A comparison of differential reinforcement procedures for treating automatically reinforced behavior

Three kids with autism kept flapping, rocking, or humming during work time. The team wanted to know which works better without touching the child: DRA or DRO.

They flipped a coin each day to pick DRA or DRO. In DRA, the child earned a toy for every 10 seconds of quiet hands. In DRO, the child earned the same toy if no stereotypy happened during that 10 seconds. No one blocked the movements.

DRA won. Stereotypy dropped to almost zero, work time shot up to 80 percent, and tasks got finished twice as fast. DRO helped a little, but not nearly as much.

All three kids showed the same pattern. The team saw the change right away, within the first three sessions.

Williams et al. (1986) already showed that DRO can work without blocking, but they only tweaked the timing. Hedquist’s team goes further and says DRA beats DRO head-to-head.

Ohan et al. (2015) used DNRO to help a preschooler wear a medical bracelet. Like Hedquist, they skipped blocking and still saw big gains. Together, these studies tell us DR schedules can win even when we never lay a hand on the child.

Pilowsky et al. (1998) warns that thin schedules frustrate kids with ADHD. Hedquist’s kids had autism and got rich, immediate reinforcement, so the upbeat result fits: schedule thickness matters.

If your clinic bans blocking or you just don’t want to use it, choose DRA. Pick a simple, incompatible action like quiet hands, deliver a favorite item right away, and watch stereotypy fall while work rises. You can start Monday with a 10-second DRA schedule and a pocket full of mini-cars.