JOURNAL OF APPLIED BEHAVIOR ANALYSIS 2019, 9999, 1–12 NUMBER 9999 ()

A comparison of differential reinforcement procedures for treating

automatically reinforced behavior
CHELSEA B. HEDQUIST AND EILEEN M. ROSCOE
WESTERN NEW ENGLAND UNIVERSITY, THE NEW ENGLAND CENTER FOR CHILDREN

Children diagnosed with autism spectrum disorder (ASD) often exhibit stereotypy, which can
be socially stigmatizing, interfere with daily living skills, and affect skill acquisition. We com-
pared differential reinforcement of alternative behavior (DRA) and differential reinforcement of
other behavior (DRO) when neither procedure included response blocking or interruption for
(a) reducing stereotypy, (b) increasing task engagement, and (c) increasing task completion.
DRA contingencies yielded superior outcomes across each measure when evaluated with 3 indi-
viduals with autism spectrum disorder.
Key words: automatically reinforced behavior, autism spectrum disorder, DRA, DRO,
stereotypy

Stereotypy, defined as repetitive motor move- of stereotypy suggested maintenance by auto-

ments and vocalizations that serve no adaptive
purpose (Koegel, Firestone, Kramme, & Dunlap,
1974), is often exhibited by individuals diag-
nosed with intellectual disabilities, including
autism spectrum disorder (ASD; Bodfish,
Symons, Parker, & Lewis, 2000; Matson &
Dempsey, 2008). Stereotypy may be socially
stigmatizing (Jones, Wint, & Ellis, 1990); limit
opportunities for appropriate social interaction;
interfere with daily living skills such as leisure
engagement, vocational tasks, and other self-care
tasks (Dunlap, Dyer, & Koegel, 1983; Koegel &
Covert, 1972; Koegel et al., 1974; Lanovaz,
Robertson, Soerono, & Watkins, 2013; Rapp &
Vollmer, 2005); and interfere with skill acquisi-
tion in academic settings (Lovaas, Litrownik, &
Mann, 1971). Due to these concerns, stereotypy
is a common target for assessment and
intervention.
According to Rapp and Vollmer (2005),
more than 90% of published functional analyses
This study was conducted in partial fulfillment of the
first author’s requirements for the Master’s degree in
behavior analysis at Western New England University.
Address correspondence to Chelsea B. Hedquist,
New England Center for Children, 33 Turnpike
Rd. Southborough, MA 01772 (email: chedquist@necc.org)
doi: 10.1002/jaba.561
© 2019 Society for the Experimental Analysis of Behavior
1
matic reinforcement. Automatically reinforced
problem behavior poses a challenge to effective
treatment because the specific reinforcer cannot
be readily identified, and as a result, the contin-
gency between behavior and its reinforcer can-
not be eliminated via extinction as it could with
socially reinforced problem behavior.
Despite this challenge, differential reinforce-
ment of other behavior (DRO) and differential
reinforcement of alternative behavior (DRA)
have been used to effectively treat stereotypy.
DRO procedures involve delivering a putative
reinforcer following the abstention of a behav-
ior for a predetermined interval (Catania,
2013); this contingency has reduced automati-
cally reinforced skin picking (Tiger, Fisher, &
Bouxsein, 2009), vocal stereotypy (Taylor,
Hoch, & Weissman, 2005), and motor ticks
(Capriotti, Brandt, Ricketts, Espil, & Woods,
2012). For example, Taylor et al. (2005)
decreased a participant’s vocal stereotypy by
arranging a 1-min DRO. After attaining initial
reductions in vocal stereotypy, the DRO inter-
val was increased to 5 min while sustaining low
levels of stereotypy.
DRA procedures involve delivering a puta-
tive reinforcer following the occurrence of a
specific alternative behavior. For example,
2 CHELSEA B. HEDQUIST and EILEEN M. ROSCOE
Potter, Hanley, Augustine, Clay, and Phelps
(2013) decreased stereotypy by arranging
DRA contingencies to support item engage-
ment with three individuals with ASD. This
procedure specifically involved manually dis-
rupting instances of stereotypy and allowing
access to stereotypy contingent on item
engagement. Similar to Potter et al., most
DRA demonstrations with stereotypy as the
reinforcer include response blocking or
response interruption (e.g., Hanley, Iwata,
Thompson, & Lindberg, 2000) to minimize
the extent to which stereotypy continues to
produce automatic reinforcement. However,
the inclusion of response blocking or inter-
ruption may limit the utility of these proce-
dures in practical application.
Response blocking and interruption are labor
intensive in that they require a dedicated care-
giver to disrupt each instance of stereotypy. The
practical costs of staffing such a program may
prohibit adoption of the procedure in most set-
tings. Additionally, the introduction of margin-
ally intermittent or delayed schedules for
response blocking and interruption has failed to
maintain behavioral reductions (Kleibert &
Tiger, 2011; Smith, Russo, & Duy, 1999). Even
with dedicated staffing, high procedural integrity
for response blocking and interruption of each
instance of stereotypy is unlikely. In light of
these limitations associated with response block-
ing and interruption, an evaluation of DRA and
DRO without response blocking and interrup-
tion is warranted. However, the utility of DRA
alone in the treatment of stereotypy is not well
established. In one published example, Vollmer,
Marcus, and LeBlanc (1994) examined DRA
without response blocking or interruption with
two of three individuals with automatically
reinforced stereotypic hand mouthing and self-
injury. During DRA, therapists activated a
sound-producing leisure item contingent on
hand–item contact. The DRA procedure alone
decreased self-injury for one participant, whereas
the addition of a blocking and hands down
procedure was necessary to decrease hand
mouthing with the other participant.
The purpose of the current study was to com-
pare DRO and DRA contingencies in the treat-
ment of stereotypy when neither procedure
included response blocking or response interrup-
tion. In addition, caregiver-nominated vocational
activities from each participant’s Individualized
Education Program (IEP) were included during
both DRO and DRA evaluations, permitting
comparison across problem behavior, activity
engagement, and productivity.
METHOD
Participants and Settings
Three individuals diagnosed with ASD, who
attended a residential school for children with
intellectual disabilities, participated. Each was
referred for participation by their clinical teams
due to stereotypy that interfered with daily activi-
ties. John and Nick were 14-year-old young men,
and Solomon was a 16-year-old young man. Each
student communicated vocally in short phrases
and demonstrated receptive identification, imita-
tion, matching, and limited computer skills.
Sessions were conducted in the participants’
classroom while no other students were present
(John), or in a small research room (Nick and
Solomon). Each room had a chair, table, cabinet,
and task materials.
Response Measurement and Interobserver
Agreement
A primary data collector scored stereotypy, task
engagement, and task productivity during each
session. Stereotypy, scored via continuous duration
recording, was defined as any repetitive, non-
contextual, motor movement. Specific forms of
stereotypy for John included hand wringing, cir-
cular waving, jumping, finger swiping on desk,
and other repetitive hand movements. For Nick,
stereotypy included body rocking, hand waving,
hand flapping, finger tapping, and finger flicking.
For Solomon, stereotypy included body rocking,
 DRA AND DRO COMPARISON
hand flapping, and skin picking. Engagement,
scored via continuous duration recording, was
defined as any hand-to-item contact with task
materials in the absence of stereotypy. Stereotypy
and engagement were considered mutually exclu-
sive; if the participant engaged in item contact
while engaging in stereotypy, observers scored
only stereotypy. Productivity was measured by
counting the number of tasks completed. For
John and Solomon, a product was counted fol-
lowing a sequence of folding the item, placing the
item in a pile, and removing his hand. For Nick a
product was counted after he stamped a notecard,
put the notecard in an envelope, placed the enve-
lope in a completed pile, and removed his hands.
To assess interobserver agreement (IOA), a sec-
ond observer scored video records using the same
observational codes for 33% of sessions. The first
author calculated IOA for stereotypy and engage-
ment using mean duration-per-occurrence within
10-s intervals. Observers’ records were compared,
the shorter duration was divided by the longer
duration for each interval, the quotients were
averaged across the intervals and then multiplied
by 100. The first author calculated mean count-
per-interval IOA for productivity by comparing
observers’ records, dividing the smaller number of
responses by the larger number in each 10-s inter-
val, averaging the quotients and multiplying by
100. For John, mean IOA was 81% (range, 76%
to 96%) for stereotypy, 84% (range, 75% to
97%) for engagement, and 81% (range, 68% to
98%) for productivity. For Nick, mean IOA was
92% (range, 80% to 100%) for stereotypy, 91%
(range, 81% to 100%) for engagement, and 91%
(range, 83% to 100%) for productivity. For Solo-
mon, mean IOA yielded 90% (range, 85% to
100%) for stereotypy, 91% (range, 84%
to 100%) for engagement, and 92% (range, 86%
to 100%) for productivity.
Functional Analysis
A functional analysis was conducted to rule
out social sources of reinforcement as
3
maintaining variables for stereotypy. During
the first phase, the first author conducted a
series of 10-min alone sessions (Querim et al.,
2013), in which the participant was alone in
the room such that no social consequences
were provided following stereotypy. During
the second phase, 10-min alone, attention,
demand, and play conditions were alternated
using procedures similar to Iwata, Dorsey,
Slifer, Bauman, and Richman (1994/1982).
Figure 1 depicts the functional analysis results
for John (top panel), Nick (middle panel),
and Solomon (bottom panel). When exposed
to only alone sessions, participants exhibited
moderate to high levels of stereotypy.
Because Solomon exhibited inconsistent levels
of stereotypy during the first 11 sessions,
materials typically present in his classroom
(e.g., vocational stimuli, match-to-sample
stimuli, silverware, etc.) were added for the
remainder of the analysis to create a more eco-
logically valid environment. Solomon’s stereo-
typy increased during the final three sessions
of the alone condition. During the mul-
tielement phase, when all conditions were
conducted, stereotypy occurred at moderate-
to-high levels across conditions, with slightly
lower levels in the attention (all participants)
and play (Solomon) conditions. These results
indicated that stereotypy was not socially
maintained as no social-test condition resulted
in increased levels (i.e., a reinforcement
effect).
Edible Preference Assessment
A paired-stimulus preference assessment
(PSPA; Fisher et al., 1992) was conducted to
identify three highly preferred edibles to use
during subsequent treatment sessions. Prior to
each treatment session, the therapist presented
these three edibles in an array, instructed the
participant to “pick one” and delivered the
selected edible according to the DRO and
DRA contingencies described below.
4 CHELSEA B. HEDQUIST and EILEEN M. ROSCOE

100 Alone Extended Analysis Solomon), stapling (Nick), hole punching

(Nick), silverware wrapping (Solomon), and
80
sorting office supplies (Solomon). The task
60 Alone Play
assessment consisted of two phases. The first
Demand phase included sessions of 10 trials. During
40 each trial, the therapist presented an instruction
20 to complete the target task and delivered a pre-
ferred edible reinforcer contingent on comple-
Attention John
0 tion. Tasks that were completed independently
on 80% or more trials were included in the
Stereotypy (Percentage of Session)

100 subsequent phase. During the second phase,

80 the therapist presented each task, singly, for
5 min and provided an initial instruction to
60 engage with the materials. There were no fur-
ther prompts or reinforcers provided for com-
40
pleting the task. The goal of this assessment
20 was to select a task that participants
Nick
(a) completed when prompting and edible rein-
0
forcement were provided, (b) did not perform
consistently in the absence of prompting and
100
Materials edible reinforcement. Based on the results of
added
80 this assessment, shirt and towel folding was
selected for John (8% engagement) and Solo-
60
mon (32% engagement), and stamping and
40 stuffing envelopes was selected for Nick (28%
engagement).
20

0 Solomon
5 10 15
Sessions
Figure 1. Results from the series of alone sessions and
the extended functional analyses for John, Nick, and
Solomon.
Task Assessment
A task assessment was conducted to identify
a previously mastered vocational task from each
participant’s IEP that he could complete inde-
pendently. For each participant, five to six tasks
were included in the task assessment. These
included folding shirts and towels (John and
Nick), stamping and stuffing envelopes (Nick),
stuffing envelopes (Solomon), tracing letters
(John), sorting silverware (John, Nick, and
20 25 30 Treatment Assessment
During the treatment assessment, conditions
included a no-reinforcement baseline, DRA,
and DRO. The effects of DRA and DRO were
evaluated using a combination of multielement
and reversal designs. The relative and absolute
effects of DRA and DRO were evaluated using
a multielement design, and the absolute effects
of DRA and DRO relative to baseline were
evaluated using a reversal design. Three to five
5-min sessions were conducted per observation
period, and three to six observation periods
were conducted per week.
Before each observation period, the therapist
presented the three edibles selected from the
PSPA and vocally prompted the participant to,
“pick one.” The selected item was used for all
 DRA AND DRO COMPARISON
sessions within that observation period. At the
beginning of each session, the therapist sat next
to the participant, presented task materials, and
stated, “You can do [task] if you want to.”
During baseline sessions, two different col-
ored versions of the target task were presented,
that would later be associated with DRO and
DRA conditions (e.g., a blue set versus a white
set of towels or a green versus pink poster
board under task materials). The first author
drew slips of paper from a hat to determine the
alternation pattern of DRA and DRO sessions,
with the expectation that no more than two
consecutive DRA or DRO sessions were
allowed. There were no social consequences for
motor stereotypy or productivity during base-
line sessions.
The DRA sessions were similar to baseline
except the therapist placed edibles within the
participant’s eyesight and delivered one edible
directly into the participant’s mouth for each
completed task. There were no programmed
consequences in effect for motor stereotypy.
The DRO sessions were similar to baseline
except that the therapist delivered one edible
directly into the participant’s mouth at the end
of each omission interval. The first author iden-
tified omission intervals by calculating 85% of
the mean interresponse time between bouts of
stereotypy during the last three baseline sessions
for each participant. This calculation yielded
omission intervals of 30 s (John), 14 s (Nick),
and 7 s (Solomon). If stereotypy occurred
before the interval ended, the therapist reset the
timer without comment and did not respond to
task engagement at any point during sessions.
RESULTS
Figure 2 depicts the results from John’s
treatment analysis. During baseline, stereotypy,
task engagement, and productivity occurred at
moderate levels, and no systematic differences
were observed across material sets (i.e., white
and blue task materials to be associated with
5
DRO and DRA). When DRO and DRA were
implemented in a multielement comparison,
stereotypy decreased across conditions with
minimal differences between DRO and DRA
(M = 12.1% of session during DRO relative to
28.6% in baseline; M = 7.8% of session during
DRA relative to 22.1% in baseline). The return
to baseline produced small increases in stereo-
typy to near baseline levels (M = 20.6% of ses-
sion for DRO and 20.5% of session for DRA).
No systematic changes from baseline occurred
in engagement or productivity across the first
three phases of the treatment analysis. Because
the initial multielement comparison of DRO
and DRA may have been susceptible to carry-
over effects, each treatment was evaluated indi-
vidually relative to baseline in subsequent
phases. The DRA procedure decreased stereo-
typy (M = 6.8% of session relative to 27.9% in
baseline), increased task engagement (M =
78.7% of session relative 45.3% in baseline),
and increased productivity (M = 3.4 products
per min [ppm] relative to 1.5 ppm in baseline).
The DRO procedure did not result in
a meaningful reduction in stereotypy (M =
14.1% of session relative to 19.9% in baseline);
however, engagement and productivity
increased slightly (M = 71.5% engagement rel-
ative to 56.4% in baseline; M = 2.5 ppm rela-
tive to 1.8 ppm in baseline). When the DRA
versus baseline phase was reimplemented, ste-
reotypy decreased (M = 2.1% of sessions rela-
tive to 49.0% in baseline), engagement
increased (M = 94.9% of sessions relative to
28.8% in baseline), and productivity increased
(M = 4.6 ppm relative to 1.2 ppm in baseline).
Figure 3 depicts the results of the treatment
analysis for Nick. During baseline, stereotypy
and task engagement occurred at moderate and
variable levels, with no tasks completed and no
systematic differences between material sets. Both
the DRO and DRA contingencies produced
decreased stereotypy (M = 1.6% of session in
DRO relative to 38.4% in baseline; M = 1.1%
of session in DRA relative to 33% in baseline),
6 CHELSEA B. HEDQUIST and EILEEN M. ROSCOE

DRA vs.
BL BL DRA vs. BL DRO vs. BL DRA vs. BL
Motor Stereotypy (Percentage of Session)

100 DRO

80

60

40

20

100
Engagement (Percentage of Session)

80
BL TX
60 DRO (white)
DRA (blue)

40

20

5
Productivity (Rate)

0 John
25 50 75 100 125
Sessions

Figure 2. For John, the top panel depicts motor stereotypy, the second engagement, and the third productivity
across baseline (BL), differential reinforcement of alternative behavior (DRA) compared to differential reinforcement of
other behavior (DRO), return to BL, DRA compared to BL, DRO compared to BL, then a return to DRA compared
to BL. During baseline the only difference between the conditions was the color of the materials.

increased engagement (M = 90.1% of session in and increased productivity (M = 1.3 ppm in

DRO relative to 35.4% in baseline; M = 93.0% DRO relative to 0.0 in baseline; M = 2.3 ppm
of session in DRA relative to 28.2% in baseline), in DRA relative to 0.0 in baseline). A return
 DRA AND DRO COMPARISON 7

DRA vs. DRA vs

BL DRO BL DRA vs. BL DRO vs. BL . BL DRA Fading
100
Motor Stereotypy (Percentage of Session)

80

60

1 4
40
2 20

20

100
Engagement (Percentage of Session)

80

60 BL TX
DRO (green)
40 DRA (pink)

20

5
Productivity (Rate)

0 Nick
25 50 75 100 125
Sessions

Figure 3. For Nick, the top panel depicts motor stereotypy, the second engagement, and the third productivity
across baseline (BL), differential reinforcement of alternative behavior (DRA) compared to differential reinforcement of
other behavior (DRO), return to BL, DRA compared to BL, DRO compared to BL, then a return to DRA compared
to BL. During baseline the only difference between the conditions was the color of the poster board under the
materials.
8 CHELSEA B. HEDQUIST and EILEEN M. ROSCOE
to baseline produced increased stereotypy (M =
34.8% of session in DRO baseline relative to
45.6% in DRA baseline), decreased task engage-
ment (M = 35.3% of session in DRO baseline
relative to 35.3% in DRA baseline), and
decreased productivity (M = 0.3 ppm in DRO
baseline relative to 0.4 ppm in DRA baseline).
There were no systematic differences between
the DRA and DRO conditions across the first
three phases. As with John, DRA and DRO
were subsequently evaluated individually relative
to baseline. DRA contingencies decreased stereo-
typy (M = 0.5% of session relative to 41.0%
in baseline), increased task engagement (M =
95.4% of session relative to 45.9% in baseline),
and increased productivity (M = 4.2 ppm rela-
tive to 0.0 in baseline). The DRO procedure did
not result in reduced stereotypy (M = 26.3% of
session relative to 20.7% in baseline), nor did it
increase task engagement (M = 67.8% of session
relative to 67.3% in baseline) or productivity
(M = 0.2 ppm relative to 0.2 in baseline). When
DRA was reimplemented, stereotypy decreased
(M = 1.2% of session relative to 75.5% in base-
line), engagement increased (M = 96.3% of
session relative to 17.3% in baseline), and pro-
ductivity increased (M = 4.5 ppm relative to 0.0
in baseline). Next, the DRA schedule was faded
by delivering tokens that could be exchanged for
an edible and by gradually increasing the number
of tokens required for an exchange from 1 to
2, to 4, and to 20.
Figure 4 depicts the results of the treatment
analysis for Solomon. During baseline, stereo-
typy occurred at moderate to high levels, and
task engagement and productivity occurred at
low levels. No systematic difference between
material sets was observed. In the DRA and
DRO treatment comparison phase, similar out-
comes occurred across conditions. Stereotypy
decreased (M = 18.1% of session in DRO rela-
tive to 57.8% in baseline; M = 14.3% of ses-
sion in DRA relative to 63.0% in baseline),
engagement increased (M = 53.3% of session
in DRO relative to 13.3% in baseline;
M = 60% of session in DRA relative to 15.7%
in baseline), and productivity increased
(M = 2.9 ppm in DRO relative to 0.8 ppm in
baseline; M = 3.7 ppm in DRA relative to
0.9 ppm in baseline). During the return to
baseline, stereotypy increased, and engagement
and productivity decreased. Given the similar
outcomes across DRA and DRO conditions,
they were each evaluated individually relative to
baseline in subsequent phases. DRA contingen-
cies decreased stereotypy (M = 16.0% of session
relative to 66.2% in baseline), increased task
engagement (M = 78.5% of session relative to
7.4% in baseline), and increased productivity
(M = 4.9 ppm relative to 0.4 ppm in baseline).
DRO contingencies also decreased stereotypy
(M = 10.8% of session relative to 56.0% in
baseline), increased task engagement (M = 68%
of session relative to 0.3% in baseline), and
increased productivity (M = 3.5 ppm relative to
0.1 ppm in baseline). Although similar
decreases in stereotypy occurred during DRA
and DRO phases, DRA resulted in greater
increases in engagement and productivity than
DRO. For this reason, the DRA versus baseline
phase was reimplemented. Stereotypy decreased
during DRA (M = 4.3% of session relative to
77.0% in baseline), engagement increased
(M = 91.9% of session relative to 0.3% in base-
line), and productivity increased (M = 5.4 ppm
relative to 0.0 ppm in baseline). Following this
phase, tokens were delivered on a fixed ratio
(FR) 1 schedule with an FR 20 exchange sched-
ule, and treatment outcomes maintained.
DISCUSSION
The relative efficacy of DRO and DRA
was compared, without response blocking or
interruption, for decreasing automatically
reinforced stereotypy, sustaining task engage-
ment, and increasing task productivity for
three individuals diagnosed with ASD. DRA
contingencies reduced stereotypy to below
baseline levels for each participant, whereas
 DRA AND DRO COMPARISON 9

DRA DRA
BL vs. DRO BL DRA vs. BL DRO vs. BL vs. BL DRA (FR 20)
Motor Sterotypy (Percentage of Session)

100

80

60

40

20

100
Engagement (Percentage of Session)

80

60
BL TX
DRA (blue)
40
DRO (white)

20

40

30
Productivity (Rate)

20

10

0 Solomon
20 40 60 80 100

Figure 4. For Solomon, the top panel depicts motor stereotypy, the second engagement, and the third productivity
across baseline (BL), differential reinforcement of alternative behavior (DRA) compared to differential reinforcement of
other behavior (DRO), return to BL, DRA compared to BL, DRO compared to BL, then a return to DRA compared
to BL. During baseline the only difference between the conditions was the color of the materials.

DRO contingencies reduced stereotypy for greater extent than DRO. Thus, the results
only one participant. DRA also increased indicate that DRA resulted in superior treat-
item engagement and productivity to a ment outcomes when compared to DRO.
10 CHELSEA B. HEDQUIST and EILEEN M. ROSCOE

The differential outcomes between DRA and
DRO can most easily be attributed to arranging
a direct contingency for an appropriate and
potentially incompatible behavior (i.e., task
engagement) during DRA. In a brief review
Jessel and Ingvarsson (2016) discuss mecha-
nisms that are potentially responsible for
increasing the effectiveness of DRO. For exam-
ple, DRO procedures may increase other
behaviors than the target behavior through
adventitious reinforcement. If DRO procedures
are effective due to adventitious reinforcement,
repeated exposures to the contingency may be
necessary for other behaviors to be strength-
ened sufficiently to displace stereotypy. By con-
trast, the repeated reinforcement of a singular
alternative behavior during DRA may result in
more rapid acquisition of this behavior and a
concomitant decrease in the target behavior.
Although more prolonged exposure to DRO
contingencies may have reduced stereotypy, the
speed of attaining reductions via DRA seems
preferable.
The DRA conditions may also have resulted
in superior outcomes due to differences in the
frequency with which reinforcement was deliv-
ered. That is, the rate of reinforcement could
have been raised under DRA conditions by
responding faster, whereas the maximum
reinforcement rate in the DRO conditions was
fixed. This increased access to, and time spent
consuming reinforcement, may have also
accounted for differences in interventions. Ret-
rospective review of videos of DRA and DRO
sessions revealed the frequency of reinforcer
delivery in each condition (see Table 1). DRA
resulted in higher reinforcement rates than
DRO for John (3.3 reinforcers per minute
[rpm] relative to 1.1 rpm, respectively) and
Nick (3.9 rpm relative to 2.5 rpm, respec-
tively). Reinforcement rates were roughly equal
for Solomon (4.7 rpm relative to 4.4 rpm dur-
ing DRA and DRO, respectively); this may be
due to Solomon’s brief (7 s) omission interval
during DRO. Thus, the differential outcomes
obtained across DRA and DRO could have
been the result of differences in schedules of
reinforcement rather than the contingency. To
isolate the role of the reinforcement contin-
gency, researchers could control for differences
in reinforcement schedule across DRA and
DRO by yoking the DRO omission interval to
the DRA mean interreinforcement interval
(e.g., if reinforcement is delivered every 20 s
during DRA sessions, the abstention interval
could be set at 20 s during DRO sessions).
During the DRA conditions, reinforcement
delivery occurred only following product

Table 1
Reinforcer Delivery Rate and Stereotypy During DRA vs. DRO

John Nick Solomon

Phase RDR (rpm) Stpy (%) RDR (rpm) Stpy (%) RDR (rpm) Stpy (%)
Total Sessions
DRA 3.3 5.6 4 0.8 4.7 12.2
DRO 1.1 29.7 2.5 18.1 4.4 13.5
DRA vs. DRO
DRA 2.5 7.8 4.8 1.1 3.4 14.3
DRO 1.3 12.1 3.6 1.6 3.8 18.1
DRA vs. BL
DRA 3.4 6.8 4.2 0.5 4.9 16
DRO vs. BL
DRO 1.2 14.1 2.2 26.3 4.8 10.8
DRA vs. BL
DRA 4.5 2.1 4.3 1.2 5.4 4.3

Note. Reinforcer Delivery Rate = RDR; Stereotypy = Stpy; Reinforcers per minute (rpm).
 DRA AND DRO COMPARISON
completion without problem behavior. These
DRA conditions could be conceptualized as a
conjunctive DRA:DRO schedule in that both
the absence of stereotypy and the alternative
response were required to produce reinforce-
ment. This DRA arrangement is commensurate
with typical applications; future researchers
could further isolate the role of DRO from
DRA by delivering reinforcement for task com-
pletion, independent of stereotypy.
Although the DRA conditions included omis-
sion criteria, the findings are unique in that
DRA yielded effective results without response
blocking or response interruption procedures. As
noted, there have been relatively few demonstra-
tions of DRA contingencies without response
blocking. Another feature of the current study is
that we targeted a vocational task, whereas previ-
ous evaluations of DRA for treating automati-
cally reinforced problem behavior typically have
targeted appropriate leisure item engagement
(Favell, McGimsey, & Schell, 1982; Vollmer
et al., 1994). Stereotypy is frequently identified
as a problem behavior to the extent that it com-
petes with engaging in learning experiences.
Targeting engagement with leisure items may
not address this practical concern to the same
extent that targeting direct engagement in voca-
tional and academic tasks would; but the most
appropriate alternative activity is likely best dic-
tated by the context from which the client is
being referred. Practitioners may increase the
social validity of intervention outcomes by all-
owing caregivers to nominate desired alternative
tasks to include in a treatment analysis.
Despite the positive outcomes associated with
DRA, the sessions were relatively brief (i.e.,
5 min). Practical application would require simi-
lar behavioral changes during lengthier exposure
to contingencies and under leaner reinforcement
schedules. Future research should examine DRA
during extended application to determine the
maintenance of these intervention effects.
Finally, clinicians might thoroughly consider
when stereotypy does and does not constitute a
11
problem behavior for their clients before
adopting DRA as a component of their treat-
ment approach. This decision should be made
in consultation with clients’ caregivers and the
client themselves, if possible. With the exception
of repetitive self-injurious behavior, the com-
plete elimination of noninjurious stereotypy is
likely not an appropriate goal, as this would
restrict access to reinforcement for individuals
who may have relatively few reinforcers. Instead,
we encourage clinicians to teach their clients to
discriminate when the occurrence of stereotypy
is problematic relative to when it is harmless
(Tiger, Wierzba, Fisher, & Benitez, 2017).
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Received February 19, 2018
Final acceptance March 8, 2019
Action Editor, Jeffrey Tiger