ABA Fundamentals

Analyzing Consequence Variables Within the High-Probability Instructional Sequence for a Child Diagnosed With CHARGE Syndrome

Davis et al. (2021) · Behavior Analysis in Practice 2021
★ The Verdict

Let the child choose the reinforcer before you run a high-p sequence and compliance stays high.

✓ Read this if BCBAs working with children who have multiple disabilities and low compliance.
✗ Skip if Practitioners already getting strong compliance with standard praise or edibles.

01Research in Context

01

What this study did

Davis et al. (2021) worked with one child who has CHARGE syndrome. The team wanted better compliance with tough requests.

They used a high-probability sequence. First they asked the child to do three easy tasks. Then they gave one hard task. They tested three reinforcers: praise, tiny candy, and the child's favorite music video.

02

What they found

Praise and candy worked at first, then faded fast. The music video kept compliance high across every session.

The team ran a quick choice test before each session. The child picked the video every time. That single reinforcer held the whole program together.

03

How this fits with other research

Rosales et al. (2021) tried the same high-p sequence with three autistic kids. They used standard praise and edibles. Two kids showed only modest gains; the third needed extra differential reinforcement. Davis adds one step: a presession choice assessment. That tiny add-on flipped the outcome from mixed to strong.

Wanchisen et al. (1989) first showed that letting the child pick the reinforcer before class wipes out non-compliance. Davis moves that idea into the high-p sequence and shows it still works for a child with visual and hearing challenges.

Penrod et al. (2012) and Meier et al. (2012) used high-p sequences for feeding without preference checks. Davis shows the same tactic works for general compliance if you first ask, 'What do you want right now?'

04

Why it matters

Next time you set up a high-p sequence, spend two minutes on a choice assessment. Lay out three options, let the child pick, and use that item after the low-p request. You may turn a shaky procedure into a solid one. One child, one reinforcer, one extra step—big jump in compliance.

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Run a 2-minute choice assessment, then deliver the top pick right after the low-p request.

02At a glance

Intervention
other
Design
changing criterion
Sample size
1
Population
developmental delay, other
Finding
positive
Magnitude
large

03Original abstract

Many individuals with developmental disabilities exhibit noncompliance during intensive instruction. As a treatment for noncompliance, the high-probability instructional sequence (high-p sequence) consists of delivering several high-p instructions before a low-p instruction. The purpose of this study was to extend the research on comparing consequences for high-p demands—namely, praise, edibles, and videos—with an 11-year-old girl diagnosed with CHARGE syndrome. CHARGE syndrome is a rare medical condition often resulting in multisensory impairments and developmental delays. In Treatment Analysis 1, we compared praise versus edibles as consequences for compliance with high- and low-p instructions. Results showed the edibles were initially more effective than praise, but the effects did not maintain. In Treatment Analysis 2, we changed the consequence for compliance with high- and low-p instructions to a music video and then attempted to fade the number of high-p instructions. We replicated the efficacy of the high-p sequence but failed to fade the number of high-p instructions and failed to achieve maintenance. Therefore, in Treatment Analysis 3, we conducted presession preference assessments of music videos in order to use a selected video as the consequence for compliance. This “varied reinforcement” intervention resulted in high levels of compliance. Results are discussed in terms of motivating operations and recommendations for practice.

Behavior Analysis in Practice, 2021 · doi:10.1007/s40617-020-00524-w