Kahng, Iwata, DeLeon, & Worsdell (1997)

Purpose & Method

• Purpose:
  This study compared the use of FCT to Non-Contingent Reinforcement (NCR). NCR was used as a control procedure during this study.
  • FCT involves establishing a socially appropriate responding that will produce reinforcers that are functionally the same as those identified through behavioral assessment, which currently maintains inappropriate responses.
  • For example, if a maladaptive behavior is maintained by attention, an FCT intervention may involve teaching the student to express their desire for attention using an appropriate word/phrase, or (if non-verbal) methods such as PECS cards, gestures, or signs.
• Method:
  • Three adult participants residing in a state residential facility (ARF) for people diagnosed with developmental disabilities. All were referred to a specialized day program for assessment due to SIB.
    • Todd – 50-year-old male, with profound mental retardation (intellectual disability) & tuberous sclerosis. SIB is head-banging (wears a helmet for seizures and SIB).
    • Lynn – 29-year-old female, with severe mental retardation (intellectual disability), SIB was hand-mouthing.
    • Bob – 45-year-old male, with severe mental retardation (intellectual disability), SIB was eye-poking.
• Experiment:
  • 10-15-minute sessions, 2-4-times per day, 5 days per week at the participants’ day program at their ARF.
  • Todd – head banging was defined as forceful contact of his head against walls or furniture.
    • DRA response during FCT training was raising an arm
      • Initially defined as lifting the hand above the level of his shoulder.
      • After Session 23, during the treatment phase of the study, the definition of arm raising was changed to lifting the hand above the level of his chest.
      • This was due to observations indicating Todd could only raise his arm to chest height.
  • Lynn – hand mouthing was defined as the insertion of the hand into the mouth, past the plane of the upper and lower lips.
    • DRA response was saying ‘‘hi.’’
  • Bob – Eye-poking was defined as the insertion of a finger into the eye socket.
    • DRA response was signing “finished”.
  • IOA was taken in 32.7% of Todd’s sessions, 40.3% of Lynn’s, and 27.5% of Bob’s.
  • Functional Analysis (FA) was conducted using a multielement design. Specifically, Multiple Baseline Across Subjects Design.
    • 2 Baselines were conducted simultaneously, 1 by each experimenter.
      • Experimenter 1, who implemented FCT.
      • Experimenter 2, who implemented NCR.
    • 4 Condition – Alone, Attention, Play, Demand
  • During NCR sessions, reinforcement schedules were made to match the reinforcement schedules of FCT sessions.

FA Results

• Todd – SIB occurred almost exclusively during the Demand, indicating SIB was maintained by negative reinforcement in the form of escape from demands.
• Lynn – SIB occurred across all conditions, but highest during Attention. This suggested SIB was maintained by positive reinforcement in the form of attention from caregivers.
• Bob – SIb was highest during Demand, indicating SIB was maintained by negative reinforcement in the form of escape from demands.

Treatment Results

• FCT suppressed SIB for all 3 participants, and NCR successfully decreased SIB at similar but lower rates than FCT. This indicates that motivation, Establishing Operations (EO’s), may have been more critical initially than delivery of reinforcement. However, the successful emitting of alternative responses (DRA responses) indicates that FCT was effective in treating SIB for the participants.
• Todd – After changing the definition of his DRA response, Todd’s independent arm raising increased significantly during both FCT and NCR.
• Lynn – Significant difference in FCT responding (higher) than NCR (lower).
• Bob – DRA responding occurred at variable rates during FCT, and only once during NCR conditions.

Discussion

• Todd and Lynn’s generalization of DRA responding from FCT to the beginning of NCR conditions shows that FCT can generalize responding to settings without reinforcement, however, the decrease in responding as NCR sessions neared their end indicates that extinction will occur if the schedule of reinforcement is too thin.
• NCR schedule may have been too rich to account for deprivation that occurs within the participants’ natural environment.
• FCT may be easier on therapists, as the client is responsible for triggering reinforcement, while NCR means the therapist must maintain awareness of reinforcement delivery schedules.