11/15/2017
1
GregoryP.HanleyPh.D.,BCBA‐D
PracticalFunctionalAssessmentandSkill‐BasedTreatmentofSevereProblemBehavior
Formoreinformationgoto:
www.practicalfunctionalassessment.com
November,2017MOABA
Whydo“lifestyles”dictatedbyproblembehaviorpersistformanyfamiliesofchildrenwithautismandsomefamiliesofchildrenwithintellectualdisabilities?
Restrictivelifestylespersistpartlybecauseproblembehaviorofchildrenismerely
modifiedmedicated
mollifiedmicro‐analyzed
remediedapartfromskilldevelopment
11/15/2017
2
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?
11/15/2017
3
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
0
1
2
3
4
Reinforcem
ent (%)0
20
40
60
80
100
Pro
blem
Beh
avio
rpe
r m
in
0
1
2
3
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
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
EngagedinSevereSIBandAggression
1:1inSpecializedSchool
11/15/2017
4
0
1
2
3
4
0
1
2
3
4
Com
plex
FC
Rpe
r m
in
0
1
2
3
4
Reinforcem
ent (%)0
20
40
60
80
100
Pro
blem
Beh
avio
rpe
r m
in
0
1
2
3
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
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
Amoreinteractionalresponse(shouldertap,waitforteacheracknowledgement,two‐buttonpress:MayIhave/Mywayplease”)ispromptedandreinforced
TreatmentAnalysis
Zeke
14‐yearoldboy
diagnosedwithAutism
EngagedinSevereSIBandAggression
1:1inSpecializedSchool
0
1
2
3
4
0
1
2
3
4
Com
plex
FC
Rpe
r m
in
0
1
2
3
4
Reinforcem
ent (%)0
20
40
60
80
100
Pro
blem
Beh
avio
rpe
r m
in
0
1
2
3
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
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
Responsestodisappointmentarepromptedandreinforced:(Takeabreathandnoddingyes)
Now,FCRsarereinforcedhalfthetime.Theotherhalf,theteacherdeniesthebid(e.g.,says’s no,doyourworkwithoutme,please)
Cuesofdisappointment,Delaystoreinforcement,andunpredictableoutcomeshavenowbeenintroduced!
TreatmentAnalysis
Zeke
14‐yearoldboy
diagnosedwithAutism
EngagedinSevereSIBandAggression
1:1inSpecializedSchool
0
1
2
3
4
0
1
2
3
4
Com
plex
FC
Rpe
r m
in
0
1
2
3
4
Reinforcem
ent (%)0
20
40
60
80
100
Pro
blem
Beh
avio
rpe
r m
in
0
1
2
3
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
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
Now,FCRsarereinforced1/3ofthetime.
TRsarereinforced1/3ofthetime.
Andcompliancewithprogressivelylongerandmorechallenginginstructionsisreinforced
TreatmentAnalysis
Zeke
14‐yearoldboy
diagnosedwithAutism
EngagedinSevereSIBandAggression
1:1inSpecializedSchool
11/15/2017
5
0
1
2
3
4
0
1
2
3
4
Com
plex
FC
Rpe
r m
in
0
1
2
3
4
Reinforcem
ent (%)0
20
40
60
80
100
Pro
blem
Beh
avio
rpe
r m
in
0
1
2
3
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
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
TreatmentAnalysis
Zeke
14‐yearoldboy
diagnosedwithAutism
EngagedinSevereSIBandAggression
1:1inSpecializedSchool
Whatisthetreatment????
Intermittentandunpredictablereinforcementoflifeskills:FunctionalCommunicationDelay/denialtolerationCompliance
Hanley,Jin,Vanselow,&Hanratty(2014)
• Skill‐basedtreatmentforsocially‐mediatedPB
Functionalcommunicationrequest(FCR)
DeniedTolerance
response(TR)
Variableamountofwork/playexpectations
Compliance
ReinforcementGranted
20%
60%
11/15/2017
6
ResponseReinforcementis: requirementis:Function‐based VariableDifferential UnpredictableIntermittentUnsignaledVariableinduration
TreatmentImplementation
*Materialsnotneeded:LaminateLaminatingmachineGluegunsVisavismarkersVelcroTokensTokenboardsTimersStickersCandiesAnythingthatwasnotalreadyin
thechild’senvironment!
1. Puttheseinyourpocket2. Pulloneoutwhilechildis
experiencingtheirreinforcers
3. Keepittoyourself4. Requirethatbehaviornext
time
Appcalled“NamesinaHat”
11/15/2017
7
Appcalled“Roundom”P
robl
em B
ehav
ior
pe
r m
in
0.0
0.5
1.0
1.5
2.0
2.5
3.0
Sim
ple
FC
R
p
er m
in
0.0
0.5
1.0
1.5
2.0
Com
plex
FC
R
per
min
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
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
11/15/2017
8
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
11/15/2017
9
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)
11/15/2017
10
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
2
3
4
Thr
owin
gpe
r m
inut
e
0
1
2
3
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
diagnosedwith“SPD”
Engagedinsevereaggression&meltdowns
Processinclinicwithanalystandmotherimplementing
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
diagnosedwith“SPD”
Engagedinsevereaggression&meltdowns
Processinclinicwithanalystandmotherimplementing
11/15/2017
11
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
diagnosedwith“SPD”
Engagedinsevereaggression&meltdowns
Processinclinicwithanalystandmotherimplementing
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
11/15/2017
12
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
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
Samesimpleresponsereinforcedeachtime
Experts ImplementingIn Practice ContextsDuring Short Sessions
(5 – 10 min or 5 trials)
11/15/2017
13
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
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)
11/15/2017
14
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)
ThecFCR issometimesdifferentiatedintospecificmands(Wardetal.,2018)
Anobtainingalistener responseAbreak responseAnaccesstopreferredtoysresponseAnattentionrecruitmentresponse
(e.g.,““Excuseme[pause,waitforacknowledgement],MayIhaveabreak,please?“….MayIhavemystuffplease”....”Willyouplaywithme”)
Differentiatethecomplexresponse
11/15/2017
15
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
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)
Notethechaining
Thenchainingofcontextuallyappropriatebehavior(CAB)andmoreSrintermittencyandunpredictabilityfollows
Typical5‐trialsequenceinearlychainingphase:
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
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)
NowcompliancechainingandmoreSrintermittencyandunpredictability
Noteagainthechainlengths
Thenchainingofcontextuallyappropriatebehavior(CAB)andmoreSrintermittencyandunpredictabilityfollows
Typical5‐trialsequenceinearlychainingphase:
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
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)
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
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)
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
Terminal DelayWithout Extinction
% 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
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
Terminal DelayWithout Extinction
% 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
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)
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
FunctionalCommunicationTraining
ToleranceResponseTraining
ComplianceChaining
then Parents/StaffImplementing in Varied
Contexts duringLongSessions
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)
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
FunctionalCommunicationTraining
ToleranceResponseTraining
ComplianceChaining
then Parents/StaffImplementing in Varied
Contexts duringLongSessions
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)
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
FunctionalCommunicationTraining
ToleranceResponseTraining
ComplianceChaining
then Parents/StaffImplementing in Varied
Contexts duringLongSessions
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)
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
FunctionalCommunicationTraining
ToleranceResponseTraining
ComplianceChaining
then Parents/StaffImplementing in Varied
Contexts duringLongSessions
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)
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
FunctionalCommunicationTraining
ToleranceResponseTraining
ComplianceChaining
then Parents/StaffImplementing in Varied
Contexts duringLongSessions
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)
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
FunctionalCommunicationTraining
ToleranceResponseTraining
ComplianceChaining
then Parents/StaffImplementing in Varied
Contexts duringLongSessions
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)
Attheterminalschedule:
manyappropriatebehaviorsdonotyieldreinforcementimmediately,butthereisnodelaytoreinforcementperse
Considerthissession….
Attheendoftreatment:
manyappropriatebehaviorsdonotyieldreinforcementimmediately,butthereisnodelaytoreinforcementperse
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 “No” ToleranceResponse Instruction CAB(3)
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
FunctionalCommunicationTraining
ToleranceResponseTraining
ComplianceChaining
then Parents/StaffImplementing in Varied
Contexts duringLongSessions
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)
Attheterminalschedule:
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
FunctionalCommunicationTraining
ToleranceResponseTraining
ComplianceChaining
then Parents/StaffImplementing in Varied
Contexts duringLongSessions
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)
Attheterminalschedule:
54appropriatesocialresponsesoccurper5‐trialsession
Reinforcer periodsrangefrom30sto10min(mode:2min)
11/15/2017
24
Theaveragechainlengthisprogressivelyincreased,butcommunication,toleration,andshort/unexpectedcontextually‐appropriatebehaviorchainsarereinforcedsometimes,evenattheendoftreatment
Sr“No”
SrComplexFCR “No” ToleranceResponse Instruction CAB(3)
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
FunctionalCommunicationTraining
ToleranceResponseTraining
ComplianceChaining
then Parents/StaffImplementing in Varied
Contexts duringLongSessions
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
2
Shorties
Experts ImplementingIn Practice ContextsDuring Short Sessions
(5 – 10 min or 5 trials)
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
FunctionalCommunicationTraining
ToleranceResponseTraining
ComplianceChaining
then Parents/StaffImplementing in Varied
Contexts duringLongSessions
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
2
Shortiesnevergoaway.
Thiswaywekeephopealive!
Experts ImplementingIn Practice ContextsDuring Short Sessions
(5 – 10 min or 5 trials)
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
FunctionalCommunicationTraining
ToleranceResponseTraining
ComplianceChaining
then Parents/StaffImplementing in Varied
Contexts duringLongSessions
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)
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
FunctionalCommunicationTraining
ToleranceResponseTraining
ComplianceChaining
then Parents/StaffImplementing in Varied
Contexts duringLongSessions
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
2
Andremember….
Longies areinitiallyremovedwhentransitioningtonewstimulusconditions(thathavehistoricalrelevance)
Longies getreintroducedaftersuccesswithsmallerchains
Experts ImplementingIn Practice ContextsDuring Short Sessions
(5 – 10 min or 5 trials)
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
intermittently,unpredictably, and exclusively
followingvariouschainlengthsofappropriate
behaviorthatincludes
communication,toleration,andcompliance
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
FunctionalCommunicationTraining
ToleranceResponseTraining
ComplianceChaining
then Parents/StaffImplementing in Varied
Contexts duringLongSessions
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)
TreatmentPersonalized andsynthesized reinforcersdelivered
intermittently,unpredictably, and exclusively
followingvariouschainlengthsofappropriate
behaviorthatincludes
communication,toleration,andcompliance
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+
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
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
29
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
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+
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
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+
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
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