Noncontingent reinforcement for the treatment of severe problem behavior: An analysis of 27 consecutive applications
NCR alone works fast for socially maintained severe behavior, but plan to add matched stimuli or DRO when the behavior is automatic.
01Research in Context
What this study did
Phillips and team looked back at 27 kids who got noncontingent reinforcement (NCR) for severe problem behavior. All kids had intellectual or developmental disabilities. Each child first had a full functional analysis to see if the behavior was social or automatic. Then staff gave the reinforcer on a fixed-time schedule no matter what the child did.
What they found
NCR alone worked for 14 of the the kids whose behavior was social. The behavior dropped fast and stayed low. For the the kids with automatic reinforcement, NCR rarely worked by itself. Most of those cases needed extra help like response blocking or matched toys.
How this fits with other research
Llinas et al. (2022) extends this picture. They showed that continuous access to matched toys beats lean FT schedules for automatically maintained stereotypy. That gives you a clear next step when Phillips tells you NCR alone is not enough.
Wilder et al. (2023) adds another tool. They found momentary DRO schedules work just as well as NCR for automatic cases. If caregivers want something simple, you can switch to FM-DRO and still see big drops.
Peters et al. (2013) helps you spot the difference fast. Their 5-minute alone probe correctly flags automatic cases a large share of the time. Run the probe first so you know right away whether to start NCR alone or plan add-ons.
Why it matters
You no longer have to guess if NCR will be enough. Run a brief alone condition. If the behavior is social, move ahead with NCR on a fixed-time schedule. If it is automatic, pair the schedule with continuous matched stimuli or switch to momentary DRO. This saves weeks of failed treatment and keeps caregivers on board.
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02At a glance
03Original abstract
Noncontingent reinforcement (NCR) is a commonly used treatment for severe problem behavior displayed by individuals with intellectual and developmental disabilities. The current study sought to extend the literature by reporting outcomes achieved with 27 consecutive applications of NCR as the primary treatment for severe problem behavior. All applications of NCR were included regardless of treatment outcome to minimize selection bias favoring successful cases. Participants ranged in age from 5 to 33 years. We analyzed the results across behavioral function and with regard to the use of functional versus alternative reinforcers. NCR effectively treated problem behavior maintained by social reinforcement in 14 of 15 applications, using either the functional reinforcer or alternative reinforcers. When we implemented NCR to treat problem behavior maintained by automatic reinforcement, we often had to add other treatment components to produce clinically significant effects (five of nine applications). Results provide information on the effectiveness and limitations of NCR as treatment for severe problem behavior.
Journal of Applied Behavior Analysis, 2017 · doi:10.1002/jaba.376