Skip to main content
SpringerLink
Log in

Preference for Prompting Procedures to Address Escape-Maintained Behavior in Autistic Adolescents

  • ORIGINAL ARTICLE
  • Published:
Journal of Developmental and Physical Disabilities Aims and scope Submit manuscript

Abstract

Differential reinforcement of alternative behavior (DRA) is a common strategy for escape-maintained behaviors targeted for reduction (i.e., targeted behavior) exhibited by youth with intellectual and developmental disabilities. DRA often involves various methods of prompting to ensure the instruction or task remains in place until contingencies for the DRA are met. Currently, there is little research on client preference for these different prompting strategies in the context of DRA treatments. The current study includes four participants diagnosed with autism spectrum disorder (ASD) who exhibited targeted behavior maintained by escape from instructional tasks. We evaluated efficacy and preference for three prompting strategies (three-step least-to-most, repeated vocal prompt, or a single initial prompt) embedded in a DRA treatment aimed at reducing targeted behavior (e.g., aggression) and improving task completion. For all participants, more than one prompting strategy was effective when positive was combined with negative reinforcement in the DRA. We then implemented a concurrent-chains assessment to determine client preference, a rank-order task for caregiver preference, and an acceptability questionnaire for therapists. Two participants demonstrated a clear preference, and preference was obtained from a total of two caregivers and seven therapists. The initial and repeated verbal prompts were most preferred. Results are discussed in the context of client autonomy and incorporating choice in treatment planning.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Notes

  1. We use the term targeted behavior in place of “challenging behavior” and “problem behavior.” Although common within some settings and outlets, these latter terms have several negative connotations (e.g., Bottema-Beutel et al., 2021). We use “targeted behavior” to minimize negative associations but also refer to multiple topographies individualized to the participant.

References

  • Bannerman, D. J., Sheldon, J. B., Sherman, J. A., & Harchik, A. E. (1990). Balancing the right to habilitation with the right to personal liberties: The rights of people with developmental disabilities to eat too many doughnuts and take a nap. Journal of Applied Behavior Analysis, 23(1), 79–89. https://doi.org/10.1901/jaba.1990.23-79.

    Article  PubMed  PubMed Central  Google Scholar 

  • Beavers, G. A., Iwata, B. A., & Lerman, D. C. (2013). Thirty years of research on the functional analysis of problem behavior. Journal of Applied Behavior Analysis, 46(1), 1–21.

    Article  PubMed  Google Scholar 

  • Behavior Analyst Certification Board (2020). Ethics code for behavior analysts. https://bacb.com/wp-content/ethics-code-for-behavior-analysts/.

  • Bottema-Beutel, K., Kapp, S. K., Lester, J. N., Sasson, N. J., & Hand, B. N. (2021). Avoiding ableist language: Suggestions for autism researchers. Autism in Adulthood: Challenges and Management, 3(1), 18–29. https://doi.org/10.1089/aut.2020.0014.

  • Briggs, A. M., Dozier, C. L., Lessor, A. N., Kamana, B. U., & Jess, R. L. (2019). Further investigation of differential reinforcement of alternative behavior without extinction for escape-maintained destructive behavior. Journal of Applied Behavior Analysis, 52(4), 956–973. https://doi.org/10.1002/jaba.648.

    Article  PubMed  Google Scholar 

  • Call, N. A., Miller, S. J., Mintz, J. C., Mevers, J. L., Scheithauer, M. C., Eshelman, J. E., & Beavers, G. A. (2016). Use of a latency-based demand assessment to identify potential demands for functional analyses. Journal of Applied Behavior Analysis, 49(4), 900–914. https://doi.org/10.1002/jaba.341.

    Article  PubMed  Google Scholar 

  • Chazin, K. T., & Ledford, J. R. (2021). Constant time delay and system of least prompts: Efficiency and child preference. Journal of Behavioral Education, 30, 684–707.

    Article  Google Scholar 

  • Chazin, K. T., Velez, M. S., & Ledford, J. R. (2022). Reducing escape without escape extinction: A systematic review and meta-analysis of escape-based interventions. Journal of Behavioral Education, 31(1), 186–215.

    Article  Google Scholar 

  • Chen, E., Borrero, C. S. W., Frank-Crawford, M. A., & Borrero, J. C. (2022). Accumulated‐ and distributed‐reinforcer arrangements in the treatment of challenging mealtime behavior. Behavioral Interventions, 37(4), 1058–1079. https://doi.org/10.1002/bin.1899.

    Article  Google Scholar 

  • Conners, J., Iwata, B. A., Kahng, S., Hanley, G. P., Worsdell, A. S., & Thompson, R. H. (2000). Differential responding in the presence and absence of discriminative stimuli during multielement functional analyses. Journal of Applied Behavior Analysis, 33(3), 299–308. https://doi.org/10.1901/jaba.2000.33-299.

    Article  PubMed  PubMed Central  Google Scholar 

  • Dart, E. H., Radley, K. C., Mason, B. A., & Allen, J. P. (2018). Addressing escape-maintained behavior for students with developmental disabilities: A systematic review of school‐based interventions. Psychology in the Schools, 55(3), 295–304.

    Article  Google Scholar 

  • Dawson, G., Franz, L., & Brandsen, S. (2022). At a crossroads—reconsidering the goals of autism early behavioral intervention from a neurodiversity perspective. JAMA Pediatrics, 176(9), 839. https://doi.org/10.1001/jamapediatrics.2022.2299.

    Article  PubMed  PubMed Central  Google Scholar 

  • DeLeon, I. G., Chase, J. A., Frank-Crawford, M. A., Carreau-Webster, A. B., Triggs, M. M., Bullock, C. E., & Jennett, H. K. (2014). Distributed and accumulated reinforcement arrangements: Evaluations of efficacy and preference. Journal of Applied Behavior Analysis, 47(2), 293–313. https://doi.org/10.1002/jaba.116.

    Article  PubMed  Google Scholar 

  • Donaldson, J. M., DeLeon, I. G., Fisher, A. B., & Kahng, S. (2014). Effects of and preference for conditions of token earn versus token loss. Journal of Applied Behavior Analysis, 47(3), 537–548. https://doi.org/10.1002/jaba.135.

    Article  PubMed  Google Scholar 

  • Dunlap, G., Deperczel, M., Clarke, S., Wilson, D., Wright, S., White, R., & Gomez, A. (1994). Choice making to promote adaptive behavior for students with emotional and behavioral challenges. Journal of Applied Behavior Analysis, 27(3), 505–518. https://doi.org/10.1901/jaba.1994.27-505.

    Article  PubMed  PubMed Central  Google Scholar 

  • Fahmie, T. A., Iwata, B. A., Harper, J. M., & Querim, A. C. (2013). Evaluation of the divided attention condition during functional analyses. Journal of Applied Behavior Analysis, 46(1), 71–78.

    Article  PubMed  Google Scholar 

  • Ferguson, J. L., Cihon, J. H., Leaf, J. B., Van Meter, S. M., McEachin, J., & Leaf, R. (2019). Assessment of social validity trends in the journal of applied behavior analysis. European Journal of Behavior Analysis, 20(1), 146–157. https://doi.org/10.1080/15021149.2018.1534771.

    Article  Google Scholar 

  • Foran-Conn, D., Hoerger, M., Kelly, E., Cross, R., Jones, R., Walley, S., H., & Firth, L. (2021). A comparison of most to least prompting, no‐no prompting and responsive prompt delay procedures. Behavioral Interventions, 36(4), 1024–1041.

    Article  Google Scholar 

  • Gearing, R. E., Mian, I. A., Barber, J., & Ickowicz, A. (2006). A methodology for conducting retrospective chart review research in child and adolescent psychiatry. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 15(3), 126–134.

  • Geiger, K. B., Carr, J. E., & Leblanc, L. A. (2010). Function-based treatments for escape-maintained problem behavior: a treatment-selection model for practicing behavior analysts. Behavior Analysis in Practice, 3(1), 22–32. https://doi.org/10.1007/BF03391755.

  • Graff, R. B., & Karsten, A. M. (2012). Assessing preferences of individuals with developmental disabilities: A survey of current practices. Behavior Analysis in Practice, 5(2), 37–48. https://doi.org/10.1007/bf03391822.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hagopian, L. P., Fisher, W. W., Sullivan, M. T., Acquisto, J., & LeBlanc, L. A. (1998). Effectiveness of functional communication training with and without extinction and punishment: A summary of 21 inpatient cases. Journal of Applied Behavior Analysis, 31(2), 211–235. https://doi.org/10.1901/jaba.1998.31-211.

  • Hagopian, L. P., Long, E. S., & Rush, K. S. (2004). Preference assessment procedures for individuals with developmental disabilities. Behavior Modification, 28(5), 668–677. https://doi.org/10.1177/0145445503259836.

    Article  PubMed  Google Scholar 

  • Hanley, G. P., Piazza, C. C., Fisher, W. W., Contrucci, S. A., & Maglieri, K. A. (1997). Evaluation of client preference for function-based treatment packages. Journal of Applied Behavior Analysis, 30(3), 459–473. https://doi.org/10.1901/jaba.1997.30-459.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hanley, G. P., Iwata, B. A., & McCord, B. E. (2003). Functional analysis of problem behavior: A review. Journal of Applied Behavior Analysis, 36(2), 147–185.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hanley, G. P., Piazza, C. C., Fisher, W. W., & Maglieri, K. A. (2005). On the effectiveness of and preference for punishment and extinction components of function-based interventions. Journal of Applied Behavior Analysis, 38(1), 51–65. https://doi.org/10.1901/jaba.2005.6-04.

    Article  PubMed  PubMed Central  Google Scholar 

  • Harding, J. W., Wacker, D. P., Berg, W. K., Cooper, L. J., Asmus, J., Mlela, K., & Muller, J. (1999). An analysis of choice making in the assessment of young children with severe behavior problems. Journal of Applied Behavior Analysis, 32(1), 63–82. https://doi.org/10.1901/jaba.1999.32-63.

    Article  PubMed  PubMed Central  Google Scholar 

  • Harper, A. M., Dozier, C. L., Briggs, A. M., Villegas, S. D., Brandt, A., J. A., & Hirst, J., E. S (2021). Preference for and reinforcing efficacy of different types of attention in preschool children. Journal of Applied Behavior Analysis, 54(3), 882–902. https://doi.org/10.1002/jaba.814.

    Article  PubMed  Google Scholar 

  • Hartley, S., Sikora, D., & McCoy, R. (2008). Prevalence and risk factors of maladaptive behaviour in young children with autistic disorder. Journal of Intellectual Disability Research, 52(10), 819–829.

    Article  PubMed  Google Scholar 

  • Hantula D. A. (2019). Editorial: Replication and reliability in behavior science and behavior analysis: A call for a conversation. Perspectives on Behavior Science, 42(1), 1–11. https://doi.org/10.1007/s40614-019-00194-2.

  • Heal, N. A., Hanley, G. P., & Layer, S. A. (2009). An evaluation of the relative efficacy of and children’s preferences for teaching strategies that differ in amount of teacher directedness. Journal of Applied Behavior Analysis, 42(1), 123–143. https://doi.org/10.1901/jaba.2009.42-123.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hupp, S. D. A., & Reitman, D. (1999). The effects of stating contingency-specifying stimuli on compliance in children. The Analysis of Verbal Behavior, 16(1), 17–27. https://doi.org/10.1007/bf03392944.

    Article  PubMed  PubMed Central  Google Scholar 

  • Iwata, B. A., Dorsey, M. F., Slifer, K. J., Bauman, K. E., & Richman, G. S. (1994). Toward a functional analysis of self‐injury. Journal of Applied Behavior Analysis, 27(2), 197–209. https://doi.org/10.1901/jaba.1994.27-197.

  • Klaus, S., Hixson, M. D., Drevon, D. D., & Nutkins, C. (2019). A comparison of prompting methods to teach sight words to students with autism spectrum disorder. Behavioral Interventions, 34(3), 352–365.

    Article  Google Scholar 

  • Libby, M. E., Weiss, J. S., Bancroft, S., & Ahearn, W. H. (2008). A comparison of most-to-least and least-to-most prompting on the acquisition of solitary play skills. Behavior Analysis in Practice, 1, 37–43.

    Article  PubMed  PubMed Central  Google Scholar 

  • Markham, V., Giles, A., & May, R. (2020). Evaluating efficacy and preference for prompt type during discrete-trial teaching. Behavior Modification, 44(1), 49–69.

    Article  PubMed  Google Scholar 

  • Owen, T. M., Luczynski, K. C., Rodriguez, N. M., & Fisher, W. W. (2021). Assessment of children’s and caregivers’ preferences for treatments for escape-maintained problem behavior. Journal of Applied Behavior Analysis, 54(3), 946–965. https://doi.org/10.1002/jaba.817.

    Article  PubMed  Google Scholar 

  • Piazza, C. C., Fisher, W. W., Hagopian, L. P., Bowman, L. G., & Toole, L. (1996). Using a choice assessment to predict reinforcer effectiveness. Journal of Applied Behavior Analysis, 29(1), 1–9. https://doi.org/10.1901/jaba.1996.29-1.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rajaraman, A., Austin, J. L., Gover, H. C., Cammilleri, A. P., Donnelly, D. R., & Hanley, G. P. (2022a). Toward trauma-informed applications of behavior analysis. Journal of Applied Behavior Analysis, 55(1), 40–61. https://doi.org/10.1002/jaba.881.

    Article  PubMed  Google Scholar 

  • Rajaraman, A., Hanley, G. P., Gover, H. C., Staubitz, J. L., Staubitz, J. E., Simcoe, K. M., & Metras, R. (2022b). Minimizing escalation by treating dangerous problem behavior within an enhanced choice model. Behavior Analysis in Practice, 15(1), 219–242. https://doi.org/10.1007/s40617-020-00548-2.

    Article  PubMed  Google Scholar 

  • Riesen, T., & Jameson, J. M. (2018). Comparison of prompting procedures to teach work tasks to transition-aged students with disabilities. Education and Training in Autism and Developmental Disabilities, 53(1), 100–110.

    Google Scholar 

  • Sabielny, L. M., & Cannella-Malone, H. I. (2014). Comparison of prompting strategies on the acquisition of daily living skills. Education and Training in Autism and Developmental Disabilities, 145–152.

  • Sheridan, E., Gillespie, S., Johnson, C. R., Lecavalier, L., Smith, T., Swiezy, N., Turner, K., Pritchett, J., Mruzek, D. W., & Evans, A. N. (2021). Using parent target problem narratives to evaluate outcomes in children with Autism Spectrum Disorder. Research on Child and Adolescent Psychopathology, 49(11), 1527–1535.

    Article  PubMed  Google Scholar 

  • Steenfeldt-Kristensen, C., Jones, C. A., & Richards, C. (2020). The prevalence of self-injurious behaviour in autism: A meta-analytic study. Journal of Autism and Developmental Disorders, 50(11), 3857–3873.

    Article  PubMed  PubMed Central  Google Scholar 

  • St. Peter, C. C. (2023). On the importance of fidelity, integrity, and adherence in behavior-analytic publications: An Introduction to the special issue on procedural fidelity. Education and Treatment of Children, 46(3), 195–199. https://link.springer.com/article/10.1007/s43494-023-00105-w.

  • Tarbox, J., Zuckerman, C. K., Bishop, M. R., Olive, M. L., & O’Hora, D. P. (2011). Rule-governed behavior: Teaching a preliminary repertoire of rule-following to children with autism. The Analysis of Verbal Behavior, 27(1), 125–139. https://doi.org/10.1007/bf03393096.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tiger, J. H., Hanley, G. P., & Hernandez, E. (2006). An evaluation of the value of choice with preschool children. Journal of Applied Behavior Analysis, 39(1), 1–16. https://doi.org/10.1901/jaba.2006.158-04.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tincani, M., & Travers, J. (2019). Replication research, publication bias, and applied behavior analysis. Perspectives on Behavior Science, 42(1), 59–75. https://doi.org/10.1007/s40614-019-00191-5.

  • Vaughn, B. J., & Horner, R. H. (1997). Identifying instructional tasks that occasion problem behaviors and assessing hte effects of student versus teacher choice among these tasks. Journal of Applied Behavior Analysis, 30(2), 299–312. https://doi.org/10.1901/jaba.1997.30-299.

    Article  PubMed  PubMed Central  Google Scholar 

  • Weyman, J. R., & Sy, J. R. (2018). Effects of neutral and enthusiastic praise on the rate of discrimination acquisition. Journal of Applied Behavior Analysis, 51(2), 335–344. https://doi.org/10.1002/jaba.440.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, Marcus Autism Center, Emory University School of Medicine, 1920 Briarcliff Rd NE, Atlanta, GA, 30329, USA

    Mindy C. Scheithauer, Summer B. Bottini & Meara X. H. McMahon

Authors
  1. Mindy C. Scheithauer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Summer B. Bottini
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Meara X. H. McMahon
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mindy C. Scheithauer.

Ethics declarations

Ethical Approval

All ethical guidelines related to human subject research were followed during conduct and dissemination of this research project and the study was performed in accordance with the ethical standards outlined in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed Consent

All participants consented to standard clinical care at the start of their treatment admission.

Conflict of Interest

The authors do not have any conflicts of interest related to the conduct of this study.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Scheithauer, M.C., Bottini, S.B. & McMahon, M.X.H. Preference for Prompting Procedures to Address Escape-Maintained Behavior in Autistic Adolescents. J Dev Phys Disabil (2024). https://doi.org/10.1007/s10882-024-09965-5

Download citation

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10882-024-09965-5

Keywords

Search

Navigation