Brief functional analysis and treatment of bizarre vocalizations in an adult with schizophrenia.

Cullinan et al. (2001) worked with one adult who had schizophrenia. The man made odd sounds all day.

The team ran a five-minute test each day for one week. They watched what happened right before and after each sound.

They wanted to know if the sounds were kept going by staff attention.

Attention was the fuel. When staff looked, talked, or shushed, the sounds poured out.

They stopped giving attention for sounds and praised normal speech instead. The odd sounds dropped and real words grew.

Williams et al. (2002) later used the same quick test with two elders who had dementia. Attention again kept the sounds alive, but they chose non-contingent reinforcement instead of extinction. Both studies show the test works across diagnoses.

Liberman et al. (1973) did the same trick decades earlier. They cut off interviews the moment speech turned delusional and reopened them for rational talk. Their data set the stage for using extinction plus differential reinforcement in schizophrenia.

Jaffe et al. (2002) tried the test on vocal tics in Tourette’s. Reinforcement alone failed, but the team still used the same test–tweak–test cycle. The lesson: when the first plan flops, dig for odd variables like body position.

You can run a five-minute functional analysis even on an inpatient unit. If attention keeps the noise, stop feeding it and boost the words you want to hear. Try it Monday: count odd sounds for ten minutes, give attention only for clear requests, and watch the change.