Immediate and Subsequent Effects of Response Interruption and Redirection on Targeted and Untargeted Forms of Stereotypy

Abstract

A number of studies have shown that response interruption and redirection (RIRD) decreases immediate engagement in targeted stereotypic behaviors; however, its effects on untargeted stereotypy have not yet been studied, and its effects following removal of treatment are unclear. We evaluated the immediate and subsequent effects of RIRD on targeted motor stereotypy, as well as untargeted but higher probability vocal stereotypy, of two participants diagnosed with autism, using a three-component multiple-schedule design. Treatment with RIRD decreased immediate engagement in motor stereotypy for both participants, and did not increase subsequent engagement above baseline levels for either participant. In addition, RIRD produced modest changes in immediate engagement in untargeted vocal stereotypy for both participants. We briefly discuss the clinical implications and limitations of the findings from this study.

Keywords

motor stereotypy RIRD untargeted behavior vocal stereotypy

Several studies have shown that response interruption and redirection (RIRD) decreases stereotypic behaviors displayed by children with autism spectrum disorder (ASD; Ahearn, Clark, MacDonald, & Chung, 2007; Ahrens, Lerman, Kodak, Worsdell, & Keegan, 2011; Colón, Ahearn, Clark, & Masalsky, 2012; Dickman, Bright, Montgomery, & Miguel, 2012; Duffy-Cassella, Sidener, Sidener, & Progar, 2011; Liu-Gitz & Banda, 2009; Love, Miguel, Fernand, & LaBrie, 2012; Miguel, Clark, Tereshko, & Ahearn, 2009; Schumacher & Rapp, 2011). Ahearn et al. (2007) were among the first researchers to examine the effects of RIRD on vocal stereotypy exhibited by four children. Results showed that RIRD decreased vocal stereotypy for all four participants and increased appropriate vocalizations for three of four participants. Ahrens et al. (2011) examined the effects of vocal and motor RIRD on vocal stereotypy. In their study, RIRD involved experimenter-issued instructions that require a participant to emit either a vocal response (e.g., to answer a trainer’s questions or imitate vocalization) or a motor response (e.g., following a trainer’s instruction to “stand up”). Results showed that vocal and motor RIRD produced comparable decreases in vocal stereotypy, as well as increases in appropriate vocalizations. Ahrens et al. conducted a follow-up experiment wherein RIRD was implemented for vocal and motor stereotypy. Results showed that both types of RIRD were effective in decreasing vocal and motor stereotypy, and both procedures resulted in increased engagement in appropriate vocalizations.

A potential limitation of many studies on RIRD is that participants’ subsequent engagement in stereotypy was not evaluated. Interventions involving a putative punishment component, such as RIRD, may produce an increase, decrease, or no change in stereotypy following removal of the intervention (see Rapp, 2006, 2007). If removal of an intervention were to result in an increase in engagement in stereotypy, the utility of the intervention would be somewhat limited. In response to this concern, Schumacher and Rapp (2011) used a three-component multiple schedule to evaluate the immediate and subsequent effects of RIRD on the vocal stereotypy of two participants. Schumacher and Rapp exposed the participants to a no-interaction (NI) sequence and a RIRD sequence in an alternating fashion. Each sequence contained three consecutive 10-min components, and the authors conducted only one sequence per day. During the NI sequence, the authors did not provide social consequences for engagement in stereotypy in any of the three components. During the RIRD sequence, the first and third components were the same as in the NI sequence, and the authors implemented RIRD throughout the second component. When RIRD was in effect, the experimenter issued an instruction following each episode of vocal stereotypy and continued to present instructions until the participant responded correctly three times consecutively. The authors did not provide social consequences for appropriate vocalizations. Results indicated that (a) vocal stereotypy decreased for both participants when RIRD was in effect and (b) RIRD did not produce a subsequent increase in stereotypy for either participant.

The findings from the Schumacher and Rapp (2011) study are potentially limited for at least two reasons. First, because the study contained only two participants, the generality of the findings for the subsequent effects of RIRD on vocal stereotypy are limited. Second, one participant emitted relatively low baseline levels of vocal stereotypy, suggesting that the product of vocal stereotypy was not necessarily a potent reinforcer for this participant. As such, the subsequent effects for someone who emits higher baseline levels of stereotypy may be different.

Interventions involving response blocking or contingent punishment could be construed as response restriction procedures wherein the target behavior is not permitted to occur, and alternative reinforcement may or may not be programmed (e.g., Green & Striefel, 1988; McEntee & Saunders, 1997; Rapp, Vollmer, Peter, Dozier, & Cotnoir, 2004). The goal of such interventions is to restrict access to an undesirable response in order to facilitate reallocation of responding to more appropriate behaviors. Rapp et al. (2004) evaluated the separate and combined effects of response restriction and environmental enrichment on various topographies of stereotypy and object manipulation in five participants. Rapp et al. exposed participants to a free-operant (FO) condition, wherein the authors permitted all behavior, and restricted-operant condition, wherein the authors blocked the most frequently occurring motor stereotypy (denoted R¹). Results for three of four participants indicated that restricting R¹ decreased engagement in at least one untargeted response and increased engagement in other responses that had been less probable in FO conditions. Similarly, Rapp et al. (2012) found that noncontingent access to preferred items decreased immediate engagement in targeted vocal stereotypy (R¹), but it increased immediate or subsequent engagement in untargeted motor stereotypy for 8 of 14 participants. Given the mixed findings in the literature, additional research on the effects of behavioral interventions on untargeted stereotypy is warranted.

To date, no published studies have evaluated the effects of RIRD on untargeted topographies of stereotypy. Investigating changes in the frequency of one behavior that are correlated with changes in another behavior could potentially increase the success and efficiency of behavioral interventions, whether the behaviors of interest are members of the same response class or not. In the few studies that have evaluated the effects of an intervention on untargeted automatically reinforced repetitive or stereotypic behavior, most selected the higher probability response, which was determined from each participant’s response allocation during FO conditions, for intervention (e.g., Friman & Hove, 1987; Rapp et al., 2004; Rapp et al., 2012; Rollings & Baumeister, 1981). It is possible, however, that decreasing a less probable stereotypy (e.g., a motor stereotypy) with treatment for some individuals may also decrease untargeted, but higher probability, vocal stereotypy. Such an outcome could be advantageous for practitioners, as it is may be easier to interrupt motor stereotypy than vocal stereotypy. In addition, it may be conceptually interesting to evaluate the extent to which automatically reinforced behaviors are related in an individual’s repertoire. For example, based on studies from the behavioral economics literature (see Green & Freed, 1993), a number of researchers have speculated that two or more automatically reinforced behaviors could produce complementary reinforcement (e.g., Friman, 2000; Rapp, 2005; Rapp et al., 2004; Rapp et al., 2012) or may be part of a response chain (e.g., Austin & Wilson, 2001; Friman & Hove, 1987).

Although there is empirical support for the use of RIRD to decrease stereotypic behavior, the literature base is potentially limited insofar as (a) only the Schumacher and Rapp (2011) study has evaluated the subsequent effects of RIRD on vocal stereotypy and (b) only the Ahrens et al. (2011) study has evaluated the immediate, but not subsequent, effects of RIRD on motor stereotypy. Thus, additional research on the immediate and subsequent effects of RIRD on vocal and motor stereotypy is warranted.

The primary purposes of this study were to (a) replicate and extend the findings of the Ahrens et al. (2011) study on RIRD for motor stereotypy, (b) extend the finding of the Schumacher and Rapp (2011) study by evaluating the subsequent effects of RIRD on motor stereotypy, and (c) extend the findings of Duffy-Cassella et al. (2011) by providing data on the implementation of RIRD across sessions for each participant. The secondary purpose of this study was to extend the findings of the Rapp et al. (2004) study by evaluating the effects of RIRD on untargeted stereotypy. As emphasized by Rapp et al. (2012), the three-component method is intended to serve as pretreatment evaluation that predicts the effects of a specific intervention on an individual’s behavior before the intervention is implemented on a broader basis.

Method

Participants and Target Behaviors

Two boys with clinical diagnoses of autistic disorder participated in the study. Both participants were receiving applied behavior analytic services from Board-Certified Behavior Analysts (BCBAs), and each emitted at least one motor stereotypy as well as vocal stereotypy for a minimum of 20% of a 10-min NI baseline session. Each participant emitted vocal stereotypy for a higher percentage of time than motor stereotypy.

Emmett was also diagnosed with Down syndrome, and was 9 years and 9 months old at the start of the study. He did not display any communicative vocal verbal behavior, but he was able to follow simple gross motor imitation instructions. We defined Emmett’s vocal stereotypy as any vocalization using the vocal chords. For both participants, we excluded vocalizations occurring as a result of coughing or sneezing from the definition of vocal stereotypy. Emmett’s motor stereotypy comprised hand flapping, which we defined as repeated (two or more back-and-forth movements of the arm from the elbow or the hand from the wrist with or without an object in hand within 5 s).

Andrew was aged 6 years and 11 months. He did not consistently display communicative vocal verbal behavior and had limited receptive language skills (he did not respond correctly to gross motor imitation or one-step instructions). We defined his vocal stereotypy as any vocalization activating the vocal chords, whispered sounds, rapid audible breathing (two or more breathing cycles in 1 s), and exhaling through the lips causing audible vibration. Andrew’s motor stereotypy involved surface rubbing, which we defined as moving the palms of the hands, fingertips, or soles of the feet back and forth (two or more times within 3 s) on any surface. For each participant, we also collected data on noncompliance during RIRD sessions. We defined noncompliance as a failure to initiate a response within 5 s of the experimenter instruction, attempted elopement following the delivery of an instruction, or both.

Setting

We conducted all sessions in a closed room in each participant’s home. For Emmett, we conducted sessions in the living room, which was blocked by a door on one side and a child safety gate on the other side. For Andrew, we conducted sessions in his bedroom. The room contained furniture such as tables and chairs, couches or a bed, as well as a video camera on a portable tripod. We removed all toys (other than those used in the RIRD procedure for Andrew) from the room prior to beginning each session.

Response Measurement and Interobserver Agreement (IOA)

We videotaped each session using a digital camera. Subsequently, we scored the target behaviors using the continuous duration recording method described by Miltenberger, Rapp, and Long (1999). We also scored the frequency with which we implemented RIRD and the frequency of each participant’s noncompliance during each RIRD session. We calculated the percentage of time spent engaged in each type of stereotypy for each session by dividing the total number of seconds engaged in the stereotypy by the total number of seconds in the session and multiplying this number by 100%.

A second observer scored at least 33% of all sessions for each participant for both motor and vocal stereotypy. The first author, a graduate student, was the primary data collector, and the reliability observer was a BCBA who had recently completed studies at the same university. We calculated IOA scores using the block-by-block method described by Mudford, Martin, Hui, and Taylor (2009). Across all sequences in the multiple-component schedule, mean IOA scores for Emmett were 94.3% (range, 91.7%-96.1%) for motor stereotypy and 92.4% (range, 91.8%-92.8%) for vocal stereotypy. Mean IOA scores for Andrew were 94.1% (range, 91.9%-95.4%) for motor stereotypy and 94.6% (range, 94%-95.7%) for vocal stereotypy. Mean IOA scores for RIRD implementation were 100% for both participants.

Experimental Design

We used a multielement design with an embedded three-component multiple schedule to evaluate the effects of RIRD on motor stereotypy (targeted) and vocal stereotypy (untargeted) for each participant (Lanovaz, Rapp, & Fletcher, 2010). We used the NI sequence to demonstrate that the target stereotypy persisted in the absence of social consequences (Iwata & Dozier, 2008; Schumacher & Rapp, 2011).

Procedures

We conducted only one sequence (either NI or RIRD) per day in an alternating order across days. Each sequence consisted of three consecutive 10-min components. We conducted sessions 5 days per week whenever possible; however, this schedule varied due to participant availability. We considered data paths to be differentiated when no overlap occurred in the last three data points of NI and RIRD data paths. We continued sessions until the data paths in the second component for the primary target behavior (motor stereotypy) became differentiated. Sessions for each participant were typically run at the same time of the day.

NI Sequence

The NI sequence consisted of three identical 10-min components, presented consecutively. In this sequence, an experimenter was present in the room and at the beginning of each component she instructed the participant to “Do what you want.” The experimenter did not interact further with the participant, and she did not provide social consequences for engagement in either form of stereotypy. In addition, we did not arrange programmed consequences for engagement in appropriate speech (Schumacher & Rapp, 2011). During NI components, the experimenter either remained seated at the side of the room reading work materials or managed the camera, which was mounted on a tripod in a corner of the room.

RIRD Sequence

The RIRD sequence was similar to the NI sequence, with the exception of the second component in the sequence during which RIRD was implemented. Contingent on engagement in motor stereotypy during the second component of the RIRD sequence, the experimenter instructed the participant to follow a series of gross motor imitation antecedents (Emmett) or to complete a simple mastered task such as putting blocks into a bucket (Andrew). For Emmett, the experimenter presented gross motor imitation antecedents until the participant correctly and independently responded to three consecutive instructions in the absence of the target motor stereotypy (Schumacher & Rapp, 2011). For incorrect or nonresponses the experimenter reissued the antecedent and provided brief (approximately 1 s in duration) physical prompting to assist the participant in demonstrating the response. Because Andrew did not comply with gross motor imitation antecedents, the experimenter issued an instruction to complete a known independent completion task (either putting blocks into a bucket or putting balls into a container). The experimenter did not physically guide Andrew to remain at the task until it was completed, as engagement in the task was always effective at interrupting engagement in stereotypy. However, if Andrew attempted to elope following an experimenter instruction, the experimenter blocked his way and pointed to the task. The experimenter did not provide social praise for appropriate vocalizations, and the time spent implementing RIRD was not subtracted from total session time. In addition, the experimenter hung a 1 m × 1 m green poster board on the wall during the RIRD component to signal that the intervention was in effect.

Data Analysis

We used the model described by Lanovaz et al. (2010) and Simmons, Smith, and Kliethermes (2003) to evaluate the immediate and subsequent effects of RIRD on targeted motor stereotypy and untargeted vocal stereotypy. The first components of each sequence assessed pretreatment levels of targeted and untargeted stereotypy. The second components of each sequence assessed the effects of RIRD on targeted and untargeted stereotypy (sometimes called the “immediate” effects). Finally, the third components of each sequence assessed the posttreatment effects of RIRD on targeted and untargeted stereotypy (sometimes called the “subsequent” or persisting effects). Specifically, we first conducted a between-sequence analysis in which we compared patterns of responding across each component of NI and RIRD sequences. For example, we compared levels of stereotypy in the second component of the NI sequence with levels of responding in the second component of the RIRD sequence. In addition, we used a variation of a within-sequence analysis to evaluate possible changes in each participant’s immediate or subsequent engagement in untargeted vocal stereotypy. In this analysis, we examined the subsequent effect of RIRD on stereotypy by comparing the first component of the test sequence to the third component of the same sequence to clarify possible subsequent effects of RIRD on the targeted behavior, untargeted behavior, or both.

Motor Stereotypy (Targeted)

We conducted a between-sequence analysis to evaluate the immediate and subsequent effects of RIRD on each participant’s targeted motor stereotypy. First, assuming that the first components of the two sequences were undifferentiated, we compared levels of motor stereotypy in the second component of the NI sequence to levels of motor stereotypy in the second component of the RIRD sequence. Although Lanovaz et al. (2010) concluded that a within-sequence analysis may only be necessary when the data paths for the third components of the two sequences are not differentiated, we conducted a within-sequence analysis for all data sets to evaluate possible response covariation or reallocation, which might not be detected by a between-sequence analysis. Lanovaz et al. suggested that the within-sequence analysis is more sensitive to small behavior changes than the between-sequence analysis; a handful of studies have relied exclusively on this method for evaluating immediate and subsequent changes in automatically reinforced behavior (e.g., Morrision, Roscoe, & Atwell, 2011; Rapp, 2006, 2007; Simmons et al., 2003).

Using the within-sequence analysis, we evaluated the subsequent effects of RIRD on motor stereotypy by comparing levels of the behavior in the first component of the test sequence to levels in the third component of the same sequence. Specifically, we counted the number of sessions for which responding in the third component was higher than the first component for the NI and RIRD sequences. If the third component contained more stereotypy than in the first component for substantially more RIRD sessions than for NI sessions, we would have concluded that RIRD increased subsequent engagement in motor stereotypy.

Vocal Stereotypy (Untargeted)

In addition to the between- and within-sequence analyses described for motor stereotypy, we conducted an additional within-sequence analysis wherein we focused on the second component of the RIRD sequence. Regardless of whether the data paths from the second and third components of the two sequences were differentiated, we counted the number of NI and RIRD sessions during which the second component contained the (a) lowest level of vocal stereotypy of the three components and (b) highest level of vocal stereotypy of the three components. If there were clearly more RIRD sessions than NI sessions with the lowest level of vocal stereotypy in the second component, we concluded that RIRD, which was provided for motor stereotypy, produced an immediate decrease in untargeted vocal stereotypy. By contrast, if there were clearly more RIRD sessions than NI sessions with the highest level of vocal stereotypy in the second component, we concluded that RIRD produced an immediate increase in untargeted vocal stereotypy. This outcome, which is not clinically desirable, could suggest that decreasing the targeted stereotypy with RIRD facilitated reallocation to another form of stereotypy.

Results

Figure 1 (upper left panel) shows that during the first components, the data paths for Emmett’s motor stereotypy were relatively undifferentiated in the NI (M = 77.3%) and RIRD (M = 71.7%) sequences. During the second components (middle upper panel), his motor stereotypy was lower during the RIRD sequence (M = 32.9%) than during the NI sequence (M = 72.6%). We implemented RIRD 18 to 29 times per session (M = 23.3; lower panel), and the need to implement it did not decrease in later sessions. During RIRD implementation, Emmett engaged in noncompliance for a mean 10.2 times per session (range = 7-15 responses). During the third components (upper right panel), his motor stereotypy was undifferentiated in the RIRD (M = 66.0%) and NI (M = 69.2%) sequences. Figure 1 (center three panels) also depicts Emmett’s engagement in vocal stereotypy across sequences. During the first components, Emmett’s vocal stereotypy was undifferentiated in the NI (M = 43.7%) and RIRD (M = 43.7%) sequences. During the second component (center middle panel), Emmett initially emitted higher levels of vocal stereotypy during the RIRD sequence (M = 48.7%) than during the NI sequence (M = 34.6%); however, the data paths ultimately became undifferentiated. During the third components (lower right panel), engagement in vocal stereotypy during the NI (M = 28.7%) and RIRD (M = 19.7%) sequences was relatively low and undifferentiated.

Figure 1.

Percentage of time Emmett engaged in motor stereotypy (upper three panels) and vocal stereotypy (center three panels) during the first, second, and third components of the NI and RIRD sequences, and number of times we implemented RIRD across sessions during the second component of the RIRD sequence (lower panel).

Because Emmett’s engagement in motor stereotypy was lower in the second component of the RIRD sequence than in the NI sequence, and data paths for the two sequences were not differentiated in the third component, we also conducted a within-sequence analysis. Figure 2 shows the results of the within-sequence analyses for Emmett’s motor and vocal stereotypy. Results show that Emmett’s motor stereotypy (upper panel) was higher in the third component than in the first component for one of six sessions in both sequences (RIRD and NI), which suggests that RIRD did not increase Emmett’s subsequent engagement in motor stereotypy. Although the data paths for vocal stereotypy were not differentiated in the second components of the two sequences, we conducted a within-sequence analysis to examine the indirect effects of RIRD. Results show that Emmett’s vocal stereotypy (lower panel) was highest in the second component for one of six sessions in the NI sequence and four of six sessions in the RIRD sequence. In addition, vocal stereotypy was lowest in the second component for three of six NI sessions and for zero of six RIRD sessions. Together, these findings suggest that RIRD increased Emmett’s immediate engagement in vocal stereotypy, although this effect was temporary (as indicated by the between-sequence analysis). In summary, RIRD decreased Emmett’s immediate engagement in motor stereotypy, temporarily, and only modestly, increased his immediate engagement in vocal stereotypy, and did not increase his subsequent engagement in either motor stereotypy or vocal stereotypy.

Figure 2.

Within-sequence analysis showing the percentage of time Emmett engaged in motor stereotypy (upper panel) and vocal stereotypy (lower panel) across the first, second, and third components of NI and RIRD sequences.

Figure 3 (upper left panel) shows that during the first components, Andrew’s engagement in motor stereotypy was undifferentiated in the NI (M = 49.5%) and RIRD (M = 40.6%) sequences. During the second components (upper middle panel), motor stereotypy became differentiated such that it was lower during the RIRD sequence (M = 13.3%) than the NI sequence (M = 42.3%). We implemented RIRD 10 to 16 times per session (M = 12.8; lower panel), and the need to implement it did not decrease in later sessions. During RIRD implementation, Andrew exhibited relatively few instances of noncompliance (M = 0.6; range = 0-2 responses). In the third component (upper right panel), Andrew engaged in lower levels of motor stereotypy during the RIRD sequence (M = 37.4%) than during the NI sequence (M = 57.9%); however, the data paths were not clearly differentiated during the last three data points of each sequence. Figure 3 (center three panels) also depicts Andrew’s engagement in vocal stereotypy. During the first components, Andrew’s vocal stereotypy was undifferentiated in the NI (M = 89.2%) and RIRD (M = 87.5%) sequences. In the second components (center middle panel), data paths for vocal stereotypy during NI (M = 78.3%) and RIRD (M = 70.3%) were also undifferentiated. During the third components, data paths for vocal stereotypy were again undifferentiated in the NI (M = 80.1%) and RIRD (M = 80.5%) sequences.

Figure 3.

Percentage of time Andrew engaged in motor stereotypy (upper three panels) and vocal stereotypy (center three panels) during the first, second, and third components of the NI and RIRD sequences, and number of times we implemented RIRD across sessions during the second component of the RIRD sequence (lower panel).

Figure 4 shows the within-sequence analyses for Andrew’s motor stereotypy (upper panel) and vocal stereotypy (lower panel). Results show that his motor stereotypy was higher in the third component than in the first component for four of five NI sessions and two of five RIRD sessions, suggesting that RIRD did not increase his subsequent engagement in motor stereotypy. Results also show that engagement in vocal stereotypy was lowest during the second component for four of the five RIRD sessions, whereas it was lowest during the second component for only one of the five NI sessions, suggesting that Andrew’s vocal stereotypy decreased when RIRD was implemented for motor stereotypy. Furthermore, the second component of both sequences never contained the highest level of vocal stereotypy in a session. Taken with the results of the between-sequence analysis for Andrew’s motor stereotypy, the results suggest that RIRD decreased his immediate engagement in motor stereotypy and vocal stereotypy (though only modestly) and did not increase his subsequent engagement in either behavior.

Figure 4.

Within-sequence analysis showing the percentage of time Andrew engaged in motor stereotypy (upper panel) and vocal stereotypy (lower panel) across the first, second, and third components of NI and RIRD sequences.

Discussion

For both participants, the results showed that RIRD decreased immediate engagement in targeted motor stereotypy and did not increase subsequent engagement in either targeted motor stereotypy or untargeted vocal stereotypy. For untargeted vocal stereotypy, RIRD produced an immediate but temporary increase for Emmett and an immediate decrease for Andrew. Although RIRD decreased immediate engagement in targeted motor stereotypy for both participants, implementation of RIRD did not decrease across sessions for either participant.

Results of this study replicate and extend the literature on the assessment and treatment of stereotypy in several ways. First, the current study provides a partial replication of prior studies on the use of RIRD to decrease engagement in stereotypy (Ahearn et al., 2007; Colón et al., 2012; Duffy-Cassella et al., 2011; Liu-Gitz & Banda, 2009; Love et al., 2012; Miguel et al., 2009; Schumacher & Rapp, 2011). In particular, we partially replicated findings from Ahrens et al.’s (2011) study by applying RIRD involving motor movements to successfully decrease engagement in motor stereotypy. Second, we found that RIRD did not increase subsequent engagement in either targeted or untargeted stereotypy. This finding is consistent with the results reported by Schumacher and Rapp (2011). In addition, we extended the findings from the Duffy-Cassella et al. (2011) study by showing that RIRD implementation does not necessarily decrease across sessions for each participant. This outcome could potentially influence the clinical utility of RIRD. Finally, consistent with results from the Rapp et al. (2004) study on response restriction, we found the effects of RIRD on untargeted vocal stereotypy to be idiosyncratic across participants.

Some effects of RIRD on targeted and untargeted stereotypy warrant interpretation. First, RIRD produced an immediate but temporary increase in vocal stereotypy for Emmett. Specifically, the within-sequence analysis indicated that engagement in vocal stereotypy was highest during the second component for four of six RIRD sessions, and only one of six NI sessions (see Figure 2). It is not clear why this increase occurred; however, an informal within-session analysis indicated that increased vocal stereotypy did not consistently co-occur with increased engagement in either motor stereotypy or noncompliant behavior. That is, his vocal stereotypy did not appear to be induced by the implementation of RIRD. It is possible that increased engagement in vocal stereotypy occurred as a result of response reallocation (Rapp et al., 2004). Specifically, after stimulation generated by motor stereotypy was restricted, stimulation generated by vocal stereotypy may have become more valuable to Emmett. However, decreased levels of his motor stereotypy did not necessarily correspond to increases in vocal stereotypy during NI components. Second, the covarying reduction in Andrew’s vocal stereotypy when RIRD was provided contingent on motor stereotypy may be the result of adventitious punishment (Lerman, Kelley, Vorndran, & Van Camp, 2003). In this way, if Andrew exhibited both forms of stereotypy simultaneously or in close temporal proximity, the delivery of RIRD may have punished both behaviors. However, because vocal stereotypy was a higher probability response than motor stereotypy for Andrew, a high proportion of his vocal stereotypy responses were not followed by RIRD (i.e., it was an intermittent punishment schedule). Thus, it seems unlikely that adventitious punishment accounts for his decreased vocal stereotypy. Alternatively, it is possible that the relative value of stimulation produced by engaging in vocal stereotypy decreased when stimulation produced by motor stereotypy was restricted (e.g., Friman, 2000; Rapp, 2005; Rapp et al., 2004). Regardless of mechanism, the effect of RIRD on untargeted vocal stereotypy appeared to be relatively small (i.e., the changes were probably not clinically meaningful), and the relation between the targeted and untargeted stereotypy was unclear because we did not perform a contiguity analysis (e.g., Lerman et al., 2003).

Several potential limitations to the findings of this study should be noted. First, we did not provide contingent attention for appropriate speech during any of the components. This procedure deviated from those described by Ahearn et al. (2007) and Ahrens et al. (2011); increased appropriate speech may have led to further decreases in vocal stereotypy for one or both participants. As in the Schumacher and Rapp (2011) study, we omitted contingent attention to isolate the effects of RIRD on targeted motor stereotypy and untargeted vocal stereotypy. Had we delivered attention for vocal behavior, the results for each participant’s untargeted vocal stereotypy would have been equivocal. In addition, neither of the participants emitted functional verbal speech, and we did not provide prompts during any of the components, so it is unlikely that functional speech would have increased for participants during this study.

A second potential limitation is that it is not clear whether the poster board signaled that the intervention was in effect during the second component of the RIRD sequence. That is, removal of the poster board may not have been sufficient to signal termination of RIRD. Specifically, the punishing effects from the second component of the RIRD sequence may have carried into the third component of the RIRD sequence for Andrew (Schumacher & Rapp, 2011). Following removal of the poster board in the third component of the RIRD sequence, Andrew’s motor stereotypy remained lower than in the NI sequence, which suggests that his behavior may have been under stimulus control of a recent punisher (see Doughty, Anderson, Doughty, Williams, & Saunders, 2007). Had we conducted a more extended post-RIRD analysis, a subsequent increase in one or both participant’s motor stereotypy may have been detected. Future research could incorporate longer posttreatment analyses to assess subsequent effects of RIRD.

A third potential limitation is that reductions in stereotypy may have been due to reduced time to engage in stereotypy while the RIRD procedures were being implemented; however, this account is unlikely as participants could still engage in motor and vocal stereotypy throughout RIRD implementation. Moreover, although it was necessary to implement RIRD during each treatment session with each participant, participants typically complied with the contingent demands, and physical prompts that we provided to participants for noncompliance were brief (i.e., approximately 1 s in duration). Thus, very little session time was lost to performing RIRD. A related limitation is that RIRD implementation did not decrease across sessions, potentially obscuring punishment effects. It is possible that a clear punishment effect would have been produced with RIRD had we not alternated RIRD sessions with NI sessions (i.e., extended periods of time without social consequences for motor stereotypy). Future research should address this question.

Fourth, as in the Rapp et al. (2012) study, we did not evaluate the extent to which each participant’s targeted and untargeted stereotypy was sensitive to social consequences (e.g., escape from demands, trainer’s attention). For example, it is possible that one or both participants’ motor stereotypy was also maintained by attention from the trainer. In part, such an outcome would explain why our implementation of RIRD, which involves the contingent delivery of attention, did not decrease across sessions for either participant. Nevertheless, conducting a complete functional analysis (Iwata, Dorsey, Slifer, Bauman, & Richman, 1982/1994) for the targeted and untargeted stereotypy with each participant would have required a protracted number of sessions. Moreover, we demonstrated the persistence of motor and vocal stereotypy across numerous 30-min sessions (the NI sequence), which strongly suggests that both participants’ behaviors were automatically reinforced.

Finally, we did not attempt to directly treat each participant’s vocal stereotypy with RIRD or another behavioral intervention. Thus, we do not know the extent to which treating motor stereotypy with RIRD may have affected subsequent treatment for vocal stereotypy. For example, participants with extensive exposure to RIRD may habituate to the aversive properties of the procedures, making it less effective as a punisher (Lerman & Vorndran, 2002).

Future research could evaluate the effect of teaching functional or leisure skills through object imitation or vocal instructions during RIRD. With the exception of the tasks for Andrew during RIRD implementation, all sessions took place in rooms devoid of anything but basic furniture. It is possible that the inclusion of a programmed replacement activity would result in less experimenter intervention as the participant learned the new skill. A recent study by Love et al. (2012) provides some support for including functionally matched stimulation as an additional component in an RIRD intervention, and the stimulation provided by a programmed replacement activity could potentially be matched to that generated by engagement in stereotypy. However, it should be noted that matched stimulation has also been shown to produce undesirable collateral effects on untargeted forms of stereotypy (Rapp et al., 2012). Additional studies are needed to further evaluate the effects of matched stimulation on untargeted behaviors.

Another avenue for future research is to evaluate the relative effects of the presence or absence of a stimulus to signal that intervention is in effect. The implementation of RIRD did not decrease over time for either participant; however, it is possible that this may have occurred if additional sessions had been run or if the postintervention component had been more extended in duration (e.g., 20 min). Future studies could also examine the effects of RIRD on an untargeted stereotypy that reliably co-occurs with the target stereotypy (e.g., Friman & Hove, 1987). Although vocal stereotypy frequently occurred with the target motor stereotypy for each participant, both motor and vocal stereotypy also occurred in isolation (i.e., the two responses did not appear to be sequentially dependent).

Footnotes

Authors’ Note

Portions of this study were conducted in partial fulfillment of a master’s degree in behavior analysis by the first author.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Author Biographies

Sarah J. Pastrana graduated from St. Cloud State University with an MS in Applied Behavior Analysis. She is a Board Certified Behavior Analyst providing behavior analytic services to children and youth with autism and their families in Vancouver, British Columbia. Her current research interests include automatically reinforced behavior, skill acquisition and verbal behavior. She will commence her PhD in Special Education at the University of British Columbia in September 2013.

John T. Rapp is a professor in the Behavior Analysis program at St. Cloud State University. His research interests include automatically reinforced behavior, stereotypy, data collection methods, and experimental designs.

Tyla M. Frewing is Board Certified Behavior Analyst serving children and adults with autism in Vancouver, British Columbia. Tyla completed her Master of Science at St. Cloud State University and will commence a Ph.D. in Special Education at the University of British Columbia in September, 2013.

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