Differential Reinforcement of Other Behavior (DRO)

Study: Kennedy & Haring (1993)

Study Type: Single-Subject Design

Participants: Convincing Evidence

Risk Status: Teachers identified whether students engaged in problem behavior that interfered with instruction, and reported students’ histories of engaging in problem behavior. All participants had severe intellectual disabilities.

Demographics:

 

Age/ Grade

Gender

Race-ethnicity

Socioeconomic status

Disability Status

ELL status

Other Relevant Descriptive Characteristics

Case 1: Debbie

19 years old

Female

Not reported

Not reported

Severe intellectual disability, “autistic-like behavior,” and cerebral palsy

Not reported

Debbie was estimated to be functioning at the 1.4 year-old level by the Vineland Adaptive Behavior Scales (VABS) and had an IQ of less than 20 as estimated by the Wechsler Intelligence Scale for Children – Revised (WISC-R). She was nonverbal but used three to five signs to indicate specific needs. At the time of the study, she had a 15-year history of screaming, hitting others, and tearing her clothes during instruction (Kennedy & Haring, 1993).

Case 2: Ed

19 years old

Male

Not reported

Not reported

Autism and severe intellectual disability

Not reported

Ed’s VABS scores indicated functioning at 5.5 years of age. According to the Peabody Picture Vocabulary Test, he was estimated to have a receptive vocabulary of 5.6 years of age. Ed could make and follow two step requests. He had a 10-year history of perseverative vocalizations, delayed echolalia, and stereotypic hand movements (Kennedy & Haring, 1993).

Case 3: Rick

21 years old

Male

Not reported

Not reported

Down syndrome and severe intellectual disability

Not reported

Rick’s adaptive behavior was estimated to be at the 3.2-year-old level by the VABS and his IQ was estimated to be 34 by the Leiter Developmental Scales. He used two-to five-word utterances to request and comment. He had approximately a 10-year history of emitting delayed echolalia and other stereotypic responses that interfered with instruction (Kennedy & Haring, 1993).

Training of Instructors: Instructors were not described.

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? Yes

If the study is a multiple baseline, is it concurrent? Not applicable

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

Rate of problem behavior (per minute)

Interobserver agreement was calculated for 25% of sessions across students and phases by dividing the number of agreements by agreements plus disagreements and multiplying by 100. Mean agreement of occurrence across behaviors was 93% (range, 82% to 100%). Mean agreement of nonoccurrence across behaviors was 89% (range, 79% to 98%).

Topographies of problem behaviors included screaming, hitting others, tearing clothing, perseverative verbalizations, delayed echolalia, stereotypy, and head weaving. These behaviors are considered relevant to the program’s focus.

N/A

 

Broader Measure

Reliability statistics

Relevance to program focus

Exposure to related support among control group

N/A

 

 

 

 

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:

Debbie: Rates of problem behavior were undifferentiated across tasks in baseline and were moderately high and stable. In the DRO method comparison, rates of problem behavior were initially moderately high across conditions. Rates of problem behavior were differentiated across conditions across subsequent sessions. After session four of ten, rates of problem behavior dropped to near-zero levels in the combined condition, where they remained. Rates of problem behavior in the combined condition did not overlap with rates in other conditions after session three. Rates increased and remained moderately high across sessions in the escape DRO condition, and were highest, most variable, and showed an increasing trend across the reward DRO condition. In the final phase, combined DRO was implemented across tasks. Initially, rates of problem behavior during tasks associated with other DRO conditions were high, but showed decreasing trends over the first three sessions in the final phase. In the combined DRO condition, rates of problem behavior remained at near-zero levels for the first two sessions, but increased briefly. Ultimately, rates of problem behavior dropped to near-zero levels across all three tasks and remained near zero for the final four data points, indicating combined DRO was effective regardless of task.

Ed: Rates of problem behavior were undifferentiated across tasks in baseline (showing significant overlap) and were moderately high and somewhat variable. In the DRO method comparison, rates of problem behavior were initially moderately high across conditions. Problem behavior showed a decreasing trend across all three DRO conditions for the first several sessions, until trends reversed in the escape and reward DRO conditions. Problem behavior in the combined DRO condition reached near-zero rates in the final five sessions of the comparison phase and remained low, with no overlap with other conditions. In the final phase, combined DRO was implemented across tasks. Rates of problem behavior dropped to near-zero levels across all three tasks and remained near zero for the final three data points, indicating combined DRO was effective regardless of task.

Rick: Rates of problem behavior were undifferentiated across tasks in baseline and were high and increasing in trend across all three tasks. In the DRO method comparison, rates of problem behavior initially overlapped across conditions. Rates of problem behavior increased across sessions in both the reward DRO and escape DRO conditions, and were highest in the reward DRO condition. However, rates of problem behavior in the combined DRO condition showed a steadily decreasing trend, and reached low rates and remained stable. Rates did not overlap across conditions. In the final phase in which combined DRO was implemented across tasks, rates of problem behavior during tasks associated with other DRO conditions were high, but showed decreasing trends across sessions. In the combined DRO condition, rates of problem behavior initially increased from previous levels (in the comparison phase) but decreased steadily back to low levels. Ultimately, rates of problem behavior were undifferentiated and showed decreasing trends as behavior reached low levels, indicating combined DRO was effective regardless of task.

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.