1. Justin Daigle, MA, BCBA, LBA Program Director

2. There are four functions of behavior that have been found through research. Attention, Escape, Automatic, and Access to Tangibles Iwata created a Functional Analysis as a way to assess functions of behaviors

3. Presentation Goal: Review the development and growth of our understanding of functions

4. S.I.B. Self-Injurious Behavior Behaviors where the “mentally handicapped” would repeatedly, and without regard to their health, cause physical harm to themselves without context.

5. 1960-70 Towards the end of the “Mental Institution Revolution” What to do with these severe cases that include self-injury.

6. Rapid solutions were needed This begin a big “boom” in applied behavior analysis Other fields immediately had a growing interest in what Watson, Skinner, and others were doing.

7. Published “The Motivation of Self- Injurious Behavior: A review of some hypothesis” 1977 Meta-Analysis of existing “hypothesis” behind what motivated SIB

8. Positive Reinforcement Hypothesis Negative Reinforcement Hypothesis Self-Stimulatory Hypothesis Organic Hypothesis Psychodynamic Hypothesis

9. Cited a Lovaas study: (Lovaas, et al, 1965) Stated that some hypothesize that receiving a physical reinforcer may motivate SIB This has now become “Access”

10. I want cookie. I can’t speak. Mom won’t give me cookie. I’m going to hit myself until mom gives me the cookie because she “doesn’t know what else to do”?

11. Cited a Carr study: (Carr, et al, 1976) Stated that some hypothesize that the removal of an adverse stimulus could motivate SIB This has now become “Escape”

12. I dislike the smell of cookies. I cannot talk. Mom is baking cookies. It makes me sick. She won’t stop. I begin hitting myself in the head. Mom stops.

13. Cited a Carr study: (Carr, 1961) Stated that some hypothesize that some internal pleasure is derived from SIB This has now become “Automatic”

14. At this point, highly theoretical Some saw it as an “excuse explanation” It is still debated about how SIB could “feel good” to any person Why stereotypy is often called “stimming”

15. Hitting myself in the head feels good I hit myself in the head

16. Hypothesis that states there are medical reasons to explain SIB There are medical reasons in some cases, but not in all A BCBA should ensure a client has consulted a pediatrician and/or neurologist

17. Points to (Cain, 1961) to cover them Mostly traditional psychology attempting to address SIBs with their “theories” Carr says there is a “lack of evidence” and dismisses this category completely

18. These theories include “Sensory Integration” (remember this was published back in 1977).

19. Positive Reinforcement (Access) Negative Reinforcement (Escape) Self-Stimulatory (Automatic) Organic (Medical) Psychodynamic (Dismissed) What’s missing?

20. Within “Psychodynamic”, Carr pointed out that there was on one exception to the “lack of evidence” Lovaas’s “guilt hypothesis” …which seems silly now, but I’m sure at the time made tons of sense

21. “Guilt hypothesis”: Individuals with developmental delays feel guilty about their actions and engage in SIB as a way to punish themselves. Every time a client would hit themselves, Lovaas would say something along the lines of “I don’t judge you” or “It’s not your fault”

22. There was one huge problem For the client Lovaas was working with, the “guilt hypothesis” increased the behavior Lovaas suggested that maybe social interaction increased SIB

23. Thus Lovaas stumbled upon the fourth, and final function: Attention!

24. Carr laid out criteria for which functions we should focus on: 1) “[SIB] rates can be reduced when the reinforcer is removed” (subject to extinction)

25. 2) “[SIB] rates can be increased when reinforcement is made contingent upon the behavior (subject to reinforcement) 3) “[SIB] can come under the control of a stimulus” (subject to stimulus control)

26. “The review of the literature on [SIB] suggest that a single factor is not responsible for the motivation of all [SIB]. [O]ne could profitably make a distinction between.. the underlying maintenance of [SIB].” It wasn’t until 1994 that someone took him up on his offer.

27. In 2007, researchers with the Kennedy Krieger Institute (within John Hopkins) suggested a 5 th function. “Interruption of free-operant behavior” Fell under the umbrella of “access”

28. Recent research suggest that if “access” is a function at all, it happens very infrequently. This began to movement to return to the original nomenclature: Social Positive (Attention) Social Negative (Escape) Automatic Positive (Stereotypy) Automatic Negative (Pain Alleviation)

29. If stereotypy is maintained by automatic reinforcement and there are not current assessments to determine what is positive and what is negative reinforcement, is it ethical to eliminate stereotypy?

30. Justin Daigle, MA, BCBA, LBA Program Director

31. When using an extinction procedure with rats in a Skinner box you will almost always see: Extinction burst Extinction induced aggression

32. When using an extinction procedure with a client the rate dramatically decline: 39% had an extinction burst 22% had extinction induced aggression 19% had both simultaneously 58% had no side effects

33. What causes this dramatic change? May be the function – article suggest that 57% of extinction interventions based on social negative reinforcement had extinction burst But that is still just over half

34. Current thought: When Extinction is used alone, it will almost always have the common side effects. When Extinction is used with another procedure (such as reinforcement) the side effects are less likely.

35. The authors suggest to independently measure and intervene on aggression and extinction burst.

36. Extinction-Induced Variability In the article called “Response Variability” Novel behaviors appear as a “test” for replacement behaviors.

37. Field if often criticizes for created “robots”. Can response variability help that? Remember Carbonne (2010) used extinction-induced variability to promote verbalizations in non-verbal children Side effects are ripe for research

38. Thank you for your time!