Assessment and treatment of problem behavior maintained by escape from attention

Abstract

This study describes the assessment and treatment of problem behavior for two participants whose functional analysis results identified escape from attention as the function of problem behavior. Treatment involved functional communication training to teach an appropriate alternative behavior that produced escape from attention. Additionally, in both cases, we expanded treatments by using graduated exposure to attention to facilitate increases in social interaction while maintaining low levels of problem behavior. We discuss findings as they relate to (a) functional analysis procedures to identify escape from attention as a function for problem behavior, (b) treatment strategies to reduce problem behavior, and (c) treatment strategies aimed at decreasing escape from, and avoidance of, social interaction for individuals who demonstrate this problem behavior function.

Behavior-analytic assessment and treatment of problem behavior maintained by social escape with individuals with intellectual and developmental disabilities: A systematic review.

“…Reinforcement thinning in the context of social escape treatment has most frequently included a FCT component. A multiple schedules procedure has been implemented with three participants across two studies (Cengher et al, 2022; Fisher et al, 2020) and delay signals have been utilized with two participants across two studies (Cengher et al, 2021; Slocum et al, 2022). The average mean reduction in problem behavior for treatments including a multiple schedules procedure was 87.1% (range = 67.85%–100%) and the average NAP was 0.9 (range = 0.83–1).…”

“…We included all data points of the comparison conditions in a functional analysis demonstrating a social escape function to compute the mean and standard deviation. There was an exception for Cengher et al (2021Cengher et al ( , 2022 in that we did not include staff-implemented functional analysis conditions for James and Tyson, only parent-implemented functional analysis conditions. This was because a social escape function was only identified during parent-implemented sessions.…”

“…Across reinforcement thinning studies, the interval during which reinforcement was restricted (e.g., during a delay to reinforcement) was less than 10 min. As for multiple schedule procedures, Cengher et al (2022) reported an 8-min reinforcement-restriction interval whereas Fisher et al reported a 2-min interval. As for restricted reinforcement in studies utilizing delay signals, Cengher et al (2021) reported a 2-min delay while Slocum et al reported a 30-s delay for social escape and a 5-min delay for alternative reinforcement.…”

Application of a terminal schedule probe method to inform schedule thinning with multiple schedules

“…A functional analysis was conducted for each participant following procedures based on Iwata et al (1982Iwata et al ( /1994. Some functional analyses included conditions to test for challenging behavior related to interruption of activities (Hagopian et al, 2007), compliance with mands (Bowman et al, 1997), and escape from attention (Cengher et al, 2022). After the functional analysis, a treatment evaluation was conducted to identify effective interventions to reduce challenging behavior and increase alternative behavior.…”

Secondary and within‐session analyses to improve the feasibility and precision of assessments of sociability

“…Using assessments of sociability in this way may help increase the likelihood that individuals advocate for their interests and contact reinforcement in their social environments. Moreover, doing so may prevent or perturb the development of challenging behavior maintained by social avoidance (Cengher et al, 2021(Cengher et al, , 2022Harper et al, 2013;Slocum et al, 2022). Second, assessments of sociability could elucidate the indirect effects that specific interventions (e.g., extinction for escape-maintained challenging behavior) or molar interventions strategies (e.g., early intensive behavioral intervention, parent training) have on sociability.…”