A systematic review of procedures for establishing conditioned reinforcers

Establishing conditioned reinforcers is often critical to treatment for individuals diagnosed with autism spectrum disorder or intellectual and developmental disabilities (IDDs). Although researchers have evaluated several procedures, methods and results vary across studies, making it difficult to draw conclusions about these procedures' general and relative effectiveness. The purpose of this systematic review was to assess the overall and relative effectiveness of stimulus-stimulus (S-S) pairing, response-stimulus (R-S) pairing, and operant discrimination training (ODT) for establishing conditioned reinforcers for children on the autism spectrum or who have an IDD. Thirty-one studies, including 12 theses and dissertations, met inclusion criteria. Eight studies evaluated S-S pairing, 20 evaluated R-S pairing, and nine evaluated ODT. Combined, S-S pairing, R-S pairing, and ODT were effective at establishing conditioned reinforcers in only half of all attempts. However, analysis indicated that R-S pairing is the most effective procedure, followed by S-S pairing and ODT, in that order.