Association for Behavior Analysis International

The use of indirect assessments in the identification of function for challenging behavior can be beneficial in informing assessment and treatment. In this symposium, the utility of various indirect assessments will be discussed. First, a comparison of the Questions About Behavioral Function (QABF) to Experimental Functional Analysis (EFA) in school settings will be presented, with particular emphasis on the utility of the QABF in clarifying inconclusive functional analyses. Next, a comparison between the QABF, the Questions About Behavioral Function—Mental Illness (QABF-MI), EFA, and concurrent operant assessments in persons with dual diagnosis will be presented. The clinical usefulness, particularly of the QABF or the QABF-MI for this specialized population will be discussed. The third presentation will be an evaluation of a novel assessment developed to measure severity of problem behavior, The Problem Behavior Severity Scale (PBSS). The clinical significance of this tool will be discussed. Finally, Robert LaRue will provide a synthesis and discussion of the utility of indirect assessments in the treatment of problem behavior and the need for continued development of tools to measure variables critical to identification of behavioral function.

Experimental functional analysis (EFA) is designed to simulate the conditions in the natural environment (Iwata et al., 1982). However, it can often pose a challenge to clinicians faced with limited resources in public school settings. Because of these challenges, descriptive methods alone and in combination with indirect assessments are routinely used in many classrooms. Indirect assessments in particular, provide an efficient way to determine the nature of the variables that maintain aberrant behaviors while circumventing the need for additional staff training or resources. One such indirect measure is the Questions About Behavior Function (QABF) (Matson & Vollmer, 2000). The purpose of this study was to examine the concordance between the QABF and EFA in 7 students with autism spectrum disorders presenting with aberrant behaviors (e.g., physical aggression, self-injury). The results of the QABF indicated escape as a primary function for all but 1 student. However, EFA showed an escape function for only half of the 7 students; the remaining students' results were either different from those obtained from the QABF, undifferentiated, or the frequency of the aberrant behaviors was too low to ascertain a clear function. The QABF appears to be an ecologically valid measure that may elucidate inconclusive EFA.

There is very little research regarding the comparison of indirect versus direct assessments with individuals with dual diagnosis. Indirect assessments such as the Questions about Behavioral Function Scale (QABF) and the Questions about Behavioral Function in Mental Illness (QABF-MI) have been used as an alternative to functional analysis (FA) as a way to determine the function of behaviors for individuals with intellectual disabilities and mental illness, respectively. Although FAs are the gold standard, individuals with a dual diagnosis are a unique population that can often display challenging behaviors (e.g., high intensity aggression), which can result in a variety of barriers to conducting an FA such as safety or difficulty with identification of variables to assess. Six individuals with dual diagnosis participated in this study. A comparison of FA's and concurrent operant assessments to QABF, QABF-MI, was completed. Results indicated a high, but not perfect correspondence between all measures used for 4 of 6 participants. Additionally, results indicated little to no measurable difference between the QABF and the QABF-MI for these individuals. Results will be discussed in terms of implications for use of indirect assessment in this unique population and additional variables to consider for future research.

The severity of problem behavior is a key factor in triage and placement decisions. Although a few standardized rating scales provide information about the severity of problem behavior, they are not ideally suited to this purpose for individuals with developmental disabilities who exhibit severe behavior. The Problem Behavior Severity Scale (PBSS) was developed to provide an objective measure of the severity of problem behavior as it relates to injury to self or others, property destruction, and the level of intervention or staff required to safely intervene. The PBSS was administered to 285 individuals by a trained clinician who completes intake evaluations for intensive and community-based behavior programs. A severity score produced by the PBSS score was used to determine the appropriate level of intervention. Results were compared to recommendations from clinicians knowledgeable about the case. The clinicians and PBSS produced the same recommendation for 87% of the individuals. Disagreements were analyzed to determine which recommendation (PBSS or clinician) was more appropriate, as determined by successful completion of one program or a referral to a different program. Recommendations from the clinicians were more appropriate for 6%, where as the severity score from the PBSS was more appropriate for 1%.