Matched Sensory Stimulation to Reduce Automatically Maintained Challenging Behavior: A Systematic Review and Meta-Analysis

Abstract Automatically reinforced challenging behavior presents unique intervention challenges because the behavior produces its own reinforcer. Matched stimulation (Piazza et al., Journal of Applied Behavior Analysis , 31 , 165–189, 1998) is a method of providing access to the putative sensory consequences that maintain challenging behavior through interaction with an alternative stimulus (e.g., toys, items). This approach may reduce motivation to engage in automatically reinforced challenging behavior, resulting in response reduction. In this article, we conducted a systematic literature review and meta-analysis of 32 studies that examined matched stimulation to reduce automatically maintained challenging behavior. We descriptively coded each article at the participant level to extract information about behaviors, participants, assessments, and intervention variables and determine how the effects of matched stimulation have been evaluated in the literature. We then conducted a random effects meta-analysis to estimate the average effects of matched stimulation. We found that matched stimuli produced a statistically significant decrease in challenging behavior when compared to a control condition and when compared to unmatched stimuli. Last, we conducted a moderator analysis to explore how assessment and treatment characteristics influenced the magnitude of effect, which revealed that functional behavior assessment type and number of matched stimuli moderated intervention effects, whereas the use of competing stimulus assessments and preference assessments did not moderate the effectiveness of matched stimulation.