Literature Review. Disruptive Behaviors Of Children With Autism

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Literature Review

Over the years, a great deal of research has been conducted on interventions to reduce tantrum behaviors in children with developmental disabilities. However, there is also a large amount of research which supports the notion that teachers do not implement behavior support plans with fidelity. Because of this, it is important to review studies that address implementation as well as function-based interventions.

Implementation

Tillery, Varjas, Meyers, and Collins (2010) conducted a study to evaluate teacher perceptions of student behaviors and intervention strategies in the general education setting. More specifically, they looked in teacher perceptions of using praise, rewards, and multi-tiered systems of supports. The participants in this study included 20 general education teachers, who taught either kindergarten or first grade, from five different schools within one school district. All participants were female and Caucasian; which was representative of the district’s teacher population. Data was collected utilizing one-on-one, in-depth, semi-structured interviews. Data from the interviews was coded into four categories: teacher perceptions of behavior, teacher behavior management strategies, teacher behavior management and intervention training, and program knowledge (Tillery, Varjas, Meyers, & Collins, 2010).

Results of the study revealed that teachers perceive behavior as something that can be observed. Additionally, they believe behaviors occur because of multiple external and internal factors. Teachers reported that they believe they are one of the strongest contributing factors of positive behavior in the schools. When teachers were asked about how they respond to negative behaviors in the classroom, many reported that they utilize some form of a behavior chart, and when negative behaviors occur, they lose a token (stick or card) from their chart. This concept is known as response cost. Finally, when teachers were asked about training received in behavior management, many of them responded that they had received little-to-no formal training on the subject. The researchers also noted that there were no significant differences between kindergarten and first grade teacher perceptions (Tillery, Varjas, Meyers, & Collins, 2010). This information is important because it demonstrates that teachers are not utilizing function-based behavioral strategies in the classroom, and that the majority of the population has not received training in behavioral supports and interventions.

Witt, Noell, LaFleur, and Mortenson (1997) conducted a study to determine the integrity in which general education teachers implemented academic performance interventions in the classroom. Additionally, they researched whether or not performance feedback would increase treatment integrity, in the general education setting. The participants in this study included four female elementary school teachers, and four male elementary-aged students. The treatment the teachers were implementing, if implemented correctly, resulted in three permanent products: 1) a grade on the top of the student’s paper, 2) rewards slips given to the children and kept in a box for safekeeping, and 3) rewards that were redeemed via the reward slips, were noted on the back of the slips (Witt, Noell, LaFleur, & Mortenson, 1997).

            The study utilized a nonconcurrent, multiple-baseline design. In phase 1, teachers received training on how to implement the intervention. During phase 2, teachers were given a chance to implement the intervention independently. Next, in phase 3, they were provided performance feedback. Finally, in phase 4, teachers were given another opportunity to implement interventions without researcher involvement. Results of the study showed that all teachers demonstrated 100% treatment integrity during the initial training phase. During the following post-training baseline, all teachers demonstrated a declining trend in treatment integrity. Additionally, Witt, Noell, LaFleur, and Mortenson (1997) showed that performance feedback resulted in marked increase in treatment implementation and following treatment integrity. The results of this study are important because, although they show that treatment integrity was initially low, the utilization of performance feedback lead to positive results for the integrity of implementation, which in turn lead to positive student academic outcomes.

Interventions

Marcus and Vollmer (1996) conducted an experimental study, with reversal design, in order to determine whether or not non-contingent reinforcement (NCR) and a schedule of differential reinforcement of alternative behavior (DRA) can be used in conjunction to decrease target behaviors and strengthen mands. According to Lennox, Miltenberger, Spengler, and Erfanian (1988), “Differential reinforcement procedures are the most commonly used treatment for aberrant behavior.” Additionally, literature contained within the article discusses how NCR has already been demonstrated to be an effective behavior-reduction procedure. However, one aspect of NCR that had not been previously analyzed was the effects of NCR on motivating operations. 

Marcus and Vollmer (1996) included three preschool-aged participants, who all demonstrated behaviors with an access to tangibles function. The setting of the study was in an unoccupied room within the children’s preschool building. During treatment, the students were placed on simultaneous NCR and DRA schedules, where they could access tangibles either on a fixed-time schedule, or contingent on a mand. The study included rate data, in the form of responses per minute, for both problem behaviors and mands. The data was presented on three separate ABAB design graphs; one for each participant. The study found that an NCR schedule did not preclude the children from learning to mand for items. Additionally, the study found that NCR and DRA were effective at decreasing target behaviors for all participants.

Hayes, Leader, Healy and Grey (2009) conducted a study to determine if the use of a predictive stimulus (Time Timer) and delayed reinforcement can be used to increase appropriate waiting behavior in a child with developmental disabilities and problem behavior maintained by access to tangible items and activities. The study included one participant, an 11-year-old girl with an intellectual disability. The participant was chosen for engaging in inappropriate waiting behavior (tantrums), which were maintained by an access to tangibles function.

The study utilized a changing criterion design with a baseline and three intervention phases (Hayes, Leader, Healy, & Grey, 2009). The three intervention phases included: presence of a red card during waiting periods, presence of the red card on the Time Timer, and presence of the Time Timer. The study utilized duration data to calculate intervals of appropriate waiting. They also kept track of whether or not inappropriate behaviors occurred during the intervals. The study found that the Time Timer could be used to increase appropriate waiting behaviors for a child with intellectual disabilities, whose behavior was maintained by an access to tangibles function. This demonstrates that the treatment was successful (Hayes, Leader, Healy, & Grey, 2009).

Wilder, Chen, Atwell, Pritchard, and Weinstein (2006) conducted a study to determine if advance notice of a transition and differential reinforcement of other behavior (DRO) with extinction can be used to reduce tantrum behaviors in preschool children. The participants in the study included two children, a 34-month-old girl, and a 40-month-old boy; neither had been diagnosed with a disability. The setting for study was a therapy room within a university ran clinic. In order to determine which conditions elicited tantrums, a brief functional analysis was conducted at the start of the study. After this, two interventions were evaluated with each participant using reversal designs; these included: advance notice of a transition and differential reinforcement of other behavior (DRO) with extinction. Results of this study found that advance notice of an upcoming transition was not an effective intervention to reduce tantrum behaviors. In contrast, differential reinforcement of other behavior plus extinction was successful at reducing tantrums for both participants.

Discussion/summary