An assessment of the necessary strength of behavioral treatments for severe behavior problems

We conducted a clinical assessment of the effects of different levels of treatment implementation for behavioral treatments of aggression and pica for three participants with developmental disabilities. Treatments were based on differential reinforcement of an alternative behavior and brief rime-out. Two treatment components, the schedule of reinforcement and time-out, were systematically varied in a range from 100%, to 50%, to 25% of initial treatment recommendations as one measure of treatment ''strength.'' For all participants, treatment effects were maintained when time-out was implemented at 50%, and for two participants, treatment effects were maintained at even lower levels. The implications of a prior assessment of necessary treatment strength are discussed.