Past research has shown that response interruption and redirection (RIRD) can effectively decrease automatically reinforced motor behavior (Hagopian & Adelinis, 2001). Ahearn, Clark, MacDonald, and Chung (2007) found that a procedural adaptation of RIRD reduced vocal stereotypy and increased appropriate vocalizations for some children, although appropriate vocalizations were not targeted directly. The purpose of the current study was to examine the effects of directly targeting appropriate language (i.e., verbal operant training) on vocal stereotypy and appropriate speech in 3 children with an autism spectrum disorder. The effects of verbal operant (i.e., tact) training were evaluated in a nonconcurrent multiple baseline design across participants. In addition, RIRD was implemented with 2 of the 3 participants to further decrease levels of vocal stereotypy. Verbal operant training alone produced slightly lower levels of stereotypy and increased appropriate vocalizations for all 3 participants; however, RIRD was required to produce acceptably low levels of stereotypy for 2 of the 3 participants.
Response interruption and redirection has been shown to effectively decrease stereotypy, but its application outside an experimental setting has not been well studied. In Experiment 1, decreases in automatically maintained vocal stereotypy were obtained following treatment in a controlled setting for 3 participants diagnosed with autism spectrum disorder. Descriptive data on the consistency and accuracy of response interruption and redirection were then collected in the classroom setting. Results showed that the consistency of treatment implementation varied across participants and staff members. Failure to implement the treatment was the most common error. However, when response interruption and redirection was implemented, the components were generally carried out as prescribed. In Experiment 2, we conducted a parametric analysis in a controlled setting to test the impact of consistency errors on response interruption and redirection. The results indicated that response interruption and redirection was generally effective at 50% treatment implementation or higher. Furthermore, we observed treatment effects when 25% implementation sessions were interspersed with 100% treatment implementation sessions. Application of response interruption and redirection in light of previous studies and clinical implications are discussed.
In summary, in a large sample of clinically referred Veterans with persistent cognitive complaints after mild TBI, a third demonstrated invalid clinical neuropsychological testing, and, of those performing at or above cutoff on PVTs, over half performed within normative expectations across most neuropsychological tests administered. Results highlight the importance of objective assessment of cognitive functioning in this population as subjective reports do not correspond to objective assessment in the majority of cases.
A few studies on response blocking as well as response interruption and redirection (RIRD) as a treatment for automatically maintained problem behavior have examined different levels of treatment integrity. Results from these studies have shown continued suppression of responding under low levels of integrity for some participants after they were exposed to blocking at full integrity. The current study compared the treatment effects of RIRD at two levels of integrity (100 and 33%). The 33% condition was not preceded by exposure to full integrity. Four children diagnosed with an autism spectrum disorder between the ages of 8 and 16 participated. The effects of treatment integrity on vocal stereotypy were assessed using an ABAB-variant design in which B consisted of an alternating-treatments comparison of different levels of integrity. Results varied across participants, and although both conditions decreased stereotypy, 100% integrity produced lower levels of stereotypy quicker than 33%. The current study expands upon current literature by suggesting that lower levels of integrity (33%) may still suppress vocal stereotypy.
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