Treatment of escape-maintained challenging behavior using chained schedules: an evaluation of the effects of thinning positive plus negative reinforcement during functional communication training

Zangrillo et al. (2016) tested a new twist on FCT for three children with autism. All kids had escape-maintained self-injury. The team first taught each child to ask for a break. Then they chained two schedules together. The child got a short break right away, but had to wait longer for the big break. Positive and negative reinforcement were thinned together.

The study ran in a therapy room. Sessions moved from dense reinforcement to lean chained schedules. Two weeks later they checked if the gains stuck. Finally they added extinction probes to see if problem behavior would return.

Chained-schedule FCT cut self-injury to near zero for all three children. The kids kept using their break requests. Gains lasted the full two-week follow-up. When the team later introduced extinction, problem behavior popped back up. This resurgence tells us the contingency still mattered.

Livingston et al. (2023) extended the same chained-schedule package to kids whose behavior was driven by both escape and tangible reinforcement. Their results matched: one streamlined FCT package worked for multiple functions. The 2023 study builds on Zangrillo’s escape-only case.

Fisher et al. (2020) and WFrazier et al. (2018) both saw the same resurgence Zangrillo found when extinction followed FCT. They added fixes: Fisher used a clear S-delta stimulus during extinction probes; WW kept FCT on a lean VR schedule longer. Both tweaks cut the later relapse.

Torelli et al. (2024) looks like a contradiction at first. They dropped extinction in public-school FCT and saw only mixed effects. Problem behavior stayed high for one student. The difference is setting and procedure: no extinction in a busy classroom versus full extinction in a controlled clinic. The papers disagree on method, not on FCT itself.

You can adopt chained-schedule thinning tomorrow for escape-only behavior. It keeps reinforcement dense at first, then stretches the wait time. Plan for resurgence: when you later probe extinction, problem behavior may spike. Add a clear S-delta card or keep FCT on a lean schedule longer to buffer the relapse. If the child has multiple functions, see Livingston et al. (2023) for a single-package fix.