The individual is then taught a command to gain access to the same reinforcer while maintaining the problem behavior, and the individual is given opportunities to practice the command for reinforcement (Radhakrishnan et al., 2019). For example, techniques that promote EO tolerance, such as schedule bias, have been associated with generalized outcomes (eg, Ghaemmaghami et al., 2021).
Participants and Settings
For all children, one research assistant acted as the therapist during initial training (ie, during FCT and during instruction in the first generalization training [GT] context). Two different researchers acted as therapists during instruction in the second and third GT contexts (see Table 1 for demographic information pertaining to the therapists).
Materials
Each therapist was assigned a distinct location (eg, bedrooms, living rooms) and never acted as therapist in alternate locations.
Response Measurement
Specifically, all sessions were to be terminated immediately if the child engaged in any behavior that resulted in redness or bruising of anyone involved in the session (including the child). For each child, one was scored each time they independently touched a therapist with a picture card, or (for Child 1 and Child 3) when they vocally asked for a functional reinforcer (eg, “toy please”).
Interobserver Agreement
- Functional Analysis
- Baseline
- Training
- Functional Communication Training
- Generalization Training
- Maintenance Probes
- Remediation in Generalization Context
- Procedural Fidelity
The second was used to evaluate the extent to which the effects of direct training generalized to a context in which training did not occur, and in which both coercive and challenging behaviors were reinforced on FR1 schedules. After the pre-session contingency reviews and forced choice confrontations, the therapist began each session by presenting the EOs of challenging behavior (i.e., the presentation of demands, the denied access to tangibles). The therapist reinforced the relevant mand on an FR1 schedule of reinforcement, and challenging behavior was set to extinction (i.e., there were no programmed consequences for problem behavior).
This condition continued until challenging behavior remained at or below 10% of baseline responding over three consecutive sessions during which at least one basket was released during a non-reinforcement period. This condition ended after each child emitted at least one basket after removal of the bracelet, while challenging behavior remained at or below 10% of the baseline response, over three consecutive sessions during sessions in which the S∆ was present for 15 s intervals, and then again when the S∆ was present for 30 s intervals. At the lower level, the therapist presented the S∆ (i.e., bracelet on the wrist) and a visual timer reset. While at the lower level, challenging behavior's EOs [i.e. demands, denied access to tangible items]) constantly present.
Both GT2 and GT3 ended after each child emitted at least one man after bracelet removal while challenging behavior remained at or below 10%. A three-tier multiple baseline evaluative control of FCT over challenging behavior and manning in training contexts is shown in Figure 5. A three-tier multiple baseline evaluating the generality of reductions in challenging behavior and manning to uncued generalization contexts is shown in Figure 7.
Training
Functional Communication Training
For Child 1, we observed high levels of problem behavior in the escape condition compared to the other conditions. Again, once again a secondary function (i.e., attention) may also have been present, but we chose to address the tactile function as it was the condition in which the problem behavior most reliably occurred. During the initial sessions for child 2, we observed high levels of problem behavior and no instances of independent deficits (Figures 3 and 5).
After the introduction of response blocking, we observed lower rates of problem behavior and the independent task remained in place. Specifically, we observed a 97.50% reduction in problem behavior during the last three FCT sessions compared to the last three baseline sessions. During FCT, problem behavior was reduced to zero, but independent command (i.e., reinforcement was obtained through requested command) was inconsistent and compliance remained high.
After the introduction of enriched interruptions (ie, tactile escape + attention), rates of independent retrieval increased, compliance dropped to zero, and problem behavior remained low.
Generalization Training
However, this is not surprising because compliance is functionally incompatible with demands for breaks, which were reinforced on an FR1 schedule in this condition. That is, because Child 1 engaged in such high rates of independent manning, there were few opportunities for compliance, and compliance was not necessary. During baseline sessions for Child 3, Child 3 was both compliant and aggressive and was never required to take breaks (see Figures 4 and 5).
Despite therapists no longer implementing treatment components and reinforcing both challenging behavior and mandating on FR1 schedules, challenging behavior remained low and both discriminated mandating and discriminated adherence were maintained. When therapists ceased response blocking and reinforced both manding and problem behavior on FR1 schedules, challenging behavior immediately returned and manding dropped to nearly zero levels. Twenty-two days after completing GT for Child 3, we performed his maintenance examinations (Figures 4 & . 6).
Like Child 1, Child 3 continued to engage in low levels of problem behavior, discriminated ordering, and discriminated compliance, despite the fact that treatment contingencies no longer applied and both problem behavior and coercion were reinforced in an FR1.
Generalization Probes
Unsignaled Generalization Probes
Signaled Generalization Probes
During baseline cued GP sessions and post-FCT sessions (which functionally served as an extension of the baseline for these probes) for child 1, challenging behavior occurred on 5 of 6 probes, no discriminated ordering (i.e., , he either did not mandate or mandated during S∆ periods in addition to mandate during SD periods), and compliance did not occur (Figures 2 & 8). During post-GT investigations, the discriminated command and discriminated compliance achieved in the training context were briefly generalized to Child 1's mother. During the baseline and post-FCT sessions signaled by Child 3, challenging behavior occurred repeatedly and command did not never happened
Because challenging behavior continued to occur during post-GT probes and discriminated manning and discriminated compliance never generalized to Child 3's mother, we did not ask Child 3's mother to complete maintenance probes.
Remediation in Generalization Context
Figure 1
Each condition was run until it could be confirmed as a function or ruled out as a function of the child's problem behavior. The upper panels depict the response with the research team, while the lower panels depict the response with Child 1's mother. The upper panels depict the response with the research team, while the lower panels depict the response with Child 2's mother.
The top panels show responses with the research team, while the bottom panels show responses with Child 3's mother. The data in these graphs only represents responses before the implementation of the GT package. Data in the top and third panels represent problem behaviors and obligations, while data in the second and last panels represent compliance.
No data were obtained for Child 2 during the GT phase and no data were obtained for Child 3 during the maintenance phase. The data in the top graph shows the data obtained with the mother conducting the sessions, while the data in the bottom graph shows the sessions in which the research team conducted the sessions.
Sessions
General Discussion
Interestingly, we observed higher rates of problem behavior in all participants during the GP baseline sessions, compared to the rates of problem behavior observed in the research team during the baseline sessions. After implementing the FCT contingency training with the research team, we have seen a decrease in problem behavior and compliance (where relevant), as well as an increase in the number of independent assignments. After the implementation of a GT package in Child 1 and Child 3, we observed low rates of problem behavior and discriminated assignment and discriminated adherence across all therapists and settings.
Combined with the observation that initial baseline rates of problem behavior with respective mothers were higher than rates with the research team, it is interesting that FCT results did not generalize consistently. Interestingly, rates of problem behavior were higher with mothers compared to the research team in most contexts, as this may be due to the strength and duration of reinforcement. It is also possible that we observed high rates of problem behavior because of behavioral contrast.
That is, because of multiple schemas at play for the child, the child may engage in higher levels of problem behavior with the mothers.
Limitations
This suggests that it may be useful to initially implement FCT – in addition to in evaluations of generalization and maintenance – with non-arbitrary therapists to ensure that accurate rates of problem behavior are observed. However, it is difficult to determine whether the results observed in the current study are the norm, because again, few studies in the literature have evaluated whether the general effects of FCT are maintained over time (cf. Ghammaghami et al. , 2016). . Given our results, we suggest that future researchers extend our study using parametric analysis to explore the degree and the circumstances under which generalization of treatment outcomes to challenging behavior is most likely.
For example, without intentional programming involving endogenous implementers in the intervention process, our results suggest that the benefits of therapy delivered by external agents are unlikely to generalize. In contrast, teaching parents to implement the therapy themselves and formally incorporating it into the intervention process appears to provide significantly more benefit to them (see Figures 9, 10, and 11). However, even these demonstrations are limited by formal measurement systems under fairly contrived conditions, which make it difficult to predict the extent to which treatment effects would generalize to less structured conditions (i.e., throughout the day and in the absence of external factors).
Thus, we argue that there is much we do not yet understand about the generality and utility of treatment effects established during formal therapy.
Future Directions
Furthermore, we felt it best not to include GT for Child 2 for several reasons - for example, due to his limited communication skills, we felt it best not to place his newly learned communication at the risk of extinction and thus risk his only so-learned communication method. however, so far this once again limits what can be said at all levels in terms of the effects of EO tolerance and generalization. An evaluation of multiple dependent variables across different classes of preceding stimuli before and after functional communication. Producing meaningful improvements in the problem behavior of children with autism through synthesized analyzes and treatments.
Multioperant discrimination training to increase accuracy of delta stimuli after treatment of challenging behavior. An individualized system of levels and systematic combination of stimuli to reduce repeatedly controlled aggression of a child with autism spectrum disorder.
