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Reducing Escape without Escape Extinction: A Systematic Review and Meta-Analysis of Escape-Based Interventions

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Abstract

Individuals with disabilities may engage in challenging behavior to escape aversive stimuli, like academic tasks or non-preferred foods. Interventions to reduce these behaviors often employ escape extinction; that is, the implementer withholds escape following challenging behavior. Escape extinction can increase risk of injury, restrict autonomy, and worsen the learner–implementer relationship. To mitigate collateral effects, interventions can use strategies without escape extinction (i.e., escape-based); that is, implementers can provide escape contingent on challenging behavior during intervention, in conjunction with other intervention components. However, no comprehensive syntheses of these interventions have been conducted. We identified 39 articles that included escape-based interventions, which contained 273 single-case designs. Escape-based interventions were associated with lower levels of challenging behavior and higher levels of adaptive behavior than baseline conditions. Most comparisons between escape-based and escape extinction interventions showed no functional relation, indicating that escape extinction may not add substantial benefit to intervention efficacy.

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Acknowledgements

We would like to thank Marney S. Pollack, Dr. Johanna L. Staubitz, and Dr. Gregory P. Hanley for their thoughtful feedback on early iterations of this project.

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  1. Department of Special Education, Vanderbilt University, Peabody Box 228, Nashville, TN, 37203, USA

    Kate T. Chazin, Marina S. Velez & Jennifer R. Ledford

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  1. Kate T. Chazin
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Contributions

All authors contributed to the conception of this review. The literature search and data analysis were performed by Kate Chazin and Marina Velez. The first draft of the manuscript was written by Kate Chazin and Marina Velez. The work was critically revised by Jennifer Ledford. All authors read and approved the final manuscript.

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Correspondence to Kate T. Chazin.

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As a systematic review with no human or animal participants, ethics approval from an institutional review board was not required. There are no conflicts of interest to disclose. No financial support has been provided for the research, authorship, or publication of this article. No materials in this manuscript are the copyrighted work of another individual or organization.

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Chazin, K.T., Velez, M.S. & Ledford, J.R. Reducing Escape without Escape Extinction: A Systematic Review and Meta-Analysis of Escape-Based Interventions. J Behav Educ 31, 186–215 (2022). https://doi.org/10.1007/s10864-021-09453-2

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