| Identify a strategy that may be effective in this scenario. | When describing the treatment to caregivers or staff, what would you tell them to expect as far as implementation and outcomes? | What are the possible clinical obstacles you may encounter? |
|---|---|---|
| Response interruption and redirection (RIRD) | To expect that once the treatment is removed the behaviour may increase again. That the vocal stereotypy may still be stronger than the redirection response. That it may take some time for Cyrus to understand the interruption and redirection. | He continues to be distracted by the vocal stereotypy. That once the redirective responses are faded, the vocal stereotypy may reappear. That the procedure may still interfere with completing the required tasks. |
| Augmented competing stimulus assessment (Hagopian et al., 2020) | ||
| Intervention for perseverative speech (Kuntz et al., 2020) | there may be alot of increase of behavior in the beginning | distress from client |
| Intervention for perseverative speech (Kuntz et al., 2020) | It may not generalize to the natural environment when the intervention is removed | Educational staff may not have the training or time to implement intervention, the intervention might not be able to be faded |
| Augmented competing stimulus assessment (Hagopian et al., 2020) | not sure if the new stimuli can compete and for where and how long | The same as above |
| FA screening for automatically-reinforced behavior (Querim et al., 2013) | We will be observing the client in the alone condition and recording data representative of their engagement in the vocal stereotypy. | Identifying competing stimuli and generalizing to other conditions |
| Response interruption and redirection (RIRD) | ||
| Response interruption and redirection (RIRD) | That we would redirect him to his current task when he begins to engage in vocal stereotypy. He can have specific times available to engage in it, just trying to keep him focused during his tasks | The continuation of vocal stereotypy, or other behaviors beginning to occur |
| Response interruption and redirection (RIRD) | ||
| Choice-making intervention for restrictive behaviors (Fisher et al., 2019) | ||
| Leveraging restrictive behavior for interactive play (Watkins et al., 2019) | ||
| Augmented competing stimulus assessment (Hagopian et al., 2020) | timulus Identification and Testing: We'll start by presenting a variety of stimuli (e.g., sensory items, fidget tools, or auditory alternatives) to Cyrus. These will be tested systematically, with and without prompting and possibly response blocking, to see which ones reduce his vocal stereotypy while maintaining engagement. Use During Target Activities: Once we identify effective competing stimuli, we’ll introduce them before or during critical tasks (like table work or self-care routines). Staff may need to prompt Cyrus to use the items at the start and monitor for appropriate engagement. Monitoring and Fading: Over time, the goal is to fade the use of competing stimuli, as Cyrus builds skills and tolerates longer periods of engagement with fewer distractions. The team will track data on stereotypy and engagement to guide adjustments. | Access Interfering With Task Performance The team will need to balance access to stimuli with task participation, possibly teaching delayed reinforcement or building tolerance. |
| Response interruption and redirection (RIRD) | To use the least intrusive method to interrupt the behavior and redirect to task and alternative reinforcement | How strongly reinforcing the stereotypy is. |
| Response interruption and redirection (RIRD) | need to continue alt reinforcement | lack of competing stimuli, global procedural fidelity |
| Competing stimulus | access more naturally reinforcers in his environment. | reinforcers in his environment. |
| Competing stimulus | ||
| Response interruption and redirection (RIRD) | We are going to interrupt his vocal stereotypy in addition to presenting the alternative stimulus so that he will be more engaged at table time and self care. Research has shown this to be an effective intervention but we will have to monitor it during maintenance to see if it has a lasting effect. | It will be difficult to maintain the gains of the intervention once we end the RIRD. |
| Response interruption and redirection (RIRD) | Interrupt instances of vocal sterotypy by prompting a vocal response related to the current activity. | Client may not engage in alternative prompted response |
| Intervention for perseverative speech (Kuntz et al., 2020) | ||
| FA screening for automatically-reinforced behavior (Querim et al., 2013) | Depending on the results of the screening the treatment would vary for the client. Competing stimuli would need to be present in order to reduce the effectiveness of the automatically reinforced behavior. | Lack of skills |
| Augmented competing stimulus assessment (Hagopian et al., 2020) | Client will increase maladaptive behaviors | NO response to stimuli, need to apply a new functional analysis |
| Augmented competing stimulus assessment (Hagopian et al., 2020) | ||
| Response interruption and redirection (RIRD) | feasibility of implementation within the natural environment | increase in disruptive behaviors |
| Competing stimulus | ||
| Augmented competing stimulus assessment (Hagopian et al., 2020) | Be consistent with recommendations and lower your expectations as far as completely extinguishing the target behavior. | Disagreement with treatment intervention, lack of treatment integrity due to high behavioral effort on the part of staff. |
| Identify a strategy that may be effective in this scenario. | When describing the treatment to caregivers or staff, what would you tell them to expect as far as implementation and outcomes? | What are the possible clinical obstacles you may encounter? |
