Skip to main content
Log in

Brief Report: Avoidance Extinction as Treatment for Compulsive and Ritual Behavior in Autism

  • Brief Report
  • Published:
Journal of Autism and Developmental Disorders Aims and scope Submit manuscript

Abstract

Treatment options for maladaptive repetitive behaviors associated with autism are limited. This is particularly so for ritual and compulsive forms of repetitive behavior, which commonly interfere with adaptive activities and may cause distress to individuals with autism and their families. The present study assessed an avoidance extinction approach to treatment of frequent, idiosyncratic ritual and compulsive behaviors among a small clinical sample (n = 3) of adults with autism and intellectual disability. Single case experimental design results indicate that intervention achieved extinction for 2 of the 3 participants, with the third showing a marked decrease in target behavior. A distinct extinction pattern consistent with functionally avoidant behavior was noted for the two participants who best responded to treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

References

  • Baum, M. (1970). Extinction of avoidance responding through response prevention (flooding). Psychological Bulletin, 74(4), 276–284.

    Article  PubMed  Google Scholar 

  • Bodfish, J. W., Symons, F. J., Parker, D. E., & Lewis, M. H. (2000). Varieties of repetitive behavior in autism: Comparisons to mental retardation. Journal of Autism and Developmental Disorders, 30(3), 237–243.

    Article  PubMed  Google Scholar 

  • Boyd, B. A., McDonough, S. G., & Bodfish, J. W. (2011). Evidence based behavioral interventions for repetitive behaviors in autism. Journal of Autism and Developmental Disorders, 42(6), 1236–1248.

    Article  Google Scholar 

  • Boyer, P., & Lienard, P. (2006). Why ritualized behavior? Precaution systems and action parsing in developmental, pathological, and cultural rituals. Behavioral and Brain Science, 29(6), 595–613.

    Google Scholar 

  • Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement, 20(1), 37–46.

    Article  Google Scholar 

  • Dinsmoor, J. A. (2001). Stimuli inevitably generated by behavior that avoids electric shock are inherently reinforcing. Journal of the Experimental Analysis of Behavior, 75(3), 311–333.

    Article  PubMed  Google Scholar 

  • Franklin, M. E., Abramowitz, J. S., Kozak, M. J., Levitt, J. T., & Foa, E. B. (2000). Effectiveness of exposure and ritual prevention for obsessive-compulsive disorder: a randomized compared with non-randomized samples. Journal of Counseling and Clinical Psychology, 68(4), 594–602.

    Article  Google Scholar 

  • Iwata, B. A., Dorsey, M. F., Slifer, K. J., Bauman, K. E., & Richman, G. S. (1982/1994). Toward a functional analysis of self-injury. Journal of Applied Behavior Analysis, 27(2), 197–209.

    Google Scholar 

  • Kennedy, C. H., Meyer, K. A., Knowles, T., & Shukia, S. (2000). Analyzing the multiple functions of stereotypical behavior for students with autism: Implications for assessment and treatment. Journal of Applied Behavior Analysis, 33(4), 559–571.

    Article  PubMed  Google Scholar 

  • Kuhn, D. E., Hardesty, S. L., & Sweeny, N. M. (2009). Assessment and treatment of excessive straightening and destructive behavior in an adolescent diagnosed with autism. Journal of Applied Behavior Analysis, 42(2), 355–360.

    Article  PubMed  Google Scholar 

  • Lam, K. S. L., Bodfish, J. W., & Piven, J. (2008). Evidence for three subtypes of repetitive behavior in autism that differ in familiarity and association with other symptoms. Journal of Child Psychology and Psychiatry, 49(11), 1193–1200.

    Article  PubMed  Google Scholar 

  • Lerman, D. C., Iwata, B. A., & Wallace, M. D. (1999). Side effects of extinction: Prevalence of bursting and aggression during the treatment of self-injurious behavior. Journal of Applied Behavior Analysis, 32(1), 1–8.

    Article  PubMed  Google Scholar 

  • Lerman, D. C., Kelley, M. E., Vorndran, C. M., & Van Camp, C. M. (2003). Collateral effects of response blocking during the treatment of stereotypic behavior. Journal of Applied Behavior Analysis, 36(1), 119–123.

    Article  PubMed  Google Scholar 

  • Lewis, M. H., & Bodfish, J. W. (1998). Repetitive behavior disorders in autism. Mental Retardation and Developmental Disabilities Research Reviews, 4(2), 80–89.

    Article  Google Scholar 

  • Matson, J. L., & Dempsey, T. (2009). The nature and treatment of compulsions, obsessions, and rituals in people with developmental disabilities. Research in Developmental Disabilities, 30(3), 603–611.

    Article  PubMed  Google Scholar 

  • O’Brien, S., & Repp, A. C. (1990). Reinforcement-based reductive procedures: A review of 20 years of their use with persons with severe or profound retardation. Journal of the Association for Persons with Severe Handicaps, 15(3), 148–159.

    Google Scholar 

  • Rincover, A., Newsom, C. D., & Carr, E. G. (1979). Using sensory extinction procedures in the treatment of compulsive like behavior of developmentally disabled children. Journal of Consulting and Clinical Psychology, 47(4), 695–701.

    Article  PubMed  Google Scholar 

  • Rodriguez, N. M., Thompson, R. H., Schlichenmeyer, K., & Stocco, C. S. (2012). Functional analysis and treatment of arranging and ordering by individuals with an autism spectrum disorder. Journal of Applied Behavior Analysis, 45(1), 1–22.

    Article  PubMed  Google Scholar 

  • Russell, A. J., Mataix-Cols, D., Anson, M., & Murphy, D. G. M. (2005). Obsessions and compulsions in Asperger syndrome and high-functioning autism. British Journal of Psychiatry, 186, 525–528.

    Article  PubMed  Google Scholar 

  • Schiff, R., Smith, N., & Prochaska, J. (1972). Extinction of avoidance in rats as a function of duration and number of blocked trials. Journal of Comparative and Physiological Psychology, 81(2), 356–359.

    Article  PubMed  Google Scholar 

  • Scotti, J. R., Evans, I. M., Meyer, L. H., & Walker, P. (1991). A meta analysis of intervention research with problem behavior: Treatment validity and standards of practice. American Journal on Mental Retardation, 96(3), 233–256.

    PubMed  Google Scholar 

  • Sidman, M. (1989). Coercion and its fallout. Boston, MA: Author’s Cooperative, Inc.

    Google Scholar 

  • Siegeltuch, M. B., & Baum, M. (1971). Extinction of well-established avoidance responses through response prevention (flooding). Behavior Research & Therapy, 9(2), 103–108.

    Article  Google Scholar 

  • Thyer, B. A., Baum, M., & Reid, L. D. (1988). Exposure techniques in the reduction of fear: A comparative review of the procedure in animals and humans. Advances in Behaviour Research and Therapy, 10(3), 105–127.

    Article  Google Scholar 

Download references

Acknowledgments

The authors wish to thank our participants and their families. Thanks also to Jennifer McComas, Joe Reichle, and ICF residential staff for their assistance with this research.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jason J. Wolff.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wolff, J.J., Hupp, S.C. & Symons, F.J. Brief Report: Avoidance Extinction as Treatment for Compulsive and Ritual Behavior in Autism. J Autism Dev Disord 43, 1741–1746 (2013). https://doi.org/10.1007/s10803-012-1721-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-012-1721-7

Keywords

Navigation