A comparison of intervention for problematic speech using reinforcement with and without preferred topics

Abstract

Previous research has shown that responding to the appropriate and problematic speech of individuals diagnosed with developmental disabilities with interested and uninterested listener responses, respectively, can promote more appropriate conversational engagement. However, Fisher et al. (2013) also responded to appropriate speech with access to preferred conversational topics. This study examined the influence of listener interest on the problematic speech of 8 participants and tested the additive effects of (Study 1) and participant preference for (Study 2) delivering preferred topics as reinforcement for appropriate speech. Interventions were equally effective with or without arranging access to preferred topics, but a majority of participants demonstrated a preference for intervention with contingent access to preferred topics. Caregivers and speech‐language pathologists rated the intervention procedures as acceptable and changes in participants' speech satisfactory.

A translational evaluation of listener interest on the presentation of conversation topics to individuals who exhibit restricted interests

“…It is important to note that Elena largely avoided or minimized uninterested responses by either (a) pairing the presentation of the restricted topic with one of the nonrestricted topics or (b) sequencing the presentation of topics by presenting the restricted topic after a nonrestricted topic (Figure 1). The results for Elena suggest that adherence might be more likely when interventions incorporate restricted interests (see Gunn & Delafield-Butt, 2016;Harrop et al, 2019), such as using access to restricted topics as reinforcement for speech about nonrestricted topics (Fisher et al, 2013;Stocco et al, 2021). Future research could compare caregiver adherence across interventions with (Fisher et al, 2013;Stocco et al, 2021) and without (Kuntz et al, 2020;Rehfeldt & Chambers, 2003;Roantree & Kennedy, 2012) using restricted topics as reinforcement.…”

“…The results for Elena suggest that adherence might be more likely when interventions incorporate restricted interests (see Gunn & Delafield-Butt, 2016;Harrop et al, 2019), such as using access to restricted topics as reinforcement for speech about nonrestricted topics (Fisher et al, 2013;Stocco et al, 2021). Future research could compare caregiver adherence across interventions with (Fisher et al, 2013;Stocco et al, 2021) and without (Kuntz et al, 2020;Rehfeldt & Chambers, 2003;Roantree & Kennedy, 2012) using restricted topics as reinforcement.…”

“…Uncovering the behavioral processes that influence the presentation of restricted interests may be a necessary step toward understanding nonadherence and, therefore, designing interventions that promote adherence (Allen & Warzak, 2000;Stocco & Thompson, 2015). Although studies have reported effective interventions for excessive speech about restricted topics (Fisher et al, 2013;Kuntz et al, 2020;Lepper et al, 2017;Noel & Rubow, 2018;Rehfeldt & Chambers, 2003;Roantree & Kennedy, 2012;Stewart et al, 2007;Stocco et al, 2021), adherence to interventions has not been evaluated. These results suggest that adherence might depend on behavioral sensitivity to escape from uninterested listener responses.…”

“…Because making and maintaining relationships may require conversing about topics outside of their restricted interests (Black & Hazen, 1990; see also Rodriguez & Thompson, 2015; VanBergeijk et al, 2008), researchers have evaluated strategies for increasing conversation about nonrestricted topics (Fisher et al, 2013; Kuntz et al, 2020; Lepper et al, 2017; Noel & Rubow, 2018; Rehfeldt & Chambers, 2003; Roantree & Kennedy, 2012; Stocco et al, 2021). Although components of these strategies often vary (e.g., the form and schedule of reinforcement), the presentation of nonrestricted topics and differential reinforcement of related speech are quite standard.…”

Descriptive assessment of conversational skills: Towards benchmarks for young adults with social deficits

“…In the context of a conversation, the number of different words spoken and the mean length of an utterance on a given topic is predictive of meaningful friendships (Friedman et al, 2019). Prior behavioral interventions have demonstrated effectiveness in teaching children, adolescents, and young adults to: (a) ask and answer questions (Bambara et al, 2016; Beaulieu et al, 2013; Dotson et al, 2010; Grob et al, 2019; McConnell et al, 1991; Minkin et al, 1976; Nuernberger et al, 2013); (b) initiate a conversation (Koegel et al, 2001); (c) wait for their turn to speak so as to not interrupt their conversation partner (Beaulieu et al, 2013; Hood et al, 2017); (d) provide positive feedback (Dotson et al, 2010; Minkin et al, 1976); (e) give or accept compliments (Hood et al, 2020; Leaf et al, 2009); (f) sustain conversation on a given topic (Bambara et al, 2016; Fisher et al, 2013; Hood et al, 2017; Koegel & Frea, 1993; Leaf et al, 2009; Nuernberger et al, 2013; Stocco et al, 2021); (g) respond to indices of uninterest by confirming the conversation partner's availability (Mann et al, 2020), inviting them to contribute (Mann et al, 2020; Peters & Thompson, 2015;), or changing the topic (Hood et al, 2017; Mann & Karsten, 2020; Peters & Thompson., 2015); h) make eye contact throughout a conversation (Koegel et al, 1993; Nuernberger et al, 2013); and (i) not engage in distracting nonvocal behavior (Hood et al, 2017; Hughes et al, 1998; see also Reichow & Volkmar, 2010, and Wang et al, 2013 for reviews). Behavioral interventions have demonstrated success in addressing such conversational concerns but have largely occurred in the absence of a thorough account of what constitutes a mutually reinforcing conversation.…”