Treatment of Ritualistic Behavior Using Principles of Behavioral Economics

Background: Autism is a developmental disorder characterized by difficulties in communication, social functioning, as well as the presence of stereotyped behaviors and restricted interests.  These stereotyped and restricted behaviors can include highly preferred interests in certain objects or the repetition of certain activities.  These patterns can influence academic and work environments.  For example, students may choose tasks in a particular order, have a restricted task or reinforcement repertoire, or show resistance to non-preferred tasks.  In order to address these rituals, physical prompting is often required.  This is a particular concern for older learners, as attempting to physically prompt older, stronger individuals may put staff, family members, and the learner themselves at risk for injury.  One potential strategy to address ritualistic behavior without physical prompting is through the manipulation of “pay rates” of less-preferred tasks and the “cost “ of preferred reinforcing items.  By manipulating these economic variables, it may be possible to increase the range of task and preference selections, as well as to increase the completion of less-preferred tasks.

Objectives: The purpose of the current study was to address ritualistic behavior by manipulating the pay rate of tasks and the cost of preferred reinforcers.  

Methods: Using an MSWO preference assessment procedure, highly preferred and non-preferred tasks and reinforcers were established for a 36 year-old male diagnosed with Autistic Disorder.  Four tasks and four reinforcers were introduced into an economy, and two distinct cost structures were implemented.  Under Cost structure 1, or the baseline assessment, all tasks payed $1 and all reinforcers cost $1.  Under Cost structure 2, the most highly preferred reinforcer cost $10 and the least preferred task payed $10. In all four phases, percent of selections were recorded for tasks and for reinforcers.  

Results: Under Baseline/ Cost structure 1, the learner established ritualistic choosing patterns for both tasks and reinforcers.  Each task was selected between 24-27% of the time and reinforcer selection alternated between two highly preferred edibles; pretzels (49%) and Nutrigrain Bar (51%).  When Cost structure 2 was introduced, task selection became varied, and the learner began to choose the low-cost edible (Nutrigrain Bar) more frequently (67%).  Additionally, selection of the high pay-out task (33%) occurred as often as the high-cost reinforcer (33%).  A reversal back to Cost structure 1 showed a reemergence of ritualistic behavior for both tasks and preferences.  The second implementation of Cost Structure 2 induced the same treatment effect; tasks became varied, and reinforcer selection reflected a preference toward the lower cost reinforcer.    

Conclusions: The results of this investigation show that ritualistic behavior can be addressed with economic manipulations.  The participant was sensitive to the price of reinforcers and reinforcer selection changed significantly as price increased.  These results suggest that the manipulation of price helped to broaden the task and reinforcer repertoire for the student.  This has broader implications for the treatment of stereotyped behavior and restricted interests in academic and work environments.