Carneiro et al.

Psicologia: Reflexão e Crítica

https://doi.org/10.1186/s41155-019-0134-3
(2019) 32:21
Psicologia: Reflexão e Crítica

RESEARCH Open Access

Evaluating the use of programmed

reinforcement in a correction procedure
with children diagnosed with autism
Ana Carolina Cabral Carneiro1, Eileen Pfeiffer Flores2, Romariz da Silva Barros1,3 and
Carlos Barbosa Alves de Souza1,3*

Abstract
Background: Procedures that reduce errors while learning a repertoire play an important role in Applied Behavior
Analysis for people with autism due to the detrimental effects that excessive exposure to error may have on
learning. Previous studies have investigated the effects of correction procedures that require active student
response after a trial with error. Some intervention manuals recommend against reinforcing responses after
correction to prevent the establishment of prompt dependence. This study directly investigated the effect of
reinforcement after an active-response correction procedure during tact training in four children with autism. An
echoic-to-tact training procedure was used to train tacts. A “no reinforcement after correction” (NRC) condition was
compared to a “reinforcement after correction” (RC) condition, using an adapted alternated treatments design.
Results: All participants needed less correction trials in RC than in NRC, and considering all 26 sessions in which
both training procedures were implemented, participants’ performance was higher with RC than without in 17
sessions and was the same in 3 sessions.
Conclusions: We discuss the effectiveness of reinforcing correct responding after an active-response correction
procedure, the absence of prompt dependence, and the implications of better correction procedures for applied
settings.
Keywords: Correction procedure, Reinforcement, Verbal behavior, Autism

Background incorrect responses are followed by error statements

An important aspect of effective autism intervention is the (saying “no” to the incorrect response) or modeling
design of procedures that minimize errors, since these the correct response, without requiring an active
may lead to performance deterioration (Greer and Ross, learner response (Barbetta, Heron, and Heward, 1993;
2008; Lovaas, 2003; Mueller, Palkovic, and Maynard, McGhan and Lerman, 2013; Smith, Mruzek, Wheat,
2007). Although errors are often inevitable, some features and Hughes, 2006). In other correction procedures, an ac-
of the teaching procedures may be relevant to make them tive learner response is required after a corrective trial, such
less frequent. as in single-response repetition procedure (the correct re-
Correction procedures are recommended in autism sponse is modeled, and the participant is required to repeat
intervention handbooks (e.g., Greer and Ross, 2008; the correct response), remove and re-present (after the in-
Maurice, Green, and Foxx, 2001; Sundberg and correct response a brief time-out is implemented and the
Partington, 1998). Several correction procedures have trial is re-presented with the correct response modeled) and
been proposed and investigated. In some procedures, directed rehearsal (the correct response is modeled and the
trial is re-presented until a specific number of correct un-
* Correspondence: carlosouz@gmail.com
1
prompted responses occur) (Barbetta, Heward, and Bradley,
Universidade Federal do Pará, Belém, PA, Brazil
3
Instituto Nacional de Ciência e Tecnologia sobre Comportamento, Cognição
1993; Barbetta, Heward, Bradley, and Miller, 1994; Carroll,
e Ensino, Sao Carlos, Brazil Joachim, St. Peter, and Robinson, 2015; Carroll, Owsiany,
Full list of author information is available at the end of the article

© The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made.
Carneiro et al. Psicologia: Reflexão e Crítica (2019) 32:21 Page 2 of 8

and Cheatham, 2018; Kodak et al. 2016; Rapp et al. 2012; Nevertheless, studies discussing possible prompt de-
Rodgers and Iwata, 1991; Turan, Moroz, and Croteau, 2012; pendence (Cividini-Motta and Ahearn, 2013; Karsten and
Worsdell et al. 2005). Carr, 2009; Vladescu and Kodak, 2010) have focused on
Taken together, studies point to the effectiveness of the effects of cues or prompts used in errorless learning
multiple error-correction procedures and suggest that procedures without addressing the issue of reinforcement
the efficiency of each procedure varies according to the on corrective trials. Therefore, the recommendation to
characteristics of the learners and correction procedures avoid programmed reinforcement for correct responding
used (Carroll et al. 2015; Carroll et al. 2018; Kodak et al. in corrective trials needs empirical support.
2016; Ingvarsson and Hollobaugh, 2011; Ingvarsson and The present investigation addresses this issue directly.
Le, 2011; Kodak, Fuchtman, and Paden, 2012; McGhan We conducted an experimental investigation of the effect
and Lerman, 2013). of reinforcing active responding in corrective trials while
Concerning the correction procedures with an active teaching tacts1 to children diagnosed with autism. We
learner response requirement (usually recommended in used an adapted alternating treatments design (Sindelar,
manuals for autism intervention, e.g., Greer and Ross, Rosenberg, and Wilson, 1985) to contrast correction with
2008; Maurice et al. 2001) studies have evaluated, with and without programmed reinforcement during tact
mixed results, two main effects. The first one is the ef- acquisition.
fect of requiring more or fewer repetitions of the cor-
rective trial (i.e., more or fewer opportunities to actively Method
practice the response, e.g., Cuvo, Ashley, Marso, Zhang, Participants
and Fry, 1995; Marvin et al. 2010; Worsdell et al. 2005). Four boys (aged 4 to 8 years) diagnosed with autism par-
The second effect is that of inserting a mastered target ticipated. We assessed participants’ verbal repertoire
between a prompted trial (after an error) and the oppor- using the Verbal Behavior Milestones Assessment and
tunity for independent response, to prevent prompt de- Placement Program (VB-MAPP–Sundberg, 2008). All
pendence (Plaisance, Lerman, Laudont, and Wu, 2016; children reached level 1 abilities (0–18 months) and at
Turan, Moroz, and Croteau, 2012). Apparently, inde- least some level 2 abilities (18 to 30 months). All four
pendently of specific features of the procedure, the ef- children were enrolled in mainstream classrooms. Par-
fectiveness of correction procedures in such cases may ticipant 1 (aged 4 years) and participant 4 (aged 6 years)
be related to negative reinforcement (Rodgers and Iwata, were enrolled in a university-based project that provided
1991). Correction procedure may be aversive and correct training for caregivers of children diagnosed with autism.
responses may function to avoid correction (but see Participant 2 (aged 8 years) and participant 3 (aged 5
Plaisance et al. 2016). years) were enrolled in the same project and additionally
However, a more basic question concerning correction received approximately 5 h per week of behavior-
procedures with an active learner response requirement analytic intervention. Participants 1 and 2 had previously
has not been investigated to date: the effect of undergone occupational and speech therapy in other
reinforcement for correct responses on corrective trials institutions.
(after an error). Overall, studies have presented praise as
a consequence for correct responses in prompted cor- Ethical considerations
rection trials, keeping edible/tangible items (supposedly This study was approved by the Research Ethics Commit-
high-magnitude reinforcers) for independent responses tee at the Health Sciences Institute, Federal University of
(e.g., Carroll et al. 2015; Carroll et al. 2018; Kodak et al. Pará (Consent Number 175.303). Participants’ caregivers
2016; Rapp et al. 2012; Turan et al. 2012). Handbooks signed an informed consent authorizing children’s partici-
focused on interventions for people with autism (e.g., pation in the study.
Greer and Ross, 2008) often caution against using pro-
grammed reinforcement to correct active responding on Setting and materials
a corrective trial that is presented after an error. The Sessions were conducted at the university, in a room (36
recommendation seeks to avoid possible prompt m2) prepared and designated for research and interven-
dependent behavior that could arise in correction proce- tion with children diagnosed with autism. Sessions were
dures. It is assumed that this prompt dependent behav- filmed using a Sony HDD DCR-SR87 camera and target
ior can be established as a consequence of a higher behaviors were recorded using customized sheets.
reinforcement density, product of corrected and inde-
pendent responses reinforcement, or of the delayed Discriminative stimuli
reinforcement effect of the incorrect responses that pre- Stimuli were 18 anthropomorphic tridimensional objects, di-
cede the strengthening of corrected responses (Catania, vided into 3 groups with 2 sets of 3 stimuli each (see Fig. 1).
1971; DeLeon, Bullock, and Catania, 2013). Stimuli were named with two-syllable contrived words (e.g.,
Carneiro et al. Psicologia: Reflexão e Crítica (2019) 32:21 Page 3 of 8

Fig. 1 Stimulus sets by group of training in RC and NRC conditions.

Baco, Gami, Lemu) to minimize uncontrolled effects of chil- Procedure

dren’s learning history regarding the stimuli. Sessions were conducted 2–3 times a week. Initially, we
assessed which syllables each child could pronounce and
used them to compose the two-syllable-contrived stimu-
Consequence stimuli
lus names.
We interviewed caregivers about possible reinforcers and
conducted daily multiple-stimulus-without-replacement
Assessment of syllable pronunciation
preference assessments (Carr, Nicolson, and Higbee,
An assessment session consisted of 20 trials in which the
2000) to rank items by preference (see DeLeon and Iwata,
experimenter asked the child to imitate vocal one-syllable
1996 on correlations between preference and reinforcing
stimuli (e.g., “ba”). Tangible and social reinforcements
function). Praise and approval were also used (e.g., “Well
followed correct responses. Errors or failure to respond
done!” “Cool!”).
after 5 s led to a new trial. Sessions were continued until
at least 10 syllables were found that the child could repro-
Experimental design duce correctly.
We used an adapted alternating treatments design (Sindelar
et al. 1985) to evaluate the effect of reinforcement after cor- Tact training
rection on tact acquisition. Each participant was exposed to Tacts were taught using an echoic-to-tact training pro-
alternating treatments using two sets of three stimuli. For cedure (Greer and Ross, 2008)2. Each session consisted
one set, we used an active-response correction procedure of 12 trials with one of the 3-stimuli sets (4 trials per
followed by reinforcement of correct responses stimulus). Stimuli were presented in random order.
(“reinforcement after correction” condition—NRC). For the Inter-trial interval varied depending on the reinforcer
other set, there was no reinforcement for corrected presented on the previous trial.
responses (“no reinforcement after correction” condition— The training was implemented in two stages (training with
NRC). Dependent variables were count of tacts learned, ses- vocal prompt; and training with delayed vocal prompt). The
sions to mastery criterion, and number of correction trials in first training stage used simultaneous vocal prompts. Each
each condition. Order of conditions was balanced between trial began with the experimenter presenting a tridimen-
participants. sional stimulus and saying: “[stimulus name]. What’s this
Carneiro et al. Psicologia: Reflexão e Crítica (2019) 32:21 Page 4 of 8

called?” or “[stimulus name]. What´s this?” (The experi- NRC condition). Correct or incorrect response ended
menter alternated the two question formats). Correct re- the trial, and correct response resulted in social
sponses led to social and tangible reinforcement (with a reinforcement in RC condition.
low-magnitude reinforcer, as previously defined by the The learning criterion in this first stage was at least
multiple-stimulus preference assessment) and ended the three correct responses out of four trials for each stimu-
trial. Incorrect responses or failure to respond after 5 s led lus (i.e., at least 9 correct responses in 12 trials and at
to the correction procedure (see Fig. 2). most 1 incorrect response for each stimulus).
Immediately after an incorrect response, the experi- Once a participant reached the learning criterion for
menter showed the stimulus and repeated the prompt as one of the stimuli with vocal prompt, training for that
described above. A correct response ended the trial in stimulus proceeded to a second stage in which a 5-s delay
the NRC condition or led to social reinforcement and was inserted between stimulus presentation and vocal
the end of the trial in the RC condition. If the partici- prompt. The experimenter presented the stimulus and, in
pant gave an incorrect response or did not respond after alternating trials, asked “What’s this called?” or “What’s
5 s, the experimenter repeated the trial, this time this?” and waited for 5 s. In other trials, the experimenter
stretching out the syllables of the vocal prompt. If the simply presented the stimulus and waited for 5 s. In either
participant responded incorrectly or failed to respond, case, correct responses were given before the vocal
the experimenter repeated the procedure up to two prompt lead to social and tangible reinforcement (with a
more times, stretching out the syllables of the vocal higher-magnitude reinforcer, as previously defined by the
prompt. If the participant did not respond correctly after multiple-stimulus preference assessment) and ended the
the third repetition, the trial was ended. Correct re- trial. If the child emitted an incorrect response or did not
sponses at this point led to social reinforcement and respond after 5 s, the experimenter began the same cor-
repetition of the trial without stretching out the syllables rection procedure used in the previous training phase.
of the vocal prompt (in RC condition) or just to a repeti- The same learning criterion was used as in the previous
tion of the trial without the stretching-out procedure (in stage (minimum of 9/12 correct responses with maximum
one error per stimulus).
After three consecutive sessions, the experimenter
began training with a new set of three stimuli, whether
or not the child had reached criterion for all stimuli of
the previous set. This was done to avoid excessive ex-
posure to error.

Inter-observer agreement and treatment integrity

A second experimenter independently observed the filmed
records of 30% of experimental sessions and scored per-
formance in order to establish inter-observer agreement
([agreements/disagreements + agreements] × 100). The
second observer also judged treatment integrity by observ-
ing whether all planned procedures were correctly and
thoroughly implemented ([correct procedures/planned
procedures] × 100 for stimulus presentation, consequence
presentation, and correction procedures). Inter-observer
agreement for performance scores varied between 93.5%
and 100%. Treatment integrity for stimulus presentation
was 100% for all four participants. Treatment integrity for
consequences and for correction procedures was 100% for
participants 1, 3, and 4 and 94 % for participant 2.

Results
During the initial tact training stage, with simultaneous
vocal prompts, all four participants reached 100% cor-
rect responses in one session. Therefore, correction pro-
cedures were unnecessary at this stage.
Fig. 2 Correction procedure flowchart. NR = no reinforcement after
Total percentage of correct tacts in the training stage
correction condition. RC = reinforcement after correction condition
with delayed vocal prompts was 32.81% for stimulus set
Carneiro et al. Psicologia: Reflexão e Crítica (2019) 32:21 Page 5 of 8

used in NRC Condition, and 50.55% for stimulus set reached criterion in only one session in RC but did
used in RC condition. Mean trials to criterion for each not reach criterion after three sessions in NRC, and
stimulus were 4.58 in the NRC condition and 2.5 in the for set 3 he reached criterion during the third ses-
RC condition for participant 1; 5.25 in the NRC and 4.5 sion with RC but did not reach criterion after three
in the RC condition for participant 2; 2.5 in NRC and sessions in NRC.
1.67 in RC for participant 3; 8.75 in NRC and 5 in RC Participant 2 reached the learning criterion for set 1 at
for participant 4. the end of the second session in the RC condition but
Figure 3 shows the percentage of unprompted cor- did not reach criterion after 3 sessions in the NRC con-
rect responses per session, for all three sets of trained dition. For set 2, he reached criterion after 3 sessions in
tacts, for each participant, with (RC condition) and both conditions, and for set 3 he did not reach criterion
without reinforcement (NRC condition) for correct after three sessions in RC and reached criterion during
responses after correction procedures. Taking into ac- the third session in NRC.
count all 26 sessions in which both training proce- Participant 3 needed only one session to reached
dures were implemented, participants’ performance learning criterion for set 1 in the RC condition, but did
was higher with RC than without in 17 sessions and not reach learning criterion after two training sessions in
was the same in three sessions, i.e., performance NRC (due to experimenter error, a third session was not
tended to be more accurate when reinforcement was held in this condition). For set 2, he required three ses-
delivered contingent on correct responses after cor- sions to reach criterion in RC and two sessions in NRC,
rection procedures. and for set 3 he needed only one session to achieve the
Considering participants’ performance with each learning criterion in RC but did not reach criterion after
set of stimuli, it is possible to observe that partici- three sessions in NRC.
pant 1 reached the learning criterion for set 1 during Participant 4 reached the learning criterion for set 1 in
the second session, for both conditions. For set 2, he two sessions in RC condition but did not reach learning

Fig. 3 Percent unprompted correct responses per session for three trained sets of tacts (set 1, set 2, and set 3) for each participant (P1, P2, P3,
and P4), during training sessions with delayed echoic prompts, with and without reinforcement for correct answers after correction procedures
Endnotes1Tact: A verbal operant controlled by non-verbal antecedent stimuli and maintained by generalized reinforcement (Skinner, 1992). For
example, a child sees a toy bear and says “Bear.”2Echoic: a verbal operant controlled by verbal stimuli and maintained by generalized
reinforcement, in which there is point-to-point correspondence and formal similarity between antecedent and response (Skinner, 1992). For
example, a child hears her father say “Good girl” and she repeats “Good girl.”
Carneiro et al. Psicologia: Reflexão e Crítica (2019) 32:21 Page 6 of 8

criterion at the end of three training sessions in NRC. correction trials. Conceivably, such guidelines should be
For sets 2 and 3, in both conditions, participant 4 did derived from research showing that prompting procedures
not reach criterion, but performance was superior in the can lead to prompt dependency, since prompting is often
RC condition for four out of six sessions. involved in correction procedures, but as mentioned be-
Table 1 presents the frequency and level of correction fore, studies discussing possible prompt dependence (e.g.,
trials needed in RC and NRC conditions. All participants Cividini-Motta and Ahearn, 2013; Karsten and Carr, 2009;
needed a higher frequency of correction trials when Vladescu and Kodak, 2010) have focused on the effects of
there was no reinforcement after correction (NRC) than prompts in errorless learning procedures, without ad-
when there was (RC). Three participants (P1, P2, and dressing the issue of reinforcement on corrective trials.
P4) also needed correction beyond the first delayed vocal The present study directly investigated the effect of
prompt (stretched-out vocal prompts) in the NRC con- reinforcement after an active-response correction proced-
dition, but not in the RC condition. ure during tact training in children with autism, and the
results do not offer empirical support for claims that
Discussion reinforcement of correct responding on correction trials is
This study investigated the effect of reinforcement after detrimental to performance.
correction with active response procedure on the learn- As previously indicated, it is assumed that prompt
ing of tacts by children with autism. A correction trial dependent behavior can be established as a consequence of a
requiring an active response was presented immediately higher reinforcement density, as a product of reinforcement
after each error (Worsdell et al. 2005; Barbetta et al. of corrected as well as independent responses or through the
1994). This procedure was compared with another in delayed reinforcement effect of incorrect responses that pre-
which reinforcement did not follow corrected responses, cede the strengthening of corrected responses (Catania,
as recommended in some intervention handbooks (e.g., 1971; DeLeon, Bullock, and Catania, 2013). The results of
Greer and Ross, 2008; Maurice et al. 2001). the present study also do not support this assumption, but
In general, data from the present study suggest that deliv- considering that parametric manipulations of the magnitude
ering reinforcement contingent on correct responses during of the reinforcers have not been performed, new studies
correction trials can benefit tact acquisition in children with must be carried out to evaluate this question more
autism. Performance was generally superior when systematically.
prompted responses were corrected, as measured by attain- The adapted alternating treatments design used in this
ment of learning criterion, trials or sessions to criterion, study (Sindelar et al. 1985) allowed us to evaluate the ef-
percent correct responses, as well as frequency and level of ficacy of two different procedures on correction trials on
correction necessary for learning. Of course, it is possible the acquisition of tacts. However, with this type of alter-
that difference in participants’ performance between RC nating treatment design it is not possible to rule out
and NRC conditions could diminish with additional train- completely carryover effects from one treatment to the
ing, considering that training with each set of stimuli ended other. A replication of the present study using a sequen-
after three sessions (even though performance was quite tial alternating treatment design (Wacker et al. 1990)
low in both conditions—see participant 4’s performance). with order presentation counterbalanced across-subjects
However, this does not affect the result that, in a general is therefore in order.
way, participants needed fewer trials or sessions, with lower Further development of this line of research may con-
frequency and level of correction, to criterion in RC condi- tribute to our understanding of the effects of
tion, which has implications when planning more effective reinforcement after correction procedures on teaching
interventions for people with autism. other verbal repertoires for children with autism, as well
The results of this study are at odds with guidelines as with other correction procedures reported in the litera-
presented in some handbooks of Applied Behavior Ana- ture (e.g., directed practice, response repetition—Carroll
lysis (e.g., Greer and Ross, 2008; Maurice et al. 2001) et al. 2015; McGhan and Lerman, 2013; Rapp et al. 2012).
which recommend against reinforcing responses on Future studies may also include follow-up measures to

Table 1 Level and frequency of correction needed in RC and NRC conditions for each participant
Reinforcement after correction (RC) No reinforcement after correction (NRC)
Participants
Level of correction P1 P2 P3 P4 P1 P2 P3 P4
Delayed vocal prompt 30 51 20 58 47 59 30 94
Stretched-out vocal prompt 1 0 3 0 2 4 4 0 4
Stretched-out vocal prompt 2 0 0 0 0 4 0 0 7
Carneiro et al. Psicologia: Reflexão e Crítica (2019) 32:21 Page 7 of 8

assess the long-term effectiveness of the procedures inves- Author details

1
tigated in this study. Besides that, considering that during Universidade Federal do Pará, Belém, PA, Brazil. 2Universidade de Brasília,
Brasília, Brazil. 3Instituto Nacional de Ciência e Tecnologia sobre
the correction procedure in the present study it was used Comportamento, Cognição e Ensino, Sao Carlos, Brazil.
as reinforcer praise only (in line with previous research,
e.g., Carroll et al. 2015; Carroll et al. 2018; Kodak et al. Received: 22 October 2018 Accepted: 10 September 2019

2016; Rapp et al. 2012; Turan et al. 2012), futures studies

should evaluate situations in which the use of social
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