| 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? |
|---|---|---|
| Competing stimulus | ||
| FA screening for automatically-reinforced behavior (Querim et al., 2013) | the caregivers and staff would expect to conduct competing stimuli assessment for Cyrus and to provide reinforcement in contingent and non contingent on alternative behavior to the vocal stereotypy. | Limited availability of competing stimuli and reinforcement in naturalistic settings. |
| Response interruption and redirection (RIRD) | It will need to be generalised to other situations to produce corresponding effects in other environments | Needing to train staff in his skill teaching class to ensure fidelity of implementation |
| Response interruption and redirection (RIRD) | When the target behavior occurs, it will be interrupted and Cyrus will be redirected to engage in the current activity at hand. Reinforcement will be delivered following engagement in the current task. | Fading intervention procedure, restrictiveness of procedure |
| Response interruption and redirection (RIRD) | to try to engage Cyrus in an incompatible skill like singing a song or answering a question about a preferred topic. Then embed or insert learning tasks for short time bursts so he could resume the stereotypy when task is completed | Cyrus not being redirected by the questions, prompts, or directives. |
| Response interruption and redirection (RIRD) | increase in vocalizations at first. | interest in subject matter of his educational curriculum |
| Augmented competing stimulus assessment (Hagopian et al., 2020) | I do not understand this question | |
| Response interruption and redirection (RIRD) | As it is a restrictive program, I would describe this strategy and potential benefits to risks while ensuring they understand RIRD would not be the ultimate protocol and goal for the behavior. I would help the parent understand that this would be an initial program, but that the end goal is to find natural reinforcers and consequences around social and verbal behavior that would support the terminal goal of replacing vocal stereotypy with more accepted behaviors. | Problem behavior may arise from response interruption |
| Response interruption and redirection (RIRD) | requires consistent implementation over time | difficulty reducing the prompting needed for the intervention |
| Response interruption and redirection (RIRD) | When the behavior occurs at an inappropriate time, redirect and prompt a different, competing behavior. This shoudl be effective in most instances with some practice. | Behavior may increase before it decreases. |
| Response interruption and redirection (RIRD) | ||
| Augmented competing stimulus assessment (Hagopian et al., 2020) | We’ll start by finding activities or items that are just as enjoyable as the repetitive behavior. At first, we’ll need to actively prompt the person to engage with these and sometimes block the repetitive behavior. Over time, the goal is for them to choose the alternative activities on their own, leading to less stereotypy and more appropriate engagement. You should expect a learning curve in the beginning, but with consistency you’ll see reduced repetitive behavior and more meaningful participation in daily life. | finding durable competing stimuli, ensuring generalization, overcoming the labor-intensity of implementation, and balancing acceptability with effectiveness. |
| Response interruption and redirection (RIRD) | We will be trying out a strategy where we have Cyrus engage in 3-short vocal responses that will interrupt his vocal stereotopy and then redirect him to his work. We will also provide access to a competing stimulus after a brief period of interacting with his work tasks. This should decrease his stereotopy in the presence of his educational programs and allow him to learn more at those times. | It may be hard to find responses that effectively disrupt the behavior. |
| Competing stimulus | Competing stimuli may not compete enough. | |
| Response interruption and redirection (RIRD) | ||
| Intervention for perseverative speech (Kuntz et al., 2020) | ||
| FA screening for automatically-reinforced behavior (Querim et al., 2013) | ||
| Intervention for perseverative speech (Kuntz et al., 2020) | ||
| Response interruption and redirection (RIRD) | I would inform staff, as long as the individual is successfully completing the task, staff should use planned ignoring for vocal stereotypy. However, if the vocal stereotypy interferes with task completion, staff should then implement Response Interruption and Redirection (RIRD) | Vocal stereotypy can be challenging to decrease. Staff can used (RIRD), however it can also be used as a form of escape so there needs to be high levels of reinforcement once the task is complete. Vocal stereotypy can be challenging to reduce. While staff may implement Response Interruption and Redirection (RIRD), it’s important to recognize that vocal stereotypy can be used to escape non preferred tasks. Therefore, it is essential to provide high levels of reinforcement upon task completion to maintain motivation and reduce the likelihood of escape-maintained behavior |
| FA screening for automatically-reinforced behavior (Querim et al., 2013) | Once FA screening is completed, we can then take the most effective approach for curbing the | Is decreasing stereotypy socially significant for the individual? Stereotypy is reinforced automatically by the individual, so how can an educational program have this reinforcement in the natural environment? Will access to the educational program Are there any family considerations to follow? |
| Response interruption and redirection (RIRD) | Behavior can become worse before it gets better | Not effectively responding to interruptions |
| Competing stimulus | He will be offered other choices to help decrease the behavior. | It may be challenging to offer other choices and he may not be interested in them. |
| Response interruption and redirection (RIRD) | I would tell that that this behavior will not be decreased to zero rates, but that it will be shaped so that it occurs during break times instead of disrupting work and learning opportunities. | other environmental factors that are out of our control such as peer attention, peer noise level, etc |
| Competing stimulus | ||
| Choice-making intervention for restrictive behaviors (Fisher et al., 2019) | I would tell them to give him the option to engage in work and reward it and don't offer that reward for not opting into educational work. It would take some time, but eventually he will likely opt in to working. | Finding a reinforcer that works well enough |
| 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? |
