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Abstract Reliance on sedation, general anesthesia, or protective stabilization (SAS) during routine dental exams can raise care costs, increase the risk of undesirable side effects, and deter caregivers from seeking dental care for people with intellectual and developmental disabilities (IDD). In this study, the experimenters evaluated the effects of an interdisciplinary, telehealth model that aimed to increase the comfort and cooperation of adults with IDD during routine dental exams. Thirty participants and their caregivers completed the study. During baseline, 73% of participants successfully completed a dental exam without SAS despite having a history of receiving SAS during routine dental exams. For the remaining participants, the experimenters remotely coached caregivers to implement up to five increasingly complex behavioral interventions during mock dental exams at home until they successfully cooperated with all exam steps. All but one participant then successfully completed a dental exam conducted by a dentist who received coaching from experimenters. However, these outcomes did not generalize to a community dentist who did not receive coaching. Results have important implications for the use of SAS with patients with IDD and methodologies for disseminating behavior-analytic interventions to patients who are unable to tolerate dental procedures.

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AbstractHow the subjective value of an outcome changes as a function of time, probability, or effort has been an active area of psychological and economic research for decades. The exact functional form of how a commodity is discounted has been debated, and there have been numerous forms proposed. One of the challenges when trying to determine the functional form of discounting data is how models are compared, what modeling methods are used, how many data points are used, and what comparison metrics were used. Thus, we sought to replicate and extend previous research comparing discounting model selection methods by simulating discounting data from five functional forms: the Mazur hyperbolic model (Mazur, 1987), Rachlin hyperboloid (Rachlin, 2006), Myerson–Green hyperboloid (Myerson & Green, 1995), Samuelson exponential model (Samuelson, 1937), and beta‐delta model (Laibson, 1997). With each of these models we manipulated the number (i.e., density) of data points, used two forms of modeling, and assessed the degree to which each model generalizes to data it has not used in the fitting process. Model comparisons were conducted using the Akaike information criterion (AIC), Bayesian information criterion (BIC), and leave‐one‐out cross validation (LOOCV). In general, AIC, BIC, and LOOCV selected the correct model, whereas the Rachlin model had the lowest error across folds of LOOCV when relying on multilevel modeling.

AbstractRenewal is defined as relapse of a previously extinguished target behavior following a change in context. This form of relapse has been shown to occur when an alternative source of reinforcement that was made available during extinction of the target response is abruptly switched to a different type of reinforcement. The current experiment examined a method for mitigating renewal produced by switching reinforcement by fading reinforcer type during extinction. In Phase 1, rats' target‐lever pressing was reinforced with one type of reinforcement (O1). In Phase 2, lever pressing was extinguished and noncontingent reinforcers were delivered. The forward fading group initially experienced all alternative (O2) reinforcement, and the percentage of O1 reinforcement was increased across sessions. The reverse fading group initially experienced 90% O1 and 10% O2 reinforcement, and the percentage of O2 reinforcement was increased across sessions. A third group received delivery of O2 only, serving as a control. In Phase 3, all groups received noncontingent delivery of O1 reinforcement only. Robust renewal was seen in the control group relative to both fading groups. Furthermore, levels of renewal were lower and did not differ significantly between the forward fading and reverse fading group. These findings provide further insight into the role of context in relapse and may provide suggestions for future clinical applications.

AbstractResearchers have reported that children engage in pretend play that reflects the conventional activities of their environment (i.e., learned‐combinations play). In contrast, children with autism spectrum disorder (ASD) display fewer and less varied play behaviors. Research on teaching pretend play to children with ASD often involves prompting and reinforcing scripted responses. Although effective, these procedures may be limited because they can produce rigid, rote play rather than pretend play reenacting real‐life events. This study evaluated the effects of teaching actions with real objects on the emergence of generalized learned‐combinations play with three children with ASD. Overall, teaching children actions using real objects facilitated generalization of those actions with toys. We provide future directions for research when limited generalization is observed with some toys. Additionally, we discuss the implications of automatic reinforcement and the motivating operation in relation to our findings.

AbstractAcross five treatment applications, we evaluated two forms of treatment relapse (renewal, resurgence) with a version of functional communication training known as delay‐and‐denial tolerance teaching. Renewal of challenging behavior following a context change occurred for most treatments, but challenging behavior did not increase to clinically significant levels in most cases. Resurgence of challenging behavior following decrements in alternative reinforcement occurred only in two of five extinction tests when communication responses were placed on extinction. Omitting alternative activities during extinction tests led to an appreciable increase in resurgence for one of the three participants who did not display resurgence initially. Despite promising findings during the extinction test, resurgence frequently occurred during most treatments when thinning reinforcement for communication responses. When resurgence occurred during schedule thinning, it tended to be at clinically significant magnitudes. We discuss these findings in relation to the larger literature on treatment relapse.