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Behavior Analysis in Intellectual and Developmental Disabilities

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DOI: 10.1037/a0018791

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Psychological Services In the public domain
2010, Vol. 7, No. 2, 103–113 DOI: 10.1037/a0018791

Behavior Analysis in Intellectual and Developmental Disabilities

Pamela L. Neidert and Claudia L. Dozier Brian A. Iwata

University of Kansas University of Florida

Megan Hafen
University of Kansas

Individuals with intellectual and developmental disabilities (IDD) have deficits in

adaptive behavior, slow rates of learning, and behavior disorders that interfere with
learning or place them or others at risk. Since the 1960s, researchers and clinicians in
the field of applied behavior analysis have used methods based on principles of learning
to increase adaptive behavior and decrease the occurrence of behavior disorders of
individuals with IDD. This article provides an overview of assessment and treatment
strategies used in behavior analysis to effect positive changes in the quality of life for
individuals with IDD and presents an illustrative case study.

Keywords: functional analysis, function-based treatment, behavior disorders, adaptive behavior

Intellectual and developmental disabilities order involving chromosome 15 and usually is

(IDD) are (a) genetic or acquired conditions that
(b) begin prior to 22 years of age, (c) result in
deficits in several areas of functioning (e.g.,
self-care, language), and (d) include relatively
permanent and chronic conditions such as men-
tal retardation, autism, Down’s syndrome, and
so forth (Developmental Disabilities Assistance
and Bill of Rights Act, 2000). The causes of
IDD may include genetic or chromosomal ab-
errations, infection, nutritional deficiencies, ex-
posure to environmental toxins, perinatal and
neonatal insult, and trauma (Howard, Williams,
& Port, 1999; McIlvane & Deutsch, 2004). De-
pending on the population surveyed and the
survey method used, reported prevalence esti-
mates for IDD have been as high as 10%
(McDermott, Durkin, Schufp, & Stein, 2007).
Diagnosis and classification of IDD often are
based on syndromes, some of which have
unique behavioral characteristics. For example,
Prader–Willi syndrome (PWS) is a genetic dis-
Pamela L. Neidert, Claudia L. Dozier, and Megan Hafen,
Department of Applied Behavioral Science, University of
Kansas; and Brian A. Iwata, Department of Psychology,
University of Florida.
Correspondence concerning this article should be ad-
dressed to Pamela L. Neidert, Department of Applied Be-
havioral Science, University of Kansas, Lawrence, KS
66045–7555. E-mail: pneidert@ku.edu
103
associated with mild mental retardation
(Dykens & Shah, 2003). Individuals with PWS
also share a number of behavioral characteris-
tics, including excessive eating, leading to ex-
treme obesity, and self-injurious behavior.
Other IDD diagnoses such as autism are based
exclusively on behavioral characteristics (e.g.,
impairments in social interaction and commu-
nication, repetitive and stereotyped patterns of
behavior). Thus, the term IDD encompasses a
large constellation of disorders not well-defined
by any particular marker except for (a) deficits
in adaptive behavior, (b) slow rates of learning
(i.e., it may take longer for these individuals to
learn a particular skill or set of skills, or they
may require a more systematic method of teach-
ing to learn a particular skill), and (c) behavior
disorders that interfere with learning or place
them or others at risk (Condillac, 2007; Harris
& Glasberg, 2007). IDDs are a significant con-
cern because they produce emotional and finan-
cial strain on individuals, their families, and
(ultimately) society (Condillac, 2007).
Although a variety of instructional methods
facilitate many students’ learning, more system-
atic and structured approaches are required for
individuals with IDD due to their pervasive and
multifaceted deficits. One such approach, be-
havior analysis, consists of learning principles,
often discovered in laboratory research, that de-
104 NEIDERT, DOZIER, IWATA, AND HAFEN
scribe the ways in which specific environmental
changes influence observable features of behav-
ior. Applied behavior analysis (ABA) is the
field that applies these principles to problems of
social importance by way of empirical (experi-
mental) demonstration (Baer, Wolf, & Risley,
1968). ABA has had a special interest in prob-
lems related to IDD for many years. Since the
1960s, results of ABA research have shown that
therapeutic procedures based on principles of
learning have produced marked improvements
in both adaptive and problem behavior of indi-
viduals with IDD (Whitman, Sciback, & Reid,
1983). Approximately 50 studies were pub-
lished during the 1960s in the major journals
devoted to IDD; currently, there are more than
600 such studies in the Journal of Applied Be-
havior Analysis alone, and a number of federal
and state statutes and regulations require the use
of ABA procedures under certain conditions
(Neef, 2001).
The purpose of this article is to briefly de-
scribe some key elements of ABA procedures
and their use with problems in individuals with
IDD. In addition, a case study with an individ-
ual diagnosed with profound mental retardation
is described to illustrate ABA assessment and
intervention with severe problem behavior.
Adaptive Behavior
Motivation
Motivation is of central importance to the
learning process, and reinforcement is usually
the key to motivation. As early as the 1940s,
researchers demonstrated the critical role of
positive reinforcement (contingent presentation
of a stimulus resulting in an increased probabil-
ity of behavior) in facilitating skill acquisition
in individuals with IDD. Fuller (1949) reported
one of the earliest demonstrations, in which arm
movements of a teenage boy with profound
mental retardation (described as “vegetative”
and unable to show any evidence of learning
prior to the study) increased as a function of the
experimenter squirting a warm sugar-milk solu-
tion into the boy’s mouth via a syringe. Nega-
tive reinforcement (contingent removal or post-
ponement of a stimulus resulting in an increased
probability of behavior) has also been shown to
play a critical role in the development of adap-
tive behavior. Azrin, Rubin, O’Brien, Ayllon,
and Roll (1968) developed an apparatus that
provided a warning stimulus followed by a tone
for slouching; that is, maintenance of correct
posture avoided the warning stimulus, and cor-
rection of slouching terminated the tone. Re-
sults showed increases in correct posture for
all 25 adults who participated in the study. Foxx
(1977) showed that 5 min of functional move-
ment training, an overcorrection procedure in-
volving the practice of varying head positions,
was superior to positive reinforcement in devel-
oping and maintaining appropriate eye contact
in three children with mental retardation. A
substantial body of literature now exists dem-
onstrating applications of positive and negative
reinforcement to increase a wide range of so-
cially important behaviors in individuals with
IDD, such as on-task behavior (Zarcone, Fisher,
& Piazza, 1997), self-help skills (K. L. Pierce &
Schreibman, 1994), communication (Reid &
Hurlbut, 1977), social behavior (Williams, Don-
ley, & Keller, 2000), and community survival
skills (Page, Iwata, & Neef, 1976) across a
range of settings such as psychiatric hospitals,
classrooms, sheltered workshops, and the home
environment.
A more fundamental aspect of motivation
often taken for granted is the selection of stimuli
to use as reinforcers and is particularly impor-
tant for individuals with IDD for at least two
reasons. First, reinforcers commonly used with
typically developing individuals may be inef-
fective with those who have IDD. For example,
many individuals are responsive to praise and
other forms of attention, but those with IDD
may find attention to have little reinforcing
value, and those with severe language and so-
cial deficits (e.g., individuals with autism) may
find any type of social interaction highly aver-
sive (Bijou & Ghezzi, 1999). Second, although
reinforcers may be identified simply by asking
most people what they want, this strategy often
is ineffective for individuals with IDD who
exhibit severe skill deficits (communication
deficits, multiple sensory impairments, limited
response repertoires, and intrusive problem be-
haviors). As a result, reinforcer selection based
on systematic preference assessments has be-
come a standard feature of clinical research and
treatment for individuals with IDD. A variety of
assessment methods have been developed; the
most common arrangement is to present test
stimuli and then to provide brief access to them
 BEHAVIOR ANALYSIS IN DISABILITIES
if the individual either approaches them or se-
lects them from an array. A reinforcer test is
conducted subsequently in which highly ranked
items from the preference assessment are used
as reinforcers for an arbitrary response prior to
their use during training or treatment programs.
Research has shown that stimuli selected in this
manner are much more likely to serve as rein-
forcers than those identified through less formal
means (e.g., caretaker report) and has led to a
number of refinements in methodology to ac-
commodate different types of items, client dis-
abilities, presentation formats, and measure-
ment procedures (see Cannella, O’Reilly, &
Lancioni, 2005, for a review).
In addition to stimulus selection, numerous
factors can determine whether a reinforcer is
effective in a given situation or if it will con-
tinue to be effective over time. One influential
variable is comprised of the antecedent condi-
tions to which one is exposed prior to reinforce-
ment, also known as establishing operations
(Michael, 1993). For example, Vollmer and
Iwata (1991) showed that exposure to reinforc-
ers immediately prior to training sessions de-
creased their effectiveness (via satiation),
whereas deprivation from access to the same
reinforcers prior to sessions increased their ef-
fectiveness. In a similar way, Egel (1981)
showed that varying reinforcers within training
sessions was effective in mitigating satiation
effects. Other determinants of reinforcement ef-
ficacy include the manner in which reinforcers
are delivered. All things being equal, reinforce-
ment is more likely to be effective when it is
delivered immediately and frequently. Cooper,
Heron, and Heward (2007) recommended the
following guidelines when designing reinforce-
ment-based training programs: (a) during initial
stages of skill acquisition, reinforcement should
be continuous (delivered for each occurrence of
the target behavior), and a strong contingency
should be arranged such that the probability of
reinforcement given behavior is higher than the
probability of reinforcement given the absence
of behavior; (b) the scheduled reinforcement
should gradually be made intermittent only
when behavior is well established; (c) reinforc-
ers should be delivered immediately following
the target response; and (d) higher quality rein-
forcers and/or a larger magnitude of reinforcers
should be delivered for behaviors that require
greater response effort.
105
Instruction
Individuals with IDD often require intensive
intervention to address their learning chal-
lenges, but a prerequisite to instruction is to first
determine whether the difficulty is a motiva-
tional versus a skill deficit. That is, it must be
determined if the target behavior exists in the
individual’s repertoire but occurs at a low fre-
quency due to a lack of motivation or if the
individual has yet to acquire the skill despite
sufficient motivation to do so (Lerman, Vornd-
ran, Addison, & Kuhn, 2004). In the former
situation, arrangement of optimal conditions for
reinforcement will be an effective strategy. In
the latter, however, reinforcement alone may
have little effect because the desired perfor-
mance never occurs. Amelioration of skills def-
icits requires supplementary instructional pro-
cedures.
Prompting is the most frequently used proce-
dure to produce new learning. Prompts are cues
that facilitate the occurrence of a desired re-
sponse. The simplest form of prompt is a verbal
instruction; however, many individuals with
IDD may be unresponsive to spoken cues. If so,
a demonstration of the desired behavior (mod-
eling) by an instructor may serve as the basis for
imitation by the student (Foxx, 1982). Through
reinforcement of imitative behavior, a student
may eventually acquire a “generalized” imita-
tive repertoire that facilitates faster learning
and/or acquisition of more complex behavior
(see W. D. Pierce & Cheney, 2004, for review).
Finally, if modeling is ineffective in producing
a desired response, physical prompting such as
hand-over-hand guidance may be necessary.
Initial attempts to perform a new response
may yield a behavior that only approximates the
desired outcome; nevertheless, it is important to
reinforce these intermediate “topographies” to
maintain motivation while eventually requiring
more skilled performance. This is accomplished
through the process of shaping, which involves
selective reinforcement of successive approxi-
mations to a target behavior combined with
discontinuation of reinforcement (extinction)
for previously reinforced topographies. Horner
(1971) used shaping with a 5-year-old child
with mental retardation and spina bifida who
was able to crawl but not able to walk. Initially,
successive approximations to taking steps while
holding onto parallel bars were reinforced with
106 NEIDERT, DOZIER, IWATA, AND HAFEN
drinks of root beer. Once walking with parallel
bars was established, successive approxima-
tions to using forearm crutches were reinforced.
Eventually, the child was able to use the
crutches to walk independently to and from his
daily activities (meals, play, school, speech
therapy, etc.). Shaping procedures have been
widely used to establish important skills in in-
dividuals with IDD including compliance with
medical treatments (Hagopian & Thompson,
1999), approaching feared stimuli (Ricciardi,
Luiselli, & Camare, 2006), requests for rein-
forcers (Bourrett, Vollmer, & Rapp, 2004), and
visual-motor skills (Mosk & Bucher, 1984).
Whereas shaping develops a behavior that an
individual does not currently exhibit, chaining
involves the development of sequences of be-
havior that comprise a larger functional unit
(e.g., cooking, brushing teeth). A task analysis
is preformed initially to identify the component
behaviors (steps) to be taught and the sequence
in which the steps are to occur. Each step in the
sequence is taught using one or more prompting
techniques, which are faded out as more parts of
the sequence are performed, until the student
has mastered the entire chain. As learning
progresses, each component behavior becomes
a reinforcer for performing the previous com-
ponent behavior and a cue for performing the
subsequent component behavior (see Foxx,
1982, for a detailed analysis). Cuvo, Leaf, and
Borakove (1978) used chaining procedures to
teach janitorial skills to six adolescents with
moderate mental retardation. The task of clean-
ing a restroom was analyzed into six general
subtasks with a total of 181 component steps.
More difficult steps were taught using a most-
to-least intrusive prompt sequence (physical
guidance, model, verbal instruction) to reduce
participant errors; less difficult steps were
taught using a least-to-most intrusive prompt
sequence in which physical guidance was pro-
vided only if the participant was unable to
perform a component step following verbal in-
struction or model prompts. Chaining proce-
dures have been used to teach a variety of skills
such as mending (Cronin & Cuvo, 1979), cook-
ing (Schleien, Ash, Kiernan, & Wehman, 1981),
following picture schedules (MacDuff, Krantz,
& McClannahan, 1993), completing vocational
tasks (Maciag, Schuster, Collins, & Cooper,
2000), and engaging in appropriate play skills
(Libby, Weiss, Bancroft, & Ahearn, 2008) to
individuals with IDD.
Behavior learned through some combination
of reinforcement, prompting, shaping, and chain-
ing may occur when these interventions are im-
plemented during training sessions but may fail to
occur in other situations. Successful treatment in-
volves not only the initial acquisition of behavior
change but also its generalization across settings
(Baer et al., 1968). That is, the goal is for newly
acquired skills to be performed independently
in a variety of situations for extended periods of
time. Control exerted by stimuli (e.g., prompts)
in the initial training environment must be trans-
ferred to naturally occurring relevant stimuli
outside of the training environment. Research
suggests that skill acquisition by individuals
with IDD often fails to generalize to settings
outside of training because the behavior of these
learners came under the control of irrelevant
features of the environment during training. For
example, Rincover and Koegel (1975) found
during the course of teaching simple responses
(e.g., touching body parts in response to a ver-
bal instruction) to children with autism that their
behavior came under the control of unintended
stimuli (e.g., arrangement of tables/chairs)
rather than the instruction. Halle and Holt
(1991) described a procedure to assess the in-
fluence of training stimuli on newly acquired
behavior for the purpose of programming gen-
eralization more effectively and efficiently.
Their analysis consisted of systematically as-
sessing each of four training stimuli by present-
ing it in isolation (while the remaining stimuli
were varied). Results were idiosyncratic across
participants (i.e., stimuli that exerted control
over behavior were different for each partici-
pant). The results of these studies underscore
the importance of explicitly programming the
generalization and maintenance of learned
skills. Stokes and Baer (1977) described several
strategies for use during training to facilitate
generalization and maintenance including:
teaching behaviors that are likely to contact
naturally occurring reinforcers, training a suffi-
cient number of exemplars, training under var-
ied conditions (use different instructions, rein-
forcers, etc.), using intermittent and delayed
schedules of reinforcement, and including in the
training setting stimuli that are likely be present
in other settings.
 BEHAVIOR ANALYSIS IN DISABILITIES
Comprehensive Skill Training Programs
Together, the basic elements of motivation
and instruction can be combined in a variety of
ways into formal training programs for teaching
individuals with IDD a wide range of skills.
Azrin and Foxx (1971) described one of the first
comprehensive training programs, which fo-
cused on independent toileting and made use of
positive and negative reinforcement, shaping,
chaining, stimulus control, and punishment to
increase continence in nine individuals with
profound mental retardation. The procedure in-
cluded the use of a urine-sensing apparatus to
detect and signal elimination, positive rein-
forcement for appropriate elimination, inhibi-
tory training for inappropriate elimination, pre-
vention of incompatible behaviors, increasing
the frequency of urinations via increased liquid
intake, stimulus control of elimination, teaching
independent dressing skills associated with toi-
leting, and modeling of appropriate elimination
responding. Results showed that incontinence
decreased to near-zero levels and maintained at
this low level for up to 140 days. The results of
the study were significant because little to no
empirical research on effective procedures for
increasing and maintaining continence of indi-
viduals with severe to profound mental retarda-
tion existed in the literature at that time. The
program was extremely effective because it re-
sulted in rapid skill acquisition, maintenance,
and generalization. Today, researchers and cli-
nicians continue to use similar types of pro-
grams to teach toileting skills not only to adults
with IDD but also to young children of typical
development (Simon & Thompson, 2006), chil-
dren with IDD (Cicero & Pfadt, 2002), and the
elderly (Schnelle et al., 1983).
Extensions of the above model currently are
used to teach skills beyond those of a self-help
nature that facilitate independent functioning in
the community. As an example, Sievert, Cuvo,
and Davis (1988) developed a program to es-
tablish self-advocacy skills in individuals with
mild disabilities. A list of commonly abridged
legal rights was generated and divided into four
categories: personal rights, community rights,
human services rights, and consumer rights. In-
dividuals were first trained via role playing to
discriminate between examples and nonex-
amples of rights violations. Tests were con-
ducted before and after training in each general
107
rights category to assess skill acquisition. Fol-
lowing successful training in legal rights dis-
criminations, individuals were taught a general
complaint process to redress rights violations
under role-play contexts in different settings
(i.e., classroom, community, etc.). Specifically,
participants were taught to identify the proper
persons to whom a complaint should be made
and to exhibit a specific response that included
an assertion of one’s rights, an explanation of
why one’s rights were violated, and a descrip-
tion of the steps previously taken to resolve the
problem. Results showed increases in the per-
centage of correct responding in both legal
rights discrimination and redressing rights vio-
lation as a function of training. In addition, data
collected after 1 and 3 months showed mainte-
nance of learned skills for several of the indi-
viduals.
In summary, applied behavior analysis in the
context of acquisition emphasizes (a) clear
specification of the behavior to be established,
(b) objective measurement of performance, (c)
analysis of the relevant antecedent and conse-
quent variables, and (d) the design and evalua-
tion of the effectiveness of an intervention that
leads to the generalization and maintenance of
the learned behavior (Baer et al., 1968). These
fundamental principles not only guide adaptive
behavior training programs but they also guide
the assessment and treatment of behavior disor-
ders exhibited by individuals with IDD.
Behavior Disorders
In addition to learning deficits, behavior dis-
orders exhibited by many individuals with IDD
pose challenges to instruction or place them and
others at risk. Common behavior problems in-
clude self-injurious behavior (SIB), aggression,
property destruction, sexual misconduct, stereo-
typy, tantrums, noncompliance, and running
away (elopement). There is no correlation be-
tween the emergence of any particular problem
and a specific IDD syndrome except in rare
cases; instead, the problems are distributed
somewhat randomly. As such, they are viewed
as learned behavior that is acquired and main-
tained through the same processes that account
for the development of adaptive behavior
(Iwata, Kahng, Wallace, & Lindberg, 2000).
These include positive reinforcement (i.e., gain-
ing attention or access to tangible items such as
108 NEIDERT, DOZIER, IWATA, AND HAFEN
snacks or toys) and negative reinforcement (i.e.,
avoiding or escaping aversive social or demand
situations), as well as automatic reinforcement
(i.e., producing sensory stimulation or terminat-
ing aversive sensory stimulation such as loud
noise or a toothache). See Iwata et al. (2000) for
a detailed discussion of these functions.
Functional Analysis
Reinforcer selection is as critical to the treat-
ment of problem behavior as it is to the process
of behavioral acquisition. The difference is that,
although any reinforcer may suffice during ac-
quisition because unlearned behavior has no
function, specific reinforcers currently maintain
problem behavior. These reinforcers need to be
identified to design interventions that will neu-
tralize their effects, and a diagnostic method
known as functional assessment has been devel-
oped for this purpose. Three general approaches
are used to conduct functional assessments: an-
ecdotal (indirect) methods, usually consisting of
caregiver interviews or questionnaires; descrip-
tive (naturalistic) analysis, in which observa-
tional data are taken on environmental events
that precede and follow problem behavior (e.g.,
Bijou, Peterson, & Ault, 1968); and functional
(experimental) analysis, in which suspected de-
terminants of problem behavior are directly ma-
nipulated (Iwata, Dorsey, Slifer, Bauman, &
Richman, 1982/1994). Although all three meth-
ods are common to some extent in clinical prac-
tice, anecdotal methods are unreliable (Zarcone,
Rodgers, Iwata, Rourke, & Dorsey, 1991; Si-
gafoos, Kerr, Roberts, & Couzens, 1993), and
descriptive analyses often provide information
that is erroneous (St. Peter et al., 2005; Thomp-
son & Iwata, 2007). The only method that pro-
vides direct evidence of cause and effect rela-
tions between the occurrence of a particular
behavior and environmental events is the func-
tional analysis.
Although a number of procedural variations
exist (see Hanley, Iwata, & McCord, 2003, for
a review), all functional analyses have in com-
mon the following: (a) direct and quantitative
observation of behavior under (b) controlled
conditions that involve (c) comparison between
one or more test conditions and control condi-
tions. The most common model for conducting
a functional analysis was described by Iwata et
al. (1982/1994) and includes three test condi-
tions and one control condition. The test condi-
tions represent environmental contingencies
that have been shown to maintain problem be-
havior: social positive reinforcement (attention
condition), social negative reinforcement (de-
mand/escape condition), and automatic rein-
forcement (alone condition) whereas the control
condition (play) eliminates these influences. In
the attention condition, for example, a therapist
withholds attention from the client during the
session (i.e., the therapists sits in the room with
the client but reads a book or a magazine) and
provides attention (i.e., a reprimand or state-
ment of concern or comfort) only contingent on
occurrences of problem behavior. In the play
condition, by contrast, attention is delivered
freely throughout the session. Individuals are
exposed to test and control conditions during
brief sessions until differential responding is
observed between one or more of the test con-
ditions and the control condition. Consistently
higher levels of problem behavior during the
attention condition relative to the control con-
dition would indicate that problem behavior is
maintained by attention. Descriptions of spe-
cific functional analysis conditions are found in
Table 1, and for a detailed description of func-
tional analysis methodology see Iwata et al.
(1982/1994).
Treatment Strategies
The development of functional analysis (FA)
has resulted not only in a better understanding
of the conditions under which problem behavior
occurs but also in greater precision with which
intervention programs based on the use of rein-
forcement can be developed (Didden, Duker, &
Korzilius, 1997; Pelios, Morren, Tesch, & Ax-
elrod, 1999; Scotti, Evans, Meyer, & Walker,
1991). Results of FAs allow therapists to design
individualized, reinforcement-based treatment
programs that alter or compete with the specific
sources of reinforcement that maintain an indi-
vidual’s problem behavior. There are three gen-
eral ways to alter environmental conditions to
reduce the occurrence of problem behavior, al-
though specific treatment procedures differ
based on the function of problem behavior: (a)
modify antecedent conditions to decrease the
motivation to engage in problem behavior (e.g.,
if assessment results suggest that behavior is
maintained by attention, attention is delivered
 BEHAVIOR ANALYSIS IN DISABILITIES 109

Table 1
Test and Control Conditions in Functional Analyses
Condition Antecedent Consequence Contingency
Attention Therapist withholds attention from Therapist provides attention for Social positive
client problem behavior reinforcement
Escape Therapist presents learning trials Therapist removes tasks and Social negative
to client instructions (30-s break) for reinforcement
problem behavior
Alone Therapist is absent from the room, None Automatic reinforcement
and client does not have access
to preferred items
Play Therapist provides social None Control condition
interaction to client; no learning
trials or other demands are
presented; leisure items are
available

frequently and noncontingently), (b) imple-
ment extinction to terminate the contingency
that maintains behavior (e.g., no longer pro-
vide attention for problem behavior), and (c)
deliver the functional reinforcer (e.g., atten-
tion) for the occurrence of an alternative re-
sponse (e.g., deliver attention for a more so-
cially acceptable response). Descriptions of
the treatments according to function of prob-
lem behavior are found in Table 2 (and see
Carr, Coriaty, & Dozier, 2000, for a detailed
discussion).
Case Example: Harold
Harold was a 3-year-old boy diagnosed with
profound mental retardation who lived at
home with his parents. He displayed no pro-
ductive language or instruction following
skills but he did appear to be socially respon-

Table 2
General Treatment Descriptions Across Functions
Function Antecedent TX Extinction TX Differential SR TX
Social positive A: Deprivation from attention Maintaining SR: Attention Establish and provide attention
reinforcement TX: Noncontingent access to TX: No longer providing for alternative attention-
(e.g., access to attention attention for problem seeking response
attention) behavior (planned ignoring)
Social negative A: Aversive event (e.g., Maintaining SR: Escape Establish and provide escape
reinforcement instruction trials) for alternative escape
(e.g., escape behavior (asking for a
TX: Noncontingent task TX: No longer providing
from aversive break), or strengthen
removal or task alteration escape for problem behavior
event) compliance (provide escape
(decrease no. of trials or (continuation of instruction
or other reinforcers for
task difficulty) trials)
compliance)
Automatic positive A: General deprivation Maintaining SR: Sensory Establish an alternative self-
reinforcement stimulation stimulatory response
(appropriate toy play)
TX: Noncontingent access to TX: Eliminate sensory
stimulation consequences produced by
problem behavior via
protective equipment (e.g.,
helmets, gloves) or response
blocking
Automatic negative A: Medical condition or Maintaining SR: Pain Establish alternative pain
reinforcement discomfort reduction reduction response
TX: Alleviate condition TX: N/A
Note. TX ⫽ treatment; SR ⫽ reinforcer; A ⫽ antecedent event; N/A ⫽ not applicable.
110 NEIDERT, DOZIER, IWATA, AND HAFEN

sive (e.g., to hugs and smiles). Harold en- differential reinforcement of alternative be-
gaged in SIB in the form of head banging. A havior plus extinction (DRA ⫹ EXT), non-
functional analysis of his SIB was conducted contingent attention was replaced by prompt-
that included the attention, escape, alone, and ing and shaping, which were used to teach
play conditions. The results of Harold’s FA Harold to wave his hand to gain access to
are shown in the first phase of Figure 1. attention and a small piece of an edible item,
Higher rates of SIB were observed in the and all instances of SIB continued to be ig-
attention condition relative to other condi- nored. Initially, all instances of waving re-
tions, indicating that Harold’s SIB was main- sulted in the delivery of attention; later, how-
tained by social positive reinforcement in the ever, the schedule of attention delivery was
form of attention. thinned gradually, with the terminal rein-
The effects of two function-based interven- forcement delivery schedule being approxi-
tions to reduce Harold’s SIB were evaluated mately every 4 min (i.e., a fixed interval [FI]
across several phases (see Phases 2– 4 in Figure schedule of reinforcement, in which attention
1). During Phase 2, a baseline was conducted to and edibles were delivered after the first re-
establish a rate of SIB and the designated re- sponse that occurred after 240 s). In addition,
placement behavior prior to treatment. During the delivery of edibles was faded out across
this baseline, high rates of SIB and zero rates of the phase. Results of this phase indicated that
waving occurred. During Phase 3, an interven- DRA ⫹ EXT was effective in maintaining
tion was implemented that consisted of two near-zero rates of SIB and increasing the rate
components: (noncontingent reinforcement, of waving. Furthermore, the schedule of rein-
[NCR] and extinction [EXT]). That is, the ther- forcement delivery was made more practical
apist delivered attention to Harold frequently (i.e., less effortful for the caregivers) via
throughout treatment sessions on a response- schedule thinning.
independent basis (NCR) but turned away from
Harold when SIB occurred (EXT). Results of Conclusions
this phase indicated that NCR ⫹ EXT was
effective in reducing the occurrence of SIB to It is not surprising that behavior analysis has
near-zero rates. The procedure, however, did had a major impact on the field of IDD. With its
not contain any explicit means for strength- emphasis on empirical evaluation and its inter-
ening alternative behavior (waving) that est in all types of performances (behavior ac-
would allow Harold to appropriately request quisition, maintenance, and reduction), re-
attention from others. Thus, during Phase 3 searchers in behavior analysis have examined

Harold
Base-
15 Functional Analysis line NCR + EXT DRA + EXT

Attention
RESPONSES PER MINUTE

10
FI-30
FI-60
FI-120
5 Alone FI-240
Demand
Sign
Play
0
0 10 20 30 40 50 60 70 80 90
SESSIONS

Figure 1. Responses per minute of self-injurious behavior and sign (waving) displayed by
Harold during functional analysis (Phase 1), baseline (Phase 2), and treatment (Phases 3– 4)
conditions. NCR ⫽ noncontingent reinforcement; EXT ⫽ extinction; DRA ⫽ differential
reinforcement of alternative behavior; FI ⫽ fixed interval schedule of reinforcement.
 BEHAVIOR ANALYSIS IN DISABILITIES
almost every behavioral characteristic of IDD,
resulting in a systematic body of data on envi-
ronmental approaches to assessment and treat-
ment. In addition to providing an effective tech-
nology for improving the behavior of individu-
als with severe learning challenges, research
methods used in behavior analysis have been
helpful in evaluating other forms of treatment
that involve learning, including some that have
not held up to close scrutiny, such as facilitated
communication (Neef, 2001). Future research in
this area will likely focus on procedural refine-
ment, long-term maintenance and generaliza-
tion of acquired skills in increasingly complex
environmental conditions, prevention of prob-
lem behavior before it becomes a serious con-
cern, and system-wide interventions capable of
producing effective outcomes for large numbers
of individuals despite limited agency resources
(Horner, 1997). The results of this work will not
only lead to direct improvements in service but
also will contribute to a more general science of
behavior.
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Received September 10, 2009
Accepted December 10, 2009 䡲