A review of timeout ribbons.
Abstract: Researchers and practitioners often employ timeout procedures to manage inappropriate classroom behavior. When implemented inappropriately, however, timeout can result in dangerous situations and have received increased scrutiny (i.e., seclusion). The timeout ribbon procedure can prevent some of the dangerous situations associated with other forms of the punishment procedure. This review examines how researchers have used the timeout ribbon to affect change in the behaviors of school-aged children. A summary of the findings indicates that the timeout ribbon procedure effectively reduced inappropriate behaviors but did not increase compliance. The review provides both implications for practitioners and additional research directions.

Keywords: Timeout ribbon, classroom management, punishment
Article Type: Report
Subject: Classroom management (Usage)
Discipline of children (Research)
Children (Behavior)
Children (Research)
Author: Kostewicz, Douglas E.
Pub Date: 03/22/2010
Publication: Name: The Behavior Analyst Today Publisher: Behavior Analyst Online Audience: Academic Format: Magazine/Journal Subject: Psychology and mental health Copyright: COPYRIGHT 2010 Behavior Analyst Online ISSN: 1539-4352
Issue: Date: Spring, 2010 Source Volume: 11 Source Issue: 2
Topic: Event Code: 310 Science & research Canadian Subject Form: Child behaviour
Geographic: Geographic Scope: United States Geographic Code: 1USA United States
Accession Number: 244271249
Full Text: Timeout, when used effectively, is a powerful behavior management tool (Turner & Watson, 1999). Timeout is defined as "the withdrawal of the opportunity to earn positive reinforcement or the loss of positive reinforcers for a specified time, contingent upon the occurrence of a behavior; the effect to reduce the future probability of that behavior" (Cooper, Heron, Heward, 2007, p. 357). Thus, timeout has two necessary conditions. First, the current environment must have reinforcing qualities. Second, a removal of those qualities must be less reinforcing than a removal from that environment. In other words, there must be a discrepancy between time-in (i.e. the environment with reinforcement) and timeout (i.e., the environment without reinforcement; Friman & Finney, 2003; Harris, 1985; Marlow, Tingstrom, Olmi, & Edwards, 1997). In early studies, researchers demonstrated timeout by placing an animal on extinction following some behavior, which subsequently decreased that behavior's probability (Anderson & King, 1974). However, as timeout was applied in more and more settings, variability rather than conformity appeared (Friman & Finney, 2003).

Even with response variability, timeout is now one of the most common disciplinary tactics used with children in the United States (Friman & Finney, 2003). There are three types of timeout: isolation or total removal from a reinforcing environment, exclusion from reinforcement within an environment, and non-exclusionary or reinforcement is stopped (Harris, 1985). Additionally, three types of nonexclusionary timeout include a removal of the reinforcing stimulus (i.e., withholding food or the cessation of music), ignoring the subject (i.e., turning away from the subject), and contingent observation (i.e., the subject must sit out and watch the appropriate behaviors of peers; Harris, 1985). With different variations available, considerations must be made when choosing a timeout procedure.

For a timeout to be effective it must be applied immediately following each occurrence of the target behavior, which is not always possible with isolation and exclusion (Hugenin & Mulick, 1981). Additionally, moving an individual during isolation, exclusion, or contingent observation timeout procedures usually involves physical guidance, which has been shown to reinforce misbehavior (Kern, Delany, Hilt, Bailin, & Elliot, 2002). Recently, the Council of Children with Behavioral Disorders (2009) has released a position statement concerning the use of seclusion and isolation. The considerations include secluding the individual too long (i.e., the loss of a considerable amount of educational time), the potential for abuse, and additional paradoxical effects (i.e., timeout as a positive or negative reinforcer for inappropriate behavior). In summary, timeouts have heightened detrimental effects when used ineffectively by inexperienced people (Harris, 1985).

On the other hand, non-exclusionary timeout procedures do not have the same negative concerns as other timeout techniques. A modified non-exclusionary timeout, the timeout ribbon procedure, combines contingent observation and the removal of a reinforcing stimulus. The availability of reinforcement is contingent upon the presence of some discriminative stimulus of which reinforcement has been paired. That stimulus is removed contingent upon the appearance of inappropriate or target behaviors and returned after a short period of time.

The timeout ribbon procedure controls for some of the negative side effects of timeout, but also raises additional concerns. The potential risk of abuse and paradoxical effects are reduced. During timeout, the child is not touched or removed from the educational environment. Also, earning a timeout does not allow the child to escape from educational demands; they are expected to continue working. However because the child remains in the educational setting, the environment must be able to maintain higher intensity inappropriate behaviors. After weighing the benefits and costs, the timeout ribbon procedure may be helpful for common occurring lower intensity, higher frequency behaviors (e.g., noncompliance) in educational settings (Ford, Olmi, Edwards, & Tingstrom, 2001).

With the many varieties, implications, and concerns regarding timeout, a critical literature review will lead to a greater understanding of one specific type: the timeout ribbon. Thus, the purpose of this review is to address the question: How has the timeout ribbon or modified ribbon procedure been used to affect change in behaviors of school-aged children? Specific questions include:

1. What timeout ribbon procedures have researchers used?

2. What target behavior outcome measures were used to evaluate the effectiveness of the timeout ribbon procedure?

Methods

Studies included in this review were located through two steps. First, a computerized search of PsychlNFO and ERIC databases was conducted. Descriptors used were timeout, time-out, and classroom. Second, an ancestral search was conducted of articles identified in specified databases.

The computerized search generated 397 articles, five of which met all of the article inclusion criteria located below. An ancestral search of five articles resulted in identification of one additional article meeting criteria. Overall, the literature search process identified six articles (Alberto, Heflin, & Andrews, 2002; Fee, Matson, & Manikam, 1990; Foxx & Shapiro, 1978; Salend & Gordon, 1987; Yeager & McLaughlin, 1994; Yeager & McLaughlin, 1995) published in six different psychology and education journals (Table 1).

For an article to be included, the following had to be met:

1. The article was published in a peer-reviewed journal.

2. The article was an empirical study using group or single subject design.

3. The article included as participants school-aged children (3-18 years old).

4. The article used as a dependent measure behaviors that either interfered with or improved instruction in an educational setting.

5. The article examined a timeout ribbon procedure or a modified timeout ribbon procedure as an intervention.

Results

Timeout Ribbon Procedures

Each of the studies reported using a timeout procedure to reduce inappropriate behavior. All of the studies, except Yeager and McLaughlin (1995), did not move the participant while in timeout. Length of timeouts varied across the studies. Timeouts ranged from one minute (Salend & Gordon, 1987), three minutes (Fee et al., 1990; Foxx & Shapiro, 1978), four minutes (Yeager & McLaughlin, 1995), to five minutes (Alberto et al., 2002). The remaining studies either had an experimental phase in which the timeout ended with the next chance for compliance (Yeager & McLaughlin, 1995) or only specified that the participant was in timeout for a period of time (Y eager & McLaughlin, 1996). Five studies adjusted the length of timeout when inappropriate behaviors occurred or continued during a timeout. Criteria included resetting the time (Salend & Gordon, 1987; Yeager & McLaughlin, 1995), resetting the time and adding one minute (Fee et al., 1990), extending timeout 30 seconds (Alberto et al., 2002) or extending the time an unspecified period (Foxx & Shapiro, 1978). Prior to starting a timeout, two studies (Fee et al., 1990; Yeager & McLaughlin, 1995) allowed for a warning before the loss of the timeout ribbon. In both cases, compliance with the request after the warning continued availability of reinforcement.

A characteristic similar across studies was the creation of a reinforcement rich time-in (i.e. an increased amount of supposed reinforcers delivered more frequently than normal). Two studies delivered reinforcement on a variable interval (VI) of either 2.5 minutes (Foxx & Shapiro, 1978) or 5 minutes (Alberto et al., 2002). Salend and Gordon (1987) delivered reinforcement on a fixed interval (FI) of 2 minutes, while Yeager & McLaughlin (1995) provided continuous reinforcement (CRF) the target behavior. Two studies did not specify their reinforcement procedures, but one (Fee et al., 1990) did state that reinforcement occurred twice as often. The reinforcers used included social praise (Fee et al., 1990), tokens (Alberto et al., 2002; Salend & Gordon, 1987) and edibles (Foxx & Shapiro, 1978; Yeager & McLaughlin, 1995). Within each of the studies some type of discriminative stimulus was used to signal the availability of reinforcement. Three of the studies (Foxx & Shapiro, 1978; Salend & Gordon, 1987; Yeager & McLaughlin, 1994) administered a ribbon, two (Alberto et al., 2002; Fee et al., 1990) used a wristband and one (Yeager & McLaughlin, 1995) used a ribbon and moved to a happy card. In all studies, reinforcement was available only when the participant's or group's discriminative stimulus (i.e., ribbon, wristband, or happy face) was present.

Target Behavior Outcome Measures and Short\Long Term Effects

All six studies reported dependent measures that either interfered with or improved educational situations. Four of the studies (Alberto et al., 2002; Fee et al., 1990; Foxx & Shapiro, 1978; Salend & Gordon, 1987) targeted decreasing inappropriate behaviors. Behaviors included yelling or inappropriate vocalizations (Alberto et al., 2002; Fee et al., 1990; Foxx & Shapiro, 1978; Salend & Gordon, 1987), out-of-seat behaviors (Fee et al., 1990; Foxx & Shapiro, 1978), inappropriate touching or hitting of others, self, or property (Alberto et al., 2002; Foxx & Shapiro, 1978), and uninvited approach of strangers (Alberto et al., 2002). Two studies (Yeager & McLaughlin, 1994; Yeager & McLaughlin, 1995) targeted increasing an appropriate behavior; namely compliance.

Additional dependent measures included teacher's perceptions of children's behavior recorded on two standardized tests: Matson Evaluation of Social Skills with Youngsters (MESSY) and Preschool Behavior Questionnaire (PBQ; Fee et al., 1990), a six item semantic differential (Fee et al., 1990), and a teacher questionnaire regarding acceptability of the timeout ribbon procedure (Fee et al., 1990; Foxx & Shapiro, 1978).

Findings from the six studies showed differing results. Researchers who targeted reducing inappropriate behaviors reported marked decreases. Fee et al. (1990) found significant decreases in talking out turn and out-of-seat behaviors as compared to the control group. Alberto et al. (2002) disclosed decreases in all inappropriate behaviors to zero across two participants and four settings. Salend and Gordon (1987) saw a reduction from 1.5-3.5 inappropriate vocalizations per group to under 0.5 inappropriate vocalizations per group. Foxx and Shapiro (1978) demonstrated a decrease to roughly zero intervals of disruptive behaviors across five participants.

When the aim was to improve appropriate behaviors, the outcomes suggested less effective results. Yeager and McLaughlin (1994) showed an increase from a mean of 4.5% intervals of compliance in baseline to a mean of 27% intervals of compliance during treatments. Yeager and McLaughlin (1995) also demonstrated a greater increase of compliance intervals (2.2% in baseline to 54.2% during timeout ribbon phase to 74.6% during timeout ribbon/precision request phase).

Additional dependent measures showed changes in teachers' perceptions and acceptability of approaches. Fee et al. (1990) found that children within the timeout ribbon group were perceived as better group members, took turns more frequently, and stayed in their seat. Additionally, the timeout ribbon procedure was considered highly acceptable (Fee et al., 1990; Foxx & Shapiro, 1978), less restrictive than other methods for decreasing behaviors (Foxx & Shapiro, 1978), and a preferable choice if equally effective with exclusionary timeout (Foxx & Shapiro, 1978).

Three studies (Alberto et al., 2002; Foxx & Shapiro, 1978; Salend & Gordon, 1987) also had maintenance measures. Alberto et al. (2002) made three measurements 14 days after completion to find zero occurrences of targeted inappropriate behavior. They also thinned the token schedule from FI5 to FI10 minutes. Foxx and Shapiro (1978) took one measurement 21 days after completion to find the same low levels of disruptive behavior. Salend and Gordon (1986) made three measurements after 14, 21, and 28 days following the study's completion and found the same low levels of inappropriate vocalizations (<0.5 per minute).

Discussion

Timeout Ribbon Procedures

Extending from Foxx & Shapiro (1978), the reviewed studies reported a basic structure for the timeout ribbon procedure. Researchers established a clear discriminative stimulus with the students, removed that stimulus (and all access to reinforcement) when students displayed the targeted inappropriate behavior and returned that stimulus after a set amount of time. While some specifics (e.g., length of discriminative stimulus removal) varied across the six studies one aspect held consistent: the creation of a reinforcement rich time-in. Necessary for the effective use of all timeout, a reinforcement-rich time-in increases the reinforcing properties of the reinforcers denied through timeout (Friman & Finney, 2003). None of the reviewed studies reported varying the type of reinforcement used; just that reinforcement was delivered frequently. Thus, students' behaviors effectively differentially reinforced teacher's delivery of reinforcement, both in type and schedule. Should inappropriate behavior fail to show a decrease, teachers can examine how time-in was created (i.e., provided consequences, wording of praise statements, rewards associated with a token system, etc.) and the density of reinforcement adjusting accordingly. If students do show a marked decrease in the targeted inappropriate behavior, the teacher can consider thinning the schedule to promote generalization (Stokes & Baer, 1977).

While satiation might raise concerns, teachers often present only minimal amounts of reinforcing contingences (Sutherland, Wehby, & Yoder, 2002). Educators often provide little positive attention for appropriate behavior, whether academic or social, that continues to decrease as students advance through their academic career (White, 1975). Additionally, low intensity but high frequency inappropriate student behaviors such as non-compliance, the types of behavior suited for the timeout ribbon procedure, often frustrate teachers into over-reaction increasing the likelihood of managing student behavior with coercion (Sidman, 1989). The time-out ribbon procedure forces teachers to provide potential reinforcers at a rate higher than normally observed, while also providing an intervention that may replace ineffective and damaging coercive contingencies.

Target Behavior Outcome Measures

Four of the studies (Alberto et al., 2002; Fee et al., 1990; Foxx & Shaprio, 1978; Salend & Gordon, 1987) reported a decrease in inappropriate behaviors with two (Yeager & McLaughlin, 1994; Yeager & McLaughlin, 1995) targeting increases in compliance. As timeout is a behavior reduction technique (Cooper et al., 2007), researchers reported effective results when used as such. However, fewer gains were noted when researchers examined subsequent increases in appropriate behavior. These differences suggest the nature of timeout and punishment techniques in general. The individual learns what not to do, rather than what to do. However, the slight gains to appropriate behavior noted by Yeager and McLaughlin in 1994 and 1995 might be the result of providing reinforcement for appropriate, alternative behaviors demonstrating the potential versatility of the timeout ribbon procedure. It might be surmised that when a teacher focuses more of the necessary reinforcing contingencies on certain appropriate behaviors, an associated increase in appropriate alternative behaviors occurs between ribbon removals.

Results from the current, yet limited, literature base do display generality across the domains suggested by Stokes and Baer (1977). Researchers measured and noted effective results for a wide range of behaviors (i.e., inappropriate approaches and vocalizations, out-of-seat behavior, etc.) across students with different exceptionalities (e.g., learning disabilities, mental retardation). Additionally, three of the studies (Alberto et al., 2002; Foxx & Shapiro, 1978; Salend & Gordon, 1987) reported follow-up measures that demonstrated positive outcomes. Considering individuals maintain behaviors in their repertoire post-intervention, successfully demonstrating the continued effects speaks to the timein/timeout nature of the ribbon procedure. To maintain a generalized effect, behavior reduction techniques such as the timeout ribbon must be used consistently on each instance of targeted inappropriate behavior and involve a systematic coordinated fading during both time-in and timeout.

Implications for Practitioners

Posing clear advantages and disadvantages, the timeout ribbon procedure has applications for teachers and clinicians working with school-aged children. Those who choose to implement a timeout procedure should use a defined, consistent, effective approach to target a well defined set of behaviors. Advantageously, the timeout ribbon procedure has certain set characteristics (e.g., a reinforcement rich time-in, a conspicuous discriminative stimulus, targeting low-intensity inappropriate behaviors) and empirical support. These aspects guide the practitioner during implementation, tethering them to the procedure, but also provide the ability to modify some of the "looks" of the procedure. For example, a teacher can employ different discriminative stimuli, how and when to deliver preferred consequences as potential reinforcers, and what low-intensity inappropriate behaviors to target. Teachers can also rely on another clear advantage; the students remains in the educational or clinical setting during the timeout. Students have the opportunity to increase their exposure to instructional situations as compared to both exclusion or isolation forms of timeout. Finally, the procedure itself demands a positive educational or clinical environment (i.e. reinforcement rich time-in). This not only sets the stage for an effective nonexclusionary timeout, but also for effective instruction, learning, and student experiences.

A clear disadvantage of the timeout ribbon procedure involves the ability of the procedure to deal with the escalation of student inappropriate behaviors. Some students, such as those with emotional or behavioral disorders, may have a history of behaviors that, when displayed, no longer allow them to safely remain in the current educational setting (Kauffman & Wong, 1991). Behaviors such as physical damage to self, property, or others, place an undue stress on many educational environments. Planning ahead, teachers can use the timeout ribbon procedure as an initial intervention for low intensity/ high frequency inappropriate behaviors. Then, as necessary and following appropriate guidelines (CCBD, 2010), implement additional timeouts (i.e., exclusion or seclusion) as a back-up intervention targeting the more dangerous behaviors only (Foxx & Shapiro, 1978).

Future Research Directions

One specific area for researchers to explore involves the amount of time students remain in timeout or in the current case without a ribbon. The current body of timeout ribbon literature suggests a range from one to five minutes, however many students remain in timeout for longer periods (CCBD, 2010). Future researchers can experimentally manipulate timeout duration with the goal of determining the minimal amount necessary to garner effective results.

Without providing a consensus, each of the studies reported a different approach to resetting or adding time to a timeout. Continued prompting or adding additional time can create adverse situations in which some students may increase the intensity and frequency of inappropriate behavior past the point of remaining in the educational setting during a non-exclusionary timeout (Gunter, Denny, Jack & Shores, 1993; Gunter, Denny, Shores, & Reed, 1994). Future research can compare the different methods to determine effectiveness.

Other avenues for research include additional examinations of the timeout ribbon procedures in a variety of settings and populations. Researchers can also vary the schedule of reinforcement (both contingent and non-contingent) and/or the discriminative stimuli used to signal time-in to examine the effect of timeout. Each of the replications/modifications builds a greater case of the power, utility, and generality of the timeout ribbon procedure.

Conclusions

Often misused, timeout still plays a role in the management of student inappropriate behaviors. Versions of timeout, even when applied appropriately, can create situations that increase the likelihood of adverse effects. Timeout ribbons present a balance. The proper use of the procedure forces a teacher to identify and provide reinforcing contingencies for all students; which may decrease escape motivated behaviors while also increasing the effect of ribbon removal (i.e., non-exclusionary timeout) on common inappropriate classroom behaviors such as non-compliance. Teachers understanding that no matter the effect students do not specifically learn what to do rather only what not to do can implement the timeout ribbon in its intended situations accompanied by other teaching strategies.

References

* Alberto, P., Heflin, L. J., & Andrews, D. (2002). Use of the timeout ribbon procedure during community-based instruction. Behavior Modification, 26, 297-311.

Anderson, K. A. & King, H. E. (1974). Time-out reconsidered. Journal of Instructional Psychology, 1, 11-17

CCBD Position Summary on the Use of Seclusion in School Settings (2009). Behavioral Disorders, 34, 235-243.

Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied Behavior Analysis (2nd ed.). Upper Saddle River, NJ: Pearson.

* Fee, V. E., Matson, J. L., & Manikam, R. (1990). A control group outcome study of a nonexclusionary time-out package to improve social skills with preschoolers. Exceptionality, 1, 107-121.

Ford, A. D., Olmi, D. J., Edwards, R. P., & Tingstrom, D. H. (2001). The sequential introduction of compliance training components with elementary-aged children in general education classroom settings. School Psychology Quarterly, 16, 142-157.

* Foxx, R M. & Shaprio, S. T. (1978). The timeout ribbon: A nonexclusionary timeout procedure. Journal of Applied Behavior Analysis, 11, 125-136.

Friman, P. C. & Finney, J. W. (2003) Time-out (and time-in). In W. O'Donohue, J. E. Fisher, & S. C. Hayes (Eds.), Cognitive behavior therapy: Applying empirically supported techniques in your practice (pp. 429-435). Hoboken, NJ: John Wiley & Sons.

Gunter, P. L., Denny, R. K., Jack, S. L., & Shores, R. E. (1993). Aversive stimuli in academic interactions between students with serious emotional disturbance and their teachers. Behavioral Disorders, 18, 265-274.

Gunter, P. L., Denny, R. K., Shores, R. E., & Reed, T. M. (1994). Teacher escape, avoidance, and counter control behaviors: Potential responses to disruptive and aggressive behaviors of students with severe behavior disorders. Journal of Child and Family Studies, 3, 211-223.

Harris, K. R. (1985). Definitional, parametric, and procedural considerations in timeout intervention and research. Exceptional Children, 51, 279-288.

Huguenin, N. H. & Mulick, J. A. (1981). Nonexclusionary timeout: Maintenance of appropriate behavior across settings. Applied Research in Mental Retardation, 2, 55-67.

Kauffman, J. M., & Wong, K. L. H. (1991).Effective teachers of students with behavioral disorders: Are generic teaching skills enough? Behavioral Disorders, 16, 225-237.

Kern, L., Delaney, B. A., Hilt, A., Bailin, D. E., & Elliot, C. (2002). An analysis of physical guidance as reinforcement of noncompliance. Behavior Modification, 26, 516-536.

Marlow, A. G., Tingstrom, D. H., Olmi, D. J., & Edwards, R. P. (1997). The effects of classroom based time-in/time-out of compliance rates in children with speech/language difficulties. Child & Family Behavior Therapy, 19(2), 1-15.

* Salend, S. J. & Gordon, B. D. (1987). A group-oriented timeout ribbon procedure. Behavioral Disorders, 12, 131-137.

Sidman, M. (1989). Coercion and its fallout. Boston: Authors Cooperative, Inc.

Stokes, T. F. & Baer, D. M. (1977) An implicit technology of generalization. Journal of Applied Behavior Analysis, 10, 349-367.

Sutherland, K. S., Wehby, J. H., & Yoder, P. J. (2002). Examination of the relationship between teacher praise and opportunities for students with EBD to respond to academic requests. Journal of Emotional and Behavioral Disorders, 10, 5-13.

Turner, H. S. & Watson, T. S. (1999). Consultant's guide for the use of time-out in the preschool and elementary classroom. Psychology in the Schools, 36, 135-148.

White, M. A. (1975). Natural rates of teacher approval and disapproval in the classroom. Journal of Applied Behavior Analysis, 8, 367-372.

* Yeager, C. & McLaughlin, T. F. (1994). Use of a timeout ribbon with and without consequences as procedures to improve a child's compliance. Perceptual and Motor Skills, 79, 945-946.

* Yeager, C. & McLaughlin, T. F. (1995). The use of a time-out ribbon and precision requests to improve child compliance in the classroom: A case study. Child & Family Behavior Therapy, 17, 1-9.

* Denotes studies included in the review.

Author Contact Information:

Douglas E. Kostewicz, PhD., BCBA

University of Pittsburgh

5146 Wesley W. Posvar Hall

230 South Bouquet Street

Pittsburgh, PA 15260

Office: (412) 648-7113

E-mail: dekost@pitt.edu
Table 1. Timeout Ribbon Studies

Study             Students         Independent Variables

Alberto et al,    Two           TI: Token delivery FI 5 min
2002              males         for appropriate behavior as
                  aged 10-      long as wristband is present;
                  11            TO Wristband procedure: 5
                                min nonexclusionary TO (loss
                                of wristband) for appearance
                                of target behavior;
                                IN behavior during TO: TO
                                extended until 30 seconds of
                                appropriate behavior;
                                Conclusion of completed TO:
                                Wristband returned

Fee et al.,       59            TI: Verbal praise 2 times
1990              children      normal (only for children with
                  ages 4-5      their wristbands)
                  years old     TO Wristband: Appearance of
                                target behavior, warning first,
                                if compliance, no TO, if not, 3
                                min nonexclusionary TO (loss
                                of wristband);
                                IN behavior during TO: Timer
                                is reset and a minute is added;
                                Conclusion of completed TO:
                                Wristband returned

Foxx &            Five          TI: Social and edible
Shaprio, 1978     males         reinforcement VI 2.5 min
                  (aged 9-      (only for children with their
                  18) with      ribbons)
                  MR            TO Ribbon: Appearance of
                                target behavior, 3 min
                                nonexclusionary TO (loss of
                                ribbon);
                                IN behavior during TO: TO
                                extended slightly until
                                misbehavior ceases;
                                Conclusion of completed TO:
                                Ribbon returned

Salend &          5 males       TI: Token delivery FI 2.5 min
Gordon, 1987      aged 6-9      (only for groups with their
                  years; 4      ribbons)
                  with LD       TO Ribbon: Appearance of
                  and one       target behavior within group, 1
                  with ED       min nonexclusionary TO (loss
                  and 3         of ribbon);
                  males and     IN behavior during TO: TO
                  1 female      extended until 1 min of
                  aged 9-10     appropriate group behavior
                  with LD       displayed
                                Conclusion of completed TO:
                                Ribbon returned

Yeager &          4 year-old    TI: Praise (when ribbon was
McLaughlin,       child         present)
1994                            TO ribbon procedure: TO for
                                target behavior
                                Additional TI: Chose story to
                                be read

Yeager &          4 year-old    TI: edible for each instance of
McLaughlin,       male with     compliance
1995              Tuberous      TO happy face: Instance of
                  Sclerosis     noncompliance, loss of happy
                                face until next chance for
                                compliance
                                End of TO: Compliance with
                                next request;
                                TO happy face and precision
                                requests: noncompliance,
                                warning 5 seconds, warning, 5
                                seconds, 4 min TO in TO chair
                                (Any time before TO
                                compliance earned edible)
                                Conclusion of TO: Happy face
                                returned when compliance
                                demonstrated

                    Dependent
Study                Variable              Results

Alberto et al,    Number of IN           Behaviors
2002              vocalizations          reduced to 0
                  when initiating a      occurrences
                  task, uninvited        for both
                  approaches of          participants
                  strangers within 3     across two
                  feet, IN self          settings and
                  touches, and/or        maintained at
                  yells                  0 occurrences
                                         during
                                         maintenance

Fee et al.,       Matson                 Treatment
1990              Evaluation of          group showed
                  Social Skills with     significant
                  Youngsters             decreases in
                  (MESSY)                both out-of-
                  Preschool              seat and
                  Behavior               talking out of
                  Questionnaire          turn
                  (PBQ) Six item         behaviors and
                  semantic               perceived as
                  differential Out-      better group
                  of-seat and talking    members.
                  out of turn (Rated
                  pairs of children
                  (20 minute pre-
                  and post-test) for
                  six consecutive 10
                  sec intervals)

Foxx &            % of 30sec             IN behaviors
Shaprio, 1978     intervals of           intervals
                  disruptive             reduced from
                  behaviors (e.g.,       a range of
                  Out-of seat,           70%-7% to a
                  banging objects        range of
                  on table, throwing     10%-1%
                  objects, hitting
                  others, crying,
                  yelling)

Salend &          IN vocalizations       Group
Gordon, 1987      per minute             reduced IN
                                         vocalizations
                                         from 1.65 and
                                         3.1 per
                                         minute to 0.1
                                         and 0.4 per
                                         minute,
                                         respectively
                                         and low
                                         levels
                                         maintained
                                         during
                                         follow-up.

Yeager &          % of compliance        Compliance
McLaughlin,                              increased
1994                                     from 7% to
                                         22% of the
                                         time

Yeager &          % of compliance        Compliance
McLaughlin,                              increased
1995                                     from 2.2% to
                                         62% of the
                                         time.

Note. MR = mental retardation, LD = learning disabilities, ED =
emotional disturbance, TI = time-in, TO = timeout, VI = variable
interval, FI = fixed interval, IN = inappropriate
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