Competition and preference in the treatment of automatically reinforced challenging behavior

Verriden et al. (2025) worked with five kids with autism who hit, bit, or rocked for automatic reinforcement. The team compared two ways to pick items for noncontingent reinforcement: a competing-stimulus assessment and a paired-stimulus preference assessment.

They ran an alternating-treatments design. Some days the child got nonstop access to items the CSA said would compete with the sensory payoff. Other days they got items the PSPA said the child liked best. The team tracked challenging behavior and also tried DRO for two kids.

NCR cut challenging behavior for four of the five kids. In three of those four, CSA-selected items worked better than PSPA items. When the team added DRO, two kids improved with only small differences between item types.

Bottom line: CSA gave better toys for NCR most of the time.

Rooker et al. (2018) reviewed 33 years of self-injury studies and already said CSA beats PSPA for NCR. The new experiment gives fresh single-case proof that matches that big picture.

Sasson et al. (2018) showed single-item access after CSA works best for skin picking. Verriden et al. now show CSA items also beat PSPA items for broader challenging behavior.

Phillips et al. (2017) warned that automatic cases often need extra help beyond NCR. Verriden et al. confirm this: one child needed DRO added before behavior dropped.

Stop skipping the CSA when the behavior is automatic. Run a quick competing-stimulus assessment, pick the top one or two items, and give free access. If progress stalls, layer in DRO while keeping the CSA items. This small shift can save you weeks of rotating toys that do little.