Rajaraman Adithyan, Hanley Gregory P, Gover Holly C, Staubitz Johanna L, Staubitz John E, Simcoe Kathleen M, Metras Rachel
Department of Psychology, UMBC, 1000 Hilltop Cir, Baltimore, MD 21250 USA.
Department of Psychology, Western New England University, Springfield, MA USA.
Behav Anal Pract. 2021 Apr 28;15(1):219-242. doi: 10.1007/s40617-020-00548-2. eCollection 2022 Mar.
To address dangerous problem behavior exhibited by children while explicitly avoiding physical management procedures, we systematically replicated and extended the skill-based treatment procedures described by Hanley, Jin, Vanselow, and Hanratty (2014) by incorporating an enhanced choice model with three children in an outpatient clinic and two in a specialized public school. In this model, several tactics were simultaneously added to the skill-based treatment package to minimize escalation to dangerous behavior, the most notable of which involved offering children multiple choice-making opportunities, including the ongoing options to (a) participate in treatment involving differential reinforcement, (b) "hang out" with noncontingent access to putative reinforcers, or (c) leave the therapeutic space altogether. Children overwhelmingly chose to participate in treatment, which resulted in the elimination of problem behavior and the acquisition and maintenance of adaptive skills during lengthy, challenging periods of nonreinforcement. Implications for the safe implementation of socially valid treatments for problem behavior are discussed.
为解决儿童表现出的危险问题行为，同时明确避免采用身体管理程序，我们系统地复制并扩展了Hanley、Jin、Vanselow和Hanratty（2014年）所描述的基于技能的治疗程序，在一家门诊诊所纳入了三名儿童，在一所特殊公立学校纳入了两名儿童，并采用了强化选择模型。在该模型中，几种策略同时被添加到基于技能的治疗方案中，以尽量减少升级为危险行为的情况，其中最显著的策略包括为儿童提供多种选择机会，包括持续的选择：（a）参与涉及差别强化的治疗，（b）“闲逛”，无条件获得假定的强化物，或（c）完全离开治疗空间。儿童绝大多数选择参与治疗，这导致在漫长且具有挑战性的无强化期内，问题行为得以消除，适应性技能得以获得和维持。本文讨论了对问题行为进行社会有效治疗的安全实施的启示。
