| 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? |
|---|---|---|
| Choice-making intervention for restrictive behaviors (Fisher et al., 2019) | Let them know that they will see resistance as there has not been a history with other responses. The treatment is teaching alternative behaviors as well as use trials to open up new options for interactions with others. | Possible fidelity of treatment, there may need to be multiple alternative stimuli that regularly need to be rotaded to hold value. |
| Leveraging restrictive behavior for interactive play (Watkins et al., 2019) | Behavior is available during play but not available during work. Outcome will be good if reinforcement delivery is consistent | Increase in vocal stereotypy during play |
| Leveraging restrictive behavior for interactive play (Watkins et al., 2019) | ||
| Response interruption and redirection (RIRD) | prompt skills and interrupt vocal stereotypy with demands | frustration from child because this is a crappy approach |
| Response interruption and redirection (RIRD) | The target stereptypy will decrease as the target replacement behavior increases | Stakeholders wanting immediate results |
| FA screening for automatically-reinforced behavior (Querim et al., 2013) | ||
| Response interruption and redirection (RIRD) | Consistency is key! | I may consider the use of an SD/Sdelta board to help signal to Cyrus the 'availability' and 'unavailability' of stereotypy/contexts or times in which it may be appropriate and times in which supplemental programming (RIRD/DRO/DRA) would be operating to suppress the occurrence of vocals. |
| Intervention for perseverative speech (Kuntz et al., 2020) | The implementation involves response extinction and prompting of alternate topics to discuss. The treatment has been demonstrated to be efficacious for most learners. | Extinction may elicit increased target behaviors. |
| Response interruption and redirection (RIRD) | The key here is to distract Cyrus towards other stimuli | Resistance |
| Competing stimulus | Hope that by increasing access to reinforcement for the competing stimulus will decrease time spent on automatically reinforced steryotypy | Finding competing stimulus |
| Augmented competing stimulus assessment (Hagopian et al., 2020) | ||
| Augmented competing stimulus assessment (Hagopian et al., 2020) | Rough beginning, but the behavior should gradually decrease over time. | The competing stimulus still being a distraction. |
| Response interruption and redirection (RIRD) | its restrictive, but effective and can be implemented with DRA procedures | Can be hard to fade and generalize to staff |
| Choice-making intervention for restrictive behaviors (Fisher et al., 2019) | The child choosing between the stereotypy behavior alone and an alternative behavior paired with reinforcement. | The potential reinforcer not being as motivating as the stereotypy. |
| Competing stimulus | vocal stereotypy will still be displayed, but will lessen with competing stimlus | the automatic reinforcement being too strong, and the competing stimulus to not be strong enough. |
| Response interruption and redirection (RIRD) | They may need to repeat the RIRD multiple times. | Redirection does not last long enough for task completion. |
| Intervention for perseverative speech (Kuntz et al., 2020) | ||
| Response interruption and redirection (RIRD) | That the treatment will likely be effective during sessions but will likely not generalize outside of the clinic. However, it will allow the client to access his education which will hopefully increase the availability of reinforcers in his environment which may then reduce his vocal stereotypy. | Time and people intensive. |
| Choice-making intervention for restrictive behaviors (Fisher et al., 2019) | When implementing Cyrus will build a wider history of reinforcement that he can access. | Placing the bx vocal stereotypy on extinction will be a challenge as the current reinforcement is automatic maintained. Keeping the alternative bx paired with a reinforcement stimulus that maintains motivational operations for Cyrus will also be a challenge. |
| Competing stimulus | Cyrus' vocal stereotypy decreases when he is presented with an alternative stimulus. Providing Cyrus with the stimulus during educational programming will decrease his vocal stereotypy during critical learning times and is the least intrusive intervention. | Teachers arguing that he shouldn't be allowed to engage with an item during instructional time. |
| Response interruption and redirection (RIRD) | Give an instruction to guide Cyrus back to the task when he engages in vocal Stereotypy and provide reinforcement for task completion. | The need for more competing reinforcers |
| Response interruption and redirection (RIRD) | When implementing the RIRD, this can be used when client is distracted by the stimulus or you can provide a variety of of other stimuli. | That the client is always distracted by a competing stimulus when presented. Where RIRD can be used exclusively instead. |
| Leveraging restrictive behavior for interactive play (Watkins et al., 2019) | Lack of Vocal behaviors | Escape from the environment |
| Response interruption and redirection (RIRD) | Consistent interest execution | Participate in Ignoring responses |
| Choice-making intervention for restrictive behaviors (Fisher et al., 2019) | This procedure allows for the use of choice while still contacting reinforcement. This procedure is less restrictive, more susceptible to naturally occurring reinforcers, and allows us to teach without introducing stimuli that may become a distraction. The choice-making intervention is a shaping procedure, so it will take more time to reach the desired outcomes than more restrictive or traditional procedures | Cyrus may choose to engage in his own choice more often than the choice of the less restrictive behavior. We can address this barrier using differential reinforcement |
| 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? |
