Abstract
Interventions based on functional assessments, particularly functional analyses (FAs), are more likely to be effective relative to interventions that are not function-based. However, few clinical investigations have used FAs to assess operant vomiting. This is notable given that operant vomiting represents a medically serious form of problem behavior. To the degree that clinicians can conduct FAs, and use those results to inform function-based treatments for operant vomiting, they can reduce behavior that is associated with considerable medical risk and is also socially conspicuous and stigmatizing. In the current study, we conducted an FA of operant vomiting in a young male with high-functioning autism spectrum disorder. Results suggested operant vomiting was maintained by access to adult attention and escape from academic demands, which is noteworthy given that vomiting is often hypothesized to be maintained by automatic reinforcement. We then implemented a function-based intervention to achieve clinically significant reductions in operant vomiting.
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Notes
Note that “vomiting” should be distinguished from “operant vomiting” based on the outcomes of function-based assessments (i.e., functional analyses) which evaluate vomiting. To the degree that vomiting is more or less likely to occur as a function of changes to antecedent or consequent events, our confidences increases that this constitutes “operant vomiting”. Within this manuscript, we use “vomiting” and “operant vomiting” interchangeably, though we caution against making determinations regarding the operant nature of vomiting a priori.
Attention and escape test conditions were selected based on a) parent and staff report indicating that vomiting was likely to occur in contexts with demands or low attention, and b) outcomes from FAs for Sam’s other topographies of problem behavior conducted in clinic (c.f., Rooker et al. 2011).
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John Michael Falligant is now at the Kennedy Krieger Institute and Johns Hopkins University School of Medicine. Odessa Luna is now at St. Cloud State University.
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Falligant, J.M., Pence, S.T., Sullivan, C. et al. Functional Analysis and Treatment of Multiply Maintained Operant Vomiting. J Dev Phys Disabil 33, 153–161 (2021). https://doi.org/10.1007/s10882-020-09740-2
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DOI: https://doi.org/10.1007/s10882-020-09740-2