Action Research

California State University, San Bernardino California State University, San Bernardino

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Electronic Theses, Projects, and Dissertations Office of Graduate Studies

6-2017

STRATEGIES TO ASSIST IN DECREASING ESCAPE MAINTAINED STRATEGIES TO ASSIST IN DECREASING ESCAPE MAINTAINED

BEHAVIORS IN CHILDREN WITH AUTISM SPECTRUM DISORDER BEHAVIORS IN CHILDREN WITH AUTISM SPECTRUM DISORDER

Kimberlee A. Luke California State University - San Bernardino

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STRATEGIES TO ASSIST IN DECREASING ESCAPE

MAINTAINED BEHAVIORS IN CHILDREN WITH

AUTISM SPECTRUM DISORDER

A Thesis

Presented to the

Faculty of

California State University,

San Bernardino

In Partial Fulfillment

of the Requirements for the Degree

Master of Arts

in

Education:

Special Education

by

Kimberlee Anne Luke

June 2017

STRATEGIES TO ASSIST IN DECREASING ESCAPE

MAINTAINED BEHAVIORS IN CHILDREN WITH

AUTISM SPECTRUM DISORDER

A Thesis

Presented to the

Faculty of

California State University,

San Bernardino

by

Kimberlee Anne Luke

June 2017

Approved by:

Dr. Sang Seok Nam, First Reader

Dr. Marissa Congdon, Second Reader

© 2017 Kimberlee Anne Luke

iii

ABSTRACT

Many children with ASD partake in escape maintain behaviors for

numerous reasons. Children with autism might have difficulty attending to long

tasks, can get overwhelmed with novel activities, and the challenging behaviors

may heighten when too many demands are placed on them. As a result,

teachers, parents and interventionists may start to witness children’s challenging

behaviors increase. Many of the challenging behaviors are thought to have an

escape function from the long or difficult task at hand. This paper will find and

address various strategies that may be applied to decrease escape maintained

behaviors in children with ASD. The aim for this review study is to describe and

evaluate research findings of antecedent-based strategies and evidence-based

practices used to assist in decreasing escape maintained behaviors in children

with ASD. This study is to suggest educational implications for interventionists

and parents.

Keywords: autism, escape, escape maintained behaviors, decrease

challenging behaviors, alternative behaviors, antecedent based intervention,

evidence based practices

iv

TABLE OF CONTENTS

ABSTRACT ........................................................................................................... iii

CHAPTER ONE: INTRODUCTION

Problem Statement ..................................................................................... 1

Purpose of the Study ........................................................................ 4

Methods ...................................................................................................... 5

Evidence-Based Practices ......................................................................... 6

Antecedent-Based Interventions ................................................................. 7

CHAPTER TWO: ANTECEDENT-BASED INTERVENTIONS

Complexity of Task Requirements ............................................................ 10

Embedding Novel Tasks and Incorporating Task Variations .................... 12

Decreased Instruction Time ...................................................................... 15

Providing Choices ..................................................................................... 17

Arranging Environment ............................................................................. 20

Changing Schedules/Routines .................................................................. 25

Structuring Time ........................................................................................ 30

Highly Preferred Activities/Items ............................................................... 32

Pre-activity Interventions ........................................................................... 34

Tolerance For Delay ................................................................................. 34

CHAPTER THREE: EVIDENCE-BASED PRACTICES

Functional Behavior Assessment .............................................................. 37

Elapsation of Time Stimulus ..................................................................... 38

v

Reinforcement/Token Economy ................................................................ 39

Non-contingent Escape and Differential Negative Reinforcement of Other Behaviors ........................................................................................ 41

CHAPTER FOUR: RESULTS

Findings .................................................................................................... 44

CHAPTER FIVE: DISCUSSIONS

Implications ............................................................................................... 47

REFERENCES .................................................................................................... 49

1

CHAPTER ONE

INTRODUCTION

Problem Statement

Children diagnosed with autism started to rise in numbers starting in the

80’s. Recent studies show the approximate ratio of children affected. According

to Christensen et al. (2016), “Approximately one in 68 children aged 8 years

living in sites participating in the Autism and Developmental Disabilities

Monitoring (ADDM) Network surveillance areas met the ASD case criteria for the

2012 surveillance year” (p.12). The American Psychiatric Association (2013),

define ASD as “a series of developmental disabilities characterized by

impairment in social communication and interaction skills, accompanied by the

existence of repetitive behaviors or activities, such as rocking movements, hand

clapping or obsessively arranging personal belongings” (as cited in Frasier-

Robinson, 2015, p. 113). Every autistic child is affected in a different way, which

is why teachers, interventionists, and parents need to be familiar with multiple

strategies that they can practice to decrease escape maintained behaviors. Each

individual will react to each strategy in a unique way allowing the strategy to be

effective or not depending on the specific individual and their needs.

Children with ASD experience various developmental disabilities creating

numerous challenges in their learning and daily lives. Matson, Wilkins, and

Macken (2009) state, “Challenging behavior is more common among children

2

with ASD than among typically developing children or children with other

developmental disabilities” (as cited in Rispoli et al., 2013, p. 67). Since it is

common for children with ASD to display challenging behaviors, it is essential for

interventionists/parents to apply strategies to help decrease challenging

behaviors. One specific type of challenging behavior that will be reviewed in

more detail is escape maintained behaviors. According to Love, Carr, and

LeBlanc (2009), they “found that escape was the second most common function

of problem behavior, identified for 50% of 32 children with autism spectrum

disorders” (as cited in Geiger, Carr, & LeBlanc, 2010, para. 1). With escape

acting as one of the top functions of problem behavior, it must to be brought to

the attention of interventionists/parents. This study will allow

interventionists/parents to be more knowledgeable of specific strategies they can

use to decrease this popular behavior. According to Butler and Luiselli (2007),

“Behavior is described as escape motivated when it terminates an unpleasant or

non-preferred interaction” (p.195). Many children with autism have a challenging

time transitioning and interacting in non-preferred activities, overwhelming

situations that occur in their least restrictive environment, new activities that are

implemented, routines that get altered, or they may get frustrated when

excessive new demands are placed on them. As a consequence, many children

participate in challenging behaviors when an excessive amount of demands are

placed on the child, which can lead to escaping activities that are non-preferred.

3

Without using extinction because it is consequence based, what

antecedent-based strategies and evidence-based practices can

interventionists/parents use to address escape-motivated behaviors in children

with ASD and decrease occurrences? In my research, I aim to describe

strategies that will decrease escape-motivated behaviors in children with ASD.

One hypothesis advanced by Kern, Choutka, and Sokol (2002), is implementing

antecedent-based intervention within a child’s regular schedule and routine. This

allows the child to learn specific interventions in their daily routine to help

decrease escape-motivated behaviors. Thus, in this study, various antecedent-

based interventions and evidence-based practices were analyzed to determine

whether implementing these strategies into a child diagnosed with ASD routine

would in fact, help decrease challenging behaviors particularly, escape

maintained behaviors. This study will build on describing particular strategies,

which have been effective in assisting children with ASD and have reduced

escape maintained behaviors. Interventionists/parents can support these children

through introducing various strategies such as several antecedent-based

interventions and evidenced-based practices to help decrease escape maintain

behaviors. According to Kern et al. (2002), it has been proven that when one can

define what exactly is setting the child off while displaying a more appropriate

behavior instead then that antecedent-based intervention may eliminate

challenging behaviors. If the interventionist/parent can replace the problem

behavior with an appropriate behavior, the child can learn to use the appropriate

4

behavior in its place diminishing the problem behavior. Various other studies will

be mentioned to discuss these strategies that were successful in reducing

challenging behaviors in children with ASD.

One problem in this study is that children with autism may be classified

from mild to moderate or moderate to severe. The range of the child’s ability can

be broad. A strategy successfully performed on one child may not have the same

effect on a different child with ASD because each child displays different

components and characteristics of the diagnosis. As a whole, all strategies

mentioned have been specifically designed to work effectively and should be

implemented in classrooms/homes for children with autism in their least

restrictive environment.

Purpose of the Study

The purpose of this review study was to describe and analyze effective

antecedent-based strategies and evidence-based practices that will reduce the

escape behaviors in a child with autism and allow the child to participate in

certain tasks, activities, and situations while flourishing in any environment. If this

were found to be true, then greater efforts might be made to encourage

interventionists/parents to use these specific antecedent-based strategies

throughout the child’s day. When interventionist/parents effectively intervene

before a challenging behavior becomes extreme or by preventing the behavior

such as escape from even occurring, then it would be great success in helping

children with ASD function in the real world.

5

Methods

Research was conducted through an electronic library using two

databases: EBSCOhost and Educational Resource Information Center (ERIC). At

first, search terms were broad and over 10,000 articles were identified, but after

gaining a clear idea of the topic more articles were searched using significant

keywords such as: autism, escape, escaped maintained behaviors, decrease

challenging behaviors, alternative behaviors, antecedent-based intervention, and

evidence-based practices. In using the advanced search on EBSCOhost, I was

able to narrow my search down to 100 articles. From there I continued to use the

advanced search on EBSCOhost using different combinations of my keywords to

narrow it down even more. Multiple article abstracts were judiciously read and

chosen that would support the study. In my final review about 55 articles where

included. Once articles were selected, each full article was read and analyzed

determining which parts of the article would support the study. Another key

component was finding facts about the topic of escaped maintained behaviors in

children with autism. Antecedent-based as well as evidence-based strategies

may be used to help decrease these challenging behaviors. Reference pages

from the articles were also viewed in order to find more articles on particular

topics. This study is to suggest educational implications for classroom teachers,

interventionists, and parents.

6

Evidence-Based Practices

Evidence-based practices (EBP) are commonly used while working with

children diagnosed with ASD. EBP’s are valid and reliable strategies. According

to Wong et al. (2015), the authors found 27 focused intervention practices that

met the criteria for evidence-based practice (EBP). EBP’s are scientifically

proven to support children with ASD function successfully within their learning

environment.

Wong et al. (2015) proves the following:

Evidence-based practices consist of interventions that are fundamental

applied behavior analysis techniques (e.g., reinforcement, extinction,

prompting), assessment and analytic techniques that are the basis for

intervention (e.g., functional behavior assessment, task analysis), and

combinations of primarily behavioral practices used in a routine and

systematic way that fit together as a replicable procedure (e.g., functional

communication training, pivotal response training). (p. 1957)

Only a few of these practices will be mentioned where research articles were

found to support decreasing escape maintained behaviors. The few practices in

which research was found to decrease escape maintained and challenging

behaviors include: antecedent-based interventions, functional behavior

assessment, time delay, task analysis, reinforcement, and visual supports.

7

Antecedent-Based Intervention

Antecedent-based intervention (ABI) approaches can be extremely

beneficial when decreasing intrusive behaviors while children increase their

involvement in appropriate and acceptable behaviors. These type of strategies

involve making adjustments in the child's routine or environment that may help

eliminate specific triggers of challenging behaviors as well as to provide the child

with opportunities to replace their behaviors. ABI strategies are easy to

implement and can be practiced by anyone who works or lives with ASD children.

Another advantage to using antecedent-based intervention is the fact that these

strategies work across multiple age ranges of children with ASD. Although

studies have shown that escape extinction is effective, ABI strategies show there

are other approaches that can be just as successful. Antecedent-based

intervention is strategies that involve altering the antecedent events before the

problem behavior occurs. When the interventionists/parents can alter the

antecedent to the escape maintained behaviors this prevents and diminishes the

behavior from occurring.

An ABI technique to escape-maintained challenging behavior is

influencing antecedent demand circumstances (i.e. modifications within

curriculum, instructional design and environment, social organization) so the child

finds instruction more enjoyable and less frustrating fueling the desire to escape.

When antecedent-based intervention strategies are implemented, it helps

educate the child with ASD to use appropriate alternative behaviors before

8

the challenging behavior occurs. This decreases the chances of the

challenging behavior from occurring and increases the child’s motivation

to learn (Kodak, Miltenberger, & Romaniuk, 2003; Vollmer, Marcus, &

Ringdahl, 1995).

After implementing antecedent-based strategies, children with ASD learn

appropriate behaviors in place of their challenging behaviors.

Antecedent-based intervention has various techniques to implement,

which will decrease escape maintained behaviors. According to Bulter and

Luiselli (2007), some of the techniques include scaffolding tasks, intertwining

novel task into child’s learnt tasks, and spending less time for instructions (p.

195). These are just a few of the strong manipulations that can be applied to the

child’s day while working on decreasing escape maintained behaviors. “When the

context for escape behavior was examined Hanley et al. (2003) noted that

idiosyncratic antecedent events, such as task difficulty, lack of choice among

tasks, social variables, and curricular factors frequently served to signal the

reinforcing value of escape” (Blakeley-Smith, Carr, Cale, & Owen-Deschryver,

2009, p. 132). These negative antecedent events functioned as the result of

escape maintained behaviors to appear. These antecedent events can be

improved and enhanced to where the behavior is reduced.

There are several additional antecedent-based strategies to implement in

the classroom or at home. According to Michael (1993), the objective of

antecedent-based interventions is to create a procedure to decrease challenging

9

behavior prior to its occurrence. These strategies include: rearranging the

environment, keeping a routine and set schedule, altering ways instruction is

administered, providing children access to sensory stimuli, offering choices

throughout the day, finding items to increase interest level or discovering highly

preferred activities, and implementing pre-activity interventions. The antecedent-

based strategies will be discussed and reviewed in further detail.

10

CHAPTER TWO

ANTECEDENT-BASED INTERVENTIONS

Complexity of Task Requirements

Children with autism have various developmental disabilities making

complex tasks and requirements challenging and frustrating. The complicated

tasks trigger problem behaviors, which lead to escaping the activity. According to

Blakeley-Smith et al. (2009), some techniques to use include making tasks short

and concise, giving children a variety of activities to work and learn from,

corresponding the students ability with the task requirements, using the students

interests to develop tasks, and offering students to make choices (p. 132). All of

these antecedent strategies mentioned have been proven to decrease triggering

behaviors in children with ASD.

Reducing task length, allows children with ASD to decrease any

frustrations they could be feeling from the lengthy, difficult task thus minimizing

challenging behaviors that may be exhibited for the purpose of escaping the

situation. It is critical to understand that most children with ASD may have short

attention spans. In the child’s least restrictive environment, the

interventionist/parent should collect baseline data on the child’s duration of

attention to a task or activity, this is to discover how long they can sit and attend

to an activity. After a baseline is determined, it will be easier to establish an

appropriate length for the task. Behaviors can get heightened quickly;

11

interventionists/parents need to be aware of early signs that the child starts

displaying before the overall problem behavior appears. Research by Butler and

Luiselli (2007), recommend giving children tasks that are simple and short as

they work their way up to more complex tasks without displaying challenging

behaviors. This allows children to work at their fullest ability and can progress to

more complicated tasks when deemed necessary and appropriate. If a task is too

difficult for a child, behaviors are going to occur because frustration is going to be

evident causing the child to escape the task.

When the interventionist/parent gradually scaffolds demands into simpler

and shorter segments, one may observe the child’s acceptance for instruction

and the interventionist/parent can expand the task at the rate they feel is best

suited for the child. According to Butler and Luiselli (2007), “The gradual fading of

task requests was conceived as a method of increasing tolerance for instruction

while simultaneously decreasing escape” (p. 197). As the child starts establishing

tolerance for completing a simple task, a more complex task can then be

introduced, or a continuation of the previous skill can be taught which may

require more of the child’s time and attention. This approach may allow the child

to stay motivated and more focused, so that he/she may be less likely to become

overwhelmed or discouraged, and thus less probable to participate in challenging

behaviors in an attempt to escape the task. Scaffolding breaks tasks into

smaller/shorter sections and may help children with ASD to be more attentive

and engaged in the task.

12

Interventionists/parents should be presenting tasks that are appropriate for

each individual child. All children learn at different paces especially children with

autism. Tasks should be based on the individual child’s ability. For example,

because one child with ASD can multiply does not mean all children with ASD

can multiply. When proposing tasks to children, modifications need to be made to

the curriculum to meet the child where they are at cognitively. In doing so,

escape maintained behaviors would decline and task achievement would

increase.

Some children with ASD are considered high functioning. A high

functioning autistic child may be displaying problem behaviors simply because a

task is “too” easy. If the task is too easy, modifications of the task should be

shaped appropriately to fit the child’s cognitive ability. Tasks that are excessively

easy trigger challenging behaviors and an incline of escaping the task takes

place. Task demands should be created to be appropriate for each child

developmentally.

Embedding Novel Tasks and Incorporating Task Variations

Many ASD learners do not cope well with new tasks. Introducing new

tasks to the child should be presented strategically. According to Carr et al.

(1976), “By embedding activities that evoke challenging behavior within a

schedule of activities that are not associated with challenging behavior, we may

reduce the probability of such behavior occurring during ongoing instruction” (as

13

cited in O'Reilly, Sigafoos, Lancioni, Edrisinha, & Andrews, 2005, p. 306).

Interventionists/parents need to observe the new activities that spark challenging

behavior and intertwine them into activities that are enjoyable for the child to

reduce behaviors. This provides the child a feeling of success and satisfaction.

Interventionists/parents must scaffold tasks so they seem more manageable for

the child to where they are able to remain on-task. Also, the mastered tasks and

activities start to become the child’s preferred tasks because they can now

successfully finish it, making that task more enjoyable. When mastered tasks are

embedded before or after a novel task is presented, the child is more willing to

finish the novel task without escaping or displaying challenging behaviors.

In the study from Winterling, Dunlap and O’Neill (1987), it displayed that

lower rates of problem behaviors occurred when varied tasks were incorporated

compared to constant task conditions. One of the figures in the study showed

when varied tasks where introduced behaviors declined to zero. According to

Winterling et al. (1987), “The first study provided empirical evidence that the

aberrant responding of two severely handicapped and autistic children could be

reduced with a simple, non-punitive strategy of task variation” (p. 111). The

current studies’ target tasks were interspersed with additional tasks that had

been mastered by the students during previous instruction, which then decreased

behaviors.

Embedding novel activities with tasks that have been previously learned is

an antecedent-based intervention that assists in decreasing challenging

14

behaviors that can result in escape from a task. It allows the child not to become

overwhelmed when participating in a new activity since a portion of the task has

already been mastered. The child may find comfort in the fact that the task and

materials are familiar and they already understand how to complete the task

successfully. According to Gunter et al. (1993), “Task difficulty is one of the

primary curricular variables that can set the occasion for problem behaviors in

the classroom” (as cited in Umbreit, Lane, & Dejud, 2004, p. 13). With this being

known, interventionists/parents need to work on various strategies to break down

the difficulty of the task to decrease and prevent problem behaviors from starting.

New tasks may appear to be overwhelming for a child with ASD but these

challenging tasks can be a success by making appropriate accommodations that

fit each individual child’s ability.

It is important to incorporate multiple mastered tasks in between working

on the novel task. Children should have fun, be motivated, and feel accomplished

when completing a task. The interventionist/parent ought to embed the child’s

mastered tasks among new tasks, which may help the child to remain focused

and engaged in the new task/activity. Interventionists/parents who embed novel

tasks into already mastered tasks may provide the child with confidence, which

keeps them motivated in completing the task, thus challenging behaviors decline.

With confidence and motivation instilled in the child, it may help the child to

complete a task effectively without escaping. When the new task is presented it

can be less challenging and overwhelming because the child may be starting off

15

the task with more self-confidence, enthusiasm, motivation, and independence

without contemplating to avoid the task.

Decreased Instruction Time

Interventionists/parents should structure their instruction time when

working with children with ASD. In keeping the instructional demands short and

concise, children can stay focused and on-task. According to Derby et al. (1992),

children often escape task demands when instruction is delivered. Children with

ASD may have short attention spans. It is vital the interventionist/parent do not

spend an overabundance of time giving instructions, instructions given to the

learner should be short and concise. When instruction time is reduced it permits

children to stay on-task and engaged displaying positive behaviors until they

learn to extend their attention spans for longer periods. According to McCoy,

Mathur, and Czoka (2010), “The longer the student is off-task, the less time

exists for engaging in opportunities for learning” (p. 22). For example, a teacher

is running a 15-minute large group there may be many distractions in the

immediate area such as; social intimidation because there are more pupils’

beside them, a student is sitting beside a loud peer, and an over stimulated

environment with excessive pictures or posters hanging on walls. Even with

these distractions interventionists expect the students listen, follow, and attend to

the teacher directions. With all of the aforementioned distractions during large

group time it may be challenging for children with ASD to remain engaged,

16

especially if the teacher is giving complex and lengthy instructions; thus leading

to the child to be more likely to engage in challenging, escape maintained

behaviors.

Instructional time needs to be short and concise and the educator should

use language familiar to the learner. For example, if a child only speaks in single

words then the interventionist should also be using one to two word phrases

when giving instructions. Using short and concise instructions as well as familiar

language may allow the child to gain a better understanding of the instructions

being given without being overwhelmed with too many unknown words to

process and understand.

Interventionists/parents can also present instructions in the form of visual

cues. McCoy et al. (2010) found, “Visually cued instruction uses graphic cues,

often pictures or images in combination with print, showing the sequence of

expected behavior and can be used to organize time effectively for children with

disabilities” (p. 23). Interventionists/parents need to provide children with ASD

visual cues to help reduce frustration when comprehending instructions. This

method provides children to stay on-task decreasing escape maintained

behaviors because they are visually able to process the instructions. Children are

able to anticipate what the upcoming activities are when visually cued

instructions are provided by the interventionist/parent, which allows the child to

gain more independence (Herman, Mclntosh, & Sanford, 2004). Visually cued

instruction is a great way for children with ASD to foresee what is expected of

17

them. Children with ASD are visual learners. When providing them with visual

cues, children are able to process the instructions more clearly. They are short

and simple for the child to understand.

Providing Choices

An antecedent based intervention is providing children with choices. It is

important to give children with ASD choices within their daily routine. These

choices can be small and simple but by doing so children’s escape maintained

behaviors decrease.

Rispoli et al. (2013) study found some choices may include:

Offering children with ASD choices between activities (e.g., working on

math or English), instructional materials (e.g., using a pen or pencil), or

environmental arrangements (e.g., where to sit) has been shown to

reduce challenging behavior maintained by escape from task demands (p.

66).

These are all useful examples of ways to incorporate choices for children. It can

be naturally accomplished when completing tabletop tasks, activities, playtime, or

lunch. Choices can be as simple as asking what color crayon to color with, what

book to read, sandwich or pizza, or to swing or slide. Teachers, interventionists,

and parents should provide opportunities for children to make choices all

throughout their day. This allows children to feel apart of the decision-making

process reducing escape maintained behaviors.

18

Choices motivate children to display positive behaviors because they feel

a part of the lesson. Research conducted by Vaughn and Horner (1997),

“Suggest that the choice itself and not simply just the student’s preference for the

choice options were responsible for reducing challenging behavior” (Rispoli et al.,

2013, 67). Offering choices creates children the ability to feel engaged and like

their voice is heard as well as making it desirable by taking their interests into

consideration. Choices may help to decrease any challenging behaviors

exhibited to escape the task. When increasing engagement and children’s

interest as they complete a task or activity, students challenging behaviors are

likely to decline.

Choice making teaches independence in children, which then reduces

problem behaviors. If children feel their voice matters it boosts their confidence

promoting independence. Children then do not rely on adults to tell them what or

how to do an activity. Providing children with choices can affect them in many

aspects of their life and thus lead to positive behaviors instead of escape

maintained behaviors. When children are given the opportunity to make choices

it can allow them to become more independent. Children who are given options

are more likely to participate and comply in an activity or task. “Higher rates of

problem behavior were observed when students were required to complete less

preferred tasks” (Kodak, Lerman, Volkert, & Trosclair, 2007, p. 37). Once choices

are given the child may feel that they have some control of the situation and are

allowed the opportunity to express his/her needs and wants. This could lead to a

19

desire to participate because they made the choice. Promoting choices allow

positive behaviors to increase while diminishing challenging escape behaviors

during tasks.

Research has classified two types of choices that can be provided for

children. The first is “across-activity choices” and the second is “within-activity

choices” (Rispoli et al., 2013, p. 68). Research by Rispoli et al. (2013) has shown

that both of these types of choices have shown to be effective in decreasing

challenging escape behaviors. The first type is “across-activity choices” which

lets children pick a different activity they want to engage in. For example, the

interventionist/parent could allow the child to choose between completing a

history assignment or writing a paper. The interventionist/parent may provide the

child with one to four tasks allowing the child to select which task they prefer to

complete first. When the child is able to choose what task to complete first it

assists in increasing positive behaviors. If the interventionists/parents start with a

task the child selects, it entices the child to stay on-task reducing escape

maintained behaviors. The child’s choice is possibly the child’s preferred task

maintaining their interest to the point where escape is not even a consideration.

The second is within-activity choices. According to Rispoli et al. (2013),

within-activity choices is when the child is able to choose what materials they will

complete the activity with (e.g., crayon or paint) (p.68). It can also mean giving

the child a choice where (environmentally) they want to complete the activity

(e.g., outside or on the floor) (Rispoli et al., 2013, p. 68). The

20

interventionist/parent chooses what task is going to be completed first but the

child is allowed to decide how they would like to complete the task, where they

would like to complete the task, and what materials they wish to use to compete

it. For example, an interventionist chooses the task to complete a jigsaw puzzle.

The child now has the option to complete the puzzle where they want (i.e. on the

floor) and what puzzle piece they want to start with (i.e. the corner piece). When

a task is decided for the child it can be more desirable for the child to complete it

when they are given choices within the activity. If an undesirable task needs to

be completed, it is essential we meet the child where they are at making it as

pleasurable as possible.

Once the two choice interventions were practiced, all four of the children in

the study’s behaviors decreased. Across-activity choices were linked to the

lowest percentages for occurrence of challenging behaviors. According to Rispoli

et al. (2013), “By providing within-activity or across-activity choices, teachers may

be able to decrease escape maintained behavior and improve student motivation

to complete academic demands” (p. 79). This proves that allowing children the

ability to make choices increases the child’s engagement on task performance

while decreasing escape maintained behaviors.

Arranging Environment

A child with ASD’s physical learning environment can play a vital role in

allowing that child to thrive and display on-task behaviors. Kern et al. (2002)

21

found rearranging a child’s environment is a common antecedent-based

intervention that occurs frequently. This allows the interventionist/parent to alter

the child’s behavior because what used to be provoking the child is no longer

present (Kern et al., 2002). If the environment has a variety of stimuli, such as a

disorganized room, bright lights, lack of structure, and distractions on the walls it

can make it challenging for children to learn in, complete tasks, listen to

directions, and may be eliciting the challenging behaviors. Arranging specific

strategies in a child’s environment help decrease escape maintained behaviors

because it reduces anxiety and frustration. There are multiple physical

characteristics that comprise a child’s environment. When a child is displaying

escape maintained behaviors, interventionists/parents need to re-evaluate what

is triggering the behavior. Are there too many distractions on the walls or a

specific color that is setting the child off (e.g. too many posters or pictures on the

walls taking away the focus of the task)? Does the child’s schedule need to be

rearranged (e.g. start with a favorite task then proceed to a non-preferred task)?

Is there a peer that is heightening the child’s behavior to escape (e.g. a peer

screaming and child is affected and sensitive to loud noises)? These are all

questions to consider when requiring the child to work in the least restrictive

environment.

When setting up an environment, it is crucial to arrange the classroom or

room at home to decrease specific triggers for the child to engage in interfering

behaviors. According to Horner et al. (2002), “Environments are changed to

22

match the behavioral needs of people in the environments” (p. 425).

Interventionists/parents need to accommodate to the unique needs that our

children require to stay focused and engaged. Changes in the environment may

work for a while but later require being reassessed and modified. As ASD leaners

enter into different developmental milestones in their lives, their environment

requires rearranging to fit their new needs before the child displays signs of

escape.

It is the interventionists/parents responsibility to evaluate what is triggering

escape maintained behaviors in the child’s environment. According to Horner et

al. (2002), “It is through environmental engineering that problem behavior can be

prevented and patterns of problem behavior altered” (p. 425). For example, the

child is over stimulated in his/her environment due to multiple distractions on the

wall, such as pictures and papers, where the child is to complete his/her task. To

reduce the desire to escape the task, the teacher can alter the child’s

environment by modifying the physical setting. The teacher can take down all the

papers and pictures making the walls bare and then identify the student’s

boundary using partitions, furniture, or taping off sections of the floor. In creating

these alterations in the child’s environment, the child is able to be seated and

attend to the task without displaying escape maintained behaviors. According to

Blakeley-Smith et al. (2009), “The redesigned environment may produce higher

levels of success for a given skill level, which may contribute to a reduction in

subsequent problem behavior” (p. 133). By changing the conditions in the child’s

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surroundings, the stimulus is removed and the child can function appropriately in

his/her environment. It is also significant to make sure that the environment the

child is in does not change abruptly. Too many environmental changes at once

may cause extreme anxiety fostering escape maintained behaviors.

Reducing escape maintained behaviors in the child’s environment could

be resolved by a combination of the individual child’s needs as well as

accommodations in the child’s environment. If the environment is creating a

negative atmosphere putting additional stress on the child, then escape

maintained behaviors are going to increase. When environmental modifications

are created, children’s proficiency within the task can increase while decreasing

problem behaviors. Once the child feels comfortable and successful in their

environment the escape maintained behavior might reduce. According to

Blakeley-Smith et al. (2009), “It is possible that environmental redesign reduced

task aversiveness, which undermined the need for escape motivated problem

behavior” (p. 143). Rearranging environments is a vital component in decreasing

escape behaviors.

Interventionists/parents who build physical environments for each child is

fundamental to promoting a decrease in challenging behaviors.

According to Strain et al. (1985), (1998) study found the following:

Environments likely to prevent the emergence of problem behaviors

include the following features (a) a high level of child engagement, (b)

access to preferred activities and rewards, (c) consistent and predictable

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system of scheduling (especially systems that incorporate visual

schedules), (d) continual access to typical peers, and (e) an immediate

and effective system of communication (as cited in Horner et al., 2002, p.

435).

A child who is engaged in the task they are completing is able to stay focused

refraining from participating in any interfering behaviors. A child with ASD is kept

engaged and motivated in a task when the child gains permission to preferred

tasks and then reinforced for their positive behavior. It is also important to

maintain a consistent schedule in their environment. This allows the child’s

predictability of what his/her day, task, or activity will consist of. Visual schedules

are an environmental change that can be easy for ASD leaners to comprehend.

When a child with disabilities has access to typical developing peers, the child

observes a role model that acts appropriately in the environment. Lastly, an

environmental change that can reduce escape is providing each child with the

ability to communicate. Whether the child is verbal or nonverbal both should have

a way to communicate his/her wants and needs. This can be difficult for a child

who is nonverbal. A few ways to promote communication is by using pictures, a

picture exchange communication system, or through technology devices. If the

child is supplied with these opportunities for communication the child is able to

speak and let the interventionist/parent know what the child is thinking or how

they are feeling, which helps reduce the possible outburst of challenging

behavior.

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Changing Schedules/Routines

Children with ASD may become anxious when there is a difficulty in

comprehending what is expected of them. According to Mesibov, Browder and

Kirkland (2002), one proven strategy when assisting children with ASD is

creating individualized schedules and predictable routines, which has been

successful in decreasing problem behavior. Interventionists/parents should

create schedules that children can anticipate and that contain a good balance

between adult/teacher directed and student directed activities (Schmit, Alper,

Raschke, & Ryndak, 2000). In a classroom setting where a child is transitioning

from multiple centers, activities, or to a new location the unfamiliarity may give

the child anxiety making it extremely difficult to transition and can lead to

challenging behaviors and attempting to escape tasks. Volkmar (1996) states,

“Many children labeled with autism tend to perseverate on tasks, to resist

requests to change activities, and to engage in stereotypical or tantrum

behaviors” (Schmit et al., 2000, Abstract section, para. 4). This creates interfering

behaviors and escaping tasks when trying to transition to and from different

activities throughout their day. When a child is unaware of a change in an activity

many may exhibit challenging behaviors while escaping the current activity

because the child was not provided with the adequate time to prepare for the

new change in schedule. McCoy (2009) mentions, “Making successful transitions

from one activity to another is difficult for many children, especially those with

cognitive, language, or behavioral disabilities” (as cited in McCoy et al., 2010, p.

26

22). Many children with ASD have a combination of these characteristics making

transitioning a challenge, so when a change occurs without notice it may upset

the child to where escape is identified.

Each child with ASD is very unique in the needs they require. When an

individualized schedule is in place, it provides the child the ability to function at a

successful rate. According to O’Reilly et al. (2005), “Individualized schedules

may act as a form of antecedent intervention to reduce challenging behavior as

they may limit the impact of various setting events (e.g., stressful activities,

unpredictable transitions) on such behaviors” (p. 305). Its purpose is to meet

each individual child’s specific demands and needs while transitioning throughout

his/her daily schedule in order to possibly reduce challenging behaviors before

they emerge. When children with ASD cannot anticipate what will happen next,

interfering behaviors may become observable. Schmit et al. (2000) suggests,

“One technique is focused on strategies for signaling students prior to transition

activities in an effort to forewarn the students and prepare them for impending

change” (Abstract section, para. 5). There are multiple strategies to signal and

prepare a child a transition and a change is approaching, preventing escape.

One strategy is by providing the child with a 3-minute warning.

Interventionists/parents can use a visual display using a timer or a visual count

down. This prepares the child to finish the task and clean up the area so they will

be ready to transition to the next activity. Another way to promote a smooth

transition without having the child escape is presenting a picture of where the

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child is transitioning or what task they will be completing next. In doing so, this

allows the child to visually build a connection and anticipate what follows. Lastly,

using a first/then card to visually exhibit first what the child will be doing at that

specific moment then where the child will be transitioning (i.e., first puzzle, then

recess). First/then cards can also be used with a toy or edible reinforcer (i.e., first

work, then car or first sit, then skittle). These strategies can be used alone or

combined together contingent to the child’s needs for a smooth transition.

Transition strategies may help decrease escape maintained behaviors because

the interventionist/parent is providing the child with a clear and predictable

routine that they can visually see and understand.

A child with ASD may be a visual learner who prefers and functions more

successfully when they can understand what comes next in their schedule/day.

As stated by Quill (1997) and Spriggs et al. (2007), “Attention to visual materials

may serve as a memory aid during transition time to provide more structure than

rapidly changing classroom events” (as cited in McCoy et al., 2010, p. 22). This

allows children with ASD to concretely see as well as to forewarn the child where

they will be transitioning or what activity they will be participating in.

Schmit et al. (2000) study found:

Because children with autism have been known to emit higher rates of

appropriate responding when presented with visual stimuli in contrast to

auditory stimuli (Volkmar, 1986), one could speculate that cueing systems

emphasizing visual signals to elicit a behavior during transition periods

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would be superior to cueing systems emphasizing only auditory signals

(Abstract section, para. 7).

Visual schedules can be implemented into the child’s day displaying what their

day is going to consist of (e.g., morning circle, small groups, lunch, recess, art,

dismissal). Also, use of visual supports such as first/then cards, picture icons,

visual timers, etc. can all signal to the child change is approaching. A child with

ASD may take longer to auditorally process spoken instruction. This permits

visual cued instructions the aptitude to support the child in a positive way. When

the child has a picture schedule it visually expresses how to complete an activity.

With this type of support, the child is able to acquire and gain more

independence. Visual schedules are found in our day-to-day lives whether we

are typically developed or specially designed. It is important to teach children to

utilize visual schedules to prevent challenging behaviors from arising.

Interventionists/parents can create visual supports to help aide children

when schedules and routines change to reduce escape maintained behaviors.

McCoy et al. (2010) found, “Visual supports may improve learning for children

who have limitations in processing or attending to transient information or who

are challenged to recall information presented verbally” (p. 22). Developing a

predictable schedule and routine for a child with ASD may be effective in

diminishing escape maintained behaviors and supports them when transitioning

from each activity independently. Schmit et al., (2000) results showed when

verbal and photographic cues are combined and presented to a child before a

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change in schedule/routine occurs, it helps decrease challenging behaviors.

Photographic cues can help a child with ASD prepare for what is approaching

next in their schedule. When a change occurs that is not usually in the child’s

daily routine, the child should be prepped of the alteration so they are ready

when the change occurs thus not engaging in escape.

It is crucial the child’s schedule becomes routine and implemented in the

child’s life consistently. Day after day the child will eventually learn what to

expect and what the following task or activity may be that is approaching. When

correct transitions are rewarded, children become motivated to continue to

transition successfully (Schmit et al., 2000). An ASD child may need to be

constantly reinforced to exhibit appropriate behavior in order to remove or

decrease the negative behavior. When a child is continuously reinforced for

successfully transitioning from place to place the desire to escape may decline.

In addition to maintaining a consistent routine and schedule,

interventionists/parents should alert the child when a transition or change is

approaching. This prepares the child ahead of time so they distinguish what to

expect. Because transitions can cause some people severe anxiety and

confusion it is important for interventionists/parents to implement a variety of

strategies to help reduce tension when there is a change in schedule. Once the

interventionist/parent is able to observe what relieves the child of anxiety during

transition then the child may be able to transition with more success. As

mentioned before, interventionists/parents working with an ASD child can design

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individual schedules for each child to help specific children to transition

effortlessly by providing his/her with a picture or object schedule. This is an

influential antecedent-based intervention that supports positive behavior because

schedules can be custom toward the child’s individual needs (Mesibov et al.,

2002). It is essential to custom a child’s schedule to accommodate their

individual needs because each child’s needs are different and unique promoting

positive behavior since demands were met based on that specific individual.

Structuring Time

An important antecedent-based intervention to decrease escape

maintained behaviors is structuring appropriate time within the child’s activities.

Structuring a child’s time can be implemented hand-in-hand with providing them

with a schedule and routine as mentioned earlier. Most times, a child with ASD

does not understand what is expected of them causing interfering behaviors and

the desire to escape activities. This unknown creates anxiety because the child is

unsure of how to complete the activity, what happens when they are finished with

the activity, and where they are to go after the activity is completed. It is

important that when generating schedules and routines a child with ASD should

not have an abundant amount of wait time between transitions or activities. When

too much wait time is allotted the child may veer off task quickly stirring up the

desire to escape since unproductive time was administered.

Interventionists/parents may have a child’s time structured in a manner

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where there are no gaps or wait times allowing the child to maintain focus and

attend to the activity. This creates smooth transitions and keeps the child

engaged and on-task participating in the activities. For example, some things to

think about when structuring time might include: how long an activity will be, if

they finish early what will the child do, being organized by having the next activity

set up and ready for the child to work on, and forewarning the child what will be

next in his/her schedule.

Any child who is provided with an excessive amount of free time may

provoke challenging behaviors. A child with ASD may require instant gratification.

If the child has completed a task and is waiting on the interventionist/parent for

directions or where to go next, the child loses their interest quick. According to

Koenig (n.d.), inappropriate behaviors can be generated because of wait times

(p.280). A few strategies to help structure time for the child might include: having

reinforcers ready for the child after they have completed a task, using visual

timers, or playing a song that indicates to the child that they are finished and it is

now time to transition to the following activity. During the child’s day, visual timers

can be a helpful tool in the classroom or at home to define specific times,

activities, or transitions. For example, when we cook, we usually use a timer so

we can anticipate when the food will be ready. A child with ASD may desire the

same anticipation of when they are going to be finished with a task and/or how

long the activity will take. Placing a visual timer where the child can see it allows

them to visually comprehend how much longer they have to complete a task or

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before another task or transition is coming. In using these strategies to help

structure time, it may assist in decreasing escape maintained behaviors because

the child is now aware of what to expect as well as keeping them on track and

engaged in the current activity.

Highly Preferred Activities/Items

Highly preferred activities and/or items may be valuable when children

with ASD partake in challenging behaviors (i.e. escape or avoiding of activities).

Children’s fascinations make suitable teaching materials. This ABI strategy

emphasizes on using children’s preferences to increase children’s interest,

engagement, and motivation in participating in non-preferred activities and daily

routines. Children with ASD should always have a preferred activity, task, or

item. According to Kodak et al. (2007), it is important to assess “preference for

positive versus negative reinforcement under different conditions” (p.37). This is

significant for interventionists/parents to discover what these highly preferred

activities and items are to use when challenging situations arise.

When ASD learners are escaping tasks, a strategy to use is offering the

child an activity or item they are interested in. This helps motivate the child to

follow the directions being asked or the demand that has been placed on them.

For example, a child will not sit in their chair during lunch. Discover the child’s

highly preferred food item displaying it on the table then state, “Sit in chair.” The

goal of this ABI strategy is to distinguish highly preferred items the child loves

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and incorporate these items in activities. This may help the child become

motivated in participating in the activity instead of engaging in any type of

challenging behavior.

When highly preferred items are incorporated into the child’s non-

preferred activities, it changes the environmental conditions that once caused

escape or behaviors in the past. Kodak et al. (2007) gives an example, “providing

preferred food reinforcers contingent on compliance might effectively increase

compliance, even if problem behavior continues to produce access to a break”

(p. 37). It should be noted however; a child’s highly preferred item or activity

should not be available and used all the time. This way the preferred item will not

get boring and become uninterested to the child, instead the item will continue to

hold value to the child. Incorporating preferred items makes activities more

meaningful and relevant to children, thus keeping them engaged. Observations

allow interventionists/parents to learn about the child’s favorite items and

interests, their strengths and new developing skills (Grisham-Brown, Hemmeter,

& Pretti-Frontczak, 2005). Observing the child for a short period of the day or

sending surveys to parents to complete allows the interventionist to create a list

of particular items or materials the child enjoys and loves. Some questions to ask

are: What makes the child happy and excited? What keeps their attention? What

does the child love to do? What don’t they like? Keep up-to-date on what the

child’s preferences and interests are. As they start to mature it changes overtime.

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Pre-activity Interventions

This ABI strategy helps children with ASD to participate and become as

independent as they can be during an activity. Interventionists/parents can

change the conditions within an activity by giving the child notice of an upcoming

activity, using visual schedules that correspond with the activity and letting the

child know about any changes. Many learners with ASD have short attention

spans, thus it is key to plan ahead and be prepared for the activity or task ahead

of time. Setting up activities prior to implementation lessens any wait time for the

child and instead promotes engagement in the activity preventing escape and

challenging behaviors. An effective way to stay organized and planned when

engaging with children who have ASD is to create an activity matrix. By

producing an activity matrix interventionists/parents are able to identify the

activity the child is to participate in, the target skills that will be expected and

observed, and finally the strategy in which will help the child be engaged and

participate in the activity.

Tolerance For Delay

Tolerance for delay (TFD) is a strategy to help with challenging behaviors

hypothesized to have the function of escape. “There is evidence that using a

tolerance for delay of reinforcement (TFD) intervention can be an effective

approach to addressing problem behavior maintained by positive or negative

reinforcement” (Chen, McComas, Reichle, & Bergmann, 2015, p.393). TFD is a

35

signaled delay when giving reinforcement. This process results in gradually

delaying reinforcement that is dependent on the child engaging in appropriate

behavior.

A delay signal can be verbal such as “wait,” or a visual cue using a visual

countdown where children can physically see time is running out. According to

Reichle, Johnson, Monn, and Harris (2010), “Delay cues can be either ‘general’

or ‘explicit’” (p. 710). A “general delay cue” does not indicate exactly what the

level of engagement needs to be in order to receive release from task; just that

relief is coming shortly (Reichle et al., 2010, p. 710). An example of a general

delay cue is signaling to the child “almost finished.” The other delay cue is

explicit. “Explicit delay cues specify an objectively quantified criterion for

continued engagement prior to the finishing task” (Reichle et al., 2010, p. 710).

An explicit delay cue is more specific for example, “last one,” or “one minute.”

This allows the child to specifically know when to anticipate a task is finishing up.

“Reichle et al. (2010), examined the differential effects of general and explicit

delay cues in increasing on-task behavior while decreasing escape maintained

problem behavior for two preschool children with autism and moderate to severe

intellectual delays” (as cited in Chen et al., 2015, p. 394). The aforementioned

showed that giving the child explicit delay cues when working on a task can help

the child finish the task and decrease escape behaviors. The delayed cue

indicates, that depending on the child’s involvement when working on a task

without displaying difficult behavior, the child will receive relief after. When the

36

child is aware of how long his/her task is and when their reinforcement is coming

then they are more prone to stay engaged till the end and finish their task without

challenging behaviors. For example, when putting pegs in a pegboard the

interventionists should give an explicit delay cue of “one more time” or “last one”

to signal to the child they are almost finished. This way the child understands that

after they are finished putting in their last peg they will be reinforced with an item,

activity, or a break will be available. The delay cue needs to be conveyed just

before the child reaches engagement to the task and almost immediately

followed by a release cue. It is also essential to start a time stimulus that is short,

(e.g., 5 minutes and if no escape or challenging behaviors occur then the time

can start being increased gradually by 1 minute or so).

TFD increases delays before the child gains access to their preferred item.

The child learns they cannot constantly receive their preferred item or activity

immediately. According to Chen et al. (2015), “Results showed that an explicit

delay cue was more effective for improving task completion and decreasing

escape maintained problem behavior of two young children with autism” (p. 394).

An example of an explicit delay cue that can be used with the child is stating, “Do

one more.” When a concrete number is stated it can help the child understand

the exact amount of times necessary to complete the activity instead of a broad

direction such as “almost done.”

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CHAPTER THREE

EVIDENCED-BASED PRACTICES

Functional Behavior Assessment

Functional behavior assessment is used when children are displaying

inappropriate behaviors that need to be reshaped. According to the National

Professional Development Center on ASD, (2014), “Functional behavior

assessment (FBA) is considered an evidence-based practice to use with

students with ASD” (Pennington & Szakacs, 2014, p. 8). It is a process in which

information is collected in order to detect why the behavior is occurring. In using

multiple assessments, it increases the accuracy of the outcome. Assessments

such as a functional analysis, direct observation, or an indirect assessment can

help determine the function of a problem behavior. When developing an FBA, a

team of professionals determine the severity of the behavior and if it interferes

with academic learning, frequent disruptions, or if they are dangerous to self or

others.

It is important to note that when an interventionist/parent is trying to

reduce the challenging behavior, an appropriate replacement behavior must be

taught in its place. According to Pennington and Szakacs (2014), “The FBA

process helps us to identify functionally equivalent (replacement) behavior or

behaviors that serve the same function as problem behavior” (p. 8). The

38

interventionists/parents overall goal should consist of increasing the child’s

independence in their natural environment (Van Houten et al., 1988).

According to Mueller, Sterling-Turner, and Moore (2005), “FBA

incorporating a functional analysis is emerging as an effective model used to

assess classroom behavior problems” (p. 425). Mueller et al. (2005) mentions,

researchers wanted “to determine the effects of attention on problem behavior

that occurs during difficult academic tasks, and to determine whether attention

delivered following problem behavior during an escape period, can increase

problem behavior” (p. 426). Results from Mueller et al. (2005), indicated children

escape when academic demands are placed on them and it creates challenging

behaviors. It also showed that when attention was provided to the child when

working on a difficult task, the child would escape the task (Mueller et al., 2005).

FBA can help professionals determine what the cause of the behavior is and

assist in decreasing escape maintained and challenging behaviors in children

with ASD.

Elapsation of Time Stimulus

If the interventionist/parents provide an excessive amount of wait time

before delivering reinforcement to the child, it may trigger challenging behaviors

because there is no observable stimulus indicating when reinforcement will be

delivered. Research by Butler and Luiselli (2007), supports challenging behaviors

can be caused by wait times. For example, reinforcers should be given to the

39

child directly after task completion. According to Didomenico (2003), most

typically developing children have access to a watch, phone, tablet, or clock

where they can visually predict how much time they have left to finish a task.

“Due to the pervasive deficits present in most children with autism, the use of a

clock can be an overwhelming task” (Didomenico, 2003, p. 134). By using the

time stimulus such as token economies or visual timers, children “are

consistently able to monitor time elapsing as well as obtain access to the

reinforcer when the time has expired” (Didomenico, 2003, p. 137). If children can

predict and visually see when they will be finished the child’s behaviors

decrease.

Reinforcement/Token Economy

Another strategy to use is a token economy system. According to

Anderson et al. (1996), “A child with autism may also particularly benefit from the

use of a token economy in that this population often requires a dense schedule of

programmed reinforcement for appropriate behavior” (as cited in Tarbox, Ghezzi,

& Wilson, 2006, p. 156). A token economy system allows the child to be

encouraged to participate in positive behavior then in return is rewarded with a

token that can be used or added to a collection tokens to be exchanged for a

reinforcer. A token economy system has several benefits. In using the token

system, it keeps the child motivated to continue to complete tasks because they

are being reinforced constantly throughout the completion of the task. The

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interventionist/parent reinforces the desirable behavior with the token itself. The

token economy system can be easily used throughout the child’s day. The tokens

are easily distributed to the students for a reward when positive behavior is

witnessed. All tokens received by the child then can be spent for a greater

reward. “Token economy interventions involve delivering small tangibles (e.g.,

tokens) contingent on the presence or absence of target behaviors and then

providing an opportunity to exchange a preset number of these tokens for backup

reinforcers” (Carnett et al., 2014, p. 369). Token economy involves giving a token

to the student when they possess a positive behavior. When a certain amount of

tokens are collected, a positive reinforcer is rewarded to the child.

The perfect incentive for operating the token economy system is modifying

it to each child’s interest. The token itself should be just as rewarding as the

reinforcer the child is working for. Usually, tokens are presumed to stand as an

impersonal stimulus that gains reinforcing impact when combined with a different

reinforcer. Interventionists/parents can use things that interest each individual

child such as, characters from their favorite cartoons, special coins, pictures of

trains, etc. whatever enthralls the child as their token because it works as an

incentive to increase the value of the token itself (Hackenberg 2009; Matson &

Boisjoli 2009).

It is important that once a token is awarded to a child, the token should

never be taken away. This creates distrust and confusion for the child. When the

target behavior is met, a token should be awarded immediately. If challenging

41

behaviors occur when using this strategy do not take a token away. Children lose

the trust you just built with them which reduces the effect and purpose of the

token economy system.

Non-contingent Escape and Differential Negative Reinforcement of Other Behaviors

One evidence-based practice that has been evaluated to decrease escape

maintained behaviors is differential reinforcement of an alternative behavior

(DRA). DRA increases the amount of desirable behaviors by reinforcing the child

while decreasing the occurrence of challenging behaviors. This creates an

opportunity for positive behaviors to occur and for the child to receive

reinforcement for displaying the desirable behavior. For proper implementation of

DRA interventionists/parents need to reinforce the positive behavior immediately

and on a regular basis. Challenging behaviors should not be reinforced. As

challenging behaviors decrease the interventionist/parent should decrease the

reinforcement of the positive behavior.

Differential reinforcement of other behavior (DRO) involves the

interventionist/parent delivering the child’s reinforcer after a specific allotted

amount of time where no challenging behavior occurs. According to Lomas,

Fisher, and Kelley (2010), “The time-based schedule should help to ensure that

the highly preferred stimulus is presented on a sufficiently dense schedule to

produce immediate reductions in problem behaviors” (p. 432). A baseline should

be determined according to the challenging behavior in order to find the

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appropriate length of time before a reinforcer is administered. The DRO should

be short when a challenging behavior occurs frequently. As the challenging

behavior decreases, the length between when the DRO is offered will increase

gradually. While implementing DRO, the interventionist/parent should have a

timer that signals to the child and interventionist/parent when to deliver the

reinforcer. It is important that the reinforcer is only delivered when a challenging

behavior is nonexistent within a specific allotted time. Lomas et al. (2010)

investigation “tested an alternative hypothesis, namely that the delivery of food

contingent on compliance may lessen the aversiveness of demands and lower

motivation for escape (i.e., food may act as an abolishing operation and lower the

effectiveness of escape as negative reinforcement for problem behavior)” (p.

431). After finding a highly motivating reinforcer, the desire to engage in escape

maintained behaviors in children with ASD can decrease.

According to a study completed by Kodak et al. (2003), it demonstrates

the significance of differential negative reinforcement of other behavior (DNRO)

approaches when decreasing escape-maintained behaviors transpiring when

demands are placed on the child. It serves as a reinforcer for the child when the

child is given a few seconds break from a task. A fixed-time schedule that is

gradually thinned also may decrease escape maintained behaviors. According to

Butler and Luiselli (2007), this strategy is described as providing the child with a

task to complete but allowing time-fixed non-contingent escape, the child taking a

break, and then going back to complete the task. This allows the child to tolerate

43

the task and decrease any escape behaviors.

Gradually the time between the breaks would increase as the child works

on a task for a lengthier time period before receiving his/her next break. When

implementing DNRO, the child must maintain positive behavior for an assigned

time period to receive a short break as reinforcement. The allotted amount of

time would need to restart if the challenging behavior occurs before the time is

completed. According to Kodak et al. (2003) study, it “found both DNRO and

NCE to be effective treatments for increasing compliance and decreasing

problem behavior” (p. 382). Research by Butler and Luiselli (2007), revealed

high-demand conditions modified by developing non-contingent escape while

scaffolding demands can effectively reduce the challenging and escape

maintained behaviors.

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CHAPTER FOUR

RESULTS

Findings

Many studies were reviewed and analyzed to determine what strategies

have been successful in decreasing challenging behaviors, especially escape

behaviors, in children with ASD. Interventionists/parents can decrease

challenging behaviors such as escape by implementing various strategies into

the child’s daily life. ABI strategies, such as: providing choices, highly preferred

activities/items, pre-activity interventions; and evidence-based practices, such as:

non-contingent escape and differential negative reinforcement of other behaviors,

functional behavior assessment and elapsation of time stimulus are proven to be

effective. As outlined previously, the antecedent-based interventions that have

data to prove they can be successful in decreasing escape maintained behaviors

include the following: modifying the complexity of task requirements to fit the

ability of the child, task variation such as embedding novel tasks into students

preferred activities or mastered tasks, decreasing instruction time keeping them

short and concise, providing each child with choices throughout their day,

arranging the child’s environment to keep environmental stimuli to a minimum,

introducing simple changes into the child’s routine or schedule, structuring time

for each individual so they are aware of the time they have to complete

activities/tasks, incorporating highly preferred activities/items into the child’s

45

curriculum, and pre-activity interventions. All of these strategies have been

researched to use for children with ASD and to successfully decrease

challenging behaviors. Antecedent-based interventions help prevent what may

be triggering the child’s behavior. Other evidenced-based strategies that are

scientifically proven to be effective among children with ASD include: antecedent

based intervention, functional behavior assessment, tolerance for delay,

elapsation of a time stimulus, and token economy systems/reinforcements, and

non-contingent escape and differential negative reinforcement of other behaviors.

There are advantages among implementing antecedent-based strategies.

One advantage is there are multiple strategies to attempt when addressing an

escape-maintained behavior. When working with an ASD child, one knows a

strategy may be successful one day but not the other. Interventionist/parents

should be familiar with multiple strategies in the event that any one strategy may

not be successful and another strategy can be applied. Another advantage to

using antecedent-based strategies is the interventionist/parent is able to apply

one or more of these strategies, which helps minimize the likelihood of the

behavior from occurring, decreasing the behaviors existence.

Interventionists/parents need to take into consideration that every child with ASD

has different needs and react to strategies in a different manner. In using these

strategies, a trial and error approach should be considered. What is successful

with one child with ASD might not be successful for another.

46

After reviewing several articles, most strategies researched are evidence-

based practices (EBP). This means there is scientific research to support these

specific practices showing they are effective and are successful to use with

children with ASD. Most studies used task analysis to take data and chart their

research. All strategies discussed are focused on children with ASD.

47

CHAPTER FIVE

DISCUSSION

Implications

The identification of antecedent-based strategies and evidenced-based

practices has evidence of efficacy when implementing these strategies for

children with ASD. There are various approaches in which an

interventionist/parent can implement these strategies into the child’s routine and

schedule to decrease challenging escape maintained behaviors. In this study,

multiple strategies were researched and proven to work successfully for children

with ASD. Whether the child is high functioning or more severe, most strategies

can be used and modified to the child’s ability level. It is imperative for

interventionists/parents to be aware that every child with ASD displays unique

characteristics therefore; some strategies may not benefit every child because

each child is affected by ASD in a different manner. The interventionist/parent

needs to observe the child’s cognitive level to deem which strategy is most

appropriate. Also, data should be taken over a few consecutive weeks to

determine what the antecedent is to the behavior and what is an appropriate

consequence following the behavior. When this is established,

interventionists/parents can decide what strategy will be appropriate and effective

in diminishing escape behaviors and will answer why the child is seeking these

types of behaviors. This means some strategies may not be appropriate, some

48

may need to be used individually, or some may even be combined with others,

which can lead to decreasing challenging and escape maintained behaviors.

Although, further effort is vital to gain a more comprehensive realization of

what is causing the behaviors to occur. The research indicates that using the

strategies such as; a token economy systems/reinforcements, allowing students

to make choices, decreasing the difficulty of task demands, embedding new

tasks within those formerly mastered, tolerance of delay, functional behavior

assessment, reducing time spent in instruction, and elapsation of time stimulus

and using DNRO or NCE may help decrease escape maintained behaviors in

children with ASD. Always remember when trying to decrease a challenging

behavior such as escape, another appropriate behavior should replace it.

Another study should be conducted to discover what the purpose of the behavior

is. It would be beneficial to determine the behaviors function to assist in

appropriately choosing the best strategy to decrease escape maintained

behaviors. It would also be beneficial to research replacement behaviors for

children with ASD who are displaying escape maintained behaviors. Lastly, to

narrow down what strategies would be most appropriate; more research should

be explored in being specific with what strategies are more effective within

different age ranges of children diagnosed with ASD.

49

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