Examining Procedural Variations of Delivering Competing Stimuli in the Treatment of Stereotypy.

Greenlee et al. (2024) compared two ways to give competing items during noncontingent reinforcement. One way rotated toys every few minutes. The other way kept the same toy but added a quick prompt like “play with this.”

Kids with autism tried both formats in an alternating-treatments design. The team tracked how much stereotypy happened under each setup.

Prompting kids to use the item beat simple rotation for two of four children. For the other two, both formats worked about the same.

No child did worse when prompts were added, so the extra instruction was low-risk.

Sasson et al. (2018) and Llinas et al. (2022) already showed that keeping one strong item beats rotating or thinning schedules. The new study keeps that single-item idea and adds a small prompt on top.

Rispoli et al. (2014) looks like it disagrees: they let kids “get their fill” of stereotypy right before group time and saw big drops. Their trick worked fast, but they only tested preschoolers. L et al. did not report age, so the clash is probably about different kids, not a true contradiction.

Verriden et al. (2025) ran a similar alternating design and also found that CSA-chosen items work best. Their paper focused on picking the right toy; the target paper shows that once you have it, a quick prompt can help even more.

If you already use noncontingent reinforcement for stereotypy, try adding a five-second prompt to “stack blocks” or “push car.” It costs nothing and helped half the kids in this study. Keep the item the child picked during your CSA; just remind them to use it.