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Understanding factors that influence the efficacy of functional communication training has both practical and conceptual benefits. The current study extended research in this area by exploring data from 95 consecutive applications of functional communication training with extinction across two independent clinics. We selected candidate predictor variables based on conceptual analysis, conducted preliminary exploratory analyses, and then selectively applied quantitative methods that are used in precision medicine to examine their accuracy and predictive utility. Treatment outcomes were better when challenging behavior was maintained by a single function than they were when it was maintained by multiple functions; however, these differences were most apparent among cases with an escape function. We also analyzed within‐session responding to explore the potential influence of unprogrammed establishing operations on decrements in treatment efficacy. Our within‐session measure only distinguished responders from nonresponders when escape was one of the multiple functions. Additional research is needed to validate these findings with an independent sample and to address a number of clinical conceptual issues. [ABSTRACT FROM AUTHOR]

Arranging periods in which requests for reinforcement are denied in a multiple schedule may result in increased destructive behavior during these periods for individuals who receive functional communication training (FCT) as treatment for severe destructive behavior. Providing access to competing activities during periods of reinforcer unavailability has been shown to minimize destructive behavior. We evaluated methods to identify effective competing activities for use when thinning reinforcement availability in a multiple schedule and compared competing activities embedded within the multiple schedule using an alternating-treatments design. Results suggested at least one competing activity facilitated favorable treatment outcomes for each participant. We discuss building on this empirical approach to identify effective competing activities for use during reinforcement schedule thinning.

Recent research findings (DeRosa, Fisher, & Steege, 2015) suggest that minimizing exposure to the establishing operation (EO) for destructive behavior when differential reinforcement interventions like functional communication training (FCT) are introduced may produce more immediate reductions in destructive behavior and prevent or mitigate extinction bursts. We directly tested this hypothesis by introducing FCT with extinction in two conditions, one with limited exposure to the EO (limited EO) and one with more extended exposure to the EO (extended EO) using a combined reversal and multielement design. Results showed that the limited-EO condition rapidly reduced destructive behavior to low levels during every application, whereas the extended-EO condition produced an extinction burst in five of six applications. We discuss these findings in relation to the effects of EO exposure on the beneficial and untoward effects of differential reinforcement interventions.

There are a growing number of publications supporting behavior-analytic strategies to increase compliance with medical procedures. However, little research has been conducted on the application of applied behavior analysis to teach compliance with and completion of the setup required for an overnight sleep study (polysomnography). The client in this report presented with autism, cerebral palsy, epilepsy, strokes, and severe destructive behavior (i.e., aggression, property destruction, self-injury). These conditions combined with a poor sleep/wake schedule and gasping during the night necessitated a sleep study. The caregiver referred their child to behavioral outpatient services due to medical noncompliance and severe destructive interfering behaviors with similar procedures (e.g., failed electroencephalogram [EEG]). We evaluated the effects of differential reinforcement without extinction and stimulus fading on compliance and reduction of destructive behavior with a 25-step sleep study procedure. Our approach successfully taught tolerance of the procedure and reduced destructive behavior. The client completed the scheduled sleep study and received a diagnosis of mild obstructive sleep apnea. [ABSTRACT FROM AUTHOR]

As people with autism spectrum disorders (ASD) mature from adolescents into adults, social deficits may become more pronounced and apparent in new areas (e.g., social functioning and sexuality). Like neurotypicals, sexuality may be directly related to quality of life for people with ASD. Current practice for addressing sexuality in the ASD population includes some curricula that may be beneficial for teaching skills related to sexuality, but the scientific support for such curricula is absent. Typically sexuality education is only implemented when a behavior is demonstrated that is considered deviant or problematic. Although reactive education may be a common practice, a strategy that includes proactive sexuality education may be more beneficial for the long-term quality of life for people with ASD. The current paper will highlight some of the areas for further investigation and program development for adolescents and adults with ASD.

Functional communication training is an effective treatment for decreasing socially reinforced destructive behavior (Carr & Durand, 1985). Clinicians frequently use multiple schedules to thin the reinforcement schedule (Hanley et al., 2001). Individuals are often taught to wait for functional reinforcers without alternative programmed stimuli. However, concurrently available items and activities are often accessible in the natural environment. In this study, we taught 4 participants a functional communication response to access functional reinforcers. We implemented a multiple schedule during schedule thinning, comparing a control condition (nothing available during SΔ intervals) to separate conditions with items/activities (moderately preferred tangible items, attention, demands) noncontingently available during SΔ intervals. After reaching the terminal schedule in one condition, therapists assessed participant preference across SΔ conditions. For all participants, the terminal schedule was reached with alternative items and activities, and participant preference corresponded with the most efficient schedule thinning condition. Therapists also indicated preference for alternative items/activities. [ABSTRACT FROM AUTHOR]

Clinicians regularly use both indirect and direct assessments to identify preferred stimuli to include in control conditions and positive reinforcement test conditions in a functional analysis (FA). However, clinicians often rely on indirect assessment alone (e.g., caregiver report) to identify aversive stimuli to include in negative reinforcement test conditions. In this study, we evaluate a paired‐stimulus demand analysis and validate assessment results via FA. Results indicate that, for all 4 participants, the demands selected least often evoked higher rates of destructive behavior than more frequently selected demands. We identified an escape function for all 4 participants in the escape–least selected (LS) condition (true positive finding) and for only 1 participant in the escape–most selected (MS) condition (false negative finding for 3 of 4 participants). These results support the utility of empirically deriving stimuli for inclusion in the negative reinforcement test condition of an FA to decrease the likelihood of false negative findings. [ABSTRACT FROM AUTHOR]

Variations to traditional functional analysis methodology, such as brief functional analyses (BFAs), are prevalent in the literature. In the current evaluation, two types of BFAs were each conducted with five participants. In one, potential motivating operations (MOs) were presented, and problem behavior resulted in delivery of an associated consequence. In the other, the same MOs were presented, but no consequences were delivered. Results of the two BFAs were compared with respect to the conditions in which problem behavior occurred and the degree of differentiation between test and control conditions. Results across the BFA methodologies generally matched across all five participants. However, greater differentiation was observed in the BFA that did not include consequences. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]