MOABA gh workshop 2017 - · PDF fileZeke Simple FCR per min Tolerance Response per min Response Chaining Treatment Analysis Zeke 14

11/15/2017

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GregoryP.HanleyPh.D.,BCBA‐D

PracticalFunctionalAssessmentandSkill‐BasedTreatmentofSevereProblemBehavior

Formoreinformationgoto:

www.practicalfunctionalassessment.com

November,2017MOABA

Whydo“lifestyles”dictatedbyproblembehaviorpersistformanyfamiliesofchildrenwithautismandsomefamiliesofchildrenwithintellectualdisabilities?

Restrictivelifestylespersistpartlybecauseproblembehaviorofchildrenismerely

modifiedmedicated

mollifiedmicro‐analyzed

remediedapartfromskilldevelopment

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PERSPECTIVECommitmentsforSuccessfullyTreatingSevereProblemBehavior:

1. Afocusonstrengtheningskillscommunication,toleration,&contextuallyappropriatebehavior

2. Relianceonpersonalized&synthesizedreinforcementcontingenciesidentifiedviainterviewandanalysis

3. Relianceonsameschedulethatdevelopedproblembehaviorrepertoireintermittent&unpredictablereinforcement

4. Skillsdevelopedinpracticesessions,thenextendedallday

PracticalFunctionalAssessment

Priortotreatingproblembehaviorofchildrenwithautism

1. Conductanopen‐endedinterviewtodiscoverthecontextandoutcomesthatseemrelevanttoproblembehavior

2. ConductanIISCA to• Determineproblembehaviorsensitivitytosuspectedreinforcementcontingency• Obtainastableandsensitivebaselinefromwhichtoevaluatetreatment• Identifyaproperlymotivatingsetofconditionstoteachfunctionalcommunication• Identifyasufficientlychallengingsetofconditionstoteach delaytolerance• Identifyamotivatingsetofconditionstoacceleratedevelopmentaltrajectory

ComeupwithatleastonequestionrelevanttoconductingaPracticalFunctionalAssessmentprocess

Whynotorwhentouse:MAS,QABF,FAST,descriptiveassessment,conditionalprobabilityanalyses,brief,trial‐based, latency‐basedanalyses,ecological“analyses,”etc.

Whattodoininterviewwhentherespondent________...?

WhataboutwhenIISCAisundifferentiated,whatthen?

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TREATMENT

Sessions

1 2 3 4 5 6

0

1

2

3

4

Escape/Tangible/Attention

Zeke

Pro

blem

Beh

avio

r pe

r m

in

FunctionalAnalysis

Zeke

14‐yearoldboy

diagnosedwithAutism

EngagedinSevereSIBandAggression

1:1inSpecializedSchool

0

1

2

3

4

0

1

2

3

4

Com

plex

FC

Rpe

r m

in

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4

Reinforcem

ent (%)0

20

40

60

80

100

Pro

blem

Beh

avio

rpe

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in

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1

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Sessions

5 10 15 20 25 30 35 40 45 50 55 60 65

Res

pons

e to

In

stru

ctio

ns (

%)

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20

40

60

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100

Treatment Extension

1 2

Compliance

Noncomp.

Levels3

BL FCT + EXT Denial and Delay Tolerance TrainingSimple FCR Complex FCR

Zeke

Sim

ple

FCR

per

min

Tol

eran

ce R

espo

nse

per

min

Response Chaining

Problembehaviornolongeryieldsthereinforcers (escapetochild‐directedplayandteacherattention)

Asimpleresponse(buttonpress:“Mywayplease”)ispromptedandreinforcedwith(escapetochild‐directedplay&teacherattention)

TreatmentAnalysis

Zeke

14‐yearoldboy

diagnosedwithAutism



11/15/2017

4

0

1

2

3

4

0

1

2

3

4

Com

plex

FC

Rpe

r m

in

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Reinforcem

ent (%)0

20

40

60

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Pro

blem

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avio

rpe

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in

0

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Sessions

5 10 15 20 25 30 35 40 45 50 55 60 65

Res

pons

e to

In

stru

ctio

ns (

%)

0

20

40

60

80

100

Treatment Extension

1 2

Compliance

Noncomp.

Levels3


Zeke

Sim

ple

FCR

per

min

Tol

eran

ce R

espo

nse

per

min

Response Chaining

Amoreinteractionalresponse(shouldertap,waitforteacheracknowledgement,two‐buttonpress:MayIhave/Mywayplease”)ispromptedandreinforced

TreatmentAnalysis

Zeke

14‐yearoldboy

diagnosedwithAutism



0

1

2

3

4

0

1

2

3

4

Com

plex

FC

Rpe

r m

in

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Reinforcem

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20

40

60

80

100

Pro

blem

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in

0

1

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4

Sessions

5 10 15 20 25 30 35 40 45 50 55 60 65

Res

pons

e to

In

stru

ctio

ns (

%)

0

20

40

60

80

100

Treatment Extension

1 2

Compliance

Noncomp.

Levels3


Zeke

Sim

ple

FCR

per

min

Tol

eran

ce R

espo

nse

per

min

Response Chaining

Responsestodisappointmentarepromptedandreinforced:(Takeabreathandnoddingyes)

Now,FCRsarereinforcedhalfthetime.Theotherhalf,theteacherdeniesthebid(e.g.,says’s no,doyourworkwithoutme,please)

Cuesofdisappointment,Delaystoreinforcement,andunpredictableoutcomeshavenowbeenintroduced!

TreatmentAnalysis

Zeke

14‐yearoldboy

diagnosedwithAutism



0

1

2

3

4

0

1

2

3

4

Com

plex

FC

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r m

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ent (%)0

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40

60

80

100

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blem

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5 10 15 20 25 30 35 40 45 50 55 60 65

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pons

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ctio

ns (

%)

0

20

40

60

80

100

Treatment Extension

1 2

Compliance

Noncomp.

Levels3


Zeke

Sim

ple

FCR

per

min

Tol

eran

ce R

espo

nse

per

min

Response Chaining

Now,FCRsarereinforced1/3ofthetime.

TRsarereinforced1/3ofthetime.

Andcompliancewithprogressivelylongerandmorechallenginginstructionsisreinforced

TreatmentAnalysis

Zeke

14‐yearoldboy

diagnosedwithAutism



11/15/2017

5

0

1

2

3

4

0

1

2

3

4

Com

plex

FC

Rpe

r m

in

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Reinforcem

ent (%)0

20

40

60

80

100

Pro

blem

Beh

avio

rpe

r m

in

0

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Sessions

5 10 15 20 25 30 35 40 45 50 55 60 65

Res

pons

e to

In

stru

ctio

ns (

%)

0

20

40

60

80

100

Treatment Extension

1 2

Compliance

Noncomp.

Levels3


Zeke

Sim

ple

FCR

per

min

Tol

eran

ce R

espo

nse

per

min

Response Chaining

TreatmentAnalysis

Zeke

14‐yearoldboy

diagnosedwithAutism



Whatisthetreatment????

Intermittentandunpredictablereinforcementoflifeskills:FunctionalCommunicationDelay/denialtolerationCompliance

Hanley,Jin,Vanselow,&Hanratty(2014)

• Skill‐basedtreatmentforsocially‐mediatedPB

Functionalcommunicationrequest(FCR)

DeniedTolerance

response(TR)

Variableamountofwork/playexpectations

Compliance

ReinforcementGranted

20%

60%

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ResponseReinforcementis: requirementis:Function‐based VariableDifferential UnpredictableIntermittentUnsignaledVariableinduration

TreatmentImplementation

*Materialsnotneeded:LaminateLaminatingmachineGluegunsVisavismarkersVelcroTokensTokenboardsTimersStickersCandiesAnythingthatwasnotalreadyin

thechild’senvironment!

1. Puttheseinyourpocket2. Pulloneoutwhilechildis

experiencingtheirreinforcers

3. Keepittoyourself4. Requirethatbehaviornext

time

Appcalled“NamesinaHat”

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Appcalled“Roundom”P

robl

em B

ehav

ior

pe

r m

in

0.0

0.5

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1.5

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Sim

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FC

R

p

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in

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plex

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per

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100

BL FCT + EXT

Sim

ple

FCR

Com

plex

FC

R

Denial BL Denial and Delay Tolerance Training

Treatment Extension

Response Chaining

Meltdownsandaggression

“Playwithme”

“Excuseme,”waitsforacknowledgementfromparent,thensays,“Willyouplaywithme,please”withappropriatetoneandvolume

Saying,“okay”whileglancingatparentwhojustsaid“No,”Wait,”“Holdon,”or“inaminute”

TreatmentAnalysis

Gail

3‐yearoldgirl

diagnosedwithAutism

Engagedinextendedmeltdownswithaggression

ProcessinClinicandhomewithmotherimplementing

0.0

Tol

eran

ce R

espo

nse

pe

r m

in

0.0

0.5

1.0

1.5

2.0

Sessions5 10 15 20 25 30 35 40 45 50 55 60 65 70

R

espo

nse

to

Inst

ruct

ions

(%

)

0

25

50

75

100

Rei

nfor

cem

ent

(%)

0

25

50

75

100

Gail

1 2 3

Compliance

Noncomp.

Levels

Visits

2

Calendar Days (2012-2013)

3 6

12/1

312

/14

7

8

9 10

11

12

13

14

1/18

1/21

1/22

1/25

1/29

2/1

2/4

2/5

2/6

15

2/12

16 17 18 19

2/15

2/18

2/19

2/20

20

3/1

21

3/2

22

3/8

Reinforcement:TimewithMom’sundividedattentionandpreferredtoys

Compliance:DoingwhateverMomaskedhertodoquicklyandcompletely

TreatmentAnalysis

Gail

3‐yearoldgirl

diagnosedwithAutism

Engagedinextendedmeltdownswithaggression

ProcessinClinicandhomewithmotherimplementing

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TimeAssessment

Steps

# of Visits (1 hr each)

Cost (in US dollars)

Range Mean Range Mean

1* Interview -- 1 -- 200

2* Functional Analysis 1 - 4 2.3 166 - 800 467

3 Functional Communication Training

1 - 3 2 200 - 534 400

4 Complex FCT 1 - 4 2.4 200 - 860 487

5 Tolerance Response Training

2 - 7 4.6 300 - 1400 913

6 Easy Response Chaining 1 - 5 2.6 200 – 960 520

7* Difficult Response Chaining 2 - 11 5.1 400 - 2240 1,013

8* Treatment Extension 4 - 9 7.3 800 - 1800 1,467

Totals: 23 - 32 27 5,467

Supervision meetings: 16 - 28 20 1000 - 1750 1250

Report writing / planning: -- 4 -- 500

Grand Totals: 6225 - 8650 7,217

CostAssessment

Steps

# of Visits (1 hr each)

Cost (in US dollars)

Range Mean Range Mean

1* Interview -- 1 -- 200

2* Functional Analysis 1 - 4 2.3 166 - 800 467

3 Functional Communication Training

1 - 3 2 200 - 534 400

4 Complex FCT 1 - 4 2.4 200 - 860 487

5 Tolerance Response Training

2 - 7 4.6 300 - 1400 913

6 Easy Response Chaining 1 - 5 2.6 200 – 960 520

7* Difficult Response Chaining 2 - 11 5.1 400 - 2240 1,013

8* Treatment Extension 4 - 9 7.3 800 - 1800 1,467

Totals: 23 - 32 27 5,467

Supervision meetings: 16 - 28 20 1000 - 1750 1250

Report writing / planning: -- 4 -- 500

Grand Totals: 6225 - 8650 7,217

Social Acceptability Questionnaire Results

Ratings

Questions Gail Dale Bob Mean

1. Acceptability of assessment procedures 7 7 7 7

2. Acceptability of treatment packages 7 7 7 7

3. Satisfaction with improvement in problem behavior 7 7 6 6.7

4. Helpfulness of consultation 7 7 7 7

Note. 7=highly acceptable, highly satisfied, or very helpful 1=not acceptable, not satisfied, or not helpful

IISCAshaveledsocially‐validated outcomes

fromHanleyetal.,2014

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PersonalizedSocialvalidityData

Parents' Comfort Level of Presenting the Evocative Situation

Comfort Levels

Questions Pre-treatment Post-treatment

Gail

1. Taking away toys 1 7

2. Telling child "no" when they ask for something 3 7

3. Giving instructions 5 7

Dale

1. Interrupting child's preferred activity and telling them to do homework or other non-preferred activities

4 6

Bob

1. Taking away DS or iPad at meal times 3 7

2. Taking away DS or iPad on a transition 3 7

3. Interrupting or correcting math work 3 7

Note. 7=very comfortable 1=not comfortable.

Onemorecaseexamplethatillustratesourcurrentparenttrainingprocess….

(seeworkbookfortool)

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Sessions

1 2 3 4 5 6

Pro

blem

beh

avio

rpe

r m

in

0.0

0.5

1.0

1.5

2.0

ControlTest

Jordan

Escape from adult instruction to tangibles, attention,

& mand compliance

IISCA

Jordan

3‐yearoldboy

diagnosedwith“SPD”

Engagedinsevereaggression&meltdowns

Processinclinicwithanalystandmotherimplementing

Sessions

1 2 3 4 5 6

Pro

blem

beh

avio

rpe

r m

in

0.0

0.5

1.0

1.5

2.0

ControlTest

Jordan

Escape from adult instruction to tangibles, attention,

& mand compliance

Voc

al d

isru

ptio

nspe

r m

inut

e

0123456

Dis

rupt

ive

beha

vior

per

min

ute

0

1

2

3

4

* A

ggre

ssio

npe

r m

inut

e

0

1

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4

Thr

owin

gpe

r m

inut

e

0

1

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4

Sr for all responses

EXT

Sessions2 4 6 8 10

Tot

al p

robl

em

beha

vior

per

min

ute

0

2

4

6

8

Sr for all responses

Jordan

Sr for aggression

ResponseClassAnalysis

Jordan

3‐yearoldboy




Reinforcem

ent (%)0

20406080100

Prob

lem

beh

avio

r

p

er m

in

02468

10

Sim

ple

FCR

per

min

0

1

2

3

4

Inte

rmed

iate

FC

R

p

er m

in

0

1

2

3

4

Com

plex

FC

R

pe

r m

in

0.0

0.5

1.0

1.5

2.0

Tol

eran

ce r

espo

nse

pe

r m

in

0.0

0.5

1.0

1.5

2.0

Com

plia

nce

(%)

020406080

100 Dem

ands

01020304050

Compliance Demands

BLSimple FCT

Simple FCBL Intermediate

FCTComplex FCT

Tolerance Training

Compliance Chaining Treatment Extension

Chi

ld-l

ed ti

me

(%)

0

25

50

75

100

Mother onlyBehavior Analyst onlyBA + Mother

Sessions10 20 30 40 50 60 70 80 90 100 110 120 130

Adu

lt-le

d tim

e (%

)

0

25

50

75

100

T

rans

ition

tim

e (%

)

0

25

50

75

100

Tre

atm

ent i

nteg

rity

Jordan

TreatmentAnalysiswithAnalystImplementation

Jordan

3‐yearoldboy




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Reinforcem

ent (%)0

20406080100

Prob

lem

beh

avio

r

p

er m

in

02468

10

Sim

ple

FCR

per

min

0

1

2

3

4

Inte

rmed

iate

FC

R

p

er m

in

0

1

2

3

4

Com

plex

FC

R

pe

r m

in

0.0

0.5

1.0

1.5

2.0

Tol

eran

ce r

espo

nse

pe

r m

in

0.0

0.5

1.0

1.5

2.0

Com

plia

nce

(%)

020406080

100 Dem

ands

01020304050

Compliance Demands

BLSimple FCT

Simple FCBL Intermediate

FCTComplex FCT

Tolerance Training

Compliance Chaining Treatment Extension

Chi

ld-l

ed ti

me

(%)

0

25

50

75

100

Mother onlyBehavior Analyst onlyBA + Mother

Sessions10 20 30 40 50 60 70 80 90 100 110 120 130

Adu

lt-le

d tim

e (%

)

0

25

50

75

100

T

rans

ition

tim

e (%

)

0

25

50

75

100

Tre

atm

ent i

nteg

rity

Jordan

TreatmentAnalysiswithMotherImplementation

Jordan

3‐yearoldboy




TreatmentReview

Personalized andsynthesized reinforcersdelivered

intermittently,unpredictably, and exclusively

followingvariouschainlengthsofappropriate

behaviorthatincludes

communication,toleration,andcompliance

Sessions10 20 30 40 50 60

Top

ogra

phic

al R

esp

onse

Cri

eter

ia

PB

SFCIFC

CFCCFC+TR

CFC+TR+3 IsF

CFC+TR+5 IsF

CFC+TR+7 IsF

CFC+TR+2 IsF

CFC+TR+4 IsF

CFC+TR+6 IsF

CFC+TR+10 IsF

CFC+TR+13 IsF

CFC+TR+20 IsF

FunctionalCommunicationTraining

ToleranceResponseTraining

ComplianceChaining

1 or 2 Experts Implementing

in 1 or 3 Practice Contextsduring Short Sessions (5 min or 5 trials)

CFC+TR+1 IF

Visits2

Calendar Days

3 4

2/9

2/11

5 6 7 8 9 10 11 12

2/13

2/16

2/18

2/21

2/23

2/25

2/28

3/1

3/4

13

3/6

14 15 16

3/9

3/12

3/15

18

3/18

19

3/20

20

3/24

21

3/27

22

3/29

23

4/2

24

4/3

4/5

251HomeClinic

2/7

BL(TestsessionsfromIISCA)

Response Criterion

Easy

Hard

2Experts ImplementingIn Practice ContextsDuring Short Sessions

(5 – 10 min or 5 trials)

Agraphicalwalkthroughoftheprocedures,emphases,andexpectationfromthechild’s/clientsperspective

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Thetreatmentisimplementedinthemostchallengingcontextthatissufficientlyconvenienttorepeatedlyarrange

Referredtoasthe“twoCs”ofcontext

Thetreatmentprocessbeginsbyprovidingpersonalized andsynthesized reinforcersforeachandeveryproblembehaviorandthenforeachandeverycommunicationresponse

Trustisbuiltbyarrangingforeasyresponsestoreliablyandimmediatelyresultinall reinforcers

Sessions10 20 30 40 50 60

Top

ogra

phic

al R

esp

onse

Cri

eter

ia

PB

SFCIFC

CFCCFC+TR

CFC+TR+3 IsF

CFC+TR+5 IsF

CFC+TR+7 IsF

CFC+TR+2 IsF

CFC+TR+4 IsF

CFC+TR+6 IsF

CFC+TR+10 IsF

CFC+TR+13 IsF

CFC+TR+20 IsF



ComplianceChaining



CFC+TR+1 IF

Visits2

Calendar Days

3 4

2/9

2/11

5 6 7 8 9 10 11 12

2/13

2/16

2/18

2/21

2/23

2/25

2/28

3/1

3/4

13

3/6

14 15 16

3/9

3/12

3/15

18

3/18

19

3/20

20

3/24

21

3/27

22

3/29

23

4/2

24

4/3

4/5

251HomeClinic

2/7


Response Criterion

Easy

Hard

Samesimpleresponsereinforcedeachtime

Experts ImplementingIn Practice ContextsDuring Short Sessions


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ThefirstcommunicationresponsetaughtisreferredtoastheSimpleFunctionalCommunicationResponse(sFCR)

ThekeyfeaturesofansFCR: Simple (Horner&Day,1991) Novel (Derbyetal.,1998) Omnibus(“Myway”) (Hanleyetal.,2014) Canbeeffectivelyprompted

Thekeyfeaturesofinitialteaching: PromptSFCpriortofullintroductionofEO (Wardetal.,2018)

• Baseonwithin‐sessionresultsofIISCA Promptresponseimmediatelyandafterproblembehavior

(Landa etal.,2018)

Shapingofthefunctionalcommunicationresponsecontinues(Ghaemmaghamietal.,2018)

….untilitcontains:

Anobtainingalistenerresponse(e.g.,“Excuseme”) Agenerativeautoclitic frame(e.g.,“MayIhave_____”) Asocialnicety Propertone,pace,volume,articulation

ItisthenreferredtoasaComplexFunctionalCommunicationResponse(cFCR)(e.g.,“Excuseme[pause,waitforacknowledgement],MayIhavemyway,please?)

Sessions10 20 30 40 50 60

Top

ogra

phic

al R

esp

onse

Cri

eter

ia

PB

SFCIFC

CFCCFC+TR

CFC+TR+3 IsF

CFC+TR+5 IsF

CFC+TR+7 IsF

CFC+TR+2 IsF

CFC+TR+4 IsF

CFC+TR+6 IsF

CFC+TR+10 IsF

CFC+TR+13 IsF

CFC+TR+20 IsF



ComplianceChaining



CFC+TR+1 IF

Visits2

Calendar Days

3 4

2/9

2/11

5 6 7 8 9 10 11 12

2/13

2/16

2/18

2/21

2/23

2/25

2/28

3/1

3/4

13

3/6

14 15 16

3/9

3/12

3/15

18

3/18

19

3/20

20

3/24

21

3/27

22

3/29

23

4/2

24

4/3

4/5

251HomeClinic

2/7


Response Criterion

Easy

Hard



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Sessions10 20 30 40 50 60

Top

ogra

phic

al R

esp

onse

Cri

eter

ia

PB

SFCIFC

CFCCFC+TR

CFC+TR+3 IsF

CFC+TR+5 IsF

CFC+TR+7 IsF

CFC+TR+2 IsF

CFC+TR+4 IsF

CFC+TR+6 IsF

CFC+TR+10 IsF

CFC+TR+13 IsF

CFC+TR+20 IsF



ComplianceChaining



CFC+TR+1 IF

Visits2

Calendar Days

3 4

2/9

2/11

5 6 7 8 9 10 11 12

2/13

2/16

2/18

2/21

2/23

2/25

2/28

3/1

3/4

13

3/6

14 15 16

3/9

3/12

3/15

18

3/18

19

3/20

20

3/24

21

3/27

22

3/29

23

4/2

24

4/3

4/5

251HomeClinic

2/7


Response Criterion

Easy

Hard



ThecFCR issometimesdifferentiatedintospecificmands(Wardetal.,2018)

Anobtainingalistener responseAbreak responseAnaccesstopreferredtoysresponseAnattentionrecruitmentresponse

(e.g.,““Excuseme[pause,waitforacknowledgement],MayIhaveabreak,please?“….MayIhavemystuffplease”....”Willyouplaywithme”)

Differentiatethecomplexresponse

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Atoleranceresponseisthentaught(Hanleyetal.,2014;Santiagoetal.,2016;Ghaemmaghamietal.,2016)

NowSrisintermittentandunpredictable

Typical5‐trialsequenceinearlychainingphase:

Sr =synthesizedreinforcementcFCR =complexfunctionalcommunicationresponseTR =toleranceresponse

*Wejustintroduceddisappointmentandambiguityatthesametime—westayhereuntiltherearenonegativeemotionalresponses

cFCR TR cFCR cFCR TR

Trial1 Sr: Trial2 Sr: Trial3 Sr: Trial4 Sr: Trial5 Sr:

Sessions10 20 30 40 50 60

Top

ogra

phic

al R

esp

onse

Cri

eter

ia

PB

SFCIFC

CFCCFC+TR

CFC+TR+3 IsF

CFC+TR+5 IsF

CFC+TR+7 IsF

CFC+TR+2 IsF

CFC+TR+4 IsF

CFC+TR+6 IsF

CFC+TR+10 IsF

CFC+TR+13 IsF

CFC+TR+20 IsF



ComplianceChaining



CFC+TR+1 IF

Visits2

Calendar Days

3 4

2/9

2/11

5 6 7 8 9 10 11 12

2/13

2/16

2/18

2/21

2/23

2/25

2/28

3/1

3/4

13

3/6

14 15 16

3/9

3/12

3/15

18

3/18

19

3/20

20

3/24

21

3/27

22

3/29

23

4/2

24

4/3

4/5

251HomeClinic

2/7


Response Criterion

Easy

Hard



Notethechaining

Thenchainingofcontextuallyappropriatebehavior(CAB)andmoreSrintermittencyandunpredictabilityfollows


cFCR 1hCAB 2eCAB TR 3eCAB

Tr 1 Sr: Tr 2 Sr: Tr 3 Sr: Tr 4 Sr: Tr 5 Sr:

11/15/2017

16

Sessions10 20 30 40 50 60

Top

ogra

phic

al R

esp

onse

Cri

eter

ia

PB

SFCIFC

CFCCFC+TR

CFC+TR+3 IsF

CFC+TR+5 IsF

CFC+TR+7 IsF

CFC+TR+2 IsF

CFC+TR+4 IsF

CFC+TR+6 IsF

CFC+TR+10 IsF

CFC+TR+13 IsF

CFC+TR+20 IsF



ComplianceChaining



CFC+TR+1 IF

Visits2

Calendar Days

3 4

2/9

2/11

5 6 7 8 9 10 11 12

2/13

2/16

2/18

2/21

2/23

2/25

2/28

3/1

3/4

13

3/6

14 15 16

3/9

3/12

3/15

18

3/18

19

3/20

20

3/24

21

3/27

22

3/29

23

4/2

24

4/3

4/5

251HomeClinic

2/7


Response Criterion

Easy

Hard



NowcompliancechainingandmoreSrintermittencyandunpredictability

Noteagainthechainlengths

Thenchainingofcontextuallyappropriatebehavior(CAB)andmoreSrintermittencyandunpredictabilityfollows


Sr =synthesizedreinforcementcFCR =complexfunctionalcommunicationresponseTR =toleranceresponseeCAB =easycontextuallyappropriatebehavior

(e.g.,completionofmasteredtask,playwithalternativebutpreferredmaterials)hCAB =hardcontextuallyappropriatebehavior

(e.g.,accuratecompletionofchallengingmathproblems,independentplayw/mundanetoys)

cFCR 1hCAB 2eCAB TR 3eCAB

Trial1 Sr: Trial2 Sr: Trial3 Sr: Trial4 Sr: Trial5 Sr:

Theaveragechainlengthgetsprogressivelylongerassuccessisexperiencedateachstep

Step Trial1 Sr: Trial2 Sr: Trial3 Sr: Trial4 Sr: Trial5 Sr: Mean#Rs/Sr Range1 cFCR TR 1eCAB 2eCAB 1eCAB 4.6 3‐6

1eCAB 2eCAB cFCR TR 1eCAB 4.6 3‐62 cFCR 1hCAB 2eCAB 3eCAB TR 5 3‐7

TR 2eCAB cFCR 3hCAB 1hCAB 5 3‐73 5eCAB cFCR 1hCAB TR 3eCAB 5.6 3‐9

TR 5eCAB cFCR 3hCAB 1eCAB 5.6 3‐94 2hCAB cFCR 4eCAB TR 6eCAB 6.2 3‐10

cFCR 6hCAB TR 4hCAB 2eCAB 6.2 3‐105 cFCR 5eCAB 3hCAB 7eCAB TR 6.8 3‐11

3hCAB cFCR 7eCAB TR 5hCAB 6.8 3‐116 TR 10eCAB cFCR 2eCAB 7hCAB 7.6 3‐13

cFCR 2hCAB 7eCAB 10hCAB TR 7.6 3‐137 2eCAB 10hCAB cFCR 13eCAB TR 8.8 3‐16

TR 13eCAB 2hCAB cFCR 10hCAB 8.8 3‐16

11/15/2017

17

Sessions10 20 30 40 50 60

Top

ogra

phic

al R

esp

onse

Cri

eter

ia

PB

SFCIFC

CFCCFC+TR

CFC+TR+3 IsF

CFC+TR+5 IsF

CFC+TR+7 IsF

CFC+TR+2 IsF

CFC+TR+4 IsF

CFC+TR+6 IsF

CFC+TR+10 IsF

CFC+TR+13 IsF

CFC+TR+20 IsF



ComplianceChaining



CFC+TR+1 IF

Visits2

Calendar Days

3 4

2/9

2/11

5 6 7 8 9 10 11 12

2/13

2/16

2/18

2/21

2/23

2/25

2/28

3/1

3/4

13

3/6

14 15 16

3/9

3/12

3/15

18

3/18

19

3/20

20

3/24

21

3/27

22

3/29

23

4/2

24

4/3

4/5

251HomeClinic

2/7


Response Criterion

Easy

Hard



Easy Hard

Maintenance Acquisition

Small field Larger field

Short response Longer response

Supported Independent

Less‐preferred tasks Aversive tasks (e.g., hygiene)

Small Motor Movements Large Motor Movements

Indep. Play w/ Preferred Toys Indep. Play w/ Non‐pref. Toys

Typical5‐trialsequenceinlaterchainingphase:

Sr =synthesizedreinforcementcFCR =complexfunctionalcommunicationresponseTR =toleranceresponseeCAB =easycontextuallyappropriatebehaviorhCAB =hardcontextuallyappropriatebehavior

Bylaststep:Average10responsesperSr(range,3‐23)

10hCAB 3eCAB 20hCAB TR cFCR

Trial 1 Sr: Trial 2 Sr: Trial 3 Sr: Trial 4 Sr: Trial 5 Sr:

Sessions10 20 30 40 50 60

Top

ogra

phic

al R

esp

onse

Cri

eter

ia

PB

SFCIFC

CFCCFC+TR

CFC+TR+3 IsF

CFC+TR+5 IsF

CFC+TR+7 IsF

CFC+TR+2 IsF

CFC+TR+4 IsF

CFC+TR+6 IsF

CFC+TR+10 IsF

CFC+TR+13 IsF

CFC+TR+20 IsF



ComplianceChaining



CFC+TR+1 IF

Visits2

Calendar Days

3 4

2/9

2/11

5 6 7 8 9 10 11 12

2/13

2/16

2/18

2/21

2/23

2/25

2/28

3/1

3/4

13

3/6

14 15 16

3/9

3/12

3/15

18

3/18

19

3/20

20

3/24

21

3/27

22

3/29

23

4/2

24

4/3

4/5

251HomeClinic

2/7


Response Criterion

Easy

Hard



Nowgapping longerchainswithsometimeslonggapsbetween

chainlengths

11/15/2017

18

Someemphases:

Progressivelyincreasetheaverageamountofbehavior (notjusttime)requiredtoterminatethedelay(Ghaemmaghamietal.,2016)

Terminatethedelayforvarious amountsofbehavior

(sometimesexpectverylittlebehavior,sometimesexpectlongerormorecomplextypesofbehaviorduringthedelay)

Probablybesttonotsignalhowmuchbehaviorisrequiredtoterminatethedelays

Asdelayincreases,FCRweakens&probabilityofPBincreases

WithonlyProgressiveReinforcementDelay(nochaining):

Sessions10 20 30 40

0

2

4

6

8

10No

DelayTerminal

Delay(no EXT)

NoDelay

NoDelay

TBPD(with EXT)

CBPD(with EXT)

Alex

Prob

lem

Beh

avio

r pe

r m

in

Scheduled Delay

Mean Experienced Delay

10 20 30 40

Res

pons

es p

er m

in

0.0

0.6

1.2

1.8

Ind TR

Ind FCR

Sessions

Time‐basedvs.Contingency‐basedProgressiveDelay

(LeadAuthor:MahshidGhaemmaghami)

11/15/2017

19

Time‐basedvs.Contingency‐basedProgressiveDelay(LeadAuthor:Mahshid

Ghaemmaghami)

0

20

40

60

80

100

0

1

2

3

0

20

40

60

80

100

0

1

2

3

4

5

0

20

40

60

80

100

Pro

blem

Beh

avio

rpe

r m

in

0

1

2

3

0

20

40

60

80

100

App

ropr

iate

Res

pons

espe

r m

in

0

1

2

3

4

FCRTolerance Response

NoDelay

Terminal DelayWithout Extinction

NoDelay

NoDelay

NoDelay

Time-BasedProgressive Delay

Contingency-BasedProgressive Delay (CBPD)

Context 1

CBPD

% of S

ession Engaged in

Em

otional Responding

Dur

atio

n of

Del

ay (

s)

0

100

200

300

400

ScheduledExperienced

Sessions5 10 15 20 25 30 35 40 45 50 55

0

100

200

300

400


% of D

elay Interval Engaged in

Alternative A

ctivity

Context 2

Context 1

Context 2

Context 1

Context 2

Jack

Time‐basedvs.Contingency‐basedProgressiveDelay(LeadAuthor:Mahshid

Ghaemmaghami)

0

20

40

60

80

100

0

1

2

3

0

20

40

60

80

100

0

1

2

3

4

5

0

20

40

60

80

100

Pro

blem

Beh

avio

rpe

r m

in

0

1

2

3

0

20

40

60

80

100

App

ropr

iate

Res

pons

espe

r m

in

0

1

2

3

4

FCRTolerance Response

NoDelay


NoDelay

NoDelay

NoDelay

Time-BasedProgressive Delay

Contingency-BasedProgressive Delay (CBPD)

Context 1

CBPD

% of S

ession Engaged in

Em

otional Responding

Dur

atio

n of

Del

ay (

s)

0

100

200

300

400

ScheduledExperienced

Sessions5 10 15 20 25 30 35 40 45 50 55

0

100

200

300

400


% of D

elay Interval Engaged in

Alternative A

ctivity

Context 2

Context 1

Context 2

Context 1

Context 2

Jack

1 2 3 4 5 6 7 8

0

1

2

3

4 Free ChoiceForced Choice

Cole

1 2 3 4 5 6 7

0

1

2

3

4

EXT Predictable Delay Unpredictable Delay

Free ChoiceForced Choice

Jeff

2 4 6 8 10 12

Cum

ulat

ive

Init

ial-

Lin

kSe

lect

ions

0

2

4

6

8

10 Free ChoiceLevel 6

ForcedChoice

Free ChoiceLevel 8

Jian

2 4 6 8 10 12 14 16 18 20 22

0

2

4

6

8

10

12

14

16 ForcedChoice

Free ChoiceLevel 5

Free ChoiceLevel 7

Luke

Sessions1 2 3 4 5 6 7 8 9

Cum

ulat

ive

Initi

al-L

ink

Sel

ectio

ns

0

1

2

3

4

5

6 ForcedChoice

Free Choice

Raj

EXTPredictable DelayUnpredictable Delay

11/15/2017

20

Sessions10 20 30 40 50 60

Top

ogra

phic

al R

esp

onse

Cri

eter

ia

PB

SFCIFC

CFCCFC+TR

CFC+TR+3 IsF

CFC+TR+5 IsF

CFC+TR+7 IsF

CFC+TR+2 IsF

CFC+TR+4 IsF

CFC+TR+6 IsF

CFC+TR+10 IsF

CFC+TR+13 IsF

CFC+TR+20 IsF



ComplianceChaining



CFC+TR+1 IF

Visits2

Calendar Days

3 4

2/9

2/11

5 6 7 8 9 10 11 12

2/13

2/16

2/18

2/21

2/23

2/25

2/28

3/1

3/4

13

3/6

14 15 16

3/9

3/12

3/15

18

3/18

19

3/20

20

3/24

21

3/27

22

3/29

23

4/2

24

4/3

4/5

251HomeClinic

2/7


Response Criterion

Easy

Hard



ImportantTIPS

1. AlwaysprovideimmediatesrforsomeFCRs

2. Teachanappropriateresponse tocuesofdelay,denial,ordisappointment

3. Progressivelyincreasetheaverageamountofbehavior (notjusttime)requiredtoterminatethedelay

4. Terminatethedelayforvarious amountsofbehavior(sometimesexpectverylittlebehaviorsometimesrequestlargerormorecomplextypesofbehaviorduringthedelay)

5. Probablybesttonotsignalhowmuchbehaviorisrequiredtoterminatethedelays

Sessions10 20 30 40 50 60

Top

ogra

ph

ical

Res

pon

se C

riet

eria

Nu

merical R

espon

se Criteria

0

10

20

30

40

50

PB

SFCIFC

CFCCFC+TR

CFC+TR+3 IsF

CFC+TR+5 IsF

CFC+TR+7 IsF

CFC+TR+2 IsF

CFC+TR+4 IsF

CFC+TR+6 IsF

CFC+TR+10 IsF

CFC+TR+13 IsF

CFC+TR+20 IsF

Total Responses

Average Responses



ComplianceChaining

then Parents/StaffImplementing in Varied

Contexts duringLongSessions



CFC+TR+1 IF

Visits2

Calendar Days

3 4

2/9

2/11

5 6 7 8 9 10 11 12

2/13

2/16

2/18

2/21

2/23

2/25

2/28

3/1

3/4

13

3/6

14 15 16

3/9

3/12

3/15

18

3/18

19

3/20

20

3/24

21

3/27

22

3/29

23

4/2

24

4/3

4/5

251HomeClinic

2/7


Response Criterion

Easy

Hard



LookataverageincreaseinnumberofbehaviorrequiredforSr

Sessions10 20 30 40 50 60

Top

ogra

ph

ical

Res

pon

se C

riet

eria

Nu

merical R

espon

se Criteria

0

10

20

30

40

50

PB

SFCIFC

CFCCFC+TR

CFC+TR+3 IsF

CFC+TR+5 IsF

CFC+TR+7 IsF

CFC+TR+2 IsF

CFC+TR+4 IsF

CFC+TR+6 IsF

CFC+TR+10 IsF

CFC+TR+13 IsF

CFC+TR+20 IsF

Total Responses

Average Responses



ComplianceChaining





CFC+TR+1 IF

Visits2

Calendar Days

3 4

2/9

2/11

5 6 7 8 9 10 11 12

2/13

2/16

2/18

2/21

2/23

2/25

2/28

3/1

3/4

13

3/6

14 15 16

3/9

3/12

3/15

18

3/18

19

3/20

20

3/24

21

3/27

22

3/29

23

4/2

24

4/3

4/5

251HomeClinic

2/7


Response Criterion

Easy

Hard



LookataverageincreaseinnumberofbehaviorrequiredforSr

Lookattheincreaseintotalbehaviorspersession

11/15/2017

21

Sessions10 20 30 40 50 60

Top

ogra

ph

ical

Res

pon

se C

riet

eria

Nu

merical R

espon

se Criteria

0

10

20

30

40

50

PB

SFCIFC

CFCCFC+TR

CFC+TR+3 IsF

CFC+TR+5 IsF

CFC+TR+7 IsF

CFC+TR+2 IsF

CFC+TR+4 IsF

CFC+TR+6 IsF

CFC+TR+10 IsF

CFC+TR+13 IsF

CFC+TR+20 IsF

Total Responses

Average Responses



ComplianceChaining





CFC+TR+1 IF

Visits2

Calendar Days

3 4

2/9

2/11

5 6 7 8 9 10 11 12

2/13

2/16

2/18

2/21

2/23

2/25

2/28

3/1

3/4

13

3/6

14 15 16

3/9

3/12

3/15

18

3/18

19

3/20

20

3/24

21

3/27

22

3/29

23

4/2

24

4/3

4/5

251HomeClinic

2/7


Response Criterion

Easy

Hard



Nowparents/staffareintroduced

Notethereset

eliminationoflongchainsfromrequirementwhenparentisintroduced

Sessions10 20 30 40 50 60

Top

ogra

ph

ical

Res

pon

se C

riet

eria

Nu

merical R

espon

se Criteria

0

10

20

30

40

50

PB

SFCIFC

CFCCFC+TR

CFC+TR+3 IsF

CFC+TR+5 IsF

CFC+TR+7 IsF

CFC+TR+2 IsF

CFC+TR+4 IsF

CFC+TR+6 IsF

CFC+TR+10 IsF

CFC+TR+13 IsF

CFC+TR+20 IsF

Total Responses

Average Responses



ComplianceChaining





CFC+TR+1 IF

Visits2

Calendar Days

3 4

2/9

2/11

5 6 7 8 9 10 11 12

2/13

2/16

2/18

2/21

2/23

2/25

2/28

3/1

3/4

13

3/6

14 15 16

3/9

3/12

3/15

18

3/18

19

3/20

20

3/24

21

3/27

22

3/29

23

4/2

24

4/3

4/5

251HomeClinic

2/7


Response Criterion

Easy

Hard



Nowmorecontexts

Notethereset

eliminationoflongchainsfromrequirementwhennewcontextisintroduced

Sessions10 20 30 40 50 60

Top

ogra

ph

ical

Res

pon

se C

riet

eria

Nu

merical R

espon

se Criteria

0

10

20

30

40

50

PB

SFCIFC

CFCCFC+TR

CFC+TR+3 IsF

CFC+TR+5 IsF

CFC+TR+7 IsF

CFC+TR+2 IsF

CFC+TR+4 IsF

CFC+TR+6 IsF

CFC+TR+10 IsF

CFC+TR+13 IsF

CFC+TR+20 IsF

Total Responses

Average Responses



ComplianceChaining





CFC+TR+1 IF

Visits2

Calendar Days

3 4

2/9

2/11

5 6 7 8 9 10 11 12

2/13

2/16

2/18

2/21

2/23

2/25

2/28

3/1

3/4

13

3/6

14 15 16

3/9

3/12

3/15

18

3/18

19

3/20

20

3/24

21

3/27

22

3/29

23

4/2

24

4/3

4/5

251HomeClinic

2/7


Response Criterion

Easy

Hard



Nowlongersessions

Notethereset

eliminationoflongchainsfromrequirementwhenlongersessionsareintroduced

11/15/2017

22

Attheendoftreatment:

manyappropriatebehaviorsdonotyieldreinforcementimmediately,butthereisnodelaytoreinforcementperse

Considerthislastpracticesession….

10hCAB 3eCAB 20hCAB TR cFCR

Trial 1 Sr: Trial 2 Sr: Trial 3 Sr: Trial 4 Sr: Trial 5 Sr:

Sessions10 20 30 40 50 60

Top

ogra

ph

ical

Res

pon

se C

riet

eria

Nu

merical R

espon

se Criteria

0

10

20

30

40

50

PB

SFCIFC

CFCCFC+TR

CFC+TR+3 IsF

CFC+TR+5 IsF

CFC+TR+7 IsF

CFC+TR+2 IsF

CFC+TR+4 IsF

CFC+TR+6 IsF

CFC+TR+10 IsF

CFC+TR+13 IsF

CFC+TR+20 IsF

Total Responses

Average Responses



ComplianceChaining





CFC+TR+1 IF

Visits2

Calendar Days

3 4

2/9

2/11

5 6 7 8 9 10 11 12

2/13

2/16

2/18

2/21

2/23

2/25

2/28

3/1

3/4

13

3/6

14 15 16

3/9

3/12

3/15

18

3/18

19

3/20

20

3/24

21

3/27

22

3/29

23

4/2

24

4/3

4/5

251HomeClinic

2/7


Response Criterion

Easy

Hard



Attheterminalschedule:


Considerthissession….

Attheendoftreatment:


Duetochainingofappropriateresponses

SrComplexFCR “No” ToleranceResponse Instruction CAB(3)

SrComplexFCR

EOpresented

EOpresented

11/15/2017

23

And,non‐reinforcementofaresponse(e.g.,amand)induces()anotherappropriateresponse(e.g.,toleranceresponse)asopposedtoproblembehavior

Sr“No”


SrComplexFCR

SrComplexFCR “No” Toleranceresponse Instruction

EOpresented

EOpresented

EOpresented

CAB(10)

EOpresented ComplexFCR ToleranceResponse

SrComplexFCR “No” Toleranceresponse InstructionEOpresented CAB(20)….

Sessions10 20 30 40 50 60

Top

ogra

ph

ical

Res

pon

se C

riet

eria

Nu

merical R

espon

se Criteria

0

10

20

30

40

50

PB

SFCIFC

CFCCFC+TR

CFC+TR+3 IsF

CFC+TR+5 IsF

CFC+TR+7 IsF

CFC+TR+2 IsF

CFC+TR+4 IsF

CFC+TR+6 IsF

CFC+TR+10 IsF

CFC+TR+13 IsF

CFC+TR+20 IsF

Total Responses

Average Responses



ComplianceChaining





CFC+TR+1 IF

Visits2

Calendar Days

3 4

2/9

2/11

5 6 7 8 9 10 11 12

2/13

2/16

2/18

2/21

2/23

2/25

2/28

3/1

3/4

13

3/6

14 15 16

3/9

3/12

3/15

18

3/18

19

3/20

20

3/24

21

3/27

22

3/29

23

4/2

24

4/3

4/5

251HomeClinic

2/7


Response Criterion

Easy

Hard




Anaverageof11appropriatesocialresponsesoccurperreinforcer(range3– 24) Oneimmediatelyreinforcedsocialresponseforevery10emitted

Sessions10 20 30 40 50 60

Top

ogra

ph

ical

Res

pon

se C

riet

eria

Nu

merical R

espon

se Criteria

0

10

20

30

40

50

PB

SFCIFC

CFCCFC+TR

CFC+TR+3 IsF

CFC+TR+5 IsF

CFC+TR+7 IsF

CFC+TR+2 IsF

CFC+TR+4 IsF

CFC+TR+6 IsF

CFC+TR+10 IsF

CFC+TR+13 IsF

CFC+TR+20 IsF

Total Responses

Average Responses



ComplianceChaining





CFC+TR+1 IF

Visits2

Calendar Days

3 4

2/9

2/11

5 6 7 8 9 10 11 12

2/13

2/16

2/18

2/21

2/23

2/25

2/28

3/1

3/4

13

3/6

14 15 16

3/9

3/12

3/15

18

3/18

19

3/20

20

3/24

21

3/27

22

3/29

23

4/2

24

4/3

4/5

251HomeClinic

2/7


Response Criterion

Easy

Hard




54appropriatesocialresponsesoccurper5‐trialsession

Reinforcer periodsrangefrom30sto10min(mode:2min)

11/15/2017

24

Theaveragechainlengthisprogressivelyincreased,butcommunication,toleration,andshort/unexpectedcontextually‐appropriatebehaviorchainsarereinforcedsometimes,evenattheendoftreatment

Sr“No”


SrComplexFCR

SrComplexFCR “No” Toleranceresponse Instruction

EOpresented

EOpresented

EOpresented

CAB(10)

EOpresented ComplexFCR ToleranceResponse

SrComplexFCR “No” Toleranceresponse InstructionEOpresented CAB(20)….

Sessions10 20 30 40 50 60

Top

ogra

ph

ical

Res

pon

se C

riet

eria

Nu

merical R

espon

se Criteria

0

10

20

30

40

50

PB

SFCIFC

CFCCFC+TR

CFC+TR+3 IsF

CFC+TR+5 IsF

CFC+TR+7 IsF

CFC+TR+2 IsF

CFC+TR+4 IsF

CFC+TR+6 IsF

CFC+TR+10 IsF

CFC+TR+13 IsF

CFC+TR+20 IsF

Total Responses

Average Responses



ComplianceChaining





CFC+TR+1 IF

Visits2

Calendar Days

3 4

2/9

2/11

5 6 7 8 9 10 11 12

2/13

2/16

2/18

2/21

2/23

2/25

2/28

3/1

3/4

13

3/6

14 15 16

3/9

3/12

3/15

18

3/18

19

3/20

20

3/24

21

3/27

22

3/29

23

4/2

24

4/3

4/5

251HomeClinic

2/7


Response Criterion

Easy

Hard

2

Shorties



Theaveragechainlengthisprogressivelyincreased,butcommunication,toleration,andshort/unexpectedcompliancechainsarereinforcedsometimes,evenattheterminalschedule

Sessions10 20 30 40 50 60

Top

ogra

phic

al R

esp

onse

Cri

eter

ia

Num

erical Resp

onse C

riteria

0

10

20

30

40

50

PB

SFCIFC

CFCCFC+TR

CFC+TR+3 IsF

CFC+TR+5 IsF

CFC+TR+7 IsF

CFC+TR+2 IsF

CFC+TR+4 IsF

CFC+TR+6 IsF

CFC+TR+10 IsF

CFC+TR+13 IsF

CFC+TR+20 IsF

Total Responses

Average Responses



ComplianceChaining





CFC+TR+1 IF

Visits2

Calendar Days

3 4

2/9

2/11

5 6 7 8 9 10 11 12

2/13

2/16

2/18

2/21

2/23

2/25

2/28

3/1

3/4

13

3/6

14 15 16

3/9

3/12

3/15

18

3/18

19

3/20

20

3/24

21

3/27

22

3/29

23

4/2

24

4/3

4/5

251HomeClinic

2/7


Response Criterion

Easy

Hard

2

Shortiesnevergoaway.

Thiswaywekeephopealive!



11/15/2017

25

Sessions10 20 30 40 50 60

Top

ogra

ph

ical

Res

pon

se C

riet

eria

Nu

merical R

espon

se Criteria

0

10

20

30

40

50

PB

SFCIFC

CFCCFC+TR

CFC+TR+3 IsF

CFC+TR+5 IsF

CFC+TR+7 IsF

CFC+TR+2 IsF

CFC+TR+4 IsF

CFC+TR+6 IsF

CFC+TR+10 IsF

CFC+TR+13 IsF

CFC+TR+20 IsF

Total Responses

Average Responses



ComplianceChaining





CFC+TR+1 IF

Visits2

Calendar Days

3 4

2/9

2/11

5 6 7 8 9 10 11 12

2/13

2/16

2/18

2/21

2/23

2/25

2/28

3/1

3/4

13

3/6

14 15 16

3/9

3/12

3/15

18

3/18

19

3/20

20

3/24

21

3/27

22

3/29

23

4/2

24

4/3

4/5

251HomeClinic

2/7


Response Criterion

Easy

Hard



Sessions10 20 30 40 50 60

Top

ogra

ph

ical

Res

pon

se C

riet

eria

Nu

merical R

espon

se Criteria

0

10

20

30

40

50

PB

SFCIFC

CFCCFC+TR

CFC+TR+3 IsF

CFC+TR+5 IsF

CFC+TR+7 IsF

CFC+TR+2 IsF

CFC+TR+4 IsF

CFC+TR+6 IsF

CFC+TR+10 IsF

CFC+TR+13 IsF

CFC+TR+20 IsF

Total Responses

Average Responses



ComplianceChaining





CFC+TR+1 IF

Visits2

Calendar Days

3 4

2/9

2/11

5 6 7 8 9 10 11 12

2/13

2/16

2/18

2/21

2/23

2/25

2/28

3/1

3/4

13

3/6

14 15 16

3/9

3/12

3/15

18

3/18

19

3/20

20

3/24

21

3/27

22

3/29

23

4/2

24

4/3

4/5

251HomeClinic

2/7


Response Criterion

Easy

Hard

2

Andremember….

Longies areinitiallyremovedwhentransitioningtonewstimulusconditions(thathavehistoricalrelevance)

Longies getreintroducedaftersuccesswithsmallerchains



Detailed Description of the Skill-Based Treatment of Problem Behavior Process (developed by G. P. Hanley, October, 2017)

Progressively Changing Response Requirements

Step Objectives Responses Reinforced Sessions

Tr 1 Sr:

Tr 2 Sr:

Tr 3 Sr:

Tr 4 Sr:

Tr 5 Sr:

x Rs per Sr

1 Verifying hunch / Building Trust PB 1--3 PB PB PB PB PB -1

2 Shifting to Appropriate / Building Trust sFCR ("My way") 4--6 sFCR sFCR sFCR sFCR sFCR 1

3 Improving Form iFCR ("May I have my way please") 7--8 iFCR iFCR iFCR iFCR iFCR 2

4 Improving Form cFCR ("Excuse me" [...] "May I have my way please") 9--10 cFCR cFCR cFCR cFCR cFCR 3

5 Preparing for Inevitable Disappointment cFCR/TR ("Okay, no problem") 11 cFCR TR cFCR TR cFCR 3.4 5 Preparing for Inevitable Disappointment cFCR/TR 12 TR cFCR TR cFCR TR 3.6 5 Preparing for Inevitable Disappointment cFCR/TR 13 cFCR cFCR TR TR cFCR 3.4

6 Preparing for Inevitable Ambiguity cFCR/TR/eCAB (Adult expected work or play) 14 cFCR TR 1eCAB cFCR 1eCAB 4 6 Preparing for Inevitable Ambiguity cFCR/TR/eCAB 15 TR 1eCAB cFCR 1eCAB cFCR 4

7 Preparing for Inevitable Ambiguity cFCR/TR/eCAB 16 cFCR TR 1eCAB 2eCAB 1eCAB 4.6 7 Preparing for Inevitable Ambiguity cFCR/TR/eCAB 17 1eCAB 2eCAB cFCR TR 1eCAB 4.6

8 Building Stamina while Keeping Hope Alive cFCR/TR/e&hCAB 18 cFCR 1hCAB 2eCAB TR 3eCAB 5 8 Building Stamina while Keeping Hope Alive cFCR/TR/e&hCAB 19 TR 2eCAB cFCR 3hCAB 1hCAB 5

9 Building Stamina while Keeping Hope Alive cFCR/TR/e&hCAB 20 5eCAB cFCR 1hCAB TR 3eCAB 5.6 9 Building Stamina while Keeping Hope Alive cFCR/TR/e&hCAB 21 TR 5eCAB cFCR 3hCAB 1eCAB 5.6

10 Building Stamina while Keeping Hope Alive cFCR/TR/e&hCAB 22 2hCAB cFCR 4eCAB TR 6eCAB 6.2 10 Building Stamina while Keeping Hope Alive cFCR/TR/e&hCAB 23 cFCR 6hCAB TR 4hCAB 2eCAB 6.2

11 Building Stamina while Keeping Hope Alive cFCR/TR/e&hCAB 24 cFCR 5eCAB 3hCAB 7eCAB TR 6.8 11 Building Stamina while Keeping Hope Alive cFCR/TR/e&hCAB 25 3hCAB cFCR 7eCAB TR 5hCAB 6.8

12 Building Stamina while Keeping Hope Alive cFCR/TR/e&hCAB 26 TR 10eCAB cFCR 2eCAB 7hCAB 7.6 12 Building Stamina while Keeping Hope Alive cFCR/TR/e&hCAB 27 cFCR 2hCAB 7eCAB 10hCAB TR 7.6

13 Finding the Balance / Task Revaluing cFCR/TR/e&hCAB 28 2eCAB 10hCAB cFCR 13eCAB TR 8.8 13 Finding the Balance / Task Revaluing cFCR/TR/e&hCAB 29 TR 13eCAB 2hCAB cFCR 10hCAB 8.8

14 Finding the Balance / Task Revaluing cFCR/TR/e&hCAB 30 3eCAB 10eCAB 20hCAB cFCR TR 10 14 Finding the Balance / Task Revaluing cFCR/TR/e&hCAB 31 cFCR 3hCAB 10eCAB TR 20hCAB 10

15 Extending Effects to Relevant People cFCR/TR/e&hCAB w/RP 32 cFCR 5eCAB 3hCAB 7eCAB TR 6.8 15 Extending Effects to Relevant People cFCR/TR/e&hCAB w/RP 33 3hCAB cFCR 7eCAB TR 5hCAB 6.8

16 Extending Effects to Relevant People cFCR/TR/e&hCAB w/RP 34 TR 1TR cFCR 2eCAB 7hCAB 7.6 16 Extending Effects to Relevant People cFCR/TR/e&hCAB w/RP 35 cFCR 2hCAB 7eCAB 10hCAB TR 7.6

17 Extending Effects to Relevant People cFCR/TR/e&hCAB w/RP 36 2eCAB 10eCAB cFCR 13eCAB TR 8.8 17 Extending Effects to Relevant People cFCR/TR/e&hCAB w/RP 37 TR 13eCAB 2hCAB cFCR 10hCAB 8.8

18 Extending Effects to Relevant People cFCR/TR/e&hCAB w/RP 38 3eCAB 20eCAB 10hCAB cFCR TR 10 18 Extending Effects to Relevant People cFCR/TR/e&hCAB w/RP 39 cFCR 3eCAB 10eCAB TR 20hCAB 10

19 Extending Effects to Relevant Contexts cFCR/TR/e&hCAB w/RP in RC 40 TR 10eCAB cFCR 2eCAB 7hCAB 7.6 19 Extending Effects to Relevant Contexts cFCR/TR/e&hCAB w/RP in RC 41 cFCR 2hCAB 7eCAB 10hCAB TR 7.6

20 Extending Effects to Relevant Contexts cFCR/TR/e&hCAB w/RP in RC 42 2eCAB 10eCAB cFCR 13hCAB TR 8.8 20 Extending Effects to Relevant Contexts cFCR/TR/e&hCAB w/RP in RC 43 TR 13eCAB 2hCAB cFCR 10hCAB 8.8

21 Extending Effects to Relevant Contexts cFCR/TR/e&hCAB w/RP in RC 44 3eCAB 20hCAB 10hCAB cFCR TR 10 21 Extending Effects to Relevant Contexts cFCR/TR/e&hCAB w/RP in RC 45 cFCR 3hCAB 10eCAB TR 20hCAB 10

22 Extending Effects to Relevant Time Periods cFCR/TR/e&hCAB w/RP in RC over RTP 46 TR 10eCAB cFCR 2eCAB 13hCAB 8.8 22 Extending Effects to Relevant Time Periods cFCR/TR/e&hCAB w/RP in RC over RTP 47 TR 13eCAB 2hCAB cFCR 10hCAB 8.8

23 Extending Effects to Relevant Time Periods cFCR/TR/e&hCAB w/RP in RC over RTP 48 3eCAB 20hCAB 10hCAB cFCR TR 10 23 Extending Effects to Relevant Time Periods cFCR/TR/e&hCAB w/RP in RC over RTP 49 cFCR 3hCAB 10eCAB TR 20hCAB 10

Notes:

Tr = trial; Sr = synthesized reinforcement; Rs = responses; PB = problem behavior; sFCR = simple functional communication response; iFCR = intermediate FCR; cFCR = c

e&hCAB = [easy and hard] contextually appropriate behavior; indep Rs = independent responses; RP = relevant people; RC = relevant context; RTP = relevant time period

TreatmentPersonalized andsynthesized reinforcersdelivered





Usethisasageneralguide

forimplementingthisprogressivetreatment

11/15/2017

26

Sessions10 20 30 40 50 60

Top

ogra

ph

ical

Res

pon

se C

riet

eria

Nu

merical R

espon

se Criteria

0

10

20

30

40

50

PB

SFCIFC

CFCCFC+TR

CFC+TR+3 IsF

CFC+TR+5 IsF

CFC+TR+7 IsF

CFC+TR+2 IsF

CFC+TR+4 IsF

CFC+TR+6 IsF

CFC+TR+10 IsF

CFC+TR+13 IsF

CFC+TR+20 IsF

Total Responses

Average Responses



ComplianceChaining





CFC+TR+1 IF

Visits2

Calendar Days

3 4

2/9

2/11

5 6 7 8 9 10 11 12

2/13

2/16

2/18

2/21

2/23

2/25

2/28

3/1

3/4

13

3/6

14 15 16

3/9

3/12

3/15

18

3/18

19

3/20

20

3/24

21

3/27

22

3/29

23

4/2

24

4/3

4/5

251HomeClinic

2/7


Response Criterion

Easy

Hard



TreatmentPersonalized andsynthesized reinforcersdelivered





Questions?

Let’stalklogisticsTimerequired: 12‐36hours(mean24hours)Distributionofhours: Flexible

5minsessions/1hr visits /3xperwk about2‐3mos total5minsessions/4hrs perday/5xperwk about2wks total

Implementation: CanbeDirectoracombinationofDirectandIndirectservicesbyBCBA

BCBA: 5minsessions/1hr visits/2xperwkParaorRBT: 5minsessions/4hrs perday/5xperwk

about6wksSetting: Any,butchooseoneortwosafeand

convenientlocationsatstartInthemeantime: BusinessasusualorSafetyProtocol

PIVOT(iftimeallows)

Canwebegintoaddresstheothercoredeficitsofautism(languageandsocial)whileaddressingstereotypy?

Canwebegintoallowthechildmorecontroloverwhereandwhentoengageinstereotypy?

Canwemakethetreatmentmoreflexiblesoitfitsintoeverydaylifealittlebetter?

Ithinkwecan.

11/15/2017

27

NewAlternative:Skill‐BasedTreatmentPermissionbasedmodelinwhichcommunication,toleration,andcontextuallyappropriatebehaviorsarestrengthened(adaptedfromHanley,Jin,Vanselow,&Hanratty,JABA,2014)

1. Teachchildtorequestaccesstostereotypy(viablockingandcontingentaccesstostereotypy)

2.Teachchildtotoleratedenialsofmands forstereotypy(viablockingandcontingent,intermittent,andunpredictableaccesstostereotypy)

3.Teachchildtoengageincontextuallyappropriatebehavior(viaprompting,blockingandcontingent,intermittent,andunpredictableaccesstostereotypy)

Slatonetal.(2017)

• Combinationofbothtreatmentpackages(Slatonetal.,2016,&Hanleyetal.,2014)

S-S-

Stereotypy blocked

Mand for stereotypy

20%

20%Denied

Tolerance response

Variable work/play

Comp.60%

S+S+

Stereotypy is allowed

15 – 45 seconds

Participants

Name Age Diagnosis Communication Work tasks

Grant 7 Autism 1‐2 word phrases Numbers, letters, sight words, pictures, matching

Milo 12 Autism No phrases Match and identify objects, pictures, numbers, letters;

short ADL tasks

Marco 21 Autism 1‐3 word phrases Leisure and time management on iPad

11/15/2017

28

Participants:stereotypytopographies

Grant Milo Marco

• Hand flapping• Finger wiggling• Object flapping• Clapping• Holding objects to eyes and rotating

• Hand flapping• Tapping on teeth• Rubbing or poking face• Finger play• Shaking objects• Tapping work materials

• Pacing or galloping• Jumping• Tapping body, furniture• Hair twirling• Knuckle cracking

0

25

50

75

100

0

5

10

15

20BL

S-S+

FCT TRT Response Chaining

Mot

orst

ereo

typy

% o

f co

mpo

nent

S- duration (min)

0

5

10

15

20

Sim

ple

FC

Rpe

r m

in

0

2

4

6

15

Com

plex

FC

Rpe

r m

in

0

2

4

6

TR

per

min

20 40 60 80 1000

25

50

75

100

0

20

40

60

801 2 3 4 7 5 6 7 8 94 10

Milo

Sessions

Acc

urac

y (%

) # demands

Instructional Baseline Tasks

• Match pictures in an array of 6• Match letters in an array of 6• Match numbers in an array of 6• Identify (touch) pictures in an array of 6• Sort objects in an array of 3• Unpack backpack• Put on shirt (over his current shirt)

0

25

50

75

100

0

5

10

15

20BL

S-S+


Mot

orst

ereo

typy

% o

f co

mpo

nent

S- duration (min)

0

5

10

15

20

Sim

ple

FC

Rpe

r m

in

0

2

4

6

15

Com

plex

FC

Rpe

r m

in

0

2

4

6

TR

per

min

20 40 60 80 1000

25

50

75

100

0

20

40

60

801 2 3 4 7 5 6 7 8 94 10

Milo

Sessions

Acc

urac

y (%

) # demands

FCT

• 10 trial sessions• Simple FCR: “play please”• Complex FCR: “Can I play please?”• Immediate vocal model, faded within session• All FCRs were immediately granted• Criteria: 3 consecutive sessions with optimal FCRs

and stereotypy at 5% or less during S‐

11/15/2017

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0

25

50

75

100

0

5

10

15

20BL

S-S+


Mot

orst

ereo

typy

% o

f co

mpo

nent

S- duration (min)

0

5

10

15

20

Sim

ple

FC

Rpe

r m

in

0

2

4

6

15

Com

plex

FC

Rpe

r m

in

0

2

4

6

TR

per

min

20 40 60 80 1000

25

50

75

100

0

20

40

60

801 2 3 4 7 5 6 7 8 94 10

Milo

Sessions

Acc

urac

y (%

) # demands

Tolerance Response Training

• 10 trial sessions• FCR granted on 4 trials, denied on 6 trials• Tolerance response following denial: “Okay”• Immediate vocal model, faded within session• Criteria: 3 consecutive sessions with optimal FCRs

and TRs, and stereotypy at 5% or less during S‐

0

25

50

75

100

0

5

10

15

20BL

S-S+


Mot

orst

ereo

typy

% o

f co

mpo

nent

S- duration (min)

0

5

10

15

20

Sim

ple

FC

Rpe

r m

in

0

2

4

6

15

Com

plex

FC

Rpe

r m

in

0

2

4

6

TR

per

min

20 40 60 80 1000

25

50

75

100

0

20

40

60

801 2 3 4 7 5 6 7 8 94 10

Milo

Sessions

Acc

urac

y (%

) # demands

Response Chaining

• 10 trial sessions• 2 trials: FCR produced the S+• 2 trials: TR produced the S+• 6 trials: compliance with work produced the S+• Criteria: 3 consecutive sessions with 80% accuracy (or

100% for 2), optimal FCRs and TRs, and stereotypy at 5% or less during S‐

0

25

50

75

100

0

5

10

15

20BL

S-S+


Mot

orst

ereo

typy

% o

f co

mpo

nent

S- duration (min)

0

5

10

15

20

Sim

ple

FC

Rpe

r m

in

0

2

4

6

15

Com

plex

FC

Rpe

r m

in

0

2

4

6

TR

per

min

20 40 60 80 1000

25

50

75

100

0

20

40

60

801 2 3 4 7 5 6 7 8 94 10

Milo

Sessions

Acc

urac

y (%

) # demands

Level Task Demandrange

Total demands

Field size

1 Match pictures 1 ‐ 3 12 3

2 +Letters, numbers 1 ‐ 3 12 3

3 (Same) 1 ‐ 6 18 3

4 (Same) 1 ‐ 10 27 3

5 (Same) 1 ‐ 10 27 4

6 (Same) 1 ‐ 10 27 5

7 (Same) 1 ‐ 10 27 6

8 +Sort objects 1 ‐ 10 27 6

9 +ADLs 1 ‐ 10 27 6

10 +Identify pictures 1 ‐ 10 27 6

11/15/2017

30

0

25

50

75

100

0

2

4

6

8

10

S-S+M

otor

ster

eoty

py%

of

com

pone

nt

0

5

10

15

20 S- duration (min)

0

10

20

30

40

*

FCR

per

min

0

5

10

15

20

0

4

8

12

16

20

TR

per

min

0

2

4

6

8

10

10 20 30 40 50 600

25

50

75

100

0

20

40

60

80

Grant

1 2 3 4 5

Acc

urac

y (%

)

20 40 60 80 1000

5

10

15

201 2 3

Marco

# demands

Sessions

Discriminationindex

• ProportionofstereotypythatoccurredduringS+• Expressedasadecimal

– 0.7– 1.0=discriminatedresponding– 0.5=indiscriminateresponding

0.0

0.2

0.4

0.6

0.8

1.0

0

2

4

6

8

10

0.0

0.2

0.4

0.6

0.8

1.0

0

5

10

15

20

20 40 60 80 1000.0

0.2

0.4

0.6

0.8

1.0

0

5

10

15

20

Sessions

Mot

or s

tere

otyp

y di

scri

min

atio

n in

dex

Grant

Milo

Marco

S- duration (m

inutes)

11/15/2017

31

0.0

0.2

0.4

0.6

0.8

1.0

0

2

4

6

8

10

0.0

0.2

0.4

0.6

0.8

1.0

0

5

10

15

20

20 40 60 80 1000.0

0.2

0.4

0.6

0.8

1.0

0

5

10

15

20

Sessions

Voc

al s

tere

otyp

y di

scri

min

atio

n in

dex

Grant

Milo

Marco

S- duration (m

inutes)

SocialValidity

Question Grant Milo Marco

Thetreatmentthatinvolvedteachingarequestforstereotypy,teachinganappropriateresponsetothedenialofthatrequest,andteachingtheindividualtocompleteanincreasingnumberofdemandsbeforeearningaccesstostereotypywasacceptable.

7 7 7

Theamountofbehaviorchange(i.e.,theeffectsoftreatment)wasacceptableorsufficient.

6 7 6

Theoverallgoalsofthistreatmentwereacceptable,appropriate,andimportantfortheindividual.

7 7 6

Iwouldrecommendthistreatmentpackagetoothertherapistsorproviderswhoareattemptingtodecreasestereotypyandincreaseappropriateengagement.

7 7 7

1=highlydisagree 7=highlyagree

FinalTake‐HomePoints

Treatmentforstereotypycan(should?)be….

function‐based

comprehensive

involveastrong,intermittent,andunpredictablecontingencytoinhibitstereotypyanddosomethingelsecontextuallyappropriate….inordertoengageinstereotypy

11/15/2017

32

Formoresupporttoengagethisprocessgoto:www.practicalfunctionalassessment.com

Goodluckwithallthatyoudoforallwhoyouteachandprovidecare

Formoreinformationgoto:www.practicalfunctionalassessment.com

Documents

MOABA gh workshop 2017 - · PDF fileZeke Simple FCR per min Tolerance Response per min Response Chaining Treatment Analysis Zeke 14