A replication and extension of the augmented competing stimulus assessment

Frank-Crawford et al. (2023) tested a beefed-up competing stimulus assessment. They added two tricks: response-promotion (kids got praise and toys for touching the item) and response-disruption (the item was moved so the child had to reach for it).

The team worked with four children who had severe, treatment-resistant self-injury that ran on automatic reinforcement. Each child got a 5-minute alone test with every toy or object. Staff counted how often the child touched the item versus hit, bit, or scratched themselves.

Every child met at least one “high-competition” item. These items cut SIB by half or more during the short test.

The added response-promotion and disruption steps made the good items even clearer. Items that looked weak in a regular test became winners once the child had to work a little to get them.

van der Miesen et al. (2024) looked at 10 years of SIB studies and found most treatments work well, but the biggest gains come when caregivers run the plan at home. Frank-Crawford gives those caregivers a quick way to pick the best items before they start.

Hayes et al. (1975) stopped SIB cold with punishment. Frank-Crawford shows you can get big drops without punishment at all. The new method is safer and easier to use in schools or homes.

Taras et al. (1993) used “response satiation” — making kids play a lot while SIB stayed — and cut SIB a large share. Frank-Crawford flips the order: find the item that competes first, then let the child play. Both studies show that keeping hands busy with strong items shrinks automatic SIB.

If a child’s SIB has failed several plans, run the augmented competing stimulus assessment before adding new drugs or restraints. In under an hour you can hand parents a short list of “magic toys” that already cut the behavior in half. Start treatment with those items, collect data, and you have a quick win that buys time for deeper assessment or caregiver training.