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Biomedical subjects

T R Vollmer

Publications and source records attributed to T R Vollmer.

At least 19 recordsLinked to original sources
PubMed1997

Negative side effects of noncontingent reinforcement.

Noncontingent reinforcement (NCR) has emerged as a treatment package for severe behavior problems. Although concerns about potential side effects (such as incidental reinforcement) have been raised, there have been few reported negative side effects in published studies to date. In this article, we report an NCR treatment evaluation for severe aggression that produced (a) an extinction burst and (b) incidental reinforcement. These side effects were evaluated by examining within-session response patterns and response distributions. As a solution, a brief omission contingency was added to the reinforcement schedule. The omission contingency resulted in decreased aggression rates.

Adolescent↗
PubMed1996

A comparison of reinforcer assessment methods: the utility of verbal and pictorial choice procedures.

We compared three methods of stimulus preference assessment for verbal children and specifically evaluated the utility of a verbal choice procedure for assessing relative reinforcer value. Using a token system, relative preference for five categories of reinforcers, representing 15 different stimuli, was assessed by three methods: a reinforcer survey, a verbal stimulus-choice questionnaire, and a pictorial stimulus-choice procedure. Results showed that the verbal and pictorial stimulus-choice assessments accurately identified high- and low-preference categories for 3 of 4 participants. Survey results alone often rated multiple categories as high preference, were less likely to identify low-preference categories, and were less likely to correspond with the results of a reinforcer assessment.

Attention Deficit Disorder with Hyperactivity↗
PubMed1996

Combining noncontingent reinforcement and differential reinforcement schedules as treatment for aberrant behavior.

Research has shown that noncontingent reinforcement (NCR) can be an effective behavior-reduction procedure when based on a functional analysis. The effects of NCR may be a result of elimination of the contingency between aberrant behavior and reinforcing consequences (extinction) or frequent and free access to reinforcers that may reduce the participant's motivation to engage in aberrant behaviors or mands. If motivation is momentarily reduced, behavior such as mands may not be sensitive to positive reinforcement. In this study, for 3 children with aberrant behavior maintained by tangible positive reinforcement, differential-reinforcement-of-alternative-behavior schedules were superimposed on NCR schedules to determine if mands could be strengthened. Results for the participants indicated that NCR did not preclude reinforcement of mands.

Autistic Disorder↗
PubMed1995

Noncontingent escape as treatment for self-injurious behavior maintained by negative reinforcement.

We extended research on the role of noncontingent positive reinforcement following a functional analysis of attention-maintained self-injurious behavior to self-injury maintained by negative reinforcement in 2 young males with developmental disabilities. During a pretreatment functional analysis, each participant's self-injury was shown to be differentially sensitive to escape from instructional activities as negative reinforcement. During noncontingent escape, escape from learning activities was provided on a fixed-time schedule that was not influenced by the participant's behavior. One participant was also exposed to differential negative reinforcement of other behavior. During this condition, escape from instructional activities was provided contingent on the omission of self-injury for prespecified intervals. Results showed that the provision of escape, even when noncontingent, resulted in significant reductions in self-injury. These results are particularly interesting in light of the experimental history of noncontingent reinforcement as a control rather than as a therapeutic procedure. Noncontingent escape is discussed as a form of extinction that may be less likely than other forms of extinction to produce severe side effects.

Adolescent↗
PubMed1995

Reinforcer assessment for children with developmental disabilities and visual impairments.

We assessed the applicability of two previously developed reinforcer assessment procedures to children with developmental disabilities and visual impairments. Greater differentiation between stimuli was observed with a choice procedure than with a preference procedure. Measurement of compliance and rate of responding in adaptive skill training confirmed that the choice procedure accurately identified reinforcing stimuli. The preference procedure produced false positive predictions of reinforcer efficacy.

Adolescent↗
PubMed1995

Pyramidal staff training in the extension of treatment for severe behavior disorders.

We implemented a pyramidal training procedure for staff working with individuals who exhibited self-injurious behavior (SIB), aggression, and disruption. Two adults with developmental disabilities and their direct-care staff and supervisors participated. Following successful treatment by the experimenters, two types of baselines were conducted with the clients and their direct-care staff. During an initial baseline, the staff implemented preexisting procedures. Staff members then received instruction on the new treatment procedures using training methods common throughout the institution, and data were collected during this "post-in-service" baseline. Experimenters then taught unit supervisors to implement treatment, collect and interpret data, and provide similar instructions and feedback to the staff members. The supervisor training was implemented in a multiple baseline design across subjects (clients and direct-care staff). Results showed little change following in-service training but noticeable improvements in direct-care staff behaviors and corresponding decreases in the clients' inappropriate behavior following the pyramidal training intervention with supervisors. Six additional clients (along with their direct-care staff and supervisors) participated in pre- and posttreatment replication designs, and their results provided additional support for the efficacy of the supervisor training procedures.

Activities of Daily Living↗
PubMed1994

Restraint fading and the development of alternative behaviour in the treatment of self-restraint and self-injury.

Restraint fading and differential reinforcement were used to reduce the self-injurious behaviour (SIB) and self-restraint of a profoundly retarded man. The variables maintaining both behaviours could not be identified via pre-treatment functional analysis; however, self-restraint exerted at least some stimulus control over SIB. In Phase 1, the subject's topography of self-restraint (wrapping arms in shirt) was replaced with another topography (wrapping wrists in towel) that could be more easily faded to a headband. However, the subject's restraints could not be completely faded, and any movement was accompanied by SIB; thus, in Phase 2, a compliance training procedure was implemented to reduce his SIB while increasing time out of restraint. In Phase 3, the subject was taught to mand for edibles during training sessions. Results indicated that restraint fading combined with the development of alternative behaviour could be an effective treatment procedure for those who engage in both self-restraint and SIB.

Adult↗
PubMed1994

The functions of self-injurious behavior: an experimental-epidemiological analysis.

Data are summarized from 152 single-subject analyses of the reinforcing functions of self-injurious behavior (SIB). Individuals with developmental disabilities referred for assessment and/or treatment over an 11-year period were exposed to a series of conditions in which the effects of antecedent and consequent events on SIB were examined systematically by way of multielement, reversal, or combined designs. Data were collected during approximately 4,000 experimental sessions (1,000 hr), with the length of assessment for individuals ranging from 8 to 66 sessions (M = 26.2) conducted over 2 to 16.5 hr (M = 6.5). Differential or uniformly high responding was observed in 145 (95.4%) of the cases. Social-negative reinforcement (escape from task demands or other sources of aversive stimulation) accounted for 58 cases, which was the largest proportion of the sample (38.1%). Social-positive reinforcement (either attention or access to food or materials) accounted for 40 (26.3%) of the cases, automatic (sensory) reinforcement accounted for 39 (25.7%), and multiple controlling variables accounted for 8 (5.3%). Seven sets of data (4.6%) showed either cyclical or inconsistent patterns of responding that were uninterpretable. Overall results indicated that functional analysis methodologies are extremely effective in identifying the environmental determinants of SIB on an individual basis and, subsequently, in guiding the process of treatment selection. Furthermore, an accumulation of assessment data from such analyses across a large number of individuals provides perhaps the most rigorous approach to an epidemiological study of behavioral function.

Adolescent↗
PubMed1994

Treatment of self-injury and hand mouthing following inconclusive functional analyses.

Numerous studies have used functional analyses to prescribe interventions for severe behavior disorders. The majority of these studies have focused on behavior that is clearly maintained by socially mediated reinforcement, such as contingent access to attention, tangibles, or escape from instructional demands. However, a significant proportion of functional analyses do not yield conclusive results. We examined interventions for 3 children with severe disabilities following inconclusive functional analyses. First, preferred stimuli were identified for each child via a stimulus preference assessment. Second, a functional analysis was conducted for 2 of the 3 children. High rates of aberrant behavior were seen even (if not especially) in no-interaction sessions. The 3rd child was observed for several consecutive no-interaction sessions; behavior persisted in this condition. Third, interventions based on environmental enrichment were analyzed in an analogue setting. For all of the children, environmental enrichment decreased aberrant behavior if preferred stimuli were used in the procedure. To obtain further reductions in aberrant behavior, explicit reinforcement of toy play was required for 2 children, and a brief (5-s) time-out was necessary with 1 child. Finally, effects of treatment carried over to the school or home environment following teacher or family training. Results are discussed in the context of basic reinforcement principles and future directions for research.

Child, Preschool↗
PubMed1994

Protective equipment as treatment for stereotypic hand mouthing: sensory extinction or punishment effects?

We examined the effects of noncontingent and contingent protective equipment as treatment for self-injurious hand mouthing exhibited by 2 individuals with profound mental retardation. Results of a functional analysis assessment revealed that neither subject's self-injury was maintained by social reinforcement: One subject's self-injury was cyclical in nature; the other's occurred during all assessment conditions but most frequently when left alone. In the noncontingent-equipment condition, oven mitts were placed on the individual's hands at the beginning of a session and remained on throughout. In the contingent-equipment condition, the mitts were briefly placed on the individual's hands following occurrences of hand mouthing. For 1 subject, noncontingent mitts produced a large decrease in the rate of hand mouthing and contingent mitts produced similar results following a return to baseline. Hand mouthing was also reduced in the 2nd subject, but this individual was exposed only to the contingent-equipment condition (i.e., there was no prior history with the noncontingent-equipment condition). These results suggest either a punishment or a time-out interpretation rather than an extinction interpretation to account for the behavior-reducing effects of contingent protective equipment on self-injury.

Adult↗
PubMed1994

Transfer of behavioral function as a contributing factor in treatment relapse.

When relapse occurs following successful treatment to reduce problem behavior, it is often attributed to inconsistent implementation of maintenance programs. Although less likely, another potential cause for relapse is a change in the behavior's maintaining contingency over time. To examine this possibility, additional assessment was conducted with 4 individuals who were rereferred to a day-treatment program due to recurrence of their self-injurious behavior (SIB) 2 months to 2 years following successful treatment. In each case, the original treatment had been developed and implemented based on the outcome of functional analysis assessments. For 1 subject, results of a second functional analysis were consistent with those from the original assessment, indicating that the function of her SIB had remained unchanged. For the other 3 subjects, results of the second assessment suggested that their SIB had acquired new or additional functions. These findings indicate that factors other than program inconsistency can lead to relapse, and that clinical reevaluation for such cases should include a current functional analysis to determine if new treatment components are needed.

Adult↗
PubMed1993

Momentum versus extinction effects in the treatment of self-injurious escape behavior.

An individual's self-injurious escape behavior was treated using a high-probability instructional sequence with and without extinction. When presented alone, the high-probability sequence did not reduce self-injurious behavior. When escape extinction was implemented either alone or in combination with the high-probability sequence, self-injury decreased and compliance increased, suggesting that extinction may be a necessary component of the treatment for behavior problems maintained by escape.

Adult↗
PubMed1993

Analysis of the reinforcement and extinction components in DRO contingencies with self-injury.

Previous research has shown that self-injurious behavior (SIB) maintained by positive reinforcement may be reduced under differential-reinforcement-of-other-behavior (DRO) contingencies. In this study, we conducted an analysis of the reinforcement and extinction components of DRO while treating the self-injury of 3 women with developmental disabilities. A functional analysis revealed that each subject's SIB was maintained by positive reinforcement in the form of attention. Subsequent reinforcer assessments identified preferred and nonpreferred stimuli for later use in conjunction with DRO. Results showed high rates of SIB for all 3 subjects during baseline, which persisted when DRO was implemented without the relevant extinction component (withholding of attention for SIB) for 2 of the subjects. Low rates of SIB were observed for all subjects when DRO plus extinction was implemented or when extinction was implemented alone, suggesting that extinction may be a critical component of DRO schedules.

Adult↗
PubMed1993

Experimental analysis and treatment of multiply controlled self-injury.

A functional analysis of the self-injurious behavior (SIB) of 3 adults with profound developmental disabilities showed that each engaged in SIB in more than one assessment condition. Such outcomes may result from a failure to isolate the variable maintaining SIB, or they may reflect multiple sources of control over SIB. In order to identify more clearly the determinants of SIB, each subject was exposed to a series of treatments appropriate to one or both of the apparent functions of SIB. These treatments, applied sequentially on baselines appropriate to each behavioral function, identified the maintaining variables for SIB through differential outcomes across baselines. Results indicated that the SIB of 2 subjects was multiply controlled, confirming the outcomes of the functional analysis. However, the SIB of the 3rd subject was eliminated using a treatment designed for a single function, suggesting spurious results of the original assessment. Alternative interpretations of undifferentiated assessment data are discussed, as are analysis and treatment issues related to multiply determined behavior disorders.

Adult↗
PubMed1993

Extinction of self-injurious escape behavior with and without instructional fading.

Three individuals with developmental disabilities participated in a study of the treatment of self-injurious behavior (SIB) maintained by negative reinforcement (escape from educational tasks). Treatment was implemented in a multiple baseline design across subjects, in which two treatments were compared in a multielement format. Both treatment conditions included an escape-extinction component in which SIB no longer produced escape. One of the conditions also included a fading component in which the frequency of instructions was initially reduced to zero and then was gradually faded back in across sessions until the instructional rate matched that of the original baseline. Results indicated that extinction alone reduced SIB to the end-of-treatment criterion in fewer sessions than did extinction plus fading for all 3 subjects. For 2 of the 3 subjects, however, there was an initial increase in the frequency of SIB at the outset of treatment with extinction (an extinction burst) that was not observed when extinction was combined with the fading component.

Adult↗
PubMed1993

The role of attention in the treatment of attention-maintained self-injurious behavior: noncontingent reinforcement and differential reinforcement of other behavior.

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.

Adult↗
PubMed1992

A content analysis of written behavior management programs.

A method is described for assessing the elements of individual behavior management programs. The content analysis, consisting of 24 items covering the general categories of behavior specification, objectives, program procedures, data collection, and quality assurance, was applied to 141 written behavior programs of two large institutions from different regions of the United States. These data can be utilized readily to establish a data base for program evaluation at both the individual and institutional levels. In addition, to provide a measure of validity, the items included in the content analysis were rated by experts in the treatment of severe behavior disorders. General strengths and weaknesses of the programs, and of the content analysis itself, are discussed in light of their implications for program implementation and evaluation.

Behavior Therapy↗