As behavior analysts, we’re constantly on the lookout for research and strategies that can help us understand the complexities of human behavior, particularly in children with autism. One article that had a significant impact on my career was “The Role of the Reflexive-Conditioned Motivating Operation (CMO-R) During Discrete Trial Instruction With Children With Autism” by Carbone et al. (2010). This article illuminated some critical concepts that deeply enhanced the way I approached therapy with my clients, and it truly marked a catapulting moment in my career.

 

The first time I was exposed to this article was during my time at the University of Kansas and again in the previous clinic I provided RBT services while working towards becoming a BCBA. I can still remember the light bulb moment of when it clicked, “this is how I can make our sessions more enjoyable, this is how I can reduce problem behaviors and start to evoke desired or alternative skills” and when I decided it was time to move back home to New York and work for a group of highly intelligent Behavior Analysts. When you are able to understand the motivating operations at play when working with children with Autism, you are able to open a whole new world of learning for them. A world of learning that isn’t met with frustration or motivation to escape. 

 

I’d like to share some of the key takeaways from the article and how it changed my understanding of motivation and behavior in children with autism, while also helping me rethink how I structured my learning environments to make a lasting impact on behavior change.

 

 

Before diving into the key takeaways, it’s essential to understand what a CMO-R is. Simply put, a CMO-R is a type of motivating operation (MO) that occurs when an event, object, or situation signals that a change in the environment is coming. This is typically something that makes a person want to avoid or escape a situation. In other words, a CMO-R “sets the stage” for what is about to happen, influencing how motivated an individual is to engage with or avoid the task or environment.

 

The unique aspect of the CMO-R is that it is reflexive—it specifically involves the anticipation of a change. The reflexive part comes into play when the individual’s behavior is influenced by the mere presence of a stimulus, which signals that conditions are either improving or worsening. It’s like a psychological "warning light" that either motivates an individual to approach or avoid, depending on what’s coming next. 

 

Think back to when you were growing up and maybe Mom or Dad asked you to complete a chore earlier, whoops you forgot. No big deal until you hear the dreaded call by your full name. BING. This is your “warning light” that something I want to avoid is coming and how can I make that happen? (Answer is complete that chore as fast as possible) 

 

 

A major takeaway from this article was gaining a deeper understanding of Establishing Operations (EOs) and how they influence behavior. EOs are environmental events or conditions that alter the value of a reinforcer and can make a behavior more or less likely to occur. They are crucial to understanding why children with autism (and all individuals, really) might engage in specific behaviors at certain times.

 

For example, if a child has been deprived of attention for a long period, the value of attention increases as a reinforcer, and this creates an EO that can increase the likelihood of behaviors that elicit attention-seeking. Understanding this helped me recognize that not all behaviors are "random." They are often directly influenced by the current value of reinforcers, which in turn is determined by the child’s environment and past experiences.

 

When it comes to working with children with autism, understanding how EOs drive behavior is essential for creating effective intervention plans. By manipulating these environmental conditions, we can increase or decrease the likelihood of certain behaviors, depending on our objectives.

 

 

The second major takeaway that truly transformed my practice was learning how to “abolish the CMO-R.” To “abolish” the CMO-R means to change the environment or my role as a therapist to signal that conditions are improving, rather than worsening. This concept was a game-changer because it made me realize how much control I had over the way a child interacted with the learning environment.

 

Imagine a child who begins to feel frustrated or anxious during a task. If they consistently experience failure, the learning environment begins to signal a worsening set of conditions, causing the child to avoid further engagement. In this case, the environment itself has become a CMO-R for escape or avoidance. As a therapist, it's essential to reverse that by changing how I structure the task, making sure the environment signals that success is achievable. This could be as simple as breaking a task down into smaller, more manageable steps, providing more reinforcement at a quicker rate, or provide prompting through the task.

 

By manipulating the conditions in which a CMO-R is established, I can abolish the reflexive motivating operation and instead establish an environment that motivates success, engagement, and learning.

 

To illustrate how this plays out in real life, let me share a few examples.

 

1. Example #1 – A child avoiding a difficult task: Let's say a child is asked to work on a task they’ve struggled with in the past, such as a tracing exercise. If every time the child attempts to trace, they fail or experience difficulty, the environment may signal a worsening set of conditions—the child anticipates failure, leading to avoidance behavior. In this scenario, the CMO-R is the signal for failure, prompting the child to escape the task.

Abolishing the CMO-R: To improve this situation, I can “abolish” the reflexive motivating operation by breaking the task into smaller, easier steps, providing reinforcement for effort and attempting the task, and setting up a context where the child experiences consistent success, even if it's just small successes. This is done through errorless teaching, after identifying the most effective yet least intrusive prompt that will lead to success. This helps the child associate the task with positive outcomes, rather than negative ones.

 

2. Example #2 – A child reluctant to communicate: If a child has learned that attempts to communicate have often led to frustration or a lack of reinforcement (like not getting what they want or not being understood), the child might avoid communication altogether. Here, the CMO-R signals that communication efforts will not lead to desired outcomes, creating a reflexive avoidance behavior.

 

Abolishing the CMO-R: In this case, I can change the environment so that communication attempts are met with reinforcement, no matter how small. For example, using a highly preferred item or activity as a reinforcer and delivering it consistently when the child emits a vocal or non-vocal request that was either prompted or independently. This procedure is known as Mand Training, which creates a situation where the child is motivated to engage in communication, rather than avoiding it. 

 

 

The insights I gained from Carbone et al. (2010) radically shifted how I thought about motivation and behavior in children with autism. Understanding the role of EOs in influencing behavior and learning how to abolish the CMO-R gave me the tools to structure more effective, motivating learning environments. By shifting the focus from "demanding compliance" to "creating conditions that foster motivation and success," I began to see more meaningful progress in my clients' behavior and skill development. This has also been a highly effective tool to share with Teachers and all staff I work with in Outreach. One that has led to meaningful and impactful change. 

 

If you haven’t yet read this article, I highly recommend it. The concepts of EOs and the CMO-R may seem complex at first, but once you grasp them, they become invaluable tools for understanding and improving behavior in meaningful, sustainable ways. And ultimately, it’s about helping our clients build skills and confidence in a way that makes learning feel like a positive experience, rather than a struggle.