Change The Way You Look At Escape Extinction:

Motivating Learner Participation Without Escape Blocking,

Forced Physical Prompts, or Nagging.

Panel Chair: Robert Schramm

Institute Knospe-ABA

Case Study Presenters:

Allison Kane
Megan DeLeon Miller
Benno Boeckh
Instructional Control
Instructional control deals with the likelihood that presented
instructions will lead to the desired behavior.

The more likely it is that an instruction will lead to the intended

response the better the instructional control.

Often instructional control is between 5% and 50% upon intake. We

consider 75% appropriate response to initial demand the minimum
criteria for having established instructional control.
Background:
Institute Knospe-ABA
- German based ABA/VB institute
- Supports the education of over 300 children
- Work in the homes and schools of children using family and current
staff for daily implimentation of ABA programs
- Successfully meeting or working toward instructional control
criteria with over 90% of cases without the need for the
following three common procedures...
Without:

1. Blocking a child‘s attempts to escape teaching

2. Forced physical prompting to complete a task
3. Paced Prompting - Repeated instructions or Nagging procedure
Current Standard of Care:
Considering Skinner's analysis of verbal behavior and Michael's
motivating operation, has supplemented the ABA community's
ability to work with “unmotivated learners” to minimize the use of
traditional compliance training procedures (such as the three
procedures listed on the last slide) that are often used as part of
escape extinction.
However:
Observationally, in clinical practice, the use of these procedures may
still be a common recommendation whenever attempts to increase
the value of the teaching setting beyond the value of the escape
condition fails.
The Value of Escape Extinction
The benefits of escape extinction has been well supported in the
literature and not in question as part of this presentation.

E.g. Hagopian & Adelinis (2001); Lerman, Iwata & Wallace (1999); Lerman,
Kelly, Vorndran & Van Camp (2003).
Problems Associated with these
Procedures Include:
- The potential to establish the teaching setting as an aversive
stimulus and increase the value of escape as a reinforcer
- An increase in the amount of attention given to escape behavior
- The escalation of the teaching setting toward physical conflict

Lerman, D.C., Iwata, B.A., Wallace, M.D. (1999).

Problems Associated with these
Procedures Include: (cont.)
-A lack of willingness on the part of parents, teachers, therapists and
administrators to use these procedures consistently or at all.
- The inability of interventionists to consistently use such procedures
with a variety of clients (older, stronger, self-injurious or agressive
behavior)

Luiselli, J.K. (2009); Matson, J. L. (2009); Wolf, M. (1978).

Who Might Benefit?
A way to earn instructional control in an efficient manner without
restraint, escape blocking, forced prompts, or paced prompting
would be a strong benefit to:
- Anyone (incl. parents, school staff) unable or unwilling to use the
above listed procedures safely, correctly, or comprehensively
- Interventionists working with children whose escape behavior is
also maintained by attention in the escape condition
- Interventionists working with children who have not responded
well to these procedures and who have not been able to reduce
escape behavior through their use
Alternative Procedures?
To effectively develop and maintain instructional control without the
use of these three procedures we have been using alternative
procedures with much success.

What are these procedures and what do they do?

1. Alternative to Escape Blocking
Instead of using escape blocking (physically not allowing the child to
leave the teaching setting), we have been using comprehensive
restriction of reinforcement in the escape condition.

1. Identify all forms of potential reinforcement in the environment

before teaching and keep them under interventionist control.
2. Escape from demands is permitted, but all forms of
reinforcement after escape are fully restricted until the child
returns and complies.
Restrict Reinforcement Instead of
Restricting Child Movement:

To see this video go to Youtube.com – “Schramm’s 7 Steps ABAI Video 1”

2. Alternative to Forced Physical
Prompting
Note: Even when using escape blocking to keep a child in the
teaching setting it is not always easy to get them to perform the
required task without forced physical prompting.

Instead of obtaining the behavior with forced hand-over-

hand„prompting“ and expecting that the reinforcment to follow will
allow us to fade the need for forced prompting over time, we have
been putting every behavior other than the behavior of interest on
extinction. In doing so we wait for the child to engage in the
required task without the inclusion of unecessary prompts.
4. Alternative to Paced Prompting
SD Presentation (Nagging)
Paced prompting is sometimes used to keep a child from escaping a
task and in many cases serves as an aversive stimulus meant to reduce
escape behavior. For children whose escape behavior has a strong
attention component, nagging could potentially serve as a reinforcer
for escape. Instead of nagging, we choose to avoid giving any
unecessary attention to the child in the escape condition. We do this
by only repeating the instruction, making eye contact, or engaging in
interaction with the child who has refused a task when they have
demonstrated a motivation for reinforcement and are more likely to
perform the behavior of interest.
Carlin
- 3-year old with diagnosis of Autism
- 2 years refusing to drink anything but chocolate milk
- Video from day 2 of initial consultation
- Successfully identified and paired ourselves with reinforcement
- Successfully implemented „Give Back“ and „Waiting“ programs
- Attempted to reduce the use of escape behavior from the SD
„drink water“
Comprehensive Extinction of All Behavior Other
Than the Behavior of Interest

To see this video go to Youtube.com – “Schramm’s 7 Steps ABAI Video 2”

 The 7 Steps To Earning
Instructional Control

Are detailed in the book “Motivation and

Reinforcement: Turning the Tables on Autism”

www.lulu.com/knospe-aba.com
The 7 Steps To Earning
Instructional Control
The process of controlling the environment in a way that you can
gain your child’s compliance without the use of Escape Blocking,
Forced Prompting and paced prompting (nagging Procedures).
Step 1:
Show your child that you are the one in control of the things he
wants to hold or play with and that you will decide if or for how long
he can have them.

Comprehensive control of all reinforcing items before teaching allows

you to be a giver and not a taker during teaching.
Step 2:
Show your child that you are fun. Make every interaction you have
with him an enjoyable experience so that he will want to follow your
directions to earn more time sharing these experiences with you.

Comprehensive pairing of the teaching setting and teacher

with reinforcement designed to increase the value of teaching
beyond that of escape.
Step 3:
Show your child that you can be trusted. Always say what you mean
and mean what you say. If you instruct your child to do something,
do not allow him access to reiforcement unless he has complied with
your request. This step allows for prompting him to completion if
necessary.

Carefully selecting your SD’s in all situations and following

through with the appropriate consequences is key to earning trust
and instructional control.
Step 4:
Show your child that following your directions is beneficial and the
best way to obtain what he wants. Give your child easy directions as
often as possible and then reinforce his decisions to participate by
following them with good experiences.

Fading in of instructions with continuous schedule of

positive reinforcement. Avoiding the use of negative reinforcement
where possible.
Step 5:
Provide consistent reinforcement. In the early stages of earning
instructional control with your child, reinforce after each positive
response. Eventually change to an ever-increasing variable ratio of
reinforcement.

Slowly thinning the variable ratio of reinforcement over time

allows for more responding to occur for less reinforcement.
Step 6:
Demonstrate that you know your child‘s priorities as well as your
own.

Use differentiated reinforcement levels depending on

response quality and make reinforcement decisions based on the
current priorities of your program.
Step 7
Show your child that ignoring your instructions or choosing
inappropriate behavior will not result in the acquisitions of
reinforcment.

Allows For:
Extinction of all behavior in the escape condition other
than the behavior of interest without restricting
movement away from the teaching setting.
Punishment: Preferably negative punishment in the form of
CMO-R (Mini-Consequences)
The 7 Steps in Practice

To see this video go to Youtube.com – “Schramm’s 7 Steps ABAI Video 3”

Studies:

Case Study: Emily

Allison Kane of Kane ABA Consulting

Multiple Baseline Study: Justin and Will

Megan DeLeon Miller of Navigation Behavioral Consulting
A Case Study with Pilot Data

2011 ABAI ANNUAL CONFERENCE

DENVER, COLORADO

ALLISON KANE
KANE ABA CONSULTING
 Method
Participant
  36 months old girl, Emily
  Diagnosed with Autism Spectrum Disorder at 33 months
  Anecdotal reports from parents included:
  Screaming and scratching at parents eyes or skin when they talked
  Screaming to gain attention, obtain access to tangibles and escape from
instructions
  Enjoyed interacting while reading books and doing puzzles, but only if
she initiated the interaction. If someone else told her to identify an
item in a book or put a puzzle piece in, she would scream, scratch and/
or walk away
 Method
Response Definitions:

  Instructions
  Attempts, No response
  Prompted, Independent

  Problem Behaviors
  Resisting prompts
  Scratching others
  Screaming/Squawking
  Saying frustration words (“no”, “stop”, “oh no”, etc) or words to escape
  Grabbing at items
  Dumping items
  Throwing items
 Method
Recording Procedure
  IOA
  Collected for 92% of the sessions
  Range: 71%-100%, IOA average of 84%

  Experimental Design
  No experimental design
  Data taken from videotapes of the initial consultation and a
follow up consultation
 Method
Intake
  Within the first 30 minutes of arrival for the initial consultation
  5 minute session lengths
  Pairing
  Minimal instructions given, but if they were given, were related to
the reinforcer
  For example: put a picture slide in a Viewfinder, label
pictures in a book she enjoyed)
 Method
Intervention Conditions
  5 minute session lengths
  Following the first 30 minutes of the initial consultation
  Video taken of initial and maintenance consultations and coded based
on the response definitions
  7 Steps to Instructional Control implemented:
  Restriction of Reinforcement
  Pairing
  Contingent Reinforcement
  Positive Reinforcement
  Schedule of Reinforcement (FR-1 Schedule at first)
  Differential Reinforcement
  Extinction and Mini-Consequences
Intervention Video
Follow Up Consultation Video
 Results:
Frequency of Problem Behavior and Instructions Given
Frequency of Problem

Intervention 7 Steps
Intake
Maintenance May 2011

Intervention 7
Steps March
2011
Behavior

Session
 Results:
Percentage of Session in Extinction

Intervention 7 Steps
Intake
Maintenance May 2011
Percentage of Session

Intervention 7
Steps March
2011

Session
 Results:
Quality of Responses

Intake Intervention 7 Intervention 7 Steps

Steps March Maintenance May 2011
2011
Frequency of Responses

Session
Results: ABLLS
 Results
•  3 hour sessions
•  March 2011: immediately following the initial consultation
•  May 2011: immediately following the maintenance
consultation

•  Data based on cold probe data taken by therapist

• Does not represent total frequency of behaviors taught during
3 hour session

March 2011 May 2011

Variety of Mands 4 13
Total Cold Probe Instructions 4 40
Total Cold Probe Frequency of 1 (25%) 30 (75%)
Independent Responses
 Discussion
  Limitations:
  Pilot data representative of the decrease in behavior over time, but not a functional
relation
  No experimental design, no controlled baseline condition
  Only one participant
  Intense extinction burst and intense, longer duration of intervention period (2 weeks
reported)

  Possible Benefits:
  Parent implementation possible
  Real world implications
  No forced physical prompting or non-contingent repetition of the SD
Multiple Baseline Study

Megan Miller, M.S., BCBA

Navigation Behavioral Consulting
ABAI May 30, 2011
Purpose

Can training on the 7 steps of earning instructional control, reduce

noncompliance behavior during 1-1 ABA sessions where the current
protocol is to use forced prompts and paced prompts?
Participants
2 boys
Diagnosed with autism
4 years old
Receiving center based ABA intervention 2 days/week
3 Tutors
At least 1 year experience providing ABA
Trained by the center
Setting
Center in Virginia
Therapy room
Table
2 chairs
Programming materials
toys
Target Behavior
Noncompliance – behaviors observed after presentation of demand
Justin
Not responding within 5 seconds
Leaving or attempting to leave the work area
Quickly grabbing at cards/materials
Pushing/throwing materials
Will
Same as above and
Negative statements “no”, “I don’t know” etc
Whining, making noises, and taking deep breaths
Method
Multiple Baseline Design
28 scheduled sessions
DV – total duration of noncompliance behavior
IV – type of procedure used
Baseline: Forced and paced prompting
Intervention: 7 steps of earning instructional control
Procedure
Baseline
Followed current procedures
Intervention
1 hour training about the 7 steps using BST
Feedback via video clips of sessions
Implemented 7 steps
   Baseline Video of Justin

Results
   Justin Alternative to Forced Prompting

Results
   Justin after 7 Steps Training

Results
   Justin After 7 Steps Training

Results
   Baseline video of Will Forced Prompting

Results
   Will baseline video of responding

Results
   Will alternatives to forced prompting

Results
   Will responding after 7 steps training

Results
Results- Escape Behavior
IOA: 92%
Justin
Baseline Average : 99 seconds
Intervention Average : 32 seconds
Will
Baseline Average : 71.5 seconds
Intervention Average : 39.25 seconds
 Results – Justin Integrity Checklist
140 100
Baseline
90
120
80

7 Steps
100 70

60
80

50 NC Duration

60 % integrity
40

40 30

20
20
10

0 0
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
 Results – Justin Integrity Checklist
140 100
Baseline
90
120
80

7 Steps
100 70

60
80

50 NC Duration

60 % integrity
40

40 30

20
20
10

0 0
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
 Results – Will Integrity Checklist
300 Training 100
Baseline
90

250
80

70
200

60

150 50 Total Duration

% NC
40

100
30

20
50

10

0 0
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34
Discussion
Escape behavior decreased
Very little time training
Inconsistency with video
Inconsistency with following procedure
Social Significance
Future Research
Component Analysis
Train on other techniques
More rigid data collection
Analysis of components necessary for success
Conclusions?
It is possible to earn Instructional
control without the use of...

1. Blocking a child‘s attempts to escape teaching.

2. Forced physical prompting to complete a task.
3. Paced Prompting - Repeated instructions ( „Nagging procedure“).
Potential Problems Associated with The
7 Steps to Earning Instructional Control
1. It appears to be somewhat less effective when working with
children who are less attention motivated or are capable of
finding self-stimulating reinforcement in the extinction or
timeout condition that cannot be blocked effectively.
2. This approach is likely less effective for therapists who have only
a short period of time with the child (ex. single hour per day) as
extinction/timeout periods may last longer than this early in the
program.
3. If we are unable to find a way to ensure complete extinction
during the escape condition we will not find success.
Potential Benefits Associated with this
Approach to Instructional Control
1. It has been reported by parents, teachers, and therapists that this
method of earning instructional control is easier to manage and
maintain in the home and school setting, making it more likely to be
implimented comprehensively in those important settings.
2. It has been reported by school staff that this approach is more
acceptable to administrators, and other staff members.
3. It appears that for children whose escape behavior has a strong
attention component, the ability to avoid giving attention in the escape
condition that this approach offers might increase success rates.
4. Consistent motivated learning might be better achieved when teaching
settings are not paired with physical restraint or forced participation as
this gives the child a perceived choice between learning fun and
extinction.
Possible Benefits Continued
5. By avoiding the use of forced physical prompts it is possible that
we may see a reduction in prompt dependence and therefore an
increase in skill acquisition rates.

And most importantly...

Possible Benefits Continued
6. By avoiding the use of aversives within the teaching setting it may
become easier to pair the teaching setting with reinforcement
allowing the teaching setting itself to become the child‘s most
preferred activity of the day.

When successful at turning the teaching setting into a child‘s most

preferred activity the mere potential loss of the teaching setting itself
can be conditioned as an establishing operation reflexive (CMO-R)
for compliance to demand.
As a CMO-R, the mere possibility of losing access
to teaching interactions can become an abolishing
operation to the value of escape.

To see this video go to Youtube.com – “Schramm’s 7 Steps ABAI Video 4”

Comparison to Current Standards
of Care?
At this point in time we have NOT performed any comparative
experimental studies between compliance training methods using
escape blocking, forced physical prompting, restraint in the teaching
setting and repeated instruction (nagging) procedure and our use of
the alternative procedures detailed in this presentation.

Our goal for today was merely to demonstrate that the techniques
described can be successful and could be considered when current
standards of care are failing to find the desired result.
Future Research
We believe that there is enough preliminary evidence here in our case
studies and Megan‘s multiple baseline study to motivate further research in
the use of these procedures including comparative studies vs.the current
standard of treatment.

As an institute, Knospe-ABA is hoping to partner with other institutions

interested in studying these procedures more experimentally.

If proven comparably effective to current standards, the potential benefits

that we have identified would make this approach a worthwhile addition to
the science of ABA.
For a More Detailed View...
The 7 Steps to Earning Instructional Control is detailed in the book
„Motivation and Reinforcement: Turning the Tables on Autism“
Available at www.lulu.com/knospe-aba

For any further information or discusson on this topic please feel free
to contact robert@knospe-aba.com

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Thank You For Your Time!

Any Questions?
For copies of this presentation please email:
robert@knospe-aba.com