Competing stimuli in the treatment of multiply controlled problem behavior during hygiene routines

The current study describes the use of noncontingent competing stimuli in the treatment of problem behavior exhibited by three individuals during staff-assisted hygiene routines. Functional analyses revealed that particular topographies of problem behaviors appeared to be maintained by their own sensory consequences, whereas other topographies appeared to be maintained by escape from demands. Competing stimulus assessments were then conducted to identify items associated with low levels of automatically-maintained problem behavior and high levels of stimulus engagement. Stimuli associated with low levels of automatically-maintained problem behavior (competing stimuli) were then delivered noncontingently during staff-assisted hygiene routines that were problematic for each participant. In all three cases, substantial reductions in all problem behaviors were observed. These results are discussed in terms of the relative ease of this intervention and possible mechanisms underlying the effects of competing stimuli on behaviors maintained by different types of reinforcement.