Differential Reinforcement of Other Behavior (DRO)

Study: Luiselli, Helfen, Colozzi, Donellon, & Pemberton (1978)

Study Type: Single-Subject Design

Participants: Convincing Evidence

Risk Status: Participant had a diagnosis of moderate intellectual disability. He engaged in hand biting that was causing irritation and abrasion to his hands, as well as disrupting learning. Hand biting occurred at high rates across classroom settings and was recorded with a frequency counter each time any part of his hand was in his mouth.



Age/ Grade



Socioeconomic status

Disability Status

ELL status

Other Relevant Descriptive Characteristics

Case 1: Mac

10 years old


Not reported

Not reported

Moderate intellectual disability

Not reported

Mac was enrolled in a public school special education classroom with nine other students. Classroom instruction was directed at developing functional language, self-care, and academic skills (Luiselli et al., 1978).

Training of Instructors: Interventionists were classroom teachers. Information about teacher background, experience, training, and ongoing support was not reported.

Design: Convincing Evidence

Does the study include three data points or sufficient number to document a stable performance within that phase? Yes

Is there opportunity for at least three demonstrations of experimental control? Yes

If the study is an alternating treatment design, are there five repetitions of the alternating sequence? Not applicable

If the study is a multiple baseline, is it concurrent? Yes

Implemented with Fidelity: Unconvincing Evidence

Description of when and how fidelity of treatment information was obtained: Fidelity of treatment data were not reported.

Results on the fidelity of treatment implementation measure: Fidelity of treatment data were not reported.

Measures Targeted: Convincing Evidence

Targeted Measure

Reliability statistics

Relevance to program focus

Exposure to related support among control group

Hand bites per 10 min

Interbserver agreement was calculated at least once per experimental phase (baseline and treatment) per setting/context using total agreement ([smaller count/larger count]*100). Interobserver agreement was 100% for the language setting, 100% for the prewriting setting, and 91.6% for the shoe-tying setting.

Hand-biting was the intervention targeted for reduction by the DRO treatment. Self-injurious behavior is considered relevant to the program’s focus.



Broader Measure

Reliability statistics

Relevance to program focus

Exposure to related support among control group






Mean ES Targeted Outcomes: N/A

Mean ES Administrative Outcomes: N/A

Effect Size:

Visual Analysis (Single-Subject Designs): Convincing Evidence

Description of the method of analyses used to determine whether the intervention condition improved relative to baseline phase (e.g. visual analysis, computation of change score, mean difference): Visual inspection.

Results in terms of within and between phase patterns: During baseline conditions across settings, mean hand bites were moderately high and variable. In the shoe-tying setting, a counter-therapeutic trend in hand-biting was apparent throughout baseline. When the DRO procedures were introduced in each respective setting, immediate reductions in both level and variability of hand-biting were apparent, and hand-biting decreased in trend as treatment conditions progressed. As DRO was introduced in each setting, baseline levels remained moderately high and variable in settings in which DRO had not yet been introduced. Ultimately, hand-biting decreased to near zero levels in DRO conditions across the three settings. Three demonstrations of effect were evident.

Disaggregated Outcome Data Available for Demographic Subgroups: No

Target Behavior(s): Externalizing

Delivery: Individual, Small groups (n<6)

Fidelity of Implementation Check List Available: No

Minimum Interventionist Requirements: Paraprofessional, No training required

Intervention Reviewed by What Works Clearinghouse: No

What Works Clearinghouse Review

This program was not reviewed by What Works Clearinghouse.

Other Research: Potentially Eligible for NCII Review: 6 studies

Call, N. A., Pabico, R. S., Findley, A. J., & Valentino, A. L. (2011). Differential Reinforcement with and without Blocking as Treatment for Elopement. Journal of Applied Behavior Analysis, 44, 903-907.

Conyers, C., Miltenberger, R. G., Maki, A., Barenz, R., Jurgens, M., Sailer, A., & Kopp, B. (2004). A Comparison of Response Cost and Differential Reinforcement of Other Behavior to Reduce Disruptive Behavior in a Preschool Classroom. Journal of Applied Behavior Analysis, 37, 411-415.

Foxx, R. M., McMorrow, M. J., Fenlon, S., & Bittle, R. G. (1986). The Reductive Effects of Reinforcement Procedures on the Genital Stimulation and Stereotypy of a Mentally Retarded Adolescent Male. Analysis & Intervention in Developmental Disabilities, 6, 239-248.

Grauvogel-MacAaleese, A., & Wallace, M. D. (2010). Use of Peer-Mediated Intervention in Children with Attention Deficit Hyperactivity Disorder. Journal of Applied Behavior Analysis, 43, 547-551.

Himle, M. B., Woods, D. W., & Bunaciu, L. (2008). Evaluating the Role of Contingency in Differentially Reinforced Tic Suppression. Journal of Applied Behavior Analysis, 41, 285-289.

Luiselli, J. K., Helfen, C. S., Colozzi, G., Donellon, S., & Pemberton, B. (1978). Controlling Self-Inflicted Biting of a Retarded Child by the Differential Reinforcement of Other Behavior. Psychological Reports, 42, 435-438.