Incorporating Curricular Revision to Treat Escape-Maintained Behavior for Children with ADHD

Functional communication training (FCT) reduces escape-maintained challenging behavior but can result in time away from instruction. Instructional time could be maintained if interventions incorporated academic interventions like curricular revision. We compared FCT with extinction to a curricular-revision treatment package involving antecedent modifications of task difficulty and differential reinforcement for compliance for three children with attention deficit/hyperactivity disorder whose behavior was maintained by escape from academic tasks. During sessions with FCT, we taught the child to request a mastered task and did not permit escape following challenging behavior. During sessions with the curricular-revision package, we modified the instruction to a simpler component of the task and initially reinforced both compliance and challenging behavior. The curricular-revision package (without extinction) was more effective than FCT for one participant. Once we added escape extinction to the curricular-revision package, that intervention suppressed challenging behavior as well as FCT, resulted in more time engaged with the academic task than did FCT, and did not increase the likelihood of relapse when the interventions were abruptly discontinued. Practitioners attempting to treat escape-maintained behavior for children with ADHD should consider a multifaceted approach that addresses both antecedents (like curricular revision) and consequences of behavior.