Question

Describe an intervention to decrease children’s disruptions during dental treatment using punishment-by-prevention contingencies. Include:

a. the response class.

b. the punishment contingencies.

c. the results.

d. Why is the main contingency punishment and not escape?

e. Why isn’t this procedure shaping?

Answer 1

Punishment is a consequence or event or the presentation of a predetermined unpleasant stimulus immediately after a response, which reduces the frequency or the occurrence of that response.

Punishment is made contingent upon response or behaviour. There is Punishment by Prevention of a Reinforcer Contingency ( where prevention of a reinforcer leads to a reduction in the frequency of a response) and Punishment by Prevention of Removal Contingency ( where prevention of removal of a negative stimulus leads to a reduction in the frequency of a response).

Children can engage in disruptive or undesirable or unacceptable behaviours during dental treatment, to avoid pain. The need of the hour is a desirable or acceptable form of behaviour of 'being still' for the treatment. 'Being still' is the response, which has to be reinforced and disruptive behaviours or responses (like screaming) have to be reduced. In such cases, Punishment by Prevention of Removal Contingency has been proved to be significant in achieving the desired result.

In the Punishment by Prevention of Removal Contingency, a drill without a bit has to be activated and gradually brought closer to the mouth of the child in the clinic. A rest period was awarded to the child by switching off the drill, after every three seconds, only when he was not disruptive. In another way, each of the child's disruptions prevented the discontinuation of the awful sound of the drill, until three seconds. It was found that disruptive behaviour reduced from 88 per cent to less than 15 per cent of the overall time.

It can be said that the technique used to encourage 'being still', which was the desirable and acceptable form of behaviour for the dental treatment was neither escape nor reinforcement contingencies nor shaping, as 'being still' was promoted by the removal of the awful sound of the drill. Rather 'being still' for the treatment is a punishment contingency for disruptions by the prevention of the removal of the sound of the drill, which can be labelled as a negative reinforcer or an unpleasant stimulus, which when removed heightens the occurrence of a positive response (being still).