Jaba_34_109.77_80.tp

2001, 34, 77–80
EVALUATION OF AN AWARENESS ENHANCEMENT JASON M. STRICKER, RAYMOND G. MILTENBERGER, MATTHEW A. GARLINGHOUSE, CRISTINE M. DEAVER, AND An evaluation of the awareness enhancement device (AED) described by Rapp, Milten-berger, and Long (1998) was conducted with 2 children who engaged in thumb suckingpast the age at which it was developmentally appropriate. The AED effectively suppressedthumb sucking for both children. Future research evaluating the AED is discussed.
awareness enhancement device, habit behaviors, thumb sucking, automatic reinforcement, automatic contingency delivery procedures on the thumb sucking of two children with- childhood can result in a number of physical in a more rigorous experimental design.
and social problems (Friman, 1987). Variousbehavioral interventions, such as the appli-cation of aversive-tasting substances to the thumb, differential reinforcement, time-out,token economy programs, and habit reversal, have been moderately to highly successful intreating this behavior. However, there may be problems with treatment integrity and ac- been diagnosed with attention deficit hyper- ceptability when the program requires close As an alternative to socially mediated in- terventions, Rapp, Miltenberger, and Long Ritalin and 100 mg of Nortriptyline per day for the duration of the investigation. All as- sessment and treatment sessions took place individual raises a hand to the head. This in the living room of each child’s home. Pri- or to the study, we conducted a functional habit behaviors (i.e., finger sucking and hair analysis involving alone, attention, escape, pulling) for 2 individuals, but it was evalu- and control conditions (these data are con- ated only after other interventions were in- tained in Stricker, Miltenberger, Anderson, effective (Ellingson et al., 2000; Rapp et al., Tulloch, & Deaver, 2000). Thumb sucking 1998). Thus, the purpose of this investiga- occurred most often in the alone condition tion was to evaluate the effects of the AED (M ϭ 93% and 77% for Mark and Jack,respectively) and rarely occurred in the other Address correspondence to Raymond G. Milten- berger, Department of Psychology, North DakotaState University, Fargo, North Dakota 58105 (E-mail: the receiver, a 65-dB pulse sounded while the units were in proximity to one another.
Thumb sucking was defined as the inser- tion of the thumb past the front teeth with ABCBAC (A ϭ baseline, B ϭ inactive AED, the lips closed over the thumb. Data on the C ϭ active AED) design for both partici- sucking were collected in 10-min sessionsusing a real-time videocassette recording method and were reported as a percentageof session time. To assess interobserver agree- Following baseline (M ϭ 94.7%), minor ment, a second observer scored 33% of all reductions in Mark’s thumb sucking were sessions. The number of seconds of agree- observed during the inactive AED condition (M ϭ 75.8%) (Figure 1). In the active AEDcondition, thumb sucking decreased to zero currence of the behavior was divided by the for four sessions and then increased during total number of seconds in the session and the inactive AED reversal (M ϭ 83.4%).
One baseline session was conducted (93.5%) thumb sucking to zero for 17 sessions across Jack’s thumb sucking was also reduced to cm by 7.5 cm) fastened on the wrists with variable early in baseline but stabilized by the sixth session (M ϭ 38.4%). Thumb sucking decreased and then increased during from the child’s mouth. When either trans- the inactive AED condition (M ϭ 50.2%).
In the active AED condition, thumb sucking (i.e., approximately 25 cm from the child’s decreased to zero for eight sessions and then mouth), the receiver’s beeper (65 dB) was increased during one inactive AED session activated while the two units were in prox- (M ϭ 98.7%) and two baseline sessions (M ϭ 94.1%). Reimplementation of the activeAED resulted in near-zero levels of thumb sucking (M ϭ 0.7%) for 27 sessions across Baseline. The participant sat by himself and watched television with the videocamera Inactive AED. The participant watched television alone and wore the AED while it each time the hand was raised to the mouth.
was turned off. No tone was delivered. This These results replicate and extend previous findings (Ellingson et al., 2000; Rapp et al., 1998) by demonstrating a clear functional relationship between contingent delivery of Active AED. This condition was similar to the tone and levels of thumb sucking. Al- that described above. However, contingent though these results demonstrate the effec- on the transmitter coming within 10 cm of tiveness of the AED, Stricker, Miltenberger, Percentage of session time of thumb sucking for Mark and Jack across baseline (BL), inactive Garlinghouse, et al. (2000) found that the and implement prescribed procedures. A sec- ond benefit was that the apparatus allowed sucking for 1 child. In this case, a more in- the children to participate in activities while tense auditory stimulus reduced the behavior it continuously detected occurrences of the behavior. This feature was appealing because both children reported that they sucked their socially mediated interventions for thumb thumbs while participating in other activities sucking. First, the device does not require a (e.g., playing video games, eating, doing person to continuously monitor the behavior It is not yet clear why the AED is effec- tive. One possibility is that the AED in-creased awareness of thumb sucking, which Ellingson, S. A., Miltenberger, R. G., Stricker, J. M., led to reductions in the behavior. Another Garlinghouse, M. A., Roberts, J., & Rapp, J. T.
possibility is that the tone punished thumb (2000). Analysis and treatment of finger sucking.
sucking and the termination of the tone neg- Journal of Applied Behavior Analysis, 33, 41–52.
Friman, P. C. (1987). Thumb sucking in childhood.
atively reinforced the movement of the hand Feelings and Their Medical Significance, 29, 11– away from the face. Future research should investigate the mechanism responsible for Rapp, J. T., Miltenberger, R. G., & Long, E. S.
(1998). Augmenting simplified habit reversal withan awareness enhancement device: Preliminary findings. Journal of Applied Behavior Analysis, 31, behaviors (e.g., nail biting, hair pulling, Stricker, J., Miltenberger, R., Anderson, C., Tulloch, also should be evaluated in future studies.
H., & Deaver, C. (2000). A functional analysis ofdigit sucking in children. Manuscript submitted for Maintenance may be achieved by fading the tone in a systematic way and by replacing Stricker, J., Miltenberger, R., Garlinghouse, M., Deav- the tone with vibration or other subtle stim- er, C., Anderson, C., & Tullach, H. (2000). Aug- menting the effectiveness of an awareness enhance- be more appropriate for use in public set- ment device to treat finger sucking. Manuscript sub-mitted for publication.
tings (e.g., the classroom or workplace). Fi-nally, when a behavior rarely occurs with subtle stimuli, the AED itself could be fad- Final acceptance November 19, 2000

Source: http://dddc.rutgers.edu/pdf/stricker_et_al.pdf