Diaphragmatic breathing as treatment for escape‐maintained aggression
Belly breathing alone stopped escape aggression in only one of three kids—have DRO and FCT ready to add.
01Research in Context
What this study did
Three boys with autism who hit, kicked, or bit to get out of tasks worked with a therapist.
The therapist taught them to take slow belly breaths instead of giving the usual break.
No extra rewards were given; breathing was the only new tool.
What they found
Only one boy’s aggression dropped and stayed low with breathing alone.
The other two kept hitting until the team added DRO and FCT.
Breathing helped one kid; the rest needed a bigger plan.
How this fits with other research
Kodak et al. (2003) showed that giving kids breaks for any behavior except the problem (DNRO) or on a set schedule (NCE) cut escape behaviors fast. Phillips kept the escape but swapped the form—breathing instead of free time—so the weak result makes sense; the reinforcer stayed the same.
Eisenhower et al. (2006) used the same belly-breath drill to stop chronic belching in one adult and it worked perfectly. The difference: belching was kept going by internal air swallowing, not by outside escape, so changing the body response was enough.
Buitelaar et al. (1999) and Livingston et al. (2021) both added DRO and FCT when a single trick failed, just like Phillips had to do. The pattern is clear: when the reinforcer stays, add differential reinforcement and a new way to ask.
Why it matters
If you test breathing first, track data minute-by-minute. If aggression does not fall in one session, pivot fast—layer in DRO for not hitting and FCT for “I need a break.” Keep the belly breaths as a calm-down cue, not the whole treatment.
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02At a glance
03Original abstract
Coping skills, such as diaphragmatic breathing, are commonly recommended to help individuals work through challenging situations. We evaluated diaphragmatic breathing as treatment for aggression of three individuals diagnosed with autism spectrum disorder or Angelman syndrome. Functional analysis results demonstrated that each participant engaged in aggression maintained by social‐negative reinforcement. Diaphragmatic breathing treatment without extinction was conducted in a work context and involved prompting diaphragmatic breathing contingent on precursors to aggression; treatment was effective in reducing the rate of aggression for one of three participants. For the two other participants, other reinforcement‐based interventions (differential reinforcement of other behavior or functional communication training with extinction) were necessary to decrease aggression.
Behavioral Interventions, 2019 · doi:10.1002/bin.1663