Stimulus Control Procedures Research Articles

Comparison Trial of Two Behavioral Sleep Interventions to Improve Sleep-Related Outcomes and Reduce Technology Usage Among College Students

Abstract Over 60% of college students are poor-quality sleepers, and many have inconsistent weekday and weekend sleep patterns. Technology usage (e.g., cellphone, computer, television) may contribute to poor sleep, but there is limited experimental research. In a comparison trial, 60 college students (mean age = 18.76, 86.7% female, 53.3% White) were randomly assigned to a 4-week sleep hygiene and stimulus control (SHSC) intervention or an enhanced intervention including technology stimulus control instructions (SHSC-E). Both groups showed improvements in sleep hygiene practices, perceived barriers to stimulus control, sleep quality, general technology usage, and technology usage before bed. However, the SHSC-E group did not have greater improvements compared to SHSC group as hypothesized, which suggests that the combination of sleep hygiene and stimulus control is a robust enough method for reducing self-reported technology usage. A longer intervention period might be necessary to observe the benefits of technology stimulus control procedures.

The effect of acceptance and commitment training on improving physical activity during the COVID-19 pandemic

This study aimed to assess whether applied behavior analysis (ABA) procedures such as feedback, goal setting and stimulus control, combined with acceptance and commitment training (ACTr) interventions implemented digitally improve levels of physical activity, consistency with self-care values and psychological flexibility during the COVID-19 pandemic. A nonconcurrent multiple baseline design across five participants was used in this study. Participants included five women with BMI's in the overweight or obese range. All participants were exposed to two intervention phases. In the first phase, feedback, goal setting and stimulus control procedures were implemented to improve physical activity. In the next phase, these procedures were combined with mindful walking exercises and values clarification exercises. In addition, psychological flexibility related to physical activity and values consistency were measured throughout the study. Results indicated that step count improved with the implementation of ABA + ACTr across all participants. Furthermore, psychological flexibility and self-care value scores improved after the intervention and maintained at 1-week follow-up. Lastly, the impact of physical activity during COVID-19, effectiveness and efficiency of ABA + ACT interventions are discussed.

택트의 자극통제 전이절차가 언어발달지연 아동의 인트라버벌에 미치는 효과

택트의 자극통제 전이절차가 언어발달지연 아동의 인트라버벌에 미치는 효과

Promising results supporting the use of an inhibitory stimulus control procedure to reduce vocal stereotypy, but more data needed to establish social validity

QCan differential reinforcement of other behavior (DRO) be used to establish inhibitory stimulus control over vocal stereotypy in children with autism?Design: The authors used a changing-criterion ...

The Use of Differential Reinforcement of Other Behaviours to Establish Inhibitory Stimulus Control for the Management of Vocal Stereotypy in Children with Autism

ABSTRACTObjective: This study examined the efficacy of an inhibitory stimulus control procedure (ISCP) for the management of vocal stereotypy in three children with autism. Method: During discrimination training, implemented within a changing criterion design, participants were taught that there were no consequences for vocal stereotypy in the absence of an inhibitory stimulus but that differential reinforcement procedures were in effect in the presence of the stimulus. Functional control of the inhibitory stimulus was subsequently assessed within a reversal design. Results: Inhibitory stimulus control was established during discrimination training, with participants inhibiting vocal stereotypy for 30 min periods in the presence of the inhibitory stimulus. Reductions in vocal stereotypy were maintained in the presence of the inhibitory stimulus and in the absence of further programmed consequences. Discussion: This study extends current knowledge by demonstrating the efficacy of ISCPs paired with reinforcement only, and illustrating the functional control of the inhibitory stimulus.

A systematic review and evaluation of inhibitory stimulus control procedures as a treatment for stereotyped behavior among individuals with autism

ABSTRACTPurpose: Stereotypy is pervasive among persons with autism and may impact negatively on social inclusion and learning. The implementation of resource-intensive behavioral interventions to decrease these behaviors has been questioned. Inhibitory stimulus control procedures (ISCPs) comprise a type of antecedent-based intervention that has been proposed as an effective treatment approach for stereotypy but has received limited research attention to date. Method: The current systematic review sought to examine and synthesize the literature reporting applications of ISCPs in the treatment of stereotypy among persons with autism. Treatment outcomes were analyzed quantitatively and the status of ISCPs as evidence-based practice was evaluated in accordance with the National Autism Center’s National Standards Report guidelines. Results: A total of 11 studies were reviewed with results indicating that ISCPs constituted an emerging treatment for the stereotypy exhibited by persons with autism. Conclusions: ISCPs comprise a promising intervention for stereotyped behavior but further research is required.

A Progression to Transfer RIRD to the Natural Environment

Response interruption and redirection has been shown to be effective for decreasing vocal stereotypy, but treatment effects in the natural environment have yet to be documented in the literature. A recent review indicated the paucity of studies that implemented response interruption and redirection during typically occurring activities or for sessions longer than 5–10 min. One method to promote generalization across settings may be stimulus control procedures. The purpose of the current study was to evaluate the progression of the intervention from a highly structured to a more natural setting, and across longer durations. We also investigated the extent to which a signal could acquire stimulus control over stereotypy. Although we were unable to bring stereotypy under the inhibitory control of a signal alone, we maintained low levels of stereotypy in the natural environment and ultimately extended sessions up to 30 min. Clinical implications and areas for future research are discussed. Copyright © 2016 John Wiley & Sons, Ltd.

Comparison of Prompting Techniques to Teach Children With Autism to Ask Questions in the Context of a Conversation

An adapted alternating treatments design was used to compare the efficacy of echoic and textual prompts to teach three students with autism (ages 8–15) to ask questions related to two pre-selected topics of conversation. Participants were first required to answer questions related to the topics to determine whether accurate responses were within their repertoire. This was followed by a transfer of stimulus control procedure to teach participants to ask relevant questions to the experimenter on the same topics. Probes with a novel conversation topic were conducted in the natural environment with a peer, and follow-up probes were conducted after training. Results indicate questions taught using an echoic prompt were acquired in fewer trials to criterion than questions taught using a textual prompt for two of the three participants. Limitations and implications for future research will be discussed.

Teaching Mands to Older Adults with Dementia.

Millions of Americans are diagnosed with dementia, and that number is only expected to rise. The diagnosis of dementia comes with impairments, especially in language. Furthermore, dementia-related functional declines appear to be moderated by environmental variables (Alzheimer's Association, Alzheimer's & Dementia: The Journal of the Alzheimer's Association 8:131-168 2012; American Psychiatric Association, 2000; Engelman et al., Journal of Applied Behavior Analysis 32:107-110, 1999; Engelman et al., Journal of Applied Behavior Analysis 36:129-132, 2003) Traditional language tests are not likely to assess or inform treatment for deficits in manding (Esch et al., The Journal of Speech-Language Pathology and Applied Behavior Analysis 5:166-191, 2010), and the mand is a verbal operant about which little is known among this population. The current study evaluated whether contriving an establishing operation within a preferred activity using a prompt-probe intermix procedure and a transfer of stimulus control procedure was effective in establishing mands in older adults with dementia. The procedure was demonstrated to be effective with one participant, but results were inconsistent with the second participant. Modifications were made throughout training for both participants, showing the importance of individualizing interventions.

An Investigation of Stimulus Pairing and Listener Training to Establish Emergent Intraverbals in Children with Autism.

We examined two methods to facilitate the emergence of untaught intraverbal responses to children with autism. Listener behavior training (LT) involved reinforcement of a selection-based response following presentation of an array of pictures on an iPad® and an auditory instruction describing a characteristic of the picture. Stimulus pairing (SP) involved presentation of one picture in isolation on the iPad® and an auditory instruction describing a characteristic of the picture. Participants were not required to emit an overt vocal response during SP. Results indicate both procedures were effective at producing some untaught intraverbal responses, but a transfer of stimulus control procedure was required for two of the three participants to meet mastery criterion. Results are discussed in terms of necessary prerequisite skills for each procedure, and the requirement of an overt or echoic response to help facilitate the emergence of intraverbals.

EFFECTS OF VERBAL REPRIMANDS ON TARGETED AND UNTARGETED STEREOTYPY

Results of brief functional analyses indicated that motor and vocal stereotypy persisted in the absence of social consequences for five participants diagnosed with autism spectrum disorder (ASD). Subsequently, effects of a stimulus control procedure involving contingent reprimands for each participant's higher probability (targeted) stereotypy were evaluated. Results indicated that contingent verbal reprimands (i) decreased the targeted stereotypy for all five participants, (ii) decreased the untargeted stereotypy for two of five participants, and (iii) increased the untargeted stereotypy for one of five participants. Although response suppression was not achieved for any participant, three participants maintained low levels of the target stereotypy with one or two reprimands during 5‐min sessions. Furthermore, two of those participants maintained near‐zero levels of motor and vocal stereotypy during 10‐min sessions. These findings suggest that signaled verbal reprimands may be a practical intervention for reducing stereotypy in some children with ASD. Some limitations of the findings and areas of future research are briefly discussed. Copyright © 2014 John Wiley & Sons, Ltd.

Associative learning mechanisms underpinning the transition from recreational drug use to addiction

Learning theory proposes that drug seeking is a synthesis of multiple controllers. Whereas goal-directed drug seeking is determined by the anticipated incentive value of the drug, habitual drug seeking is elicited by stimuli that have formed a direct association with the response. Moreover, drug-paired stimuli can transfer control over separately trained drug seeking responses by retrieving an expectation of the drug's identity (specific transfer) or incentive value (general transfer). This review covers outcome devaluation and transfer of stimulus-control procedures in humans and animals, which isolate the differential governance of drug seeking by these four controllers following various degrees of contingent and noncontingent drug exposure. The neural mechanisms underpinning these four controllers are also reviewed. These studies suggest that although initial drug seeking is goal-directed, chronic drug exposure confers a progressive loss of control over action selection by specific outcome representations (impaired outcome devaluation and specific transfer), and a concomitant increase in control over action selection by antecedent stimuli (enhanced habit and general transfer). The prefrontal cortex and mediodorsal thalamus may play a role in this drug-induced transition to behavioral autonomy.

Using Transfer of Stimulus Control Technology to Promote Generalization and Spontaneity of Language

Children with autism often use newly acquired language in restricted contexts and with limited variability. Instructional tactics that embed generalization technology have shown promise for increasing spontaneity, response variation, and the generalized use of language across settings, people, and materials. In this study, we explored the integration of textual scripts and explicit engineering of transfer of stimulus control procedures to facilitate functional conversation skills of a young girl with autism. The generalized use of prepositions, coordinating conjunctions, and subordinating conjunctions was assessed within the context of natural conversation with teachers, parents, and peers. The intentional programming of training contexts has the potential to affect language spontaneity, generalization, and variability without relying on script-fading conventions.

Self‐Help Treatment for Insomnia Symptoms Associated with Chronic Conditions in Older Adults: A Randomized Controlled Trial

To evaluate the effectiveness of a self-help cognitive behavioral intervention in improving sleep quality in older adults reporting insomnia symptoms associated with chronic disease. A pragmatic two-arm randomized controlled trial comparing supported self-help with treatment as usual (TAU). Primary care. One hundred ninety-three self-referred individuals aged 55 to 87 with long-term conditions and chronic insomnia symptoms (as defined according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition). Self-help participants received six consecutive booklets, at weekly intervals, providing structured advice on important components of cognitive behavioral therapy for insomnia (CBT-I, including self-monitoring, sleep restriction, stimulus control procedures, and cognitive strategies), plus access to a telephone helpline. Control group participants received a single sheet of advice detailing standard sleep hygiene measures. The primary outcome was sleep quality, measured by the Pittsburgh Sleep Quality Index (PSQI). Secondary outcomes were the Insomnia Severity Index (ISI), the subjective sleep efficiency index, and the Fatigue Severity Scale. In the self-help group, sleep outcomes showed significant improvements after treatment (PSQI, P<.001; ISI, P<.001; sleep efficiency, P<.001) and at 3-month (PSQI, P=.002; ISI, P=.006; sleep efficiency, P=.001) and 6-month (PSQI, P=.003; ISI, P=.003; sleep efficiency, P=.001) follow-up. Effect sizes were moderate (range of adjusted Cohen d=0.51-0.75). Treatment had no effect on levels of daytime fatigue. Most treated participants (73%) said they would recommend the self-help program to others. Self-help CBT-I offers a practical first-line response to individual reporting insomnia symptoms associated with chronic disease in primary care settings. In these individuals, symptoms of daytime fatigue may be more closely associated with disease processes than with sleep quality.

Improving sleep management in people with Parkinson's

This article considers the practicality and patient benefits of transferring evidence-based sleep management skills to community health professionals. Sleep disturbances are among the most frequently reported and poorly managed non-motor symptoms in Parkinson's. But, despite their prevalence, sleep problems in Parkinson's are often under-recognized, under-diagnosed and inadequately treated. To raise awareness and improve patient care in Parkinson's, a three-day sleep management course was developed for Parkinson's disease nurse specialists (PDNSs) practising within NHS Scotland. The course aimed to transfer skills in health education as applied to sleep and insomnia; the assessment of sleep; the practice of sleep hygiene; delivering relaxation methods; the use of stimulus control and sleep restriction procedures; and cognitive approaches to insomnia management. Between June 2010 and July 2011, 38 PDNSs and practising occupational therapists undertook the course. Interviews and evaluations with patients and professionals were carried out afterwards. Patients reported a reduction in anxiety over sleep problems, feeling able to manage their sleep, and having a sense of control over their sleep. Programme outcomes suggest that the training model used is feasible and practical; the resources designed for clinical use are practical and relevant; and that the initiative as a whole represents a valid and affordable investment in patient wellbeing.

Using stimulus control procedures to teach indoor rock climbing to children with autism

AbstractThe present study evaluated an intervention package for teaching route following to two children with autism at an indoor rock‐climbing gym. The intervention consisted of multiple within‐stimulus fading procedures in combination with errorless learning procedures, positive reinforcement, an error correction procedure, and conditional discrimination training technologies. The results demonstrated that both participants learned to climb at least 10 ft/3 m on specified routes. Furthermore, both participants learned to climb an entire 22‐ft/6.7‐m wall for at least one of three different routes without any errors in a regular rock‐climbing gym setting. The acquisition of this skill provides children with autism with an additional option for leisure participation with others. Copyright © 2010 John Wiley &amp; Sons, Ltd.

Antecedent stimulus control: Using orienting cues to facilitate first-word acquisition for nonresponders with autism

Although considerable progress has been made in improving the acquisition of expressive verbal communication in children with autism, research has documented that a subpopulation of children still fail to acquire speech even with intensive intervention. One variable that might be important in facilitating responding for this nonverbal subgroup of children is the use of antecedent orienting cues. Using a multiple baseline design, this study examined whether individualized orienting cues could be identified, and whether their presentation would result in the production of verbal expressive words. The results showed that this antecedent stimulus control procedure produced improvements in responding to verbal models in all of the children, and subsequent gains in speech for some of the children. Theoretical and applied implications of orienting cues as they relate to antecedent stimulus control for children with autism are discussed.

Training vision screening behavior to children with developmental disabilities

The American Academy of Pediatrics recommends vision screening of all children between 3 and 5 years of age, and states have mandated vision screening for all school children. Participants were three 4–6-year old school children with either a developmental delay or autism who scored “could not test” on the state required vision screening. Participants’ screening performance indicated both a visual discrimination skill deficit and escape/avoidance behavior. Discrimination training procedures included preference assessment, match-to-sample discrimination discrete trials training, transfer of stimulus control procedures, differential reinforcement, and choice making. Escape/avoidance was treated by fading-in the aversive sensory stimulus (i.e., duration of wearing glasses), escape extinction, and reinforcement of alternative behavior. Following training, two children passed their vision screening and compliance generalized to their hearing screening. The third child met the performance criterion for the two vision screening behaviors trained.

Enhancing learning for children with autism spectrum disorders in regular education by instructional modifications

Children with autism spectrum disorders sometimes are fully included in regular education classrooms with its standard curriculum and instructional methods. Under these classroom conditions, the children might perform successfully for some academic subjects but not for others. For these latter academic subjects, standard instruction could be enhanced to promote more effective stimulus control and learning. In the present study, stimulus control was enhanced by a package of response antecedent and consequence conditions. Maintenance tasks were interspersed with acquisition tasks, and the quality, quantity, immediacy, and density of reinforcement were improved compared to classroom instruction. A stimulus preference assessment was conducted, prompts and transfer of stimulus control procedures were implemented, and tangible and token reinforcers were manipulated on ratio schedules. Rapid acquisition of diverse tasks for each of the three participants was noted. Enhanced stimulus control procedures, such as those tested in the present study, can help children with autism spectrum disorders succeed in regular education classrooms.

Assessing transfer of stimulus control procedures across learners with autism.

The purpose of this study was to evaluate the effectiveness of 2 transfer of stimulus control procedures to teach tacting to individuals with autism. Five participants with differing verbal skills were assessed by a subset of the ABLLS prior to intervention, then were taught 36 previously unknown tacts using the receptive-echoic-tact (r-e-t) and echoic-tact (e-t) transfer procedures. Each transfer method was used separately to establish different tacts, in a multiple baseline design across tacts for 3 sets of stimuli. The results showed that 4 out of 5 participants (who demonstrated mands, tacts, echoics, and sometimes intraverbals prior to the study) acquired all targeted tacts when either r-e-t or e-t training was presented. One participant (who emitted no verbal operants at the onset of the study) did not acquire any tacts. While some participants appeared to learn more quickly with one transfer method, neither method emerged as more efficient with learners with fewer or more extensive verbal skills. The results indicate that both transfer methods promoted the acquisition of tacts for learners with autism with at least minimal verbal skills.