Differential Reinforcement of Other Behavior (DRO)
Study: Kennedy & Haring (1993)

Summary

Differential reinforcement of other behavior (DRO) is a treatment that requires delivering reinforcement contingent on the nonoccurrence or absence of problem behavior during a pre-specified interval of time. Reinforcers are typically identified via functional assessment, but rewards identified using preference assessment, teacher report, student selection, or other indirect means are sometimes substituted for reinforcers.

Target Grades:
K, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12
Target Populations:
  • Students with disabilities only
  • Students with learning disabilities
  • Students with intellectual disabilities
  • Students with emotional or behavioral disabilities
  • English language learners
  • Any student at risk for emotional and/or behavioral difficulties
Area(s) of Focus:
  • Physical Aggression
  • Verbal Threats
  • Property Destruction
  • Noncompliance
  • High Levels of Disengagement
  • Disruptive Behavior
  • Social Behavior (e.g., Peer interactions, Adult interactions)
  • Other: stereotypy (e.g., body rocking, tics)
Where to Obtain:
N/A
Initial Cost:
Free
Replacement Cost:
Contact vendor for pricing details.

No costs are associated with the use of DRO except for the costs of reinforcers/rewards and a timer.

Staff Qualified to Administer Include:
  • Special Education Teacher
  • General Education Teacher
  • Reading Specialist
  • Math Specialist
  • EL Specialist
  • Interventionist
  • Student Support Services Personnel (e.g., counselor, social worker, school psychologist, etc.)
  • Applied Behavior Analysis (ABA) Therapist or Board Certified Behavior Analyst (BCBA)
  • Paraprofessional
  • Other:
Training Requirements:
Less than 1 hour of training

Training procedures were typically not described, but likely included an explanation of the rationale for DRO, procedures to apply when target behaviors occurred, and procedures for delivering reinforcers or rewards when target behaviors did not occur during an interval.


n/a

Access to Technical Support:
Not available
Recommended Administration Formats Include:
  • Individual students
  • Small group of students
Minimum Number of Minutes Per Session:
Minimum Number of Sessions Per Week:
Minimum Number of Weeks:
Detailed Implementation Manual or Instructions Available:
No
Is Technology Required?
  • Other technology: A timing device that may be set and re-set is the only technology necessary to implement DRO.

Program Information

Descriptive Information

Please provide a description of program, including intended use:

Differential reinforcement of other behavior (DRO) is a treatment that requires delivering reinforcement contingent on the nonoccurrence or absence of problem behavior during a pre-specified interval of time. Reinforcers are typically identified via functional assessment, but rewards identified using preference assessment, teacher report, student selection, or other indirect means are sometimes substituted for reinforcers.

The program is intended for use in the following age(s) and/or grade(s).

not selected Age 0-3
not selected Age 3-5
selected Kindergarten
selected First grade
selected Second grade
selected Third grade
selected Fourth grade
selected Fifth grade
selected Sixth grade
selected Seventh grade
selected Eighth grade
selected Ninth grade
selected Tenth grade
selected Eleventh grade
selected Twelth grade


The program is intended for use with the following groups.

selected Students with disabilities only
selected Students with learning disabilities
selected Students with intellectual disabilities
selected Students with emotional or behavioral disabilities
selected English language learners
not selected Any student at risk for academic failure
selected Any student at risk for emotional and/or behavioral difficulties
not selected Other
If other, please describe:

ACADEMIC INTERVENTION: Please indicate the academic area of focus.

Early Literacy

not selected Print knowledge/awareness
not selected Alphabet knowledge
not selected Phonological awareness
not selected Phonological awarenessEarly writing
not selected Early decoding abilities
not selected Other

If other, please describe:

Language

not selected Expressive and receptive vocabulary
not selected Grammar
not selected Syntax
not selected Listening comprehension
not selected Other
If other, please describe:

Reading

not selected Phonological awareness
not selected Phonics/word study
not selected Comprehension
not selected Fluency
not selected Vocabulary
not selected Spelling
not selected Other
If other, please describe:

Mathematics

not selected Computation
not selected Concepts and/or word problems
not selected Whole number arithmetic
not selected Comprehensive: Includes computation/procedures, problem solving, and mathematical concepts
not selected Algebra
not selected Fractions, decimals (rational number)
not selected Geometry and measurement
not selected Other
If other, please describe:

Writing

not selected Handwriting
not selected Spelling
not selected Sentence construction
not selected Planning and revising
not selected Other
If other, please describe:

BEHAVIORAL INTERVENTION: Please indicate the behavior area of focus.

Externalizing Behavior

selected Physical Aggression
selected Verbal Threats
selected Property Destruction
selected Noncompliance
selected High Levels of Disengagement
selected Disruptive Behavior
selected Social Behavior (e.g., Peer interactions, Adult interactions)
selected Other
If other, please describe:
stereotypy (e.g., body rocking, tics)

Internalizing Behavior

not selected Depression
not selected Anxiety
not selected Social Difficulties (e.g., withdrawal)
not selected School Phobia
not selected Other
If other, please describe:

Acquisition and cost information

Where to obtain:

Address
Phone Number
Website

Initial cost for implementing program:

Cost
$0.00
Unit of cost

Replacement cost per unit for subsequent use:

Cost
Unit of cost
Duration of license

Additional cost information:

Describe basic pricing plan and structure of the program. Also, provide information on what is included in the published program, as well as what is not included but required for implementation (e.g., computer and/or internet access)

No costs are associated with the use of DRO except for the costs of reinforcers/rewards and a timer.

Program Specifications

Setting for which the program is designed.

selected Individual students
selected Small group of students
not selected BI ONLY: A classroom of students

If group-delivered, how many students compose a small group?

   Up to five students may comprise a small group.

Program administration time

Minimum number of minutes per session
Minimum number of sessions per week
Minimum number of weeks
selected N/A (implemented until effective)

If intervention program is intended to occur over less frequently than 60 minutes a week for approximately 8 weeks, justify the level of intensity:

Does the program include highly specified teacher manuals or step by step instructions for implementation?
No

BEHAVIORAL INTERVENTION: Is the program affiliated with a broad school- or class-wide management program?
No

If yes, please identify and describe the broader school- or class-wide management program:

Does the program require technology?
Yes

If yes, what technology is required to implement your program?
not selected Computer or tablet
not selected Internet connection
selected Other technology (please specify)

If your program requires additional technology not listed above, please describe the required technology and the extent to which it is combined with teacher small-group instruction/intervention:
A timing device that may be set and re-set is the only technology necessary to implement DRO.

Training

How many people are needed to implement the program ?
1

Is training for the instructor or interventionist required?
Yes
If yes, is the necessary training free or at-cost?
Free

Describe the time required for instructor or interventionist training:
Less than 1 hour of training

Describe the format and content of the instructor or interventionist training:
Training procedures were typically not described, but likely included an explanation of the rationale for DRO, procedures to apply when target behaviors occurred, and procedures for delivering reinforcers or rewards when target behaviors did not occur during an interval.

What types or professionals are qualified to administer your program?

selected Special Education Teacher
selected General Education Teacher
selected Reading Specialist
selected Math Specialist
selected EL Specialist
selected Interventionist
selected Student Support Services Personnel (e.g., counselor, social worker, school psychologist, etc.)
selected Applied Behavior Analysis (ABA) Therapist or Board Certified Behavior Analyst (BCBA)
selected Paraprofessional
not selected Other

If other, please describe:

Does the program assume that the instructor or interventionist has expertise in a given area?
No   

If yes, please describe: 


Are training manuals and materials available?
No

Describe how the training manuals or materials were field-tested with the target population of instructors or interventionist and students:
n/a

Do you provide fidelity of implementation guidance such as a checklist for implementation in your manual?

Can practitioners obtain ongoing professional and technical support?
No

If yes, please specify where/how practitioners can obtain support:

Summary of Evidence Base

Please identify, to the best of your knowledge, all the research studies that have been conducted to date supporting the efficacy of your program, including studies currently or previously submitted to NCII for review. Please provide citations only (in APA format); do not include any descriptive information on these studies. NCII staff will also conduct a search to confirm that the list you provide is accurate.

Barrett, R. P., Payton, J. B., & Burkhart, J. E. (1988). Treatment of self-injury and disruptive behavior with carbamazepine (tegretol) and behavior therapy. Journal of the Multihandicapped Person, 1, 79-91.

 

Barton, L. E., & LaGrow, S. J. (1985). Reduction of stereotypic responding in three visually impaired children. Education of the Visually Handicapped, 16, 145-151.

 

Bergstrom, R., Tarbox, J., & Gutshall, K. A. (2011). Behavioral intervention for domestic pet mistreatment in a young child with autism. Research in Autism Spectrum Disorders, 5, 218-221.

 

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.

 

Daddario, R., Anhalt, K., & Barton, L. E. Differential reinforcement of other behavior applied classwide in a childcare setting. International Journal of Behavioral Consultation and Therapy, 3, 342-348.

 

Didden, R., de Moor, J., & Bruyns, W. (1997). Effectiveness of DRO tokens in decreasing disruptive behavior in the classroom with five multiply handicapped children. Behavioral Interventions, 12, 65-75.

 

Figueroa, R. G., Thyer, B. A., & Thyer, K. B. (1992). Extinction and DRO in the treatment of aggression in a boy with severe mental retardation. Journal of Behavior Therapy and Experimental Psychiatry, 23, 133-140.

 

Flood, W. A., & Wilder, D. A. (2004). The use of differential reinforcement and fading to increase time away from a caregiver in a child with separation anxiety disorder. Education & Treatment of Children, 27, 1-8.

 

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.

 

Haring, T. G., Breen, C. G., Pitts-Conway, V., & Gaylord-Ross, R. (1986). Use of differential reinforcement of other behavior during dyadic instruction to reduce stereotyped behavior of autistic students. American Journal of Mental Deficiency, 90, 694-702.

 

Haring, T. G., & Kennedy, C. H. (1990). Contextual control of problem behavior in students with severe disabilities. Journal of Applied Behavior Analysis, 23, 235-243.

 

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.

 

Kennedy, C. H., & Haring, T. G. (1993). Combining reward and escape DRO to reduce the problem behavior of students with severe disabilities. Journal of the Association for Persons with Severe Handicaps, 18, 85-92.

 

Kodak, T., Miltenberger, R. G., & Romaniuk, C. (2003). A comparison of differential reinforcement and noncontingent reinforcement for the treatment of a child's multiply controlled problem behavior. Behavioral Interventions, 18, 267-278.

 

Luiselli, J. K. (1990). Reinforcement control of assaultive behavior in a sensory impaired child. Behavioral Residential Treatment, 5, 45-53.

 

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.

 

Lustig, N. H., Ringdahl, J. E., Breznican, G., Romani, P., Scheib, M., & Vinquist, K. (2014). Evaluation and treatment of socially inappropriate stereotypy. Journal of Developmental and Physical Disabilities, 26, 225-235

Study Information

Study Citations

Kennedy, C. H. & Haring, T. G. (1993). Combining reward and escape DRO to reduce the problem behavior of students with severe disabilities.. Journal of the Association of Persons with Severe Handicaps, 18() 85-92.

Participants Full Bobble

Describe how students were selected to participate in the study:
Participants were identified by their special education teachers as students who engaged in problem behavior at a level that interfered with instruction and required intervention. Teachers also completed the Motivation Assessment Scale (MAS; Durand & Crimmins, 1988) for each student and problem behavior. Results were used to identify topographies of problem behavior potentially related to instructional demands (i.e., scores for escape motivation were at least 30% higher than other subscales).

Describe how students were identified as being at risk for academic failure (AI) or as having emotional/behavioral difficulties (BI):
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.

ACADEMIC INTERVENTION: What percentage of participants were at risk, as measured by one or more of the following criteria:
  • below the 30th percentile on local or national norm, or
  • identified disability related to the focus of the intervention?
%

BEHAVIORAL INTERVENTION: What percentage of participants were at risk, as measured by one or more of the following criteria:
  • emotional disability label,
  • placed in an alternative school/classroom,
  • non-responsive to Tiers 1 and 2, or
  • designation of severe problem behaviors on a validated scale or through observation?
%

Provide a description of the demographic and other relevant characteristics of the case used in your study (e.g., student(s), classroom(s)).

Case (Name or number) Age/Grade Gender Race / Ethnicity Socioeconomic Status Disability Status ELL status Other Relevant Descriptive Characteristics
test test test test test test test test

Design Full Bobble

Please describe the study design:
A three-part multielement design was used to evaluate the effects of different DRO procedures across tasks for each participant. An initial multielement design was utilized to demonstrate that problem behavior occurred at comparable levels across tasks during a baseline phase. A second multielement design was used to compare the effects of DRO tasks across three different reinforcers/rewards (i.e., escape, reward, and combined). A final multielement phase was used to demonstrate the efficacy across tasks of the most effective procedure from the comparison phase. A Latin square counterbalancing of tasks and DRO conditions across students was employed so that no single DRO condition was associated with a specific task.

Clarify and provide a detailed description of the treatment in the submitted program/intervention:
Three variations on DRO were evaluated across three tasks including shelving books, straightening chairs, and sorting dishes. Escape DRO: Duration of tasks varied as a function of the omission of problem behavior in escape DRO. Tokens were earned for omitting problem behavior for the duration of an instructional trial (i.e., 15 s). Once 10 tokens were earned, the instructional task was terminated. Sessions lasted a maximum of 10 min (i.e., sessions were terminated when either 10 tokens were earned or 10 min had elapsed). During breaks following token exchange, students sat at a table for 10 min before beginning the next session. Verbal praise was delivered for completion of demands throughout sessions. Reward DRO: Tokens were earned for omitting problem behavior for the duration of an instructional trial (i.e., 15 s). A reward was earned if a student accumulated 10 tokens by the end of the task. Rewards were selected individually for each student by teacher nominations of preferred, age-appropriate activities. All sessions lasted 10 min, regardless of whether 10 tokens were earned. When 10 tokens were not earned, students were asked to sit at a table for 10 min until the next session began. Verbal praise was delivered for completion of demands throughout sessions. Combined DRO: The contingencies in both the escape and reward DRO conditions were combined. Students earned tokens for the omission of problem behavior for the length of an instructional trial (15 s). Once 10 tokens were accumulated, the session was terminated and the student-specific reward from the reward DRO condition was delivered. Sessions were terminated if 10 min elapsed before 10 tokens were earned.

Clarify what procedures occurred during the control/baseline condition (third, competing conditions are not considered; if you have a third, competing condition [e.g., multi-element single subject design with a third comparison condition], in addition to your control condition, identify what the competing condition is [data from this competing condition will not be used]):
Baseline: Each session lasted for 10 min and a 10-min interval occurred between sessions. During instruction, students received praise when they completed a trial. Problem behavior was ignored. Following completion of a task, students were asked to take a “break” and sit in a chair at a table.

Please describe how replication of treatment effect was demonstrated (e.g., reversal or withdrawal of intervention, across participants, across settings)
Effect was demonstrated via rapid alternation of conditions, with task randomly assigned to conditions (multielement design). Design included a baseline comparison across tasks as well as a comparison of the effects of the most effective treatment on problem behavior across tasks to control for task as a rival explanation for differences in level of problem behavior.

Please indicate whether (and how) the design contains at least three demonstrations of experimental control (e.g., ABAB design, multiple baseline across three or more participants).
The design contains at least three demonstrations of experimental control. In the multielement condition comparing DRO procedures to one another, 7-10 comparisons between the combined DRO conditions (most effective for all participants) and the second-most effective alternative condition were present.

If the study is a multiple baseline, is it concurrent or non-concurrent?
N/A

Fidelity of Implementation Empty Bobble

How was the program delivered?
selected Individually
not selected Small Group
not selected Classroom

If small group, answer the following:

Average group size
Minimum group size
Maximum group size

What was the duration of the intervention (If duration differed across participants, settings, or behaviors, describe for each.)?

Condition A
Weeks
3.50
Sessions per week
4.00
Duration of sessions in minutes
10.00
Condition B
Weeks
2.00
Sessions per week
4.00
Duration of sessions in minutes
10.00
Condition C
Weeks
Sessions per week
Duration of sessions in minutes
What were the background, experience, training, and ongoing support of the instructors or interventionists?
Instructors were not described.

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

What were the results on the fidelity-of-treatment implementation measure?
Fidelity of treatment data were not reported.

Was the fidelity measure also used in baseline or comparison conditions?
Fidelity of treatment data were not reported.

Measures and Results

Measures Targeted : Full Bobble
Measures Broader : Dash

Study measures are classified as targeted, broader, or administrative data according to the following definitions:

  • Targeted measures
    Assess outcomes, such as competencies or skills, that the program was directly targeted to improve.
    • In the academic domain, targeted measures typically are not the very items taught but rather novel items structured similarly to the content addressed in the program. For example, if a program taught word-attack skills, a targeted measure would be decoding of pseudo words. If a program taught comprehension of cause-effect passages, a targeted measure would be answering questions about cause-effect passages structured similarly to those used during intervention, but not including the very passages used for intervention.
    • In the behavioral domain, targeted measures evaluate aspects of external or internal behavior the program was directly targeted to improve and are operationally defined.
  • Broader measures
    Assess outcomes that are related to the competencies or skills targeted by the program but not directly taught in the program.
    • In the academic domain, if a program taught word-level reading skill, a broader measure would be answering questions about passages the student reads. If a program taught calculation skill, a broader measure would be solving word problems that require the same kinds of calculation skill taught in the program.
    • In the behavioral domain, if a program taught a specific skill like on-task behavior in one classroom, a broader measure would be on-task behavior in another setting.
  • Administrative data measures apply only to behavioral intervention tools and are measures such as office discipline referrals (ODRs) and graduation rates, which do not have psychometric properties as do other, more traditional targeted or broader measures.
Targeted Measure Reverse Coded? Evidence Relevance
Targeted Measure 1 Yes A1 A2
Broader Measure Reverse Coded? Evidence Relevance
Broader Measure 1 Yes A1 A2
Administrative Data Measure Reverse Coded? Relevance
Admin Measure 1 Yes A2
If you have excluded a variable or data that are reported in the study being submitted, explain the rationale for exclusion:

Results Full Bobble

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

Please present results in terms of within and between phase patterns. Data on the following data characteristics must be included: level, trend, variability, immediacy of the effect, overlap, and consistency of data patterns across similar conditions. Submitting only means and standard deviations for phases is not sufficient. Data must be included for each outcome measure (targeted, broader, and administrative if applicable) that was described above.
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 reach 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.

Additional Research

Is the program reviewed by WWC or E-ESSA?
No
Summary of WWC / E-ESSA Findings :

What Works Clearinghouse Review

This program was not reviewed by What Works Clearinghouse.

How many additional research studies are potentially eligible for NCII review?
6
Citations for Additional Research 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.

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