Handbook of Intellectual Disabilities by Johnny L. Matson

Author:Johnny L. Matson
Language: eng
Format: epub
ISBN: 9783030208431
Publisher: Springer International Publishing

Reinforcement-Based Interventions

The extant literature provides ample evidence that reinforcement-based interventions can be used to increase socially appropriate behavior and decrease stereotypy (e.g., Gehrman, Wilder, Forton, & Albert, 2017; Greenberg, Lau, & Lau, 2016; Lancioni et al., 2008). Previous reviews of the literature indicate that research supports the use of reinforcement-based interventions to reduce inappropriate behavior in individuals with intellectual disability (Brosnan & Healy, 2011; Chowdhury & Benson, 2011). Furthermore, professional organizations and leaders in the field recommend the use of reinforcement-based interventions for the reduction of inappropriate behavior (BACB, 2014; Horner et al., 2005).

When developing reinforcement-based interventions for stereotypy maintained by access to automatic reinforcement, highly preferred items or activities can be introduced as reinforcers. Alternatively, the reinforcer can be an item or activity that is associated with low rates of stereotypy, based on the findings from a competing items assessment. The use of competing items in the previous section referred to noncontingent access to these stimuli, whereas within reinforcement-based interventions, these items are provided contingent on the individual engaging in specific responses or refraining from engaging in stereotypy. Each of the interventions described below includes the use of reinforcement to decrease stereotypy but differ based on the behaviors in which the individual must engage to access reinforcement.

Differential reinforcement of alternative behaviors (DRA). DRA involves providing reinforcement contingent on the occurrence of an alternative, appropriate behavior (Cooper et al., 2007; Tiger, Hanley, & Bruzek, 2008). Although DRA is one of the most common function-based interventions for socially maintained challenging behavior, researchers have also evaluated the efficacy of DRA to reduce automatically maintained stereotypy (e.g., Bennett, Reichow, & Wolery, 2011; Lancioni et al., 2008). Prior to implementing DRA, an alternative behavior must be identified, the source of reinforcement must be selected, and the schedule of reinforcement for the alternative behavior (e.g., fixed ratio 1, fixed ratio 5, variable ratio 5) must be established. It is also important to include teaching strategies for the alterative behavior (e.g., modeling), especially in cases in which the alternative behavior is not part of the individual’s current skill repertoire. To implement the intervention , reinforcement should be provided contingent on the occurrence of the alternative behavior.

Differential reinforcement of incompatible behaviors (DRI). DRI is a variation of DRA, in which reinforcement is provided contingent on a behavior that is incompatible with the topography of stereotypy (Cooper et al., 2007). To implement DRI , a behavior that cannot occur simultaneously with the stereotypy (i.e., the incompatible behavior) must be identified, the source of reinforcement must be selected, and the schedule of reinforcement for the incompatible behavior must be established. During the intervention, the interventionist provides reinforcement contingent on the individual engaging in the incompatible behavior. The same considerations related to teaching strategies discussed in the DRA section are also applicable for DRI.

One of the relative strengths of DRI interventions is that they involve teaching the individual a response that cannot occur at the same time as the stereotypy. Thus, as the frequency of the incompatible behavior increases, the frequency of stereotypy decreases.

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