Why is Nonexclusion time-out recommended the method of first choice when implementing time-out?

What is Time-Out from Positive Reinforcement?:
Here is the textbook explanation of time-out from positive reinforcement (a negative punishment procedure): "The withdrawal of the opportunity to earn positive reinforcement or the loss of access to positive reinforcers for a specified time, contingent on the occurrence of a behavior." (Copper, Heron, and Heward, 2007). The overall effects of these two procedures is that they reduce the future frequency of the target behavior. Cooper, Heward, and Heron (2007) point out three very important aspects of the Time-Out from Positive Reinforcement procedure:

the distinction between the 'time-in" and the time-out environment
the response-contingent loss of access to reinforcement. In other words, access to reinforcement is lost only if the problem/target behavior has been emitted
the resultant decrease in the future frequency of the behavior.

Time-Out in the Applied Setting:There are two types of time-out procedures that can be used in the applied setting:

Nonexclusion Time-Out: In this type of time-out procedure the child is not physically removed completely from the time-in setting. The child's position compared to the setting changes but they remain within the original environment. There four ways in which nonexclusion time-out can be implemented : (a) planned ignoring (b) withdrawal of a specific reinforcer (c) contingent observation and (d) the time-out ribbon.
Exclusion Time-Out: This type of time-out procedure requires the full removal of the child from the environment for a specified amount of time, contingent on the emission of the targeted undesired behavior. Exclusion time-out can be implemented in the classroom in three ways: (a) the child is removed to a time-out room, (b) the child is separated from the rest of the children, and (c) the child is placed in the hallway.

Nonexclusion Time-Out:In this section we will discuss the four (4) different ways that nonexclusion time-out can be implemented:

Planned Ignoring: This time-out procedure involves removing social reinforcers (i.e., attention, physical contact, or verbal interaction) are removed for a brief period of time, contingent on the occurrence of the targeted inappropriate behavior. This procedure implies that the time-in setting is reinforcing and all extraneous sources of positive reinforcement can be eliminated. Implementing planned ignoring can involve systematically looking away from the child, staying quiet, refraining from any sort of interaction with child, and maintaining neutral affect. The advantage of planned ignoring is that it is a nonintrusive form of a time-out procedure and it can be applied quickly and effectively. For example, say that you are working with a child who has a very difficult and time consuming bathroom routine. Now, suppose it is time to get dressed after using the bathroom. The child is screaming, crying, and pulling on you and at points begins to laughing while pulling on you. This situation has now becoming reinforcing to the child and we can not take the child out of the bathroom without any clothes on. At this point as a therapist you should, step away from the child, reposition your body so that you are slightly turned away from the child, stop responding to the child (unless the topography of their demand has changed and they have manded for something in the appropriate manner - not while crying/screaming), and you should maintain neutral affect until the child begins to comply with the instructions that have been given. Neutral affect means that you should not look angry/upset and you should not look happy either. Once the child begins complying with instructions, you can slowly move closer to the child, reorient your body position towards them, start to interact with them, and your affect can go back to being positive. The following video shows a teacher implementing planned ignoring in a typical classroom setting. This video is very good video because it describes things that you, as a therapist, should not do when a child emits problem behaviors and the video then describes and shows how planned ignoring is implemented. It is very important to notice that the teacher sets the expectation with the class the inappropriate behaviors will be ignored but at the same time the teacher does an excellent job of praising (socially reinforcing) the occurrence of appropriate behaviors.

2. Withdrawal of a Specific Reinforcer: Withdrawal of a specific reinforcer is exactly what is sounds like. In this time-out procedure a specific reinforcer is removed contingent on the occurrence of an inappropriate behavior. The overall goal of this procedure is to reduce the occurrence of the inappropriate behavior in the future. It is our practice not to use this sort of time-out procedure unless the reinforcer that is being used has become a danger to the child or to the other children and therapists that are in the vicinity. If this is the case, then we recommend response blocking and redirecting procedures to decrease the occurrence of the inappropriate behavior. Our reasoning for not implementing this procedure is we do not want the therapists to become aversive to the child they are working with. Very little progress can be made if the child perceives the therapist as being an aversive stimulus.

3. Contingent Observation: This procedure is also known as "sit and watch". Contingent Observation requires that the child be repositioned within an existing environment so that observation of ongoing activities remains, but access to reinforcement is lost. In a classroom setting, for example, a teacher would use contingent observation when a child emits an undesirable behavior, the teacher would redirect the child to sit away from the group, and reinforcement is withheld for a specified period of time. When the contingent observation period ends, the student is allowed to rejoin the group and is able to earn reinforcement for appropriate behavior. We have provided a video of how "sit and watch" or contingent observation can be implemented in a classroom setting.

4. Time-Out Ribbon: This nonexclusion time-out procedure uses a colored band that is placed on the child's wrist and becomes discriminative for receiving reinforcement. When the band or ribbon is on the child's wrist they have the opportunity to gain access to reinforcers. If the child emits undesirable behavior, the band/ribbon is removed, and all forms of social interaction with the child is terminated for a specified period of time. (i.e., 2 to 3 minutes). It is important to realize that EO's and MO's (previously discussed under the antecedent variables section) play a large role in the effectiveness of the time-out ribbon procedure. Laraway et. al (2003) stated the following:
"In commonsense terms, losing the opportunity to earn a consequence is only important if you currently "want" that consequence. Therefore, MOs that increase the reinforcing effectiveness of particular objects or events also increase the punishing effectiveness of making those objects or events unavailable (i.e., time-out)....a single environmental event can have multiple and simultaneous motivating effects." (p. 410)

Exclusion Time-Out: As previously stated, exclusion time-out procedures requires that the child is removed from the environment for a specific amount of time, contingent on the occurrence of the targeted inappropriate behavior. We will discuss the the three different ways that exclusion time-out can be implemented.

Time-Out Room (TOR): A time-out room is defined as any confined space outside the participant's normal educational or intervention environment that lacks positive reinforcers. This room is also a place in which the person can be safely placed for a temporary period of time. Ideally, this room should be located near the time-in setting and should be minimally furnished (i.e., a table and chair). The room should be adequately lit, heated, and ventilated but again it should not have any potential reinforcing items present. Other reinforcing items could include, a telephone, breakable items, pictures on the wall, etc). The room should be secure so that the child cannot get out before the predetermined period of time but it should NEVER be locked.

Time-Out Room Advantages: There are several advantages to using the time-out room procedure: (a). The ability to encounter reinforcement during the time-out period is eliminated or substantially reduced because the time-out setting is designed to minimize reinforcement opportunities. (b). After a few trips to the time-out room the student learns the difference (they learn to discriminate) between the time-out room and other rooms in the building. It is assumed that the time-out room will acquire conditioned aversive properties and the time-in setting will become more desirable. (c). The risk of the child hurting other children in the time-in environment is greatly reduced when the child is taken to the time-out room.

Time-Out Room Disadvantages: Along with the advantages of the time-out room there are also several

disadvantages to take into consideration before implementing this procedure: (a). Resistance can be encountered from the time the child is being escorted to the room to the time they actually get into the time-out room. Therapists should be prepared for highly aggressive behavior and emotional out bursts when using this procedure. (b). Removing the child from the time-in setting prevents the child from ongoing academic or social instruction. Taking the child away from instructional time should be as scarce as possible. Also, in cases where time-out is used excessively and when it has been shown to serve as a negative reinforcer for the teacher, the use of this procedure should be reassessed. (c). While in the time-out room the child may engage in behaviors that should be redirected but go undetected (i.e., self-stimulatory or self-destructive behaviors). In the time-in setting when the child would emit these behaviors the child would be redirected to engage in an activity or task that would stop them from emitting these behaviors. (d). Therapists should be aware of the public stigma associated with the use of the time-out room. It is important that each therapist be able to explain the purpose of using a time-out room and the procedure that is used when a child is placed into a time-out room. The case managers will be in charge of describing this to the parents of each child but it is still important that we as a team know the reasoning behind the use of each procedure that is used at our center.

3. Partition Time-Out: During this type of time-out procedure the child remains within the time-in setting, but the child's view within the setting is restricted by a wall, cubicle, or similar structure. This procedure would be implemented by directing the student, contingent on the occurrence of the inappropriate behavior, to move from the area they were in to an area that is behind an in-class cubicle for a specified period. The advantage of this procedure is the child is still able to hear academic and social instruction because they are not completely removed from the environment and the therapist or teacher praising other children for appropriate behaviors. The disadvantages to this procedure are the child may still have access to covert reinforcement from other children, this type of reinforcement opportunity will make it highly unlikely that the frequency of the undesirable behavior will decrease.

4. Hallway Time-Out: In this method, the child is directed or taken to leave the classroom and sit in the hallway. This method has similar advantages to the previously described time-out procedure but there are two reasons in particular that this procedure is NOT recommended for use:

(a). There are multiple ways in which the child can obtain reinforcement while in hallway time-out. Additional reinforcement opportunities may come from children in other rooms or people walking in the hallway. (b). the increased probability of escape if the child is combative on the way to time-out. Often times, instructors are too occupied with time-in activities to observe the child in time-out closely. This procedure would probably be more useful to use with children who follow directions and have basic compliance skills.

Appealing Qualities of Time-Out:

Here we will discuss the desirable aspects of using time-out procedures. These aspects include ease of application, acceptability, rapid suppression of behavior, and combined applications. Each of these components are discussed in more detail below:

Ease of Application: Time-out procedures are relatively easy to implement. implementing time-out can be implemented with greater ease if the therapist issues the direction to the student as privately as possible. Especially when time-out is being implemented and the therapist must insist that the child leaves, this direction should be given in as close a proximity to the child as possible to prevent the child from having to challenge the teachers directions in front of a group of peers. If you are ever questioning whether to implement the time-out procedure that is outlined in the child's challenging behavior protocol or need assistance taking child to a time-out setting please call the case manager IMMEDIATELY.
Acceptability: Nonexclusion time-out procedures are considered acceptable because they meet the standard as being appropriate, fair, and effective.
Rapid Suppression of Behavior: If time-out procedures are implemented effectively, these procedures usually suppress the inappropriate target behavior at a moderate-to-rapid rate. Therefore, sometimes only a few applications of a time-out procedure achieve an appropriate reduction in the levels of the targeted inappropriate behavior. Other procedures such as extinction and differential reinforcement also produce reductions in the frequency of problem behaviors but these reductions occur at rates that are much slower than time-out procedures. Often times, we do not have the time to wait for the other procedures to produce a reduction, these are the cases in which time-out procedures should be considered. The procedure that is used to reduce challenging behaviors is to be determined by the case managers. If you feel that a given procedure to reduce challenging behaviors for a child you are working with is not reducing the challenging behaviors, we highly encourage you to discuss your concern with the child's case manager.
Combined Application: Another highly desired aspect of time-out procedures is that they can be used in conjunction with other behavior modification procedures, especially in the applied setting. For example, when time-out procedures are combined with differential reinforcement, desirable behaviors can be INCREASED and undesirable behaviors can be DECREASED. These results were shown in a study done by Byrd, Richards, Hove, and Friman in 2002.

Using Time-Out Effectively:

There are several decisions that a case manager/therapist must make before implementing a time-out procedure in order for the time-out procedure to be effective. These decisions must be made before, during, and after the implementation of time-out. Powell and Powell (1982) recommended the use of a checklist to help instructors make the various required decisions.

Reinforcing and Enriching the Time-In Environment:

In order for a given time-out procedure to be effective the time-in setting should be reinforcing. As a therapist, you should find ways to reinforce behaviors that are incompatible with behaviors that result in time-out. A method to increase the development of appropriate behaviors is differential reinforcement. When the child returns from being in time-out, the child should be reinforced for appropriate behaviors as soon as possible.

Defining Behaviors that Lead to Time-Out:

It is the case managers' responsibility to outline the behaviors that will lead to the child being place in time-out. If time-out is a apart of a child's challenging behavior protocol, the case manager will inform that child's team and the time-out protocol that is to be implemented with a given child can be found for reference in the child's programs binder.

Time-Out Duration:

The initial duration of time-out should be short, usually time-outs that last between 2 and 10 minute are sufficient however, a time-out that is too short will most likely be ineffective especially if the child has a prior history of longer time-out durations. A common rule with time-out durations is time-outs lasting longer than 15 minutes are likely to be ineffective and counterproductive. Here are reasons as to why longer time-out durations are likely to be ineffective:

The child is likely to develop a tolerance for the longer durations of time-out and will likely find ways to gain access to reinforcement while in time-out.
The longer the child is in time-out the more time they spend away from vital instructional time in which there are multiple opportunities for reinforcement and learning.

From Time-Out back to Time-In:

Ideally a child should not be able to return to the time-in environment if they are still engaging in challenging behaviors when the time-out period ends. The decision to end a period of time-out should be based on an improvement in behavior as well as the duration of the time-out period. If you anticipate the child to begin engaging in challenging behaviors at the scheduled end of the time-out period, as therapist you can handle this situation in one of two ways:

You can explain to the child that the time-out period will not start until they stop emitting the challenging behavior that got them into time-out.
You could also extend the time-out period until the child stops emitting the problem behavior.

We recommend that the child be informed that the time-out period will not begin until they stop emitting the problem behavior to avoid the time-out period becoming too long and becoming ineffective.

Nonexclusionary or Exclusionary: Which one?

The type of time-out procedure used will vary case by case. The case managers will disclose which time-out procedure is used for a given child during initial on-site training.

Explaining the Time-Out Rules:

The behaviors that will lead to time-out should be explicitly stated to the child at the beginning of each therapy session. The therapist should also explicitly explain the rules of time-out. These rules should focus on how long the time-out last and the behaviors that will lead to the end of the time-out period.

Application:

Time-out should be applied at every occurrence of the targeted inappropriate behavior(s) only if time-out is a procedure that is apart of the child's behavioral intervention plan. Not using the time-out procedure for each occurrence of the targeted inappropriate behavior(s) the child may be confused about which behaviors are acceptable and which behaviors are not. Here we have provided a short video from behavior frontiers that describes important things to keep in mind while implementing a time-out procedure: