacement behavior is a form of communication (this is called Functional Communication Training) that involves essentially asking for the reinforcer (attention, a toy, a break, etc.).
The BIP will specify the alternative, replacement behavior that you should reinforce.
EXAMPLEScreaming and crying does not receive reinforcement. Asking for a break does receive reinforcement.
What do you do if the patient engages in the alternative response or communicates appropriately with the FCT response, but engages in problem behavior at the same time?
You should ignore the alternative or communicative response at this time, and wait until the patient engages in the desired response without engaging in problem behavior. If this is happening often, your BCBA may choose to use the last differential reinforcement procedure that will be discussed (DRI).
|Problem Behavior (Extension of Undesired Behavior)|
|Steven has no crackers and no peanut butter.||⇨||Steven whines and cries.||⇨||Steven has no crackers and no peanut butter.|
|Functional Communication (Reinforcement of Desired Behavior)|
|Steven has no crackers and no peanut butter.||⇨||Steven says "I want peanut butter."||⇨||Steven gets crackers and peanut butter.|
In this example, our patient, Steven, is sitting at the table. His behavior technician has removed crackers and peanut butter from snack time.
Om, nom. Nom, nom. Nom.
Do you not want it? Nom nom?
Jump around and say, I don't want banana.
OK. Tell me what you want, then.
In this case, you reinforce a behavior that makes it physically impossible for the inappropriate behavior to occur at the same time. The alternative behavior is incompatible with the problem behavior.
EXAMPLEAn incompatible, alternative behavior for a patient who engages in hand mouthing is folded hands.
Using a DRI procedure, the incompatible behavior specified in the BIP should be reinforced using the reinforcement schedule specified in the BIP.
EXAMPLESuppose a problem behavior is a patient grinding their teeth. A behavior that they cannot do at the same time (incompatible) is using a chew tube. So the patient is taught to use a chew tube.
Thanks for standing up. You've got to look at the paper.
Note, in the DRA example, it was possible to say “I want cracker” and whine simultaneously. Thus, the two behaviors were not incompatible. However, if the patient’s problem behavior had been hitting to get crackers and the alternative behavior had been signing “cracker” to get a cracker, this would have been an example of DRI in that both hitting and signing cannot occur simultaneously. They are said to be “incompatible” with one another.
In addition, this example involves the use of an appropriate alternative response that involves communicating that the patient wants the reinforcer. Thus, this incompatible behavior is also an example of Functional Communication Training (FCT).
What you will do if he does start to have a tantrum? What is this called?
You might wait for him to stop his tantrum and then prompt him to say, "Help me."
Keep in mind that it is not correct to prompt Tommy to say, “Help me,” while Tommy is having a tantrum. This is incorrect because if you help him during the tantrum, you are not putting the tantrum on extinction. And, though you are teaching an appropriate alternative response (asking for help), you are still reinforcing the whining by offering him help.
Results show that when an appropriate alternative behavior is taught but the inappropriate behavior is still reinforced, the patient learns the new appropriate response but also continues to use the old, inappropriate response.
Therefore, the correct thing to do in this case is called extinction.
Differential reinforcement can also intersect with token economies. Deliver tokens contingent on the target behavior and exchange tokens for the backup reinforcer:
When the target behavior occurs, the BCBA may instruct the behavior technician to redirect the patient to engage in a more appropriate behavior. This can occur by providing an instruction in a neutral tone and physically prompting the patient to transition to the appropriate behavior or activity. This is often combined with response blocking or response interruption.
EXAMPLEAlec sometimes engages in tantrum behavior when he sees a tablet or cellphone. As the behavior technician transitions to the playground, Alec sees a peer playing on a tablet and begins to have a tantrum. The behavior technician redirects Alec to put his shoes on by instructing him to “Put shoes on” and pointing towards his shoes. When Alec’s shoes are on, they continue outside.
All done. We'll watch him later, OK? We'll watch him later. We'll watch him later.
No, we'll watch it later.
We have to-- Jack, settle down. Settle down. We'll watch computer later.
It's not going anywhere.
Hey, should we go jump on the bed somewhere?
What do you want to do? Should we play [INAUDIBLE].
Should we go see Daddy?
Ready? Oh, oh, oh! Uh oh! Just kidding! Should he go?
Ah! Just kidding! Ah! Oh! You got him! You--
If you're happy and you know it, clap your hands. If you're happy and you know it, clap your hands. Yay! If you're happy and you know it, then your face will surely show it. If you're happy and you know it--
Clap your hands, stomp your feet, say hooray.
There are several different types of time out procedures. Some are aversive and potentially dangerous. Because of this, we are going to focus on non-exclusionary time-out.
Non-exclusionary time-out involves the immediate removal of access to a socially mediated positive reinforcer contingent on challenging behavior, which results in a decreased frequency of that response. This does not always mean taking a patient out of a preferred situation.
Note, time out should never involve closing a patient into a room as this would be considered exclusionary and an aversive, potentially harmful procedure.
|Jodi plays on a playground.||⇨||Jodi hits Kevin.||⇨||Access to playground is removed.|
In this example of non-exclusionary time-out, Jodi was playing on the playground and hit a peer. Access to the playground was removed. The playground is a socially mediated positive reinforcer and access was lost contingent on the challenging behavior (hitting).
This does not mean removing Jodi from the situation and sending her inside alone, rather her access to the playground equipment and peers would be removed and she would be asked to sit on a bench where she could still be monitored by the teacher. This should not be included in the BIP until the BCBA has exhausted all reinforcement procedures.
Contingent on the frequency with which the challenging behavior occurs, a specific amount of a reinforcer is removed. This should result in the reduction of the occurrences of the challenging behavior in the future, following these parameters:
We often use token economies, stickers, or points during sessions so our patients can earn and then trade them in later for backup reinforcers, such as favorite toys, foods, or activities.
Sometimes the BCBA will also implement a response cost, meaning the patient would lose a token, sticker, or point for engaging in the challenging behavior. This should not be included in the BIP until the BCBA has exhausted all reinforcement procedures.
|Johnny has five candies.||⇨||Johnny screams.||⇨||Johnny loses one candy.|
When inappropriate behavior occurs, the patient is required to engage in effortful behavior related to fixing the damage caused by the behavior. There are two types of overcorrection procedures, positive practice and restitutional overcorrection:
|Josie wants to go swimming.||⇨||Josie runs at the pool.||⇨||Josie has to practice walking to the water ten times.|
|Nick's mother asks him to make his bed.||⇨||Nick throws a book on the floor.||⇨||Nick has to pick up the book he threw and all other books on the floor.|
In the positive practice example, Josie engaged in an inappropriate behavior (running at the pool). She has to repeat a correct form of the behavior of getting to the pool, walking, ten times.
In the restitutional example, Nick engaged in inappropriate behavior (throwing the book on the floor). He had to repair the damage to his room by picking up the book and then return his room to a better state than it was before the problem behavior by picking up all of the other books that were on the floor.
These interventions should not be included in the BIP until the BCBA has exhausted all reinforcement procedures.
Here is an example of the consequence interventions portion of a BIP for Josiah in the scenario from the end of the last few tutorials.
|Consequence Intervention Plan||Description|
|Functional Communication (tangible).|
-Physically block each occurrence of the behavior. Make sure to avoid injuring yourself or Josiah while blocking.
-Also, DO NOT provide any more attention than the absolute minimum reaction necessary to block the behavior. In addition, be aware that response blocking is NOT physical restraint. Do not restrain the Josiah.
-Prevent Josiah from gaining access to preferred items/activities in any way when he engages in the target behavior.
-Do not negotiate or decrease the delay to a preferred item/activity or increase the amount of preferred item/activity Josiah is already getting as a reaction to the target behavior.
-If possible, act as though the behavior did not occur. If some reaction is absolutely necessary, avoid eye contact and give the minimum reaction necessary to keep people and property safe.
|Functional Communication (escape)||-When Josiah requests a break, help, or a decrease in the amount of demands being placed on him, grant the request immediately. The duration of breaks from work will be 3 minutes.|
|Differential Reinforcement of Compliance||
-Each time Josiah completes a request, give immediate access to a break from work and/or a positive reinforcer. The duration of breaks from work will be 3 minutes.
-The positive reinforcers that will be delivered will be specified by Josiah's full-sentence mands.
-The number of requests that are required to be completed in order to earn reinforcement will be gradually increased from 1 to 3. The criterion for the number of requests to be increased by 1 will be successful completion of a demand.
-Escape from tasks/demands / requests will not be given when the Josiah engages in the challenging behavior.
-The same amount, difficulty, and rate of demands must continue, regardless of the behavior. Demands may not be postponed or negotiated in any way when Josiah is engaging in the challenging behavior.
Below is the full PDF again for reference.
Source: FROM VOLLMER T.R., & IWATA B.A. (1992). DIFFERENTIAL REINFORCEMENT AS A TREATMENT FOR BEHAVIOR DISORDERS: PROCEDURAL AND FUNCTIONAL VARIATIONS. RESEARCH IN DEVELOPMENTAL DISABILITIES, 13, 393-417.