Treatment of Challenging Behavior Maintained by Caregiver Accommodation Using Cumulative Schedules of Reinforcement

As a strategy to prevent reoccurrence of challenging behavior, some caregivers report frequent or excessive reinforcement of their child's requesting behavior. The current study describes the assessment and treatment of 14 children, ages 3–12 (M = 6.4, SD = 2.7), who engaged in challenging behavior that was reinforced by adult cooperation with manding. Following a differentiated mand analysis, treatment structure involved a 20-h caregiver training program, delivered across either 2 or 5 consecutive weeks. Caregivers were trained to conduct all procedures, which incorporated the use of a cumulative duration schedule along with reinforcement schedule-thinning in a changing criterion design. Results averaged a 94% reduction across cases and statistically significant reductions in challenging behavior both within and between appointments (Cohen's ds = 0.88 and 1.1, respectively). The current study extends the literature on the treatment of percurrent challenging behavior by incorporating caregivers as therapists and using cumulative reinforcement schedules.