Edible Reinforcers Research Articles

Is “M&M® therapy” a misnomer or a concerning truth? A descriptive analysis of the use of edible reinforcers in applied behavior analytic research

AbstractReinforcement is considered an essential component of many behavioral interventions. However, caregivers may criticize the use of edible reinforcers, particularly those viewed as unhealthy. Still, as evidenced by current attitudes toward the profession, addressing the concerns and criticisms of behavior analytic consumers is paramount. Thus, the purpose of this study was to determine the extent to which edible reinforcers are used within published behavior analytic research. To this end, we analyzed research published in six major behavior analytic journals across 3 years. Results indicate that edible reinforcement was utilized in less than one third of the studies using reinforcement often in combination with other nonedible reinforcers. However, it is important to consider potential negative externalities with the use of edible reinforcement and the need for future research on the use of edible reinforcers in clinical practice and research contexts.

Assessing Parameters of Reinforcement on Efficiency of Acquisition: A Systematic Review.

Discrete-trial training (DTT) is a common method of instruction used in early intervention amongindividuals with autism spectrum disorder and related neurodevelopmental disorders and is an effective method of teaching different skills such as tacting, listener responding, and matching. Delivery of effective reinforcers is a key component of DTT. Although general recommendations have been made for effective reinforcement delivery in DTT, no review has synthesized the available research on the efficiency of various reinforcer parameters on efficiency of acquisition. The current systematic review assessed the efficiency of various reinforcer parameters on acquisition in DTT. Results were idiosyncratic, and a general paucity of repeated measures examining specific reinforcer parameters within and across studies was observed. In general, (1) maintaining high levels of treatment integrity, (2) delivery of tangible (i.e. leisure items) or edible reinforcers in comparison with contingent praise as a reinforcer, and (3) delivery of edible reinforcers in comparison with other topographies of reinforcement were the most successful reinforcer parameter manipulations and always resulted in more efficient skill acquisition. The results of this review provide clinicians with information regarding what reinforcer parameter manipulations may be more or less likely to support efficient acquisition. The present review also provides considerations and makes recommendations for future research.

"Errorless" Toilet Training: "The Potty Party"

The current study describes the use of a procedure called the party, an all-day toilet training method using basic learning principles of “errorless” discrimination with 3 children with incontinence diagnosed with autism. At the start of treatment days, each participant was greeted and prompted to request the bathroom. After the child requested the bathroom, they were taken to the restroom, pants and underpants were removed, the child was seated on the toilet. While on-seat, participants were given liquids, less-preferred reinforcers and engaged in typical daily activities such as discrete trial training. When the child voided in the toilet, specific verbal praise and highly preferred edible reinforcers were delivered. The child was also given time off the toilet with their most preferred toys or items/activities. Time off-toilet subsequently increased with each in-toilet urination until the participants were spending the same amount of time off-toilet, out-of-bathroom, and in the classroom as their peers. Results for all three participants using 3 non-concurrent A-B phase designs indicated that the potty party procedure was effective in decreasing accidents to zero levels for all three participants and increased in-toilet urination for two. Future directions for research in toileting are discussed.

Teaching students with autism spectrum disorder to tolerate haircutting.

We describe intervention with 2 adolescent male students who had autism spectrum disorder (ASD) and resisted haircutting performed by care providers at a residential school. The students were exposed to a graduated hierarchy of steps including the presence of hair clippers, and increased duration of hair clippers against their scalp and hair. Edible reinforcement was presented contingent on completion of a step without interfering behavior. Both students learned to tolerate all of the steps in the graduated hierarchy and a full haircut with maintenance at 2-, 4-, and 6-month follow-up. The study supports previous tolerance-training research with children and youth who have intellectual and developmental disabilities and resist personal care and hygiene routines.

Analysis of Short Lever-Press Durations in Rats Responding Under a Fixed-Duration Schedule

When reinforcement schedules demand that rats depress a lever for a minimum period of time, most lever presses will meet reinforcer requirements, but others will be much shorter. This results in a bimodal distribution of lever-press durations, with one peak near the reinforced duration value, and a smaller peak at less than 1 s. We conducted an experimental and descriptive analysis of short-duration presses in rats responding under a schedule that delivered edible reinforcers for 10 s of lever depression. All rats emitted biting and idiosyncratic behavior that may have both added and subtracted to the downward force necessary to maintain lever depression for extended periods. Movement of the response levers due to vigorous biting and sniffing, as well as premature hopper entries were both responsible for response durations that fell short of reinforcer requirements. Maintenance of long lever-press durations during fixed-time schedules in two out of three rats suggested that timing failure was unlikely a factor underlying bimodal distributions of response durations.

Increasing compliance with wearing a medical device in children with autism.

Health professionals often recommend the use of medical devices to assess the health, monitor the well-being, or improve the quality of life of their patients. Children with autism may present challenges in these situations as their sensory peculiarities may increase refusals to wear such devices. To address this issue, we systematically replicated prior research by examining the effects of differential reinforcement of other behavior (DRO) to increase compliance with wearing a heart rate monitor in 2 children with autism. The intervention increased compliance to 100% for both participants when an edible reinforcer was delivered every 90 s. The results indicate that DRO does not require the implementation of extinction to increase compliance with wearing a medical device. More research is needed to examine whether the reinforcement schedule can be further thinned.

The use of auditory feedback and edible reinforcement to decrease toe walking among children with autism.

We replicated and extended previous research on the use of auditory feedback to decrease toe walking exhibited by 3 children with autism. After pretreatment screening analyses suggested that toe walking occurred independent of social consequences, we attached squeakers to the heels of each participants' shoes. The squeakers provided auditory feedback when participants walked appropriately (i.e., with a heel-to-toe gait). For all participants, the auditory feedback itself produced increases in appropriate walking. For 1 participant, this feedback was sufficient to reduce toe walking to clinically acceptable levels; however, for 2 other participants, delivery of edible items paired with the auditory feedback was necessary. Intervention effects maintained when the schedule for edible delivery was thinned for all participants. In addition, for 2 participants, effects maintained when the intervention was implemented in a different setting and with a different person with no edibles or a thin schedule of edibles.

A Comparison of Modeling, Prompting, and a Multi-component Intervention for Teaching Play Skills to Children with Developmental Disabilities.

Play skills are an essential component of a learner's repertoire, allowing access to social interactions with peers and adults. Children with developmental disabilities frequently require explicit teaching to acquire play skills rather than acquiring them through natural learning opportunities. Without targeted practice, these deficits could continue to expand, separating the children from their typically developing peers. This study aimed to teach three children with developmental disabilities independent play skills in the form of building blocks with a diagram. We evaluated three methods of teaching play skills, prompting, modeling, and a multi-component approach, within an alternating treatment design to determine which, if any, is most effective. Each teaching strategy included a three-step prompting hierarchy and was paired with an edible reinforcer delivered following independence. Successful responses at the targeted prompt level resulted in verbal praise. Following intervention, the rate of successful responses and independent responses increased across all three participants.

Further evaluation of the use of preference categories to identify novel reinforcers: A systematic replication

Preference assessments are frequently used to identify reinforcers for individuals with autism spectrum disorder and intellectual and developmental disabilities. Although well‐established procedures have been shown to identify preferred stimuli for individual items that can be used in skill acquisition and behavior reduction programs, little research has been conducted on identifying categories of preferred items. In this study, paired‐stimulus preference assessments were conducted with 4 individuals with autism spectrum disorder. Researchers classified the edible stimuli as belonging to 1 of 4 categories: chocolate (e.g., chocolate chips and M&M's®), salty/crunchy (e.g., chips and crackers), gummy (e.g., Swedish Fish® and Starburst®), or fruit/vegetable (e.g., grape and apple). Preference hierarchies were identified for individual stimuli and for categories of stimuli. For all participants, at least 3 of the 4 most preferred items came from the same category. Novel items (i.e., items not included in the preference assessments) identified by the researchers as belonging to the high‐preference category functioned as effective reinforcers during subsequent reinforcer assessments for all participants. This finding suggests that clinicians could identify likely effective edible reinforcers based on an individual's categorical preference without explicit testing.

A Preliminary Examination of a Vocal Generalized Conditioned Reinforcer

Generalized conditioned reinforcers (GCRs) in the form of tokens are commonly used in behavioral treatment. However, it is possible for non‐tangible consequences to also function as GCRs. For example, a vocal stimulus (e.g., good job) associated with completion of a work task, access to preferred actives, and peer interaction could function as a GCR. The purpose of this study was to examine the effects of pairing a vocal stimulus with multiple edible reinforcers on the Frequency math problem completion. The results suggest that a vocal statement paired with an array of four back‐up reinforcer functioned as a GCR for completing math problems for two typically developing children identified as having minor deficits in math skills. Copyright © 2015 John Wiley & Sons, Ltd.

The effects of reinforcement magnitude on skill acquisition for children with autism.

We examined the effects of reinforcement magnitude on skill acquisition during discrete-trial training. After conducting a magnitude preference assessment, we compared acquisition during conditions with large and small magnitudes of edible reinforcement to a praise-only condition. Although all participants showed a preference for the large-magnitude reinforcer, preference did not predict the magnitude that produced the fastest skill acquisition.

The Effects of Using a Conditioned Stimulus to Cue DRO Schedules

A reversal design was used to examine the effects of a differential reinforcement of other behavior (DRO) procedure and the presence of a stimulus (i.e., a bracelet), conditioned via discrimination training, on reducing socially maintained non‐contextual vocalizations in an adolescent girl with autism. Initially, a functional analysis determined that non‐contextual vocalizations were maintained by social attention. Then, discrimination training was used to establish the presence of the bracelet as a discriminative stimulus for the absence of vocalizations. Specifically, when the bracelet was on, non‐contextual vocalizations were interrupted, and edible reinforcement was provided for the absence of vocalizations. When the bracelet was off, vocalizations were not interrupted and the teacher provided social attention to the participant (i.e., reciprocated conversation with the participant about the topic). During intervention, a DRO procedure was used. The participant was presented with the bracelet, a timer set for a specified interval, and the instruction to work quietly. If vocalizations did not occur for the entire duration of the interval, the bracelet was removed and the learner was given the opportunity to engage in vocalizations. The DRO interval was systematically increased throughout the intervention. Results are discussed in terms of discrimination training as an effective addition to differential reinforcement procedure. Copyright © 2015 John Wiley & Sons, Ltd.

Distributed and accumulated reinforcement arrangements: evaluations of efficacy and preference.

We assessed the efficacy of, and preference for, accumulated access to reinforcers, which allows uninterrupted engagement with the reinforcers but imposes an inherent delay required to first complete the task. Experiment 1 compared rates of task completion in 4 individuals who had been diagnosed with intellectual disabilities when reinforcement was distributed (i.e., 30-s access to the reinforcer delivered immediately after each response) and accumulated (i.e., 5-min access to the reinforcer after completion of multiple consecutive responses). Accumulated reinforcement produced response rates that equaled or exceeded rates during distributed reinforcement for 3 participants. Experiment 2 used a concurrent-chains schedule to examine preferences for each arrangement. All participants preferred delayed, accumulated access when the reinforcer was an activity. Three participants also preferred accumulated access to edible reinforcers. The collective results suggest that, despite the inherent delay, accumulated reinforcement is just as effective and is often preferred by learners over distributed reinforcement.

Compliance Training in an Adult With Dementia of the Alzheimer’s Type and Down Syndrome

The authors describe the treatment of noncompliance and public stripping in a 53-year-old man with Down syndrome and dementia. On the basis of a review of the relevant literature and a comprehensive functional behavioral analysis, an intervention procedure utilizing contingent reinforcement of compliance is conducted. Compliance with requests to allow assistance getting dressed is reinforced with a combination of verbal praise, physical contact, and edible reinforcers. Noncompliance decreases by 85.22% at follow-up. Factors responsible for intervention success and implications for clinicians are discussed.

Compliance Training in an Adult With Dementia of the Alzheimer’s Type and Down Syndrome

The authors describe the treatment of noncompliance and public stripping in a 53-year-old man with Down syndrome and dementia. Based on a review of the relevant literature and a comprehensive functional behavioral analysis, an intervention procedure utilizing contingent reinforcement of compliance was conducted. Compliance with requests to allow assistance getting dressed was reinforced with a combination of verbal praise, physical contact, and edible reinforcers. Noncompliance had decreased by 85.22% at follow-up. Factors responsible for intervention success and implications for clinicians are discussed.

PARAMETRIC ANALYSIS OF PRESESSION EXPOSURE TO EDIBLE AND NONEDIBLE STIMULI

We assessed the effects of individually defined small, medium, and large periods of presession access to edible and nonedible reinforcers on response rates during sessions in which responding produced access to identical reinforcers. Any presession access to an edible reinforcer decreased response rates for 1 participant, and small and medium periods of presession access to nonedible reinforcers resulted in similar or increased response rates for 2 participants.

Non‐generalized and generalized conditioned reinforcers: establishment and validation

AbstractConditioned reinforcers, or tokens, are frequently used in clinical settings; however, little applied research has focused on establishing and validating their effectiveness. Following pairing of a novel token with an edible reinforcer in the present study, preference and reinforcer assessments verified that the tokens functioned as conditioned reinforcers. Results indicated that the tokens were established as conditioned reinforcers that matched the reinforcer value of the primary reinforcers with which they had been paired. The effects of motivating operations (MOs) on the effectiveness of these conditioned reinforcers were then evaluated. Conditioned reinforcer effectiveness decreased during satiation conditions. Subsequently it was found that increasing the number of backup reinforcers with which the token was paired resulted in the effectiveness maintaining during satiation conditions. Copyright © 2008 John Wiley & Sons, Ltd.

Differential reinforcement of other behavior applied classwide in a child care setting.

Abstract This study investigated the effectiveness of implementing Differential Reinforcement of Other behavior (DRO) at the classwide level to decrease the disruptive behavior of seven typically developing preschool-aged children in a child care setting. After baseline data were collected, a whole interval DRO reinforcement schedule using edible rewards was implemented for four weeks. Disruptive behavior decreased after the intervention was implemented. This report adds to the existing research literature supporting the use of DRO in classroom settings (e.g., Conyers et al., 2003; Repp, Barton, & Brulle, 1983) and extends the literature on the use of DRO with typically developing preschoolers. Limitations of this study and future research recommended in this area are discussed. Keywords: preschool age, differential reinforcement (DR), differential reinforcement of behavior (DRO), disruptive behavior, classwide, day care, child care, and community based ********** Differential reinforcement of behavior (DRO) is a procedure in which reinforcement is delivered dependent on the absence of the target behavior (Conyers, Miltenberger, Romaniuk, Kopp, & Himle, 2003). To implement this technique, data are collected on the occurrence of the target behavior and the average duration between behaviors is determined (i.e., the inter-response interval). This information drives the reinforcement schedule that is delivered if the target behavior does not occur. For example, if data gathered during baseline suggest that the target behavior occurs once every minute, reinforcement will be delivered at the end of a minute if the target behavior has not been exhibited. Once behavioral control has been established, the interval required for delivery of the reinforcement is progressively increased (de Zubicaray & Clair, 1998). DRO has proven effective in eliminating a wide variety of problem behaviors with different populations, and it is a procedure that does not require extensive training to implement (Homer & Peterson, 1980). Homer and Peterson (1980) reported that DRO schedules of reinforcement produce rapid inhibition of response in applied settings and that no undesirable side effects of the intervention had been reported in the literature. The authors predicted any possible side effects to be positive in nature due to the positive reinforcement aspect of the intervention (Homer & Peterson, 1980). By definition, DRO must be paired with some type of reinforcement of non-targeted behaviors. Past research has demonstrated that DRO paired with edible reinforcement has reduced inappropriate behaviors in children (e.g., Repp, Dietz, & Dietz, 1976). Specifically, Repp et al. (1976) reported success in reducing levels of inappropriate responding in a classroom using a DRO schedule of reinforcement paired with a token economy. The students exchanged their tokens for games, activities, and refreshments. The DRO intervention has been implemented in two ways: whole interval DRO (wDRO) and momentary DRO (mDRO). The wDRO procedure involves administering the reinforcer if behavior than the target behavior (hereafter other behavior) is exhibited for the entire interval. In contrast, the mDRO procedure involves administering the reinforcer if the behavior is exhibited at the time of a prompt (e.g., the sound of a timer). One study found that wDRO decreased inappropriate behavior more than mDRO (Repp, Barton, & Brulle, 1983). Repp et al. (1983) conducted two studies to compare the effectiveness of whole interval DRO and momentary DRO. The results indicated that although wDRO was more effective than momentary, the value of mDRO cannot be ignored. In fact, the mDRO schedule reduced inappropriate behavior (Repp et al., 1983). The authors noted the difficulty of implementing wDRO accurately due to the constant attention required by the observer. …

Increasing Physical Activity in Individuals With Autism

This study investigated the outcomes of an intervention package on participation in tWo physical activities: snoWshoeing and Walking/jogging. Three male secondary school students Who had been diagnosed With autism and Were attending a school for students With intellectual disabilities participated in a 6-month outdoor physical activity program. The authors used a changing conditions design; the program Was divided into six phases by the amount of edible reinforcers provided during sessions. A self-monitoring board, verbal cuing, and edible reinforcers Were used in the study. Distance snoWshoed, Walked, and jogged per 30-min session increased as edible and verbal reinforcement decreased. The results suggest that interventions can be developed to promote sustained participation in physical activity for individuals With autism.

Evaluation of DRO Schedules to Reduce Disruptive Behavior in a Preschool Classroom

ABSTRACT This study examined the effectiveness of momentary DRO (mDRO) and whole interval DRO (wDRO) schedules on high rates of disruptive behavior in a classroom of 22 children. In both procedures, children earned tokens for the absence of disruptive behavior and exchanged tokens for tangible or edible reinforcers. mDRO and wDRO, with tangible reinforcement, produced modest decreases in disruptive behavior (36%–44% decrease from baseline). However, wDRO with edible reinforcement produced larger decreases in disruptive behavior (66–81% decrease from baseline).