Treatment of Pica Through Multiple Analyses of Its Reinforcing Functions

Abstract

We conducted functional analyses of the pica of 3 participants. The pica of 1 participant appeared to be maintained by automatic reinforcement; that of the other 2 participants appeared to be multiply controlled by social and automatic reinforcement. Subsequent preference and treatment analyses were used to identify stimuli that would complete with the automatic function of pica for the 3 participants. These analyses also identified the specific aspect of oral stimulation that served as automatic reinforcement for 2 of the participants. In addition, functional analysis-based treatments were used to address the socially motivated components of 2 of the participants' pica. Results are discussed in terms of (a) the importance of using the results of functional analyses to develop treatments for pica and (b) the advantages of developing indirect analyses to identify specific sources of reinforcement for automatically reinforced behavior.

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

“…However, results of the competing stimulus assessment in this investigation and in the Piazza et al (1998) study suggest that this approach to identifying competing stimuli provides information not available with other preference assessments. Perhaps the best example of this is the results obtained for Sally in Phase 2.…”

“…In fact, for all of the participants, there were stimuli that appeared to be similar in terms of item interaction (i.e., how much they were preferred) but were different in terms of how well they competed with the reinforcer for destructive behavior (i.e., how well they substituted for attention). Participants in the study by Piazza et al (1998) showed similar patterns when a competing stimulus assessment was used to identify stimuli that competed with pica. Moreover, in a previous investigation we showed that a competing stimulus assessment accurately identified which stimuli would and would not compete with destructive behavior reinforced by attention (Fisher et al, 2000).…”

“…Both Hanley et al (1997) and Fischer et al (1997) used the paired-choice preference assessment described by Fisher et al (1992) in selecting the competing reinforcers. Fisher et al (2000) replicated and extended these findings by showing that a competing stimulus assessment, based on methods used to treat automatic reinforcement (e.g., Piazza et al, 1998;Shore, Iwata, DeLeon, Kahng, & Smith, 1997), could be used to predict which stimuli would and would not effectively compete with attention-maintained destructive behavior.…”

“…Rates of destructive behavior during baseline and during the extinction (EXT), noncontingent attention plus extinction (NCA ϩ EXT), and noncontingent tangible items plus extinction (NCT ϩ EXT) conditions of the treatment analyses. (Piazza et al, 1998) was used to identify stimuli (e.g., toys, music) that, when presented noncontingently during brief assessment trials, reduced rates of destructive behavior, even though this response continued to produce its reinforcer (attention) on an FR 1 schedule. In Phase 3, we evaluated whether the stimuli that competed effectively with attention in Phase 2 would enhance the effectiveness of extinction by comparing extinction implemented (a) alone, (b) in combination with NCA, and (c) in combination with the stimuli identified in Phase 2 (NCT plus extinction).…”

“…Reinforcers are said to be substitutable when consumption of one reinforcer is associated with a decrease in consumption of a concurrently available reinforcer (Green & Freed, 1993;Shore et al, 1997). Most previous studies that have used competing stimuli have done so to treat problem behavior purportedly maintained by automatic reinforcement, because it is often difficult or impossible to implement extinction for behavior thus maintained (e.g., Piazza et al, 1998;Piazza, Roane, Keeney, Boney, & Abt, 2002;Shore et al, 1997). The current results show that using a competing stimulus assessment can be useful even with responses reinforced by social consequences, for which extinction can be implemented.…”