Restricted and Repetitive Behaviors and Interests as Reinforcement

Background: The presence of repetitive and restricted interests and/or behaviors (RRIB) is a core diagnostic symptom of Autism Spectrum Disorders (ASD). To date, most of the interventions regarding RRIB in the single-subject design literature have sought to diminish these behaviors in individuals with ASD. A small segment of the literature regarding RRIB, however, has sought to use the reinforcing properties of RRIB in order to shape the behaviors of individuals with ASD in a therapeutic direction.

Objectives: Review the single-subject design literature regarding the use of RRIB in either antecedent or consequence based interventions for children with ASD. Organize the literature according to interventions aimed at (a) increasing appropriate behaviors (e.g., Language/communication, social, engagement, compliance, academics,. etc.) or (b) decreasing aberrant behaviors (e.g., problem behaviors, self-injurious behavior, stereotypy, etc.). Description of intervention procedures including but not limited to use of differential reinforcement, noncontingent reinforcement, extinction, punishment, and other reinforcement-based strategies. Provide information regarding future research directions using RRIB as an intervention strategy.

Methods: Electronic, ancestral, and expert nomination searches were performed to locate studies. Only studies published in peer reviewed journals, whose primary language was English, were considered. This resulted in 13 studies published between 1978 and 2007. Authors address the following information: (a) proportion of studies using antecedent or consequent based interventions; (b) proportion of studies addressing increasing appropriate behaviors or decreasing problem behaviors,(c) comparison of RRBI interventions to others, (d) internal validity, (e) generalizability, and (f) choice of target children.

Results: Preliminary results show that seven of the thirteen (53.8%) interventions incorporated a consequence based intervention and six (46.2%) incorporated an antecedent based intervention. Six studies reported data addressing increasing social/communication skills, four studies report data addressing decreasing negative behaviors, and seven studies report data addressing increasing correct responding of children with ASD. Three studies reported data addressing two behavior areas. Seven studies compared RRBI interventions to other interventions with support generally found for the RRBI intervention. Studies were variable in regards to the strength of internal validity and generalizability of findings. To date, no study has reported data on children with ASD whose reported diagnostic battery includes well validated measure (e.g., Autism Diagnostic Observation Schedule; ADOS). Further results will summarize participant/setting characteristics, measurement procedures, assessment strategies, design/validity issues, and effects.

Conclusions: The use of the RRBI as a reinforcement tool for shaping the behaviors of children with ASD is an underexplored area in the SSD literature. The handful of studies published to date indicates that RRBI may be used in consequence- and antecedent-based interventions to increase desired behaviors and decrease inappropriate behaviors in this population. Future studies should address the ability of RRIB-based interventions to facilitate generalization and/or maintenance of target behaviors as well as fading procedures to increase participants’ response to more naturalistic reinforcers.