Understanding of the correspondence between intervention preference and efficacy is limited. We systematically reviewed 112 articles (457 cases) evaluating efficacy of and preference for behavioral interventions. We analyzed the percentage of cases for whom interventions were preferred and efficacious across broad (e.g., behavior reduction, performance, skill acquisition) and specific (e.g., noncontingent reinforcement, video modeling) intervention types. Authors reported one preferred intervention for most cases. Regarding efficacy, authors reported about half of cases as having one efficacious intervention and the other half having multiple equally efficacious interventions. The same intervention was preferred and efficacious for 74% of cases for whom authors reported one preferred and one efficacious intervention. Several specific interventions were generally preferred and efficacious across cases (e.g., digital stimuli, computer-based instruction, accumulated reinforcement, contingent reinforcement). We discuss clinical recommendations, the importance of assessing preference, and the need for research in developing protocols for assessing intervention preference.

Functional analyses are used to assess maintaining variables of behavior. Despite the large amount of research on functional analyses with humans, there are limited examples with nonhumans and even fewer studies incorporating modifications to standard methods of assessment with nonhumans. One modification that has yet to be evaluated with nonhuman animals is the trial-based functional analysis in which control and test conditions are embedded in naturalistic environments. This study compared a standard functional analysis with a trial-based functional analysis across different topographies of problem behavior with dogs. The results of the functional analyses corresponded for every dog. Individualized treatments were designed to reduce problem behavior. Implications of the trial-based functional analysis include feasibility for privately owned dogs and dogs under the care of shelters. The trial-based functional analysis offers a modification to established functional analyses that may allow increased access to the assessment of problem behavior.

We replicated and extended Kanaman et al. (2022) by comparing outcomes of solitary (leisure items only), social (leisure items with social interaction), and combined (leisure items alone and leisure items with social interaction) stimulus preference assessments to determine the extent to which the inclusion of social interaction influenced the outcomes of preference assessments for five children with autism. We then conducted reinforcer assessments to determine the reinforcing efficacy of high- and low-preferred leisure items when presented with and without social interaction. The results showed that both high- and low-preferred items functioned as reinforcers to varying degrees for all participants and the inclusion of social interaction increased the reinforcing efficacy of some items for all participants. Additionally, the results showed that combined preference assessments predicted reinforcer assessment outcomes for two of five participants but produced false-negative outcomes for three participants. Clinical implications and directions for future research are discussed.

Choice involves engaging in a selection response when multiple options are concurrently available. Choices can be incorporated into many components of behavior-analytic treatment such as providing clients with a choice between multiple items, activities, or tasks. We reviewed the main characteristics of 38 behavior-analytic articles that compared choice and no-choice conditions. We coded the experimental arrangements of choice and no-choice conditions and analyzed potential factors affecting preferences for choice and no choice. The findings suggest that the sizing of alternatives from which to choose, the timing of choice opportunities, and the timing of the delivery of the chosen option varied across the studies. Furthermore, preferences for choice shifted with differential reinforcement history and response effort manipulations of choice or no choice. The findings suggest that individual variables should be considered when providing choices, but more research is needed.

Contingency management (CM) is notably successful as a substance use disorder treatment and is most effective when targeting monosubstance use. Evidence suggests the effects of CM exceed predictions based on the value of the incentives delivered for monosubstance abstinence. In this systematic review, we examine common variations of CM interventions applied to a single substance to determine what factors may contribute to the larger effect. Our results show that CM produced moderate to large effect sizes when single drugs were targeted, with stable effects over time. We also found that interventions targeting cocaine abstinence overwhelmingly outperformed their predicted effect, whereas interventions for smoking cessation did not. Thus, incentives alone may not account for the success of CM, at least when applied to stimulant use disorder. We propose other potential sources of the effect including social reinforcement and the specific parameters of the reinforcement schedule.

Contingency management is a well-validated behavior change intervention; however, the financial incentives can prevent it from being widely adopted. Most Americans have a smartphone with applications (apps) that they find enjoyable and engage with for a considerable amount of time. A potential avenue for contingency management dissemination is a mobile smartphone application that leverages the existing reward value of smartphone apps as a tool for behavior change. The present study examined the acceptability of the Re-Connect concept, which proposes to block nonessential but highly preferred apps and unlock them contingent on meeting the user's health goals. Out of the sample surveyed (N = 146), 63.02% reported that they would be likely to use Re-Connect and 67.81% would recommend it to someone. Acceptability of Re-Connect increased with greater user control. These results suggest that access to preferred smartphone apps could be a socially acceptable incentive in a contingency management intervention.

Many individuals with Down syndrome are diagnosed with obstructive sleep apnea (OSA), a medical condition that substantially affects health and quality of life. The most common treatment for OSA is positive airway pressure (PAP) therapy. Few studies have examined interventions to improve PAP therapy adherence for adults with developmental disabilities or have recruited the assistance of caregivers to improve adherence with this therapy in the home. This study evaluated the efficacy of a caregiver-implemented behavioral intervention to increase PAP use for four adults with Down syndrome and OSA. The experimenters trained caregivers via telehealth to implement the intervention in their homes. The intervention consisted of graduated exposure, noncontingent reinforcement, and differential positive and negative reinforcement without escape extinction. The intervention increased the duration of PAP use for all four participants. These results provide preliminary support for the efficacy of this intervention and service-delivery model.

A resurgence in research on response disequilibrium theory has prompted a concise review of the literature from the past 5 years. Response disequilibrium, also known as response deprivation, attributes reinforcement and punishment effects to constraints on free-operant baseline levels of behavior. By describing clinically relevant behaviors in terms of instrumental and contingent activities, researchers and practitioners can predict intervention outcomes with a disequilibrium model. We summarize the empirical outcomes of disequilibrium-informed interventions across six articles and discuss areas of future research.

Substance use disorders (SUDs) affect millions and have substantial negative consequences for individuals and society. Social incentives that leverage social networks for reinforcement or feedback have been used to improve health behaviors such as physical activity. This study investigated the feasibility, acceptability, and usability of a novel digital social incentive system embedded into a web- and smartphone-based platform for SUD recovery. The system leveraged a preexisting care team to deliver social incentives following notifications on recovery-related goal completion and abstinence to members undergoing SUD treatment. In total, 243 notifications were sent to care-team members, resulting in 117 social incentives, nearly all of which (99.15%) were coded as positive. Treatment members and care-team members provided favorable endorsements on acceptability and usability measures. Some areas of improvement were identified, such as increasing personalization and transparency. This digital social incentive system was feasible, acceptable, and usable as an adjunct treatment component for SUD recovery.

Contingency management (CM), which involves the delivery of incentives upon meeting behavioral goals, has the potential to improve substance use treatment outcomes. The intervention allows for flexibility through numerous modifiable components including changes to incentive magnitude and schedule, target behavior, and intervention structure. Unfortunately, numerous changes in the substance use landscape have occurred in the past 10 to 15 years: Substances are more potent, overdose risk has increased, new substances and methods of use have been introduced, and substance classes are increasingly being intentionally and unintentionally mixed. These developments potentially undermine CM outcomes. We explored recent substance use changes due to legislative, regulatory, social, and economic factors for four substance classes: stimulants, opioids, tobacco, and cannabis. We discuss potential adjustments to the modifiable components of CM for future research in response to these changes. By continually adapting to the shifting substance use landscape, CM can maintain optimal efficacy.

This article is a transcription of Murray Sidman's presentation at the annual meeting of the Society for the Quantitative Analysis of Behavior in May 1998. It describes the development (from 1965 to 1975) of behavior-change programs implemented outside the animal laboratory to benefit humans before such application was established formally as an entity derived from the experimental analysis of behavior. The presentation illustrates the use of an inductive method in practice, where working with a fluid behavior stream entails making intervention decisions on the spot. Examples include fading and backward-chaining procedures in the establishment and stimulus control of novel actions. Sidman also discusses the certification of practitioners and the interaction between client and therapist and between basic and applied endeavors. The latter define what is contemporaneously described as translational intervention. It is noteworthy that Sidman's presentation was at a meeting attended by both practitioners and scientists.

Contingency management is especially effective in supporting medication adherence and drug abstinence among people with opioid use disorder. However, the incorporation of contingency management into clinical practice has been slow. The present study was designed to evaluate the feasibility, acceptability, and usability of incentives for providers as a means of accelerating collaborative care with contingency management. Thirteen buprenorphine prescribers served as participants in a nonexperimental study. The prescribers who referred patients to a contingency-management service received monetary incentives for reviewing patient performance data and describing their use of these data in treatment decisions. The results show that this approach is feasible, acceptable, and easy to use for everyone involved. Self-reports indicate improved prescriber-patient relationships and more informed care. However, prescriber-focused incentives did not appear to greatly enhance access to contingency-management services for patients. Thus, provider incentives may be beneficial but further research is needed to advance adoption of contingency management.

Modern medical training consists largely of lecture-based instruction and in vivo or video modeling of specific skills. Other instructional methods, such as teaching with acoustical guidance (TAGteach), have rarely been evaluated. In this study, we compared teaching with tactile guidance, or tactile TAGteach in which a vibratory stimulus is delivered to indicate a correct response, with video modeling and self-evaluative video feedback to teach four participants two medical skills: simple interrupted suture and endotracheal intubation. The results showed that both instructional methods improved performance. However, three participants met the mastery criterion in the tactile TAGteach condition first, although this instructional method required more time to train the skills. We discuss the implications of these findings for training skills to medical practitioners.

When applied to functional analysis results, structured visual inspection criteria have resulted in improvements in the levels of agreement between raters as well as earlier identification of the function of challenging behavior. However, multistep criteria can be difficult to apply in real time, which could be a barrier to widespread adoption in practice. This study evaluated a Microsoft-Excel-based functional analysis decision support system (FADSS), which could aid behavior analysts with interpreting functional analysis results. Final overall agreement between the FADSS and post hoc visual inspection was high at 95%. Final overall agreement between the post hoc results generated by FADSS and ongoing results generated by FADSS was acceptable at 81%, representing a 50% increase in efficiency. These results indicate that FADSS could aid behavior analysts when interpreting functional analysis results in real time.

A competing stimulus assessment is used to identify stimuli that are associated with a low level of challenging behavior and a high level of engagement. These stimuli are often used as a treatment component for challenging behavior that is maintained by automatic reinforcement. One limitation of implementing competing stimulus assessments is that they may be time consuming. The purpose of the current study was to evaluate the efficacy and efficiency of a latency-based competing stimulus assessment. During the asssessment, a therapist presented potential competing stimuli to the participants and contingent on the first occurrence of challenging behavior, the trial was terminated. The results of a brief treatment evaluation indicated that stimuli that were associated with the longest latency to challenging behavior were more effective in competing with challenging behavior relative to stimuli that were associated with shorter latencies. However, procedural modifications were necessary for one participant. The use of latency-based measures improved the efficiency of conducting a competing stimulus assessment.

The Good Behavior Game (GBG) is an effective procedure for reducing disruptive classroom behavior. Students in three fifth-grade classes selected the rules of the GBG and then experienced the GBG with different forms of feedback for rule violations (vocal and visual, vocal only, visual only, no feedback). Following an initial baseline, the four feedback versions of the GBG and a baseline condition were alternated across sessions in a multielement design. All versions of the GBG substantially reduced disruptive behavior below baseline levels. Additionally, in one of the three classes losing the GBG produced an increase in negative peer interactions immediately following the GBG. Following the multielement comparison, we implemented a group-arrangement concurrent-chains preference assessment in which students selected one of the conditions to experience each day. The most selected condition across all classes was the GBG condition, which included both vocal and visual feedback.

This study compared the effects of video feedback (VF) as a stand-alone intervention and video modeling plus video feedback (VMVF) for improving soccer players' static ball control skills. Research has suggested that VF alone and VMVF produce substantial improvements for young athlete's skills, though no studies have compared the two. Therefore, we used a multiple-baseline-across-participants design with embedded alternating treatments to compare VF and VMVF. Two 10-year-old female soccer players and one 9-year-old male soccer player participated. The first author implemented the VF and VMVF training procedures and assessed the same three target behaviors across participants. The results suggested that VF and VMVF produced similar increases in performance for two of three participants and that VMVF produced slightly greater increases for one participant. In addition, both interventions were effective at substantially improving ball control skills from baseline levels and relative to a control skill.

Parent-mediated interventions for infants and young children with an increased likelihood of autism may help ameliorate developmental concerns; however, generalization of parents' teaching strategies to novel child target skills has not been consistently demonstrated. This study expanded our parent training program, Parent Intervention for Children at-Risk for Autism (PICARA), by incorporating telehealth general case training (PICARA-TGCT) to promote generalization of teaching skills. Five parent-child dyads participated. Child target skills were chosen from the categories of imitation, receptive language, and expressive language. A concurrent multiple-baseline-across-participants design was used to evaluate the effect of training across two cohorts of parent-child dyads. Dependent variables included the percentage of correct parent teaching skills and the percentage of child correct responses. Parent teaching skills increased across all participants for both trained and untrained child target skills, as did child skills. This study provides support for PICARA-TGCT as an efficacious and efficient early intervention model.

Despite the efficacy of functional analyses in identifying the function of challenging behavior, clinicians report not always using them, partly due to safety concerns. Understanding how researchers employ safeguards to mitigate risks, particularly with dangerous topographies like self-injurious behavior (SIB), is important to guide research and practice. However, the results of a scoping review of functional analyses of self-injurious behavior conducted by Weeden et al. (2010) revealed that only 19.83% of publications included protections. We extended the work of Weeden et al. to determine whether reporting has improved. We observed increases in all but two types of protections reviewed by Weeden et al. Additionally, we included new protections not reported by Weeden et al. In total, 69.52% of the studies included at least one protective procedure and 44.39% specified that the protections were used for safety. It appears that reporting has increased since Weeden et al. called for improved descriptions of participant protections.

The current study compared the effects of interteaching and discussion forum activities on quiz and assignment scores in a master's-level asynchronous research methods course. In an alternating-treatments design, six participants engaged in interteaching on half of the weeks and in the discussion forum on alternate weeks. Participants in the interteaching condition (M = 96.75) generally scored higher on quizzes than did those in the discussion forum condition (M = 75.95). The results of a paired-sample t test indicated statistically significant differences between the two conditions at p < .0001, with a substantial effect size of 0.6760. Significant differences in assignment scores were not observed between the interteaching (M = 87.28) and discussion forum (M = 89.08) conditions. Limitations and directions for future research are discussed.

Behavioral skills training (BST) has been used to improve football players' performance in one prior study, but limited data were collected on how the skill generalized from the training environment to the natural environment. The purpose of this study was to further evaluate the effects of BST in enhancing football players' performance while also evaluating the generalization of a skill taught in a training environment (i.e., practice) to the natural environment (i.e., game-simulated scrimmage). This study included five high school offensive line football players and recorded their run-blocking skills in the training context and a game context in baseline and following BST. The results showed that BST improved performance in the training environment, with run-blocking skills slightly generalizing from the training environment to game-simulated scrimmages. When BST was conducted in the natural environment, it further improved the participants' run-blocking skills.

We evaluated the effects of behavioral skills training on improving participant implementation of functional communication training with multiple schedules when working with a confederate. Behavioral skills training produced mastery-level responding for all six participants who required training, providing the first empirically supported training for this functional communication training approach. Next, we assessed durability during training challenges with (a) procedural changes to the original protocol, (b) a novel confederate with different discriminative stimuli and reinforcers, and (c) relapsed confederate destructive behavior. Training effects degraded at least once for all participants and in 62% of training challenges, although continuing to expose the participant to the challenging situations or providing postsession booster training resolved the degradation in most cases. We discuss these findings in relation to their clinical implications and directions for future research.

The purpose of the present experiments was to systematically replicate Step it UP! Game interventions with adults with disabilities. Participants were divided into two competing teams, and the team with the highest step count participated in a prize drawing. Experiment 1 (N = 9) evaluated the efficacy of an extended version of the Step it UP! Game that included additional and longer sessions. Experiment 2 (N = 8) evaluated the addition of contingent experimenter attention during the Step it UP! Game. Baseline, Step it UP! Game, and Step it UP! Game plus interaction sessions were evaluated in a multielement design. The Step it UP! Game was effective with additional and longer sessions, and all participants took more steps during Step it UP! Game sessions. Adding experimenter interaction to the Step it UP! Game did not increase the efficacy of the intervention.

Using telehealth technology to deliver parent training in evidence-based intervention has been suggested to increase the accessibility of such interventions and improve skill acquisition and generalization. Within behavior analysis, global restrictions in response to the COVID-19 pandemic highlighted the need for the development of telehealth supports for families. The current research examined the online delivery of a parent-mediated implementation of the Preschool Life Skills program (PLS). Four parents completed the parent PLS program with their typically developing children (aged 3-5 years) via weekly videoconferencing sessions. A multiple-probe experimental design was employed to assess the effect of the intervention on children's preschool life skills and challenging behavior. Parental embedding of PLS strategies during daily activities was also evaluated. The results demonstrated increases in children's preschool life skills, decreases in challenging behavior, and evidence of parent acquisition and use of PLS strategies.

Little research has examined specific instructional variables that influence the development and effectiveness of task-analysis instruction. We conducted two experiments using text-based task analyses to teach college students to create single-subject reversal design graphs. In Experiment 1, we tested the effects of presenting antecedent and outcome stimuli on graphing performance (accuracy, yield, time to completion). Different groups of participants experienced graphing tutorials with descriptions and pictures of (a) responses; (b) antecedent stimuli and responses; (c) responses and outcomes of correct responses; and (d) antecedent stimuli, responses, and outcomes. In Experiment 2, we compared tutorials with and without pictures. Collectively, the results suggest that graphing accuracy was positively affected by task analyses that included pictures and descriptions of antecedent stimuli and that adding outcome stimuli further benefited graphing accuracy. These results suggest critical instructional elements that should be included in future task analyses of graphing or other complex behavior chains.

Previous research has supported selecting development-matched targets rather than age-matched targets to teach play skills to children with autism spectrum disorder. However, few studies have been conducted, and replications and extensions of this research are needed. The current study replicated Pane et al. (2022) by comparing the acquisition of development-matched and age-matched play targets when teaching play skills to four children with autism. No contrived prompts or consequences were used to teach play skills in either condition. Extensions included identifying targets via a newer version of the Developmental Play Assessment, targeting different play categories, assessing additional imitation skills, and conducting a caregiver assessment to identify socially valid toys, play actions, and vocalizations based on each participant's common experiences and preferences as well as their caregiver's values and preferences. As in Pane et al., participants demonstrated a higher level of scripted play actions in the development-matched condition.

Inappropriate mealtime behavior (IMB) is a type of feeding challenge within the broader class of food refusal. The purpose of this study was to critically analyze the efficacy of interventions for the treatment of IMB through a meta-analysis of research using single-case experimental designs. We examined the extent to which different interventions resulted in decreases in IMB while also producing increases in food acceptance. This meta-analysis was also used to examine the efficiency of different interventions in achieving clinical significance. We identified 38 studies involving 266 cases in which IMB was treated with a behavioral intervention. The results indicated interventions that combined escape extinction and non-escape extinction had greater effect sizes for both reducing IMB and increasing food acceptance than either escape extinction alone or non-escape extinction alone. However, interventions that included escape extinction were slightly less efficient at decreasing IMB than were interventions that did not include escape extinction. We discuss the implications of these findings and provide recommendations for future research.

Pairing is a commonly recommended practice used to build rapport and create positive therapeutic environments. However, there are limited evaluations of training procedures to teach pairing skills to direct-care staff. The purpose of the present study was to formalize and improve the efficiency of the training process for the initial stages of pairing using video modeling with embedded voice-over instructions plus performance feedback. Participants included three dyads of behavior technicians and children with autism. The results indicated that the training package increased the consistency of pairing implementation. These outcomes were maintained in a novel setting and for up to 4 weeks following training. We also measured relevant child behaviors such as joint attention, engagement, indices of happiness, and calm. Specific areas for future research are described.

Open science practices are designed to enhance the utility, integrity, and credibility of scientific research. This article highlights how preregistration in open science practice can be leveraged to enhance the rigor and transparency of single-case experimental designs within an applied behavior analysis framework. We provide an overview of the benefits of preregistration including increased transparency, reduced risk of researcher bias, and improved replicability, and we review the specific contexts under which these practices most benefit the proposed framework. We discuss potential concerns with and unique considerations for preregistering experiments that use single-case designs, with practical guidance for researchers who are seeking to preregister their studies. We present a checklist as a tool for researchers in applied behavior analysis to use for preregistration and provide recommendations for our field to strengthen the contingencies for open science practices that include preregistration.