The use of conditioned motivating operations (CMOs) in mand training for children with autism spectrum disorder: A systematic review

The concept of the establishing operation/motivating operation (MO) provides a useful approach for understanding motivational variables in operant conditioning. Since Michael elaborated the concept of the conditioned motivating operation (CMO), three CMO subtypes (i.e., surrogate, reflexive, transitive) have been applied in the analysis of behaviour. The aims of the current review are (a) to identify the types of CMO used in mand training, (b) to identify the stimuli functioning as CMOs in the MO manipulation procedures, and (c) to analyse the effectiveness of MO manipulation procedures in mand training. The current systematic review identifies, between 1982 and 2022, 61 studies using MO manipulation procedures to teach new mand responses to children with autism spectrum disorder. All studies used transitive CMOs in mand training. Various stimuli functioned as CMOs in a range of procedures, the most common being hiding an item from view. The evaluation of effect sizes showed that mand training using CMOs had medium to strong effects in 66% of the participants in increasing their independent mand responses. Implications for practitioners and suggestions for future research on mand training using CMOs are discussed.