Functional analysis and treatment of socially stigmatizing ambulation.

Abstract

A brief functional analysis was conducted in an analogue setting to identify the maintaining variables for upright walking in a woman with developmental disabilities supported in an outpatient setting. All conditions required modification, since treatment outcomes were intended to increase, rather than decrease, the target behavior. The participant displayed a significantly greater duration of upright walking during the attention condition, which initially indicated that the desired was maintained by positive reinforcement. Treatment of socially stigmatizing ambulation was implemented during natural transition times in a reversal design and consisted of differential reinforcement of an incompatible response. Results of treatment indicated that physical assistance delivered by staff produced an immediate and large increase in upright walking while verbal attention from staff was ineffective. During treatment conditions, duration of socially stigmatizing ambulation was significantly greater in baseline. These results indicate that socially stigmatizing ambulation was maintained by automatic reinforcement, rather than socially or access-based positive reinforcement, and treatment initially chosen to function as differential reinforcement of incompatible may have also functioned as sensory matching and sensory extinction. Keywords: Socially stigmatizing ambulation, functional analysis, automatic reinforcement. ********** Functional analysis has most often included multielemental manipulation of environmental conditions in order to determine motivational variables of a response intended to decrease as a result of treatment. The original method of functional analysis, determined by Iwata, et al. (1982 & 1994) measured the environmental effects on self-injurious and set the standard for the field of Applied Behavior Analysis. The development of this standardized operant method has been used to identify functional relationships between an independent and dependent variable in numerous studies. The four standard conditions used in this method were social disapproval, academic demand, unstructured play and alone. Further expansion of the method of functional analysis has included more idiosyncratic variables to determine specific causal relationships and to narrow the four general assessment conditions previously identified, in order to decrease inappropriate responses in a variety of participants (Carr, 1994). Although functional analysis has began to narrow the four standard conditions in order to tailor the assessment to the specific subjects under study, further expansion of the method is possible. A study by Northup, et al.(1991) studied aggression and an alternative (a mand) in an out clinic setting with significant results, particular to this present functional analysis. First, the study helped to further replication of the feasibility of conducting a brief functional analysis of behavior (Northup et al., p. 518) using 5-10 minute analogue conditions. Most importantly, the results demonstrated that the contingencies identified as maintaining aggressive also served to reinforce an alternative, replacement behavior (Northup et al., p. 518). This study was based on a previous supposition by Carr (1988) that communicative responding and some severe problems may be functionally equivalent... if both responses result in the same outcome (i.e., are functionally equivalent), strengthening one response should weaken the other (Northup, et al., 1991, p. 519). Establishing this type of functional relationship between two incompatible or alternative responses would enhance an experimenter's ability to develop effective treatment strategies, particularly if it can be determined that both behaviors are maintained by the same contingency. Failure to provide a replacement might increase the probability, by default, that another inappropriate will emerge to serve the same function, especially with individuals who have very restricted repertoires of appropriate behavior (Northup et al. …