The long-term effects of functional communication training in home settings

Report of the ABAI Task Force on Contingent Electric Skin Shock

As a task force appointed by the Executive Council of the Association for Behavior Analysis International (ABAI), we investigated the clinical use of contingent electric skin shock (CESS) in behavior analytic treatments for severe problem behavior. We studied how CESS is used in contemporary behavior analysis, reinforcement-based alternatives to CESS, and current ethical and professional guidelines for applied behavior analysts. We recommended that ABAI uphold clients' right to receive CESS when it is restricted to extreme cases and used under rigorous professional and legal oversight. Our recommendation was rejected by a vote of the full members of ABAI, who instead endorsed an alternative recommendation, developed by members of the Executive Council, that opposed the use of CESS under any condition. Here we present for the record our report and initial recommendations, the formal statement that was rejected by the members of ABAI, and the statement that was endorsed.

A systematic review of the correspondence between descriptive assessment and functional analysis

Clinicians report that they often rely on descriptive assessments when developing behavior-reduction plans despite literature suggesting that functional analysis is the most rigorous assessment method. Further, research comparing the outcomes of descriptive assessments and functional analyses is mixed, with some studies showing low correspondence and others showing high correspondence. Such persistent use of descriptive assessments suggests that they may yield useful information despite inconsistent correspondence with functional analyses. A more fine-grained analysis of the relation between descriptive assessments and functional analyses may elucidate variables affecting their utility. We conducted a review of 48 studies that included descriptive assessments and functional analyses and evaluated several measures of correspondence between each pair of assessments. Results indicated that descriptive assessments had exact correspondence with functional analyses in 50% of comparisons. Results also suggested that descriptive assessments were more likely to accurately identify and predict the absence of a function relative to the presence of a function and that structured descriptive assessments were more likely to accurately predict functions.

Effectiveness of a Brief Functional Analysis and Functional Communication Training Conducted Through Telehealth

This study evaluates the effectiveness of a brief functional analysis and functional communication training conducted via telehealth. Three interventionist-child dyads took part in the study including one speech and language pathologist and two school teaching assistants, each working with one child with autism spectrum disorder. Interventionists were trained using didactic training to implement a brief functional analysis as well as synchronous coaching from a BCBA^® to implement functional communication training. A multiple baseline across participants design was utilised to evaluate if interventionists could implement functional communication training to decrease challenging behaviours that included aggression, elopement and disruption. Sessions concluded earlier than planned due to school closures mandated by the COVID-19 outbreak for two of the three participants; however, existing data provide evidence that telehealth is a valid model for enabling clinicians to work in collaboration with school personnel to effectively deliver assessment and intervention procedures remotely via telehealth.

Using Functional Communication Training to Reduce Self-Injurious Behavior for Individuals with Autism Spectrum Disorder

Children with autism spectrum disorders (ASD) have a high risk of developing self-injurious behavior (SIB), which is often a result of deficits in communication skills. The use of functional communication training (FCT) to address SIB maintained by negative reinforcement among children with ASD is supported by an emerging trend of behavioral research. The purpose of this study was to examine the effects of FCT on the SIB of children with ASD and to find out if the results would be maintained during periods of nonreinforcement. The results indicated significant reduction in SIB for all three participants and maintained for over two weeks following the withdrawal of the intervention. However, resurgence of SIB occurred when extinction was implemented for all participants.

Parent Ratings of Generalized and Indirect Effects of Functional Communication Training for Children with Autism Spectrum Disorder

Functional communication training (FCT) is a behavioral treatment that has been shown to reduce problem behavior and increase appropriate communication in young children with autism spectrum disorder (ASD). In this study, we assessed the effects of FCT on targeted and nontargeted problem behaviors outside of the training context, as well as parent stress, for 30 young children with ASD and their parents. Indirect measures of generalization treatment effects were administered prior to and following FCT treatment delivered via telehealth. Children demonstrated significant improvement on both targeted (measured via observation) and nontargeted (measured via checklist) problem behaviors, both within and outside of the training context, and parent stress was significantly reduced following treatment. These results suggest that the impact of FCT may extend beyond the training context for both the children being treated and the parents delivering treatment, even when generalization is not specifically programmed for during treatment.

A comparison of brief and extended session duration functional analyses

Many behavior analysts do not conduct a functional analysis (FA) prior to treatment in a clinical setting (e.g., Roscoe et al., 2015). When asked for an explanation, respondents commonly report that an FA is too time consuming. One way to address this perceived constraint is to evaluate the utility of an abbreviated FA with 5-min session durations. In the current study, 2 independent FAs, 1 with 5-min sessions and 1 with 10-min sessions, were conducted for the problem behavior of 5 individuals diagnosed with autism spectrum disorder (ASD). For all participants, the 5- and 10-min session duration FAs yielded the same identified function of problem behavior: escape from demands. A brief differential reinforcement of alternative behavior (DRA) analysis was subsequently conducted and found to be effective at decreasing problem behavior and increasing an appropriate communication response across participants. These findings demonstrate the utility of conducting an FA using briefer session durations followed by a brief DRA analysis.

A Systematic Review of Caregiver-Implemented Functional Analyses

The purpose of this systematic review was to systematically locate and analyze the research on caregiver-implemented functional analyses and subsequent function-based interventions. We included 36 studies and examined multiple features of the studies, including participant demographics, functional analysis characteristics, intervention characteristics, procedural fidelity, risks of bias, and social validity. Overall, the studies showed that caregivers were able to implement functional analyses that yielded differential responding, although few studies reported procedural fidelity data. Caregivers were also able to implement function-based interventions that led to socially significant changes in challenging behavior. Implications for practice and future research are discussed.

Remote Coaching of Caregivers Via Telehealth: Challenges and Potential Solutions

The use of telehealth technologies to provide clinical services to families of children with autism and other developmental disabilities is a rapidly growing area of research. In particular, remote training of caregivers via video conferencing appears to be a promising approach for disseminating behavior-analytic interventions (Neely, Rispoli, Gerow, Hong, Hagan-Burke, 2017; Tomlinson, Gore, & McGill, 2018). Although remote training offers a number of advantages, it brings a variety of challenges that are unique to this modality. The field would benefit from information on problems that practitioners may encounter when providing these services and how to train caregivers effectively. In this paper, we report on the experiences of 18 practitioners who provided caregiver training via telehealth from four different sites across a 4-year period. We describe a variety of technical and clinical issues that arose during service delivery, suggest strategies for preventing and remediating problems, and include case descriptions and data to illustrate our experiences. This information may help prepare practitioners to deliver telehealth services and guide further research in this area.

Effectiveness and acceptability of parent training via telehealth among families around the world

Teaching parents to conduct functional analyses and to implement functional communication training is an efficacious approach for treating socially maintained problem behavior (Derby et al., 1997). Research has found that delivering this assessment and intervention package via telehealth technologies is efficient and acceptable to caregivers in the United States (Wacker et al., 2013b). We replicated this work with families residing in rural and urban areas of eight countries. Two behavior therapists located in the United States conducted appointments in the participants' native languages, using interpreters as needed. Parent-implemented functional analyses and treatment with functional communication training were highly effective in reducing problem behavior in children diagnosed with autism. Furthermore, parents rated the procedures as acceptable and indicated that the treatment would be effective with their children. These findings indicate that telehealth technologies are a viable option for clinicians to provide behavior analysis services to families around the world.

Implementing Aided Augmentative Communication Systems With Persons Having Complex Communicative Needs

Augmentative and alternative communication (AAC) systems can support communication skills for people with significant developmental disabilities who experience complex communication needs (CCNs). There is a need to tailor best practices in AAC assessment and intervention to create individualized communication systems with this population. In this article, we outline the important components of AAC systems that can be implemented in authentic settings. However, given the limited evidence on AAC interventions specific to people with CCNs, we also identify some priority areas for future inquiry. Among these involve strategies to enhance decision making regarding (a) matching communication mode(s) to learner skills and contextual demands, (b) identifying communicative opportunities and obligations, (c) individualizing aided communication display features, (d) selection of vocabulary specificity, and (e) considering dosage parameters needed to acquire and maintain a communicative repertoire. In addition, we briefly discuss the use of telehealth to enhance intervention capability.

Evaluation of the accuracy, reliability, efficiency, and acceptability of fast forwarding to score problem behavior

Technological advances have allowed professionals to obtain extended recordings of caregiver-client interactions in natural settings, but scoring recorded video at normal speed to identify instances of low-rate problem behavior is impractical in terms of scoring time. Fast forwarding is a continuous measurement system in which all seconds of an observation are viewed at a speed faster than normal. In Study 1, we evaluated whether three groups of five observers could discriminate problem behavior at three fast-forwarding speeds across 10-min observations. We analyzed the efficiency of using fast forwarding compared to continuous scoring, and interobserver agreement across the fast-forwarding speeds. In Study 2, we compared the accuracy, efficiency, and social acceptability of fast forwarding (3.5x) and momentary time sampling (3.5 s) across 90-min observations. Results support the use of 3.5x fast forwarding as a viable measurement system of improving the practicality of scoring problem behavior from video.

Generalization and maintenance of functional communication training for individuals with developmental disabilities: A systematic and quality review

BACKGROUND

Functional communication training (FCT) is considered an evidence-based practice for treating problem behavior in individuals with developmental disabilities (e.g. autism, intellectual disabilities, down syndrome, etc.). However, there is little known on how to sustain behavioral change following FCT interventions. This systematic and quality review synthesizes the current literature base evaluating the maintenance and generalization of behavioral effects following FCT.

METHOD

A systematic review identified 37 studies that met the pre-set inclusion criteria. Those studies were summarized in terms of: (a) generalization dimension, (b) generalization assessment design, (c) maintenance assessment design, (d) maintenance and generalization teaching strategy, and (e) latency to maintenance probes. All studies employed single-case research designs and were evaluated using the What Works Clearinghouse pilot single-case research standards (Kratochwill et al., 2013) as adapted by Maggin, Briesch, and Chafouleas (2013). Maintenance and generalization data were evaluated using a researcher-developed rubric based on the WWC standards.

RESULTS AND DISCUSSION

Results indicate that 30 studies met standards or met standards with reservations while only six studies also met all of the maintenance and generalization standards. Of the six studies, five did not implement any additional strategies beyond the contacting natural contingencies that is inherent in the FCT intervention. Implications for future research and practice are discussed.

Predictive validity and efficiency of ongoing visual-inspection criteria for interpreting functional analyses

Prior research has evaluated the reliability and validity of structured criteria for visually inspecting functional-analysis (FA) results on a post-hoc basis, after completion of the FA (i.e., post-hoc visual inspection [PHVI]; e.g., Hagopian et al., 1997). However, most behavior analysts inspect FAs using ongoing visual inspection (OVI) as the FA is implemented, and the validity of applying structured criteria during OVI remains unknown. In this investigation, we evaluated the predictive validity and efficiency of applying structured criteria on an ongoing basis by comparing the interim interpretations produced through OVI with (a) the final interpretations produced by PHVI, (b) the authors' post-hoc interpretations (PHAI) reported in the research studies, and (c) the consensus interpretations of these two post-hoc analyses. Ongoing visual inspection predicted the results of PHVI and the consensus interpretations with a very high degree of accuracy, and PHAI with a reasonably high degree of accuracy. Furthermore, the PHVI and PHAI results involved 32 FA sessions, on average, whereas the OVI required only 19 FA sessions to accurately identify the function(s) of destructive behavior (i.e., a 41% increase in efficiency). We discuss these findings relative to other methods designed to increase the accuracy and efficiency of FAs.

Communication Intervention for Young Children with Severe Neurodevelopmental Disabilities Via Telehealth

Young children with neurodevelopmental disorders such as autism spectrum disorders (ASD) and Rett syndrome often experience severe communication impairments. This study examined the efficacy of parent-implemented communication assessment and intervention with remote coaching via telehealth on the acquisition of early communication skills of three young children with ASD (2) and Rett syndrome (1). Efficacy of the intervention was evaluated using single-case experimental designs. First, functional assessment was used to identify idiosyncratic/potentially communicative responses and contexts for each child. Next, parents implemented functional communication training (FCT). All of the children acquired the targeted communication responses. The findings support the efficacy of telehealth as a service delivery model to coach parents on intervention strategies for their children's early communication skills.

Basing assessment and treatment of problem behavior on behavioral momentum theory: Analyses of behavioral persistence

The connection, or bridge, between applied and basic behavior analysis has been long-established (Hake, 1982; Mace & Critchfield, 2010). In this article, we describe how clinical decisions can be based more directly on behavioral processes and how basing clinical procedures on behavioral processes can lead to improved clinical outcomes. As a case in point, we describe how applied behavior analyses of maintenance, and specifically the long-term maintenance of treatment effects related to problem behavior, can be adjusted and potentially enhanced by basing treatment on Behavioral Momentum Theory. We provide a brief review of the literature including descriptions of two translational studies that proposed changes in how differential reinforcement of alternative behavior treatments are conducted based on Behavioral Momentum Theory. We then describe current clinical examples of how these translations are continuing to impact the definitions, designs, analyses, and treatment procedures used in our clinical practice.

Conducting Functional Communication Training in Home Settings: A Case Study and Recommendations for Practitioners

We coached a parent to conduct functional analysis and functional communication training (FCT) procedures in her home to reduce the destructive behavior displayed by her 2-year-old son. Descriptive assessment information and functional analysis results suggested that destructive behavior was maintained by escape from demands. After conducting a series of baseline probes, the parent implemented an FCT program to teach her son to comply with designated task requests and to mand for a break to play. Results showed that destructive behavior decreased and manding and independent task completion increased during FCT. Positive intervention outcomes were maintained for 1 year. Results are discussed with respect to developing an FCT program that is both efficient and acceptable for parents to implement in their homes.

The Long-Term Effects of Functional Communication Training Conducted in Young Children's Home Settings

This article describes the results of a series of studies that involved functional communication training (FCT) conducted in children's homes by their parents. The 103 children who participated were six years old or younger, had developmental delays, and engaged in destructive behaviors such as self-injury. The core procedures used in each study were functional analyses (FA) and FCT conducted by parents with coaching by the investigators. The overall results of the projects showed that the FA plus FCT intervention package produced substantial reductions in destructive behavior (M = 90%), which were often maintained following treatment. In terms of behavioral momentum theory, these results suggest that analyses of behavioral persistence provide an explicit technology of maintenance.

A Descriptive Evaluation of Long-Term Treatment Integrity

The validity of selecting treatment contingencies on the basis of the results obtained through functional analysis is well documented. However, a number of second-generation questions have emerged: For example, what are the parameters required to achieve desired treatment outcomes? More specifically, what is the degree of treatment integrity needed for the successful reduction of problem behavior? This study had two purposes: to describe the relationship between treatment integrity levels and treatment effectiveness and to highlight the importance of reporting the treatment integrity in outcome-based research. The results indicate that a high level of treatment integrity is required for treatment success. Furthermore, the authors found that very low levels of integrity may be required for behavioral reduction procedures (i.e., extinction) if high levels of reinforcement are provided.

Agreement of Function Across Methods Used in School-Based Functional Assessment With Preadolescent and Adolescent Students

As we begin to apply functional assessment procedures in mainstream educational settings, there is a need to explore options for identifying behavior function that are not only effective but efficient and practical for school personnel to employ. Attempts to simplify the functional assessment process are evidenced by the development of informant assessment measures (e.g., interviews, rating scales). In this study, the agreement (i.e., on relative rankings and primary function) across sources of information regarding behavior function was examined for 19 students in a middle school setting. These measures included teacher ratings, student ratings, student interviews, observer ratings, and conditional probabilities. In addition, for 1 student, whether information obtained through these sources was consistent with that obtained through a brief analog analysis of function was examined. Results indicated low agreement regarding rank order of behavior function and on primary function across all sources of information.

Therapist and setting influences on functional analysis outcomes

Functional analyses (FAs) of problem behavior typically are conducted in controlled settings to minimize potential sources of confounding. Several studies have reported that results of FAs conducted in controlled settings occasionally differ from those conducted under more naturalistic conditions, although little is known about factors that may contribute to the different outcomes. We examined correspondence between FAs conducted by staff in a clinic and those conducted either by caregivers as therapists or in the home setting. If results of the 2 analyses were dissimilar, we conducted further analyses to identify variables responsible for the different outcomes. Results showed that, in most cases, correspondence of function was observed across familiar and unfamiliar stimuli. Results are discussed in terms of implications for research and clinical practice for the evaluation of problem behavior.

Conducting Functional Communication Training via Telehealth to Reduce the Problem Behavior of Young Children with Autism

Functional communication training (FCT) was conducted by parents of 17 young children with autism spectrum disorders who displayed problem behavior. All procedures were conducted at regional clinics located an average of 15 miles from the families' homes. Parents received coaching via telehealth from behavior consultants who were located an average of 222 miles from the regional clinics. Parents first conducted functional analyses with telehealth consultation (Wacker, Lee, et al., in press) and then conducted FCT that was matched to the identified function of problem behavior. Parent assistants located at the regional clinics received brief training in the procedures and supported the families during the clinic visits. FCT, conducted within a nonconcurrent multiple baseline design, reduced problem behavior by an average of 93.5%. Results suggested that FCT can be conducted by parents via telehealth when experienced applied behavior analysts provide consultation.

Conducting functional analyses of problem behavior via telehealth

Behavior consultants conducted functional analyses (FAs) via telehealth with 20 young children with autism spectrum disorders between the ages of 29 and 80 months who displayed problem behavior and lived an average of 222 miles from the tertiary hospital that housed the behavior consultants. Participants' parents conducted all procedures during weekly telehealth consultations in regional clinics located an average of 15 miles from the participants' homes. Behavior consultants briefly trained parent assistants to provide on-site support for families during consultations. FAs completed within a multielement design identified environmental variables that maintained problem behavior for 18 of the 20 cases, and interrater agreement averaged over 90%. Results suggested that behavior analysts can conduct FAs effectively and efficiently via telehealth.

Extended Analysis of Empirical Citations with Skinner's Verbal Behavior: 1984-2004

The present paper comments on and extends the citation analysis of verbal operant publications based on Skinner's Verbal Behavior (1957) by Dymond, O'Hora, Whelan, and O'Donovan (2006). Variations in population parameters were evaluated for only those studies that Dymond et al. categorized as empirical. Preliminary results indicate that the majority of empirical research in the area of verbal behavior has been conducted with the younger developmentally disabled population and has focused on verbal operants from the introductory chapters of Skinner's book. It is clear that Verbal Behavior has influenced empirical research over the past 50 years. We believe, however, that there are many underdeveloped research areas originating from Verbal Behavior that have not yet been addressed. Suggestions for extended areas of research are provided.

An evaluation of persistence of treatment effects during long-term treatment of destructive behavior

Eight young children who displayed destructive behavior maintained, at least in part, by negative reinforcement received long-term functional communication training (FCT). During FCT, the children completed a portion of a task and then touched a communication card attached to a microswitch to obtain brief breaks. Prior to and intermittently throughout FCT, extinction probes were conducted within a withdrawal design in which task completion, manding, and destructive behavior were placed on extinction to evaluate the relative persistence of appropriate and destructive behavior over the course of treatment. FCT continued until appropriate behavior persisted and destructive behavior failed to recur at baseline levels during extinction probes. The completion of FCT was followed by four challenges to the persistence of treatment effects conducted within mixed- or multiple-schedule designs: (a) extended extinction sessions (from 5 to 15 min), (b) introduction of a novel task, (c) removal of the microswitch and communication card, and (d) a mixed schedule of reinforcement in which both appropriate and destructive behavior produced reinforcement. The results showed that although FCT often resulted in quick reductions in destructive behavior and increases in appropriate behavior, destructive behavior often recurred during the extinction probes conducted during the initial treatment. When the effects of treatment persisted during the extinction probes, the remaining challenges to treatment effects resulted in only mild to moderate disruptions in behavior. These results are consistent with the quantitative predictions of behavioral momentum theory and may provide an alternative definition of maintenance as constituting behavioral persistence.

An analysis of functional communication training as an empirically supported treatment for problem behavior displayed by individuals with intellectual disabilities

This paper examines the literature on the use of functional communication training (FCT) as a treatment for problem behavior displayed by individuals with intellectual disabilities (ID). Criteria for empirically supported treatments developed by Divisions 12 and 16 of the American Psychological Association (Kratochwill & Stoiber, 2002; Task Force, 1995) and adapted by Jennett and Hagopian (2008) for evaluation of single-case research studies were used to examine the support for FCT. Results indicated that FCT far exceeds criteria to be designated as a well-established treatment for problem behavior exhibited by children with ID and children with autism spectrum disorder, and can be characterized as probably efficacious with adults.

Indirect Effects of Functional Communication Training on Non-Targeted Disruptive Behavior

The purpose of this study was to evaluate the effects of functional communication training (FCT) on the occurrence of non-targeted disruptive behavior. The 10 participants were preschool-aged children with developmental disabilities who engaged in both destructive (property destruction, aggression, self-injury) and disruptive (hand flapping, spinning in circles, shrill laughter, screaming, crying) behaviors. Only destructive behavior was targeted for the functional analyses and FCT, but data were also collected on disruptive behaviors. All procedures were conducted in the participants' homes by their mothers with investigator coaching. Phase 1 consisted of conducting a functional analysis within a multielement design. Phase 2 consisted of conducting FCT with demand fading and repeated extinction baselines within a reversal design. Single-case data are provided for 3 participants, and summary data are provided for all 10 participants. Results of phase 1 showed that all participants' destructive and disruptive behavior was maintained, at least in part, by negative reinforcement. Results of phase 2 showed that both destructive behavior and non-targeted disruptive behavior occurred at lower levels during FCT when compared to the functional analysis demand condition and baseline conditions, suggesting that FCT was effective in decreasing both target destructive behavior and non-targeted disruptive behaviors.

A review of empirical support for differential reinforcement of alternative behavior

Differential reinforcement of alternative behavior (DRA) is one of the most common behavior analytic interventions used to decrease unwanted behavior. We reviewed the DRA literature from the past 30 years to identify the aspects that are thoroughly researched and those that would benefit from further emphasis. We found and coded 116 empirical studies that used DRA, later grouping them into categories that met APA Division 12 Task Force criteria. We found that DRA has been successful at reducing behaviors on a continuum from relatively minor problems like prelinguistic communication to life-threatening failure to thrive. DRA with and without extinction is well established for treating destructive behavior of those with developmental disabilities, and to combat food refusal.

Analysis of Multiple Manding Topographies during Functional Communication Training

We evaluated the effects of reinforcing multiple manding topographies during functional communication training (FCT) to decrease problem behavior for three preschool-age children. During Phase 1, a functional analysis identified conditions that maintained problem behavior for each child. During Phase 2, the children's parents taught them to request positive reinforcers (attention or toys) via vocal manding, manual signing, or touching a picture/word card with or without a microswitch recording device. A non-concurrent multiple-baseline design across children was used to evaluate FCT outcomes. Results showed that problem behavior decreased for all three children. Results also indicated that the children initially used multiple manding topographies but displayed a preference for vocal manding over time.

General outcome measures for verbal operants

A general outcome measure (GOM) can be used to show progress towards a long-term goal. GOMs should sample domains of behavior across ages, be sensitive to change over time, be inexpensive and easy to use, and facilitate decision making. Skinner's (1957) analysis of verbal behavior may benefit from the development of GOM. To develop GOM, we conducted a review of the literature on mands, tacts, echoics, and intraverbals. The four areas reviewed included (a) an examination of the participant's response form (i.e., vocal or nonvocal), (b) the type of prompt used, (c) types of materials used, and (d) timing of responses or sessions. Based on the review of the literature, we developed GOM for mands and tacts. This paper attempts to bridge the concept of GOMs with Skinner's analysis of verbal behavior.

Empirical Applications of Skinner's Analysis of Verbal Behavior with Humans

In Verbal Behavior,Skinner (1957) provided a conceptual framework and taxonomy for the controlling variables of language that defined independent verbal operants by their functional relations to antecedents and consequences (rather than by topography or meaning). Although professional interest in this area has recently increased within the behavior analytic community, Skinner's conceptual framework may not yet have fully impacted the experimental literature. This quantitative review of the literature examined the studies on verbal behavior that were empirical in nature, concerned with human verbal behavior, and addressed at least one verbal operant (e.g., mand, tact, echoic, autoclitic, and/or intraverbal behavior) within the experiment. The results of this review suggest that a growing body of research exists to support many of the tenets of Skinner's conceptualization and taxonomy but many areas of verbal behavior research have yet to be addressed. Continued research in this area is crucial for the development and implementation of effective verbal behavior interventions for people with disabilities.

Citation Analysis of Skinner's Verbal Behavior: 1984-2004

The present study undertook an updated citation analysis of Skinner's (1957)Verbal Behavior. All articles that cited Verbal Behavior between 1984 and 2004 were recorded and content analyzed into one of five categories; four empirical and one nonempirical. Of the empirical categories, studies that employed a verbal operant from Skinner's analysis were assigned to either basic, applied, or observational categories. Empirical studies that did not employ a verbal operant were categorized as other-empirical. The total number of citations remained stable across the review period and averaged just over 52 per year. Of these, 80% were from nonempirical articles, 13.7% were from other-empirical articles, 4% were from applied articles, 1.4% were from basic articles, and 0.9% were from observational articles. An "obliteration" analysis was also conducted to identify articles that employed Skinner's verbal operant terms but did not cite Verbal Behavior. This analysis identified 44 additional articles, suggesting that a degree of obliteration had occurred in the half century since the publication of Verbal Behavior. In particular, the analysis suggests that the verbal operant of manding has sufficient presence in the applied empirical literature to render citation of Verbal Behavior redundant. Overall, Verbal Behavior continues to make an important contribution to the psychological literature.

Conditional use of a request for assistance

PURPOSE

To establish the conditional use of requests for assistance as an alternative to escape maintained challenging behaviour.

METHOD

The study involved a 12-year-old boy with a behaviour disorder. Experiment 1 involved the implementation of a reversal design comparing the learner's performance during "easy" and "difficult" addition problems. Experiment 2 involved the implementation of a quasi-experimental design to establish the conditional use of requests for assistance.

RESULTS

Conditional use of requests for assistance successfully competed with escape maintained challenging behaviour.

CONCLUSIONS

Our results suggest that for a newly acquired response to be displayed conditionally, two events must occur. First, the individual must learn the skill that has been associated with requests for assistance. Secondly, the contingencies must be such that reinforcement value is greater for an independent response than for a response that involves a request for assistance.

Contextualized behavioral support in early intervention for children with autism and their families

Parent education programs have become an effective mode of treatment delivery for teaching families effective behavioral strategies to manage challenging behavior in young children with autism. Functional assessment and functional communication training (FCT) are empirically validated procedures that have recently been introduced into parent education programming to help resolve challenging behaviors. The success of these procedures, however, is contingent on family members' ability to integrate them into the specific contexts in which challenging behaviors occur. Consequently, the application of these procedures in home settings necessitates consideration of the family context in the assessment and treatment planning process. A study is presented that investigated the use of information on family context (i.e., caregiving demands, family support, patterns of social interaction) to direct the assessment and intervention planning process. More specifically, information on family context was used to individualize behavioral support plans designed to support family use of functional communication training within important family routines. Through parent-investigator collaboration we individualized the manner in which functional communication training procedures were taught and implemented so they were contextually relevant. Utilizing a multiple baseline design, the challenging behaviors and functional communication of three children with autism were monitored across baseline, intervention (i.e., FCT, and contextulized FCT), and follow-up phases. Multiple routines for each participant were selected and monitored across all phases to evaluate changes in the dependent measures within training and generalization routines. A self-report questionnaire was administered intermittently to parents to determine if consideration of family context improved the "goodness of fit" of the functional communication training treatment packages across FCT and contextualized FCT intervention phases. Results from the study indicate that consideration of family context in the assessment and intervention planning process does not jeopardize and may contribute to the stability and durability of reductions in challenging behavior achieved with functional assessment and functional communication training procedures.

A modern behavioral perspective on child conduct disorder: integrating behavioral momentum and matching theory

It has been suggested that knowledge produced within the operant laboratory is of little or no use to clinicians. I argue, on the contrary, that laboratory science has provided clinicians with two general principles that may expand the focus of behavioral family therapy to incorporate a wide range of clinical interventions that have heretofore been considered nonbehavioral. These principles, matching theory and behavioral momentum, outline the relativity of reinforcement and the persistence of behavior in the absence of reinforcement, respectively. These principles make specific predictions concerning clinical interventions aimed not only at identified reinforcement contingencies, but also the context within which reinforcement contingencies are operative. This expanded behavioral formulation allows both the clinician and the researcher a framework for designing, implementing, and assessing techniques that target cognition, affect, and interpersonal relationships, as well as specific behaviors.

Treatment of maladaptive behavior in acquired brain injury: remedial approaches in postacute settings

This article describes remedial behavior therapy approaches for the treatment of maladaptive behavioral sequelae to an acquired brain injury (ABI). Remedial approaches are sophisticated and nonintrusive treatment strategies that involve teaching the individual skills or capacities to manage difficult life circumstances. Functional equivalence is one major category of remedial intervention and involves the determination of the behavioral function of the problem behavior and the teaching of an adaptive alternative response or skill cluster that provides the individual with efficient access to that function. Errorless remediation is a second category and entails teaching the individual to tolerate situations associated with problem behavior through hierarchical exposure to increasingly difficult conditions and reinforcement for successful management of those conditions.

Evaluating the effects of functional communication training in the presence and absence of establishing operations

We conducted functional analyses of aberrant behavior with 4 children with developmental disabilities. We then implemented functional communication training (FCT) by using different mands across two contexts, one in which the establishing operation (EO) that was relevant to the function of aberrant behavior was present and one in which the EO that was relevant to the function of aberrant behavior was absent. The mand used in the EO-present context served the same function as aberrant behavior, and the mand used in the EO-absent context served a different function than the one identified via the functional analysis. In addition, a free-play (control) condition was conducted for all children. Increases in relevant manding were observed in the EO-present context for 3 of the 4 participants. Decreases in aberrant behavior were achieved by the end of the treatment analysis for all 4 participants. Irrelevant mands were rarely observed in the EO-absent context for 3 of the 4 participants. Evaluating the effectiveness of FCT across different contexts allowed a further analysis of manding when the establishing operations were present or absent. The contributions of this study to the understanding of functional equivalence are also discussed.

The effects of presession exposure to attention on the results of assessments of attention as a reinforcer

The effects of presession exposure to attention on responding during subsequent assessments of attention as a reinforcer were evaluated across three behavioral assessments. In Experiment 1, a contingent attention assessment condition was preceded by either a noncontingent attention condition (free play) or a contingent escape condition. In Experiment 2, a diverted attention with extinction condition was preceded by either an alone or a free-play condition. In Experiment 3, a two-choice preference assessment was preceded by either 10 min of free play or 10 min of playing alone. In each experiment, the participant responded differentially within the test condition according to the presence or absence of dense schedules of attention immediately prior to that condition. The results of this study show that events occurring immediately prior to an assessment condition can influence behavior within the assessment.

Evaluation of antecedent stimulus parameters for the treatment of escape-maintained aberrant behavior

We evaluated a methodology for identifying the range of stimulus features of antecedent stimuli associated with aberrant behavior in demand contexts in natural settings. For each participant, an experimental analysis of antecedents (Phase 1) was conducted to confirm the hypothesis that task instructions occasioned increases in aberrant behavior. During Phase 2, specific stimulus features associated with the presentation of task instructions were assessed by evaluating the child's behavior across two distinct settings, therapists, and types of tasks in a sequential fashion. Aberrant behavior occurred immediately across settings and therapists, presumably because the presence of a discriminative stimulus for escape-maintained behavior (the delivery of a task instruction) occasioned aberrant behavior. However, aberrant behavior decreased initially across tasks, suggesting that familiarity with the task might be a variable. During Phase 3, an experimental (functional) analysis of consequences was conducted with 2 participants to verify that aberrant behavior was maintained by negative reinforcement. During Phase 4, a treatment package that interspersed play with task instructions was conducted to disrupt the ongoing occurrence of aberrant behavior. Immediate and durable treatment effects occurred for 2 of the 3 participants.