Association for Behavior Analysis International

Five years ago, Hanley and colleagues (2014) introduced the Interview-Informed Synthesized Contingency Analysis (IISCA) and the accompanying skill-based treatment (SBT) process as a means to improve the efficiency, safety, and social validity of the functional assessment and treatment of severe problem behavior. Since then, a number of applications of IISCA and SBT have been published as demonstrations of a practical functional assessment process. This symposium includes a review of the literature in which state-of-the-art methods for evaluating single case research were applied to evaluate the evidence base for IISCA and SBT for reducing problem behavior and supporting skill acquisition. The symposium also includes two consecutive case series in which the efficacy of variations on the IISCA and SBT approach were evaluated. Specifically, the focus of one case series was an application of the IISCA in which 3-minute sessions were used and total analysis time to inform treatment was as little as 15 minutes. In the second case series, experimenters evaluated the efficacy of SBT in the absence of physical intervention and in the context of an enhanced choice model intended to mitigate the collateral effects of extinction.

Researchers, practicing behavior analysts and graduate students

Functional analyses (FAs) are frequently being used in treatment of problem behavior. Thus, there is a need to review whether FAs represent an evidence-based practice and should be recommended. We performed a systematic review of a special application of FA, the Interview-Informed Synthesized Contingency Analysis (IISCA) resulting with Functional Communication Training and Tolerance Training (FCT-TT). A systematic search strategy was performed in relevant data bases for those peer-reviewed articles published between 2014 and 2018 in English or a Scandinavian language, employing a single-case experimental design in which treatment was a combination of IISCA and FCT-TT, the dependent variable was problem behavior, and a line-graph showing results was included. Studies were appraised and results were synthesized through the following methods: Descriptives, methodological quality and evidence base, were assessed. The synthesis included extracting the BC-SMC effect size (equal to Cohen’s d), and Meta-Analysis yielding a combined effect size and forest plot. The methodological quality was low across studies, so IISCA/FCT-TT cannot yet be regarded as an evidence-based practice. The combined ES was -2.82 (95 % CI: -6.98–1.34), (PI: -10.16–4.52). The results were quite heterogenous (I2 = .95), leaving the meta-analysis results largely uninterpretable.

Skill-Based Treatment (SBT) uses synthesized contingencies to teach alternative responses that will compete with problem behavior (Hanley et al., 2014). When manual guidance is prohibited, unsafe, or non-preferred by caregivers, the Enhanced Choice Model of SBT (ECM-SBT; Rajaraman et al., 2018) may be employed to mitigate collateral effects of extinction. Within ECM-SBT, trained responses (e.g., functional communicative responses [FCR]) and two additional alternatives to problem behavior operate concurrently. These two alternatives include (a) entering a ‘hangout’ area, in which evocative conditions are suspended and the client may access all preferred items and activities as well as low-quality attention from the therapist and (b) leaving the session entirely. We replicated ECM-SBT procedures with three elementary students in a public special day school for children who engage in severe and persistent problem behavior, in which manual guidance by non-district personnel was prohibited. We present procedures, including methodological deviations from the Rajaraman study, results of Interview-informed Synthesized Contingency Analyses, SBT, and generalization protocols, as well as client response allocation among alternatives within the ECM-SBT model.