The Role of Attention in the Treatment of Attention‐maintained Self‐injurious Behavior: Noncontingent Reinforcement and Differential Reinforcement of Other Behavior

Abstract

Because there are potentially serious limitations to differential reinforcement of other behavior (DRO) (which is probably the most widely used treatment procedure for behavior problems), we examined an alternative procedure--noncontingent reinforcement (NCR). Three females with developmental disabilities, all of whom engaged in severe self-injurious behavior, participated. During a pretreatment functional analysis, each subject's self-injury was shown to be differentially sensitive to social attention as a maintaining consequence. Next, each subject was exposed to a DRO treatment and an NCR treatment. During DRO, attention was delivered contingent on the absence of self-injury for prespecified intervals. During NCR, attention was delivered on a fixed-time schedule that was not influenced by the subject's behavior. Results showed that both procedures were highly effective in reducing self-injury, probably because the functional reinforcer for self-injury was used during treatment. Furthermore, there was evidence that NCR attenuated several of the limitations of DRO. These results are particularly interesting in light of the long experimental history of NCR as a control rather than as a therapeutic procedure.

Enhancing the Effects of Extinction on Attention‐maintained Behavior Through Noncontingent Delivery of Attention or Stimuli Identified via a Competing Stimulus Assessment

“…One approach that has been used to offset these limitations has been to combine extinction with delivery of the consequent stimulus that historically reinforced problem behavior on a response-independent or timebased schedule, a treatment sometimes referred to as noncontingent reinforcement (NCR; Vollmer, Iwata, Zarcone, Smith, & Mazaleski, 1993). Although this term has been criticized for being inaccurate and imprecise (for discussions of the terminology issues, see Poling & Normand, 1999;Vollmer, 1999), we use it here to maintain contact with the literature most relevant to the current investigation.…”

A Review and Treatment Selection Model for Individuals with Developmental Disabilities Who Engage in Inappropriate Sexual Behavior

“…The intent of extinction is to eliminate ISB; however, there is always the risk of extinction bursts (temporary increases in the rate of a behavior at the onset of an extinction period) or the emergence of new (and/or more intense) forms of challenging behaviors such as aggression (Cooper et al 2007;Vollmer et al 1993). Combining extinction with intervention strategies that teach socially appropriate alternative behaviors (e.g., communication, leisure skills) and/or function-based NCR may decrease the likelihood of an extinction burst, as some reinforcement is made available.…”

Establishing Operations: Implications for the Assessment, Treatment, and Prevention of Problem Behavior

“…Treatments have been selected for consideration partly on the basis of having been little discussed from an EO perspective. Thus, noncontingent reinforcement, the effectiveness of which has been interpreted as at least partly the result of the modification of EOs (Hagopian et al, 1994;Marcus & Vollmer, 1996;Vollmer et al, 1993Vollmer et al, , 1995Wilder & Carr, 1998), has not been considered. It should be noted that, in routine clinical practice, treatment procedures are often combined into a multicomponent treatment package (Carr, Robinson, Taylor, & Carlson, 1990;LaVigna, Willis, & Donellan, 1989;Meyer & Evans, 1989) in which they may interact in complex ways.…”

“…The modification of such EOs has become an important part of conceptions of both individual treatment (e.g., Iwata et al, 1993) and a variety of specific treatments (e.g., Horner et al, 1997;Kennedy, 1994;Vollmer et al, 1993). Given that such EOs are commonly found in the environments of people at risk for problem behavior, their systemic modification holds the promise of reducing both the occurrence of problem behavior in individuals for whom it is already part of their repertoire and preventing its initial onset in others.…”