Treatment of resistance to change in children with autism

“Resistance to change” represents a core symptom of autism that we conceptualized and assessed as resulting in part due to factors known to govern free-operant choice. During a free-choice baseline, participants chose between problematic, resistive responses and an appropriate alternative response. During the asymmetrical-choice condition, we delivered their most highly preferred item if the participant chose the alternative response (i.e., differential reinforcement of alternative behavior [DRA]). During the guided- (Experiment 1) and singular- (Experiment 2) choice conditions, we prompted participants to choose the alternative response and then delivered their most highly preferred item (i.e., DRA with escape extinction). All participants learned to tolerate (Experiment 1) or choose (Experiment 2) the alternative response when we combined DRA with escape extinction. After exposure to escape extinction, two participants showed strong maintenance effects with DRA alone. We discuss these finding relative to the effects of DRA and escape extinction on resistance to change.