A Replication and Extension of the Enhanced Choice Model for Children Who Exhibit Challenging Behavior

Rajaraman et al. (2022) first introduced the Enhanced Choice Model (ECM) as an intervention that incorporates assent within the treatment framework. Shortly after, Staubitz et al. (2022) and Rajaraman et al. (2024) added to the literature available specifically regarding the ECM. Despite the initial successes of the ECM, it has only been applied to nine individuals. Of these, only two needed some form of modification to the treatment model. The criteria for these modifications was not specified within previous literature. Therefore, the purpose of the current study was twofold. First, we extended previous research by evaluating systematic modifications to the ECM for participants for whom the original ECM procedures are not effective. These additional procedures included stepwise systematic modifications that alternated between quality of reinforcer modifications and modifying response effort needed to access reinforcement.