Treatment of resistance to change in children with autism
Add escape extinction to DRA when clients with autism resist change—prompted choices plus reinforcement quickly established tolerance and selection of the alternative.
01Research in Context
What this study did
Fisher and colleagues worked with children with autism who melted down when activities changed.
They paired two tactics: DRA (reinforcing a new choice) and escape extinction (blocking leave-taking).
The team wanted to see if kids would start picking the new activity on their own.
What they found
Every child learned to tolerate or even choose the change when both tactics were in place.
Later the staff dropped escape extinction and kept only DRA; two kids still made the new choice.
The combo gave quick gains and partial lasting control.
How this fits with other research
Briggs et al. (2019) removed escape extinction and still cut problem behavior, but they had to jack up reinforcer size and quality.
Brown et al. (2020) later showed that skipping extinction keeps resurgence risk the same later, even if behavior looks better during treatment.
Staddon et al. (2002) first showed the same DRA-plus-extinction recipe works for food refusal, so Fisher’s team simply moved the package from meals to schedule shifts.
Why it matters
If your client stalls or explodes at every transition, run DRA plus escape extinction for a week or two. Prompt the alternative response, block escape, and deliver big praise for staying put. Once the child consistently chooses the new task, try fading the physical blocks and keep the reinforcement flowing. You may keep the gains with less intrusive support.
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02At a glance
03Original abstract
"Resistance to change" represents a core symptom of autism that we conceptualized and assessed as resulting in part due to factors known to govern free-operant choice. During a free-choice baseline, participants chose between problematic, resistive responses and an appropriate alternative response. During the asymmetrical-choice condition, we delivered their most highly preferred item if the participant chose the alternative response (i.e., differential reinforcement of alternative behavior [DRA]). During the guided- (Experiment 1) and singular- (Experiment 2) choice conditions, we prompted participants to choose the alternative response and then delivered their most highly preferred item (i.e., DRA with escape extinction). All participants learned to tolerate (Experiment 1) or choose (Experiment 2) the alternative response when we combined DRA with escape extinction. After exposure to escape extinction, two participants showed strong maintenance effects with DRA alone. We discuss these finding relative to the effects of DRA and escape extinction on resistance to change.
Journal of Applied Behavior Analysis, 2019 · doi:10.1002/jaba.588