Analyzing Consequence Variables Within the High-Probability Instructional Sequence for a Child Diagnosed With CHARGE Syndrome.

Many individuals with developmental disabilities exhibit noncompliance during intensive instruction. As a treatment for noncompliance, the high-probability instructional sequence (high-p sequence) consists of delivering several high-p instructions before a low-p instruction. The purpose of this study was to extend the research on comparing consequences for high-p demands-namely, praise, edibles, and videos-with an 11-year-old girl diagnosed with CHARGE syndrome. CHARGE syndrome is a rare medical condition often resulting in multisensory impairments and developmental delays. In Treatment Analysis 1, we compared praise versus edibles as consequences for compliance with high- and low-p instructions. Results showed the edibles were initially more effective than praise, but the effects did not maintain. In Treatment Analysis 2, we changed the consequence for compliance with high- and low-p instructions to a music video and then attempted to fade the number of high-p instructions. We replicated the efficacy of the high-p sequence but failed to fade the number of high-p instructions and failed to achieve maintenance. Therefore, in Treatment Analysis 3, we conducted presession preference assessments of music videos in order to use a selected video as the consequence for compliance. This "varied reinforcement" intervention resulted in high levels of compliance. Results are discussed in terms of motivating operations and recommendations for practice.