A Quantitative Systematic Literature Review of Combination Punishment Literature: Progress Over the Last Decade

Abstract

This review evaluated single-case experimental design research that examined challenging behavior interventions utilizing punishment elements. Thirty articles published between 2013 and 2022 met study inclusion criteria. Study quality was also assessed. Through multiple levels of analysis (e.g., descriptive statistics, non-parametric statistics), we examined (a) participant and study trends, (b) differential outcomes related to temporal reinforcement approaches (antecedent, consequent, or combined reinforcement) applied alongside punishment element(s), (c) differential outcomes related to the punishment type (negative, positive) applied alongside reinforcement, and (d) effect sizes associated with study rigor across peer-reviewed and gray literature. Our results may tentatively suggest that, for certain situations, concurrently applying punishment with antecedent reinforcement approaches may coincide with significantly larger effect sizes compared to combined temporal reinforcement approaches, while positive punishment applied concurrently with reinforcement may coincide with larger but non-significant intervention effects. Most featured articles met rigor criteria, but larger effects were seen in peer-reviewed literature.

Keywords: autism; challenging behavior; intellectual and developmental disability; punishment; quantitative systematic review; single-case experimental design.

Figure 1.

Preferred reporting items for systematic reviews and meta-analyses (PRISMA). Note. This figure reports the results of the search and screening process using a PRISMA flowchart.

Figure 2.

Single case analysis and review framework scatterplot (SCARF). Note. This graph depicts the primary outcomes and the quality and rigor across the participant sample. The horizontal axis depicts an increasing quality and rigor from left to right (e.g., zero to four), and the vertical axis depicts an increasing positive outcome from zero to four. Gray publications are denoted by gray circles and peer-reviewed articles are denoted by closed circles.