Pica is a life threating form of challenging behavior displayed by individuals with intellectual and developmental disabilities. In most cases, pica is maintained by automatic reinforcement. Common interventions for pica use some combination of response blocking, response interruption and redirection (RIRD), differential reinforcement of alternative behavior (DRA), and noncontingent reinforcement with competing stimuli. However, there is need for additional research regarding DRA procedures that emphasize skills acquisition by teaching alternative behaviors that modify the established behavioral chain of pica responses that occur in the presence of non-edible stimuli. There is also a need to examine the generality of recent advances in competing stimulus assessment (CSA) methodologies—namely, the augmented-CSA (A-CSA)—to pica. Thus, the purpose of the present investigation was to systematically replicate and extend previous research for the assessment and treatment of pica in an individual with IDD. First, we conducted a functional analysis to identify environmental variables associated with pica. Next, taught Patrick a differential response (i.e., discard pica items in trash receptacle) to earn reinforcers in conjunction with a RIRD procedure. Finally, we conducted an A-CSA for pica. Overall, low rates of pica were maintained over time with a combination of these procedures, and treatment was generalized across settings and people.

中文翻译：

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使用差异强化、反应中断和重定向以及竞争刺激对异食癖进行简要评估和治疗

异食癖是智力和发育障碍人士表现出的一种危及生命的挑战性行为。在大多数情况下，异食癖是通过自动强化来维持的。异食癖的常见干预措施结合了反应阻断、反应中断和重定向 (RIRD)、替代行为的差异强化 (DRA) 以及竞争刺激的非偶然强化。然而，需要对 DRA 程序进行额外的研究，这些程序通过教授替代行为来强调技能获取，这些替代行为修改了在存在非食用刺激的情况下发生的已建立的异食癖反应行为链。还需要检查竞争刺激评估 (CSA) 方法的最新进展——即增强 CSA (A-CSA)——对异食癖的普遍性。因此，本调查的目的是系统地复制和扩展以前的研究，以评估和治疗 IDD 患者的异食癖。首先，我们进行了功能分析以确定与异食癖相关的环境变量。接下来，教帕特里克一种不同的反应（即，将异食癖物品丢弃在垃圾桶中）以结合 RIRD 程序获得强化物。最后，我们对异食癖进行了 A-CSA。总的来说，通过结合这些程序，异食癖的低发生率随着时间的推移得以维持，并且治疗在不同环境和人群中得到推广。我们进行了功能分析以确定与异食癖相关的环境变量。接下来，教帕特里克一种不同的反应（即，将异食癖物品丢弃在垃圾桶中）以结合 RIRD 程序获得强化物。最后，我们对异食癖进行了 A-CSA。总的来说，通过结合这些程序，异食癖的低发生率随着时间的推移得以维持，并且治疗在不同环境和人群中得到推广。我们进行了功能分析以确定与异食癖相关的环境变量。接下来，教帕特里克一种不同的反应（即，将异食癖物品丢弃在垃圾桶中）以结合 RIRD 程序获得强化物。最后，我们对异食癖进行了 A-CSA。总的来说，通过结合这些程序，异食癖的低发生率随着时间的推移得以维持，并且治疗在不同环境和人群中得到推广。