Increasing Functionally Complex Play Skills by Manipulating Access to Stereotypy as Reinforcement in Children with Autism

The purpose of this study was to systematically replicate and extend the procedures presented in Hanley, Iwata, Thompson, and Lindberg (2000); using stereotypy as reinforcement to increase progressively more complex and age-appropriate play while decreasing rates of motor stereotypy. The current study examined motor stereotypy of one child diagnosed with an autism spectrum disorder (ASD). Two initial assessments were conducted prior to treatment. First, a competing items assessment which indicated that the participant's stereotypy and simple engagement persisted at high rates across all items. A functional analysis was then conducted in an attempt to identify the function of the participant's behavior. Variable rates of stereotypy across all social conditions were observed during this assessment; however, the highest rates of stereotypy occurred during the control condition, indicative of automatic reinforcement. Following initial assessments, we evaluated effects of enriching the environment on the occurrence of stereotypy, simple engagement and generic functional engagement using a multi-element design with withdrawals design. These variables were assessed in four activities and under three conditions: providing prompts for engagement, blocking all instances of stereotypy, and providing the participant a 30 s access period to engage in stereotypy when the contingency for reinforcement was met.