Service Delivery

Reduction of severe behavior problems in the community using a multicomponent treatment approach.

Carr et al. (1993) · Journal of applied behavior analysis 1993
★ The Verdict

A five-part FCT package erased severe store meltdowns and still guides parent-led and telehealth models today.

✓ Read this if BCBAs sending clients into stores, restaurants, or any crowded public place.
✗ Skip if Clinicians who only serve in highly controlled clinic rooms with zero community outings.

01Research in Context

01

What this study did

The team worked with people who have developmental delays. All showed loud, scary behavior in grocery stores.

They blended five tools: choice making, task embedding, FCT, waiting practice, and clear cues for good behavior. Sessions happened during real shopping trips.

02

What they found

Problem behavior almost vanished. Shoppers finished more items and stayed calm for longer stretches.

Store staff and cashiers later said the trips looked normal and felt safe.

03

How this fits with other research

Nevill et al. (2019) later moved the same mix into family homes. Parents, not store clerks, ran the plan and still saw big drops in severe behavior.

Corr et al. (2025) pooled six big reviews and found FCT keeps cutting classroom problem behavior decades later. Their mega-review counts this 1993 market test as an early brick in the wall.

Dougherty et al. (1994) showed that when one hit gets you two things, you need two different mands. G et al. already packed multiple mands and waiting skills into one kit, so the later paper explains why that part matters.

04

Why it matters

You can copy the kit tomorrow. Give choices, teach a short mand, weave hard tasks inside easy ones, and practice short waits. Do it in the real aisle with the real cart. Staff don’t need a BCBA badge—just a script and a praise line. If it worked in busy supermarkets in 1993, it will work in your Target run today.

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→ Action — try this Monday

During the next community trip, let the client choose two items to place in the cart and require a brief wait before each choice.

02At a glance

Intervention
functional communication training
Design
single case other
Population
developmental delay
Finding
positive
Magnitude
large

03Original abstract

Problem behavior often prevents community integration of people with developmental disabilities. Therefore, we evaluated a multicomponent approach for remediating problem behavior in public community settings (specifically, supermarkets). We selected treatments based on hypotheses about the variables controlling the problem behavior (hypothesis-driven model). The multicomponent intervention included choice making, embedding, functional communication training, building tolerance for delay of reinforcement, and presenting discriminative stimuli for nonproblem behavior. Treatment progress was monitored using measures of latency and task completion rather than traditional measures of frequency and time sampling. Results showed substantial increases in task completion and duration of time spent in supermarkets without problem behavior. Outcomes were socially validated by group-home staff and cashiers. We discuss how the intervention approach taken can resolve some of the issues involved in assessing, measuring, and treating problem behavior in the community.

Journal of applied behavior analysis, 1993 · doi:10.1901/jaba.1993.26-157