Functional analysis of aberrant behavior maintained by automatic reinforcement: assessments of specific sensory reinforcers

The purpose of this study was to develop a systematic functional assessment package for aberrant behaviors maintained by nonsocial (automatic) reinforcement. The assessment package included four components: (1) functional analysis, (2) antecedent assessment of specific automatic reinforcement sources, (3) stimulus preference assessment, and (4) treatment evaluation. Functional analysis data indicated automatic reinforcement functions of the stereotypy exhibited by a 10-year-old male and the self-injury (SIB) exhibited by a 30-year-old male. Antecedent assessments of sensory classes indicated that auditory stimulation and tactile stimulation were associated with stereotypy and SIB, respectively. A multiple-stimulus-without-replacement procedure was conducted with each participant to identify the most- and least-preferred stimuli within the identified sensory classes. In an attempt to validate the assessment package for each participant, a DRO procedure was implemented using a reversal design with a multielement component. DRO procedures using stimuli within the targeted sensory classes were successful in eliminating the aberrant behaviors of both participants. The results are discussed in the context of improving the methodology for assessing and treating automatically reinforced behaviors.     

Functional analysis and treatment of aggressive behavior following resection of a craniopharyngioma

Craniopharyngioma is a relatively rare, benign tumor that most often affects pre-adolescent children. Surgical resection is a common form of treatment, which may result in adverse physical, neurological, and behavioral effects, most notably, aggressive behavior. In this case study we describe a typically developing 6 year old female who had resection of a craniopharyngioma and subsequently developed severe aggressive behavior that interfered significantly with her recovery and functioning. Results of a functional analysis indicated that her aggression was maintained by contingent escape from task demands and access to preferred food items. A highly structured behavioral intervention, consisting of differential reinforcement of alternative behaviors, together with extinction targeted to each function of the behavior, was effective in reducing her aggression to below 88% of baseline levels. Her adaptive behaviors also increased significantly. These results suggest that assessment and treatment utilizing principles of applied behavior analysis can ameliorate the occurrence of problem behavior following craniopharyngioma resection.     

A variation of noncontingent reinforcement in the treatment of aberrant behavior

We examined the effectiveness of a variation of noncontingent reinforcement (NCR) that incorporated a stimulus-delay procedure in the reduction of aberrant behavior maintained by positive reinforcement. Functional analyses for three individuals diagnosed with developmental disabilities indicated that their behaviors were maintained by positive reinforcement: one in the form of access to a tangible item, another by attention, and the third by physical contact. We implemented NCR with the delay procedure with two participants using reversal designs to evaluate effects. We also compared this NCR variation and DRO with the third participant to evaluate reinforcer-delivery rates. The variation of NCR was successful in reducing all aberrant behavior to near-zero levels. A comparison of reinforcer delivery between NCR with the stimulus-delay procedure and DRO demonstrated that the participant accessed more reinforcement with NCR. Results are discussed in the context of enhancing decelerative interventions with emphases on minimizing response effort for caregivers and maximizing access to reinforcement for the individuals.     

Functional analysis and treatment of problem behavior exhibited by children with fragile X syndrome

The efficacy of function-based interventions for the treatment of severe problem behavior exhibited by individuals with intellectual and developmental disabilities (IDD) is well established. However, few studies have reported on behavioral interventions in fragile X syndrome (FXS) specifically. The present study is a consecutive case-series analysis that reports on functional analysis and treatment of problem behavior of nine children with FXS. Assessment findings were consistent with previous research indicating that among individuals with FXS, problem behavior is more commonly maintained by escape from demands and access to tangible items, relative to the broader population of individuals with IDD. Functional analysis-based behavioral interventions resulted in a mean reduction in problem behavior of 95.2% across the nine participants. Additionally, generalization of treatment effects from controlled clinical settings to home, school, and community was demonstrated. The current findings suggest that function-based behavioral interventions shown to be effective with the broader population of individuals with IDD are also effective for individuals with FXS. Our results in combination with those of previous studies describing functional analysis outcomes provide additional evidence for a unique functional behavioral phenotype for severe problem behavior in individuals with FXS. Implications of study findings for early intervention and prevention of problem behavior in children with FXS are discussed.     

The aberrant behavior checklist: a behavior rating scale for the assessment of treatment effects

The development of a scale to assess drug and other treatment effects on severely mentally retarded individuals was described. In the first stage of the project, an initial scale encompassing a large number of behavior problems was used to rate 418 residents. The scale was then reduced to an intermediate version, and in the second stage, 509 moderately to profoundly retarded individuals were rated. Separate factor analyses of the data from the two samples resulted in a five-factor scale comprising 58 items. The factors of the Aberrant Behavior Checklist have been labeled as follows: (I) Irritability, Agitation, Crying; (II) Lethargy, Social Withdrawal; (III) Stereotypic Behavior; (IV) Hyperactivity, Noncompliance; and (V) Inappropriate Speech. Average subscale scores were presented for the instrument, and the results were compared with empirically derived rating scales of childhood psychopathology and with factor analytic work in the field of mental retardation.     

Functional analysis and treatment of nail biting

This study applied functional analysis methodology to nail biting exhibited by a 24-year-old female graduate student. Results from the brief functional analysis indicated variability in nail biting across assessment conditions. Functional analysis data were then used to guide treatment development and implementation. Treatment included a simplified habit reversal package that was modified based on results of the functional analysis. Following treatment implementation, nail biting decreased as evidenced by consistent nail growth and participant self-recorded data. Results are discussed in terms of treatment utility of functional analysis methodology for novel populations and response topographies.     

Functional analysis and treatment of Bizarre speech

Contingencies maintaining the bizarre speech of a 29-year-old woman with mild mental retardation and schizophrenia were analysed. Bizarre vocalizations occurred most frequently during demand conditions and least frequently during one-to-one interaction with attention contingent upon appropriate vocalizations. Treatment conditions derived from the assessment consisted of guided compliance and ignoring plus contingent attention. Treatment effects generalized to direct-care staff in day and residential settings. Analysis of the variables controlling bizarre speech facilitated development of interventions that were predominantly positive in nature, based on the specific and unique controlling behavior-environment interactions, and that were teachable to the direct-care staff.     

Psychometric characteristics of the aberrant behavior checklist

Information was presented on the psychometric characteristics of the Aberrant Behavior Checklist. The internal consistency and test-retest reliability of the Checklist appeared to be very good. Interrater reliability tended to vary across raters and subscales and ranged from mediocre to good but was generally in the moderate range and acceptable for research purposes. Validity was assessed by comparing Checklist scores for residents presenting with attributes thought to reflect varying degrees of social adaptation. Validity was also evaluated by comparing Aberrant Behavior Checklist scores with ratings on adaptive behavior scales and with objective observations of behavior. In general, validity was established for most Aberrant Behavior Checklist subscales. Preliminary data from drug investigations suggested that the Checklist may provide a useful adjunct for the assessment of psychotropic drug effects.     

Longitudinal trajectories of aberrant behavior in fragile X syndrome

The Aberrant Behavior Checklist-Community (ABC-C; Aman et al., 1995) has been increasingly adopted as a primary tool for measuring behavioral change in clinical trials for individuals with fragile X syndrome (FXS). To our knowledge, however, no study has documented the longitudinal trajectory of aberrant behaviors in individuals with FXS using the ABC-C. As part of a larger longitudinal study, we examined scores obtained on the ABC-C subscales for 124 children and adolescents (64 males, 60 females) with FXS who had two or more assessments (average interval between assessments was approximately 4 years). Concomitant changes in age-equivalent scores on the Vineland Adaptive Behavior Scales (VABS) were also examined. As expected for an X-linked genetic disorder, males with FXS obtained significantly higher scores on all subscales of the ABC-C and significantly lower age-equivalent scores on the VABS than females with FXS. In both males and females with FXS, scores on the Irritability/Agitation and Hyperactivity/Noncompliance subscales of the ABC-C decreased significantly with age, with little to no change occurring over time on the Lethargy/Social Withdrawal, Stereotypic Behavior, and Inappropriate Speech subscales. The decrease in scores on the Hyperactivity/Noncompliance domain was significantly greater for males than for females. In both males and females, age-equivalent scores on the VABS increased significantly over this developmental period. These results establish a basis upon which to evaluate long-term outcomes from intervention-based research. However, longitudinal direct observational studies are needed to establish whether the severity of problem behavior actually decreases over time in this population.     

Functional analysis of self-injurious behavior in an adult with Lesch-Nyhan syndrome

A three-phase functional analysis was conducted to discover controlling variables of self-injury in a 28-year-old individual with Lesch-Nyhan syndrome. Experimental verification followed information-gathering and interpretive phases. Self-injurious responses were blocked to prevent harm to the participant; therefore, responses measured were precursors to self-injury. A multielement experimental design included four assessment conditions: social attention contingent on precursory behavior, attention contingent on behavior incompatible with precursory behavior, continuous attention and minimal attention. Highest rates of precursory behavior occurred during continuous attention and when incompatible behavior was reinforced. Social attention appeared to act as a discriminative stimulus for self-injurious behavior in this participant.     

Convergent validity of the aberrant behavior checklist and behavior problems inventory with people with complex needs

The current study aimed to replicate and extend Rojahn et al. [Rojahn, J., Aman, M. G., Matson, J. L., & Mayville, E. (2003). The aberrant behavior checklist and the behavior problems inventory: Convergent and divergent validity. Research in Developmental Disabilities, 24, 391-404] by examining the convergent validity of the behavior problems inventory (BPI) and the aberrant behavior checklist (ABC) for individuals presenting with multiple complex behavior problems. Data were collected from 69 children and adults with severe intellectual disabilities and challenging behavior living in residential establishments. MANCOVA analyses showed that individuals with elevated BPI stereotyped behavior subscale scores had higher scores on ABC lethargy and stereotypy subscales, while those with elevated BPI aggressive/destructive behavior subscale scores obtained higher scores on ABC irritability, stereotypy and hyperactivity subscales. Multiple regression analyses showed a corresponding pattern of results in the prediction of ABC subscale scores by BPI subscale scores. Exploratory factor analysis of the BPI data suggested a six-factor solution with an aggressive/destructive behavior factor, four factors relating to stereotypy, and one related to stereotypy and self-injury. These results, discussed with reference to Rojahn et al. [Rojahn, J., Aman, M. G., Matson, J. L., & Mayville, E. (2003). The aberrant behavior checklist and the behavior problems inventory: Convergent and divergent validity. Research in Developmental Disabilities, 24, 391-404], support the existence of relationships between specific subscales of the two instruments in addition to an overall association between total scores related to general severity of behavioral disturbance.     

Response covariation of escape-maintained aberrant behavior correlated with sleep deprivation

We examined the relation between sleep deprivation and changes in level and allocation of aberrant behavior (aggression and self-injury) for a child with moderate mental retardation. First, a series of functional analyses identified that self-injury (SIB) and aggression were maintained by escape from demands (i.e., were members of the same response class). Escape from demand conditions were then held constant over time while natural levels of sleep deprivation occurred. This final analysis demonstrated a correlation between sleep deprivation and increases in escape-maintained aberrant behavior. Sleep deprivation seemed to be related to increases in levels of self-injury but did not seem to influence levels of aggression.     

The aberrant behavior checklist with children and adolescents with dual diagnosis

The Aberrant Behavior Checklist (ABC; Aman, Singh, Stewart, & Field, 1985a, 1985b) is a 58-item third-party informant rating scale originally developed for institutionalized, low-functioning adolescents and adults. The present study investigated the appropriateness of the scale for youngsters with dual diagnosis of mental retardation and psychiatric disturbance. Over a period of 2 1/2 years, 204 patients (199 after data reduction) from a child psychiatry unit were rated twice daily by direct care staff. Data analysis addressed internal consistency, interrater reliability, criterion validity, and robustness of the factor structure. Internal consistency was satisfactory with alpha coefficients ranging from .82 to .94. Interrater reliability varied between subscales but was relatively low (Pearson correlations between .39 to .61). In terms of its criterion validity, the ABC was sensitive to psychiatric diagnoses and age and the original 5-factor structure was robust (congruence coefficients ranged between .80 to .89). Yet, only a relatively small proportion of the variance (31.5%) was explained by factor analysis indicating possible limitations of the ABC for this population. Given the paucity of assessment instruments for this particular population and the difficulty involved in developing new population-specific instruments, the ABC can be recommended for children and adolescents with dual diagnosis.     

Abnormalities in hair trace elements as indicators of aberrant behavior

There are long-standing viewpoints that impulsive and violent behavior may stem from brain dysfunction or damage secondary to head injury, disease, or toxic chemical substances. This research has aimed to examine the relationship between potentially toxic metals and aberrant behavior, especially violent activity, through the nonintrusive technique of hair analysis for trace elements. In an initial study, phase I, it was not possible to replicate findings of others who reported high levels of lead, cadmium, and copper in violent offenders. However, high levels of manganese were found in prison versus control groups. In phase II, the possibility of artifactual results arising from prison cooking utensils was controlled for by sampling early after incarceration. Phase III was included to substantiate the initial post hoc findings in an additional jail population. In both latter phases, significantly elevated manganese levels were found in the hair of violent versus nonviolent subjects (P less than .0001). A review of the effects of manganese at deficient and toxic levels does not provide a simple answer as to why manganese levels are elevated in the hair of individuals who have been incarcerated for violent behavior. Our study does not implicate the prison environment or soaps and shampoos used in California prisons. Other factors, such as alcohol, dietary, or psychosocial factors, might influence manganese levels in hair, or any of these factors might function in combination with mild manganese toxicity to contribute to aberrant behavior.     

A review of "noncontingent" reinforcement as treatment for the aberrant behavior of individuals with developmental disabilities

The term noncontingent reinforcement (NCR) refers to the delivery of an aberrant behavior's known reinforcer on a response-independent basis. The typical result is a decrease in responding from baseline (i.e., reinforcement) levels. NCR has become one of the most reported function-based treatments for aberrant behavior in the recent literature. The purpose of this review is to briefly discuss the history of the procedure and summarize the findings from the treatment research literature. The review is organized into the following sections: (a) basic research on NCR, (b) NCR as a control procedure, (c) NCR as a function-based treatment, (d) considerations in the programming of NCR schedules, (e) behavior-change mechanisms underlying NCR effects, and (t) directions for future research.     

Effects of increased response effort and reinforcer delay on choice and aberrant behavior

A four-phase investigation was completed to analyze the utility of forced-choice preference assessments when response effort and reinforcer delays are altered within a subsequent reinforcer assessment. The results indicated that access to highly preferred stimuli continued to serve as a reinforcer when increased response effort was required. When reinforcer delay was increased, the utility of preferred stimuli to serve as a reinforcer was variable. Despite stimuli continuing to serve as reinforcers for academic task engagement, increased response effort and reinforcer delay resulted in an increased level of aberrant behavior.     

Persistence of early emerging aberrant behavior in children with developmental disabilities

This study examined the persistence of early emerging aberrant behavior in 13 preschool children with developmental disabilities. The severity of aberrant behavior was assessed every 6 months over a 3-year period. Teachers completed the assessments using the Aberrant Behavior Checklist [Aman, M. G., & Singh, N. N. (1986). Aberrant Behavior Checklist: Manual. East Aurora, NY: Slosson Educational Publications; (1994). Aberrant Behavior Checklist--Community. East Aurora, NY: Slosson Educational Publications]. Problem behaviors were present in all children at the beginning of the study. Nine of the 13 children entered the study with relatively high levels of aberrant behaviors that showed little change over the 3 years. These data suggest that aberrant behaviors often emerge early and can be highly persistent during the preschool years. Prevention would, therefore, seem to require home-based interventions that begin before 4 years of age.     

Functional analysis of the early development of self-injurious behavior: incorporating gene-environment interactions

The analysis of the early development of self-injurious behavior (SIB) has, to date, reflected the wider distinction between nature and nurture. Despite the status of genetic factors as risk markers for the later development of SIB, a model that accounts for their influence on early behavior-environment relations is lacking. In the current paper we argue that the investigation of gene-environment interactions (GxE) and other forms of gene-environment interplay could potentially enhance current approaches to the study of self-injury. A conceptual model of the early development of SIB based explicitly on such relations is presented. The model is consistent with the basic tenets of functional analysis. Implications for research and the assessment, treatment, and prevention of SIB are discussed.