Treating Operant Vomiting With Visual Screening

Abstract

The authors present a case study of an 8-year-old boy with autism who engaged in operant vomiting. Functional assessment indicated that vomiting persisted in the absence of social reinforcement. After interventions involving noncontingent access to preferred items, differential reinforcement of other behavior (DRO), and DRO plus time out failed to produce clinically significant decreases in vomiting, we implemented a contingent mouthwash procedure and a contingent visual screen (VS) procedure. The results show that the contingent mouthwash produced only temporary decreases in vomiting whereas the VS procedure gradually decreased the boy’s vomiting to zero levels over the course of 23 weeks. In addition, a 4-month follow-up assessment showed that ongoing implementation of the VS procedure produced zero levels of vomiting. The gradual reduction in the boy’s vomiting following the introduction of the VS procedure suggests that the intervention extinguished one or more of the sensory consequences that were formerly produced by vomiting.