| 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) | 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. |
| Response interruption and redirection (RIRD) | time | inattention |
| FA screening for automatically-reinforced behavior (Querim et al., 2013) | That stereotypy interferes with is learning, must first assess then identify competing stimuli | Identifying competing stimuli, having opportunities to run treatment during school day |
| Intervention for perseverative speech (Kuntz et al., 2020) | T | Test |
| Intervention for perseverative speech (Kuntz et al., 2020) | Generalization will require concerted effort to apply procedural fidelity across all environments. | Procedural fidelity. |
| Competing stimulus | ||
| Competing stimulus | An initial increase in vocal stereotypy followed by a decrease | Finding no competing stimulus |
| Response interruption and redirection (RIRD) | We are going to redirect him away from his behavior to alternative educational activities. We will make the educational activities as engaging as possible and provide very little if any attention to the sterepthy as we have defined it. | There are competing environmental stimuli that may be problematic when they are more stimulating than the educational program. We will try to eliminate those that we can from the environment. |
| 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? |
