Association for Behavior Analysis International

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47th Annual Convention; Online; 2021

All times listed are Eastern time (GMT-4 at the time of the convention in May).

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Symposium #466
CE Offered: BACB/NASP
Beyond the Typical Functional Analysis: Individualized Evaluation and Treatment of Problem Behavior
Monday, May 31, 2021
4:00 PM–5:50 PM
Online
Area: AUT/DDA; Domain: Applied Research
Chair: Lesley A. Shawler (Kennedy Krieger Institute Johns Hopkins University School of Medicine)
Discussant: Jessica L Becraft (Kennedy Krieger Institute and Johns Hopkins School of Medicine )
CE Instructor: Lesley A. Shawler, Ph.D.
Abstract:

Functional analysis of problem behavior (Iwata et al., 1982/1994) sometimes yields inconclusive results. Inconclusive results may be attributed to antecedent or consequence variables that are absent from the typical test condition(s) (Schlichenmeyer et al., 2013). Identification of these variables is essential for effective treatment; therefore, additional analyses are warranted to clarify relevant variables. This symposium describes assessment and treatment of severe problem behavior related to idiosyncratic variables (i.e. antecedents and consequences that differ from those within typical attention, demand, and alone test conditions). For example, in addition to maintenance by access to attention, escape from demands, and automatic reinforcement; problem behavior may also be maintained by multiple and combined functional reinforcers, adult compliance with mands, escape from prompts, or escape from attention. The four papers describe a process that involves: a) description of inconclusive multi-element functional analyses with typical test conditions, b) subsequent analyses to determine variables that evoked problem behavior, c) function-based treatment, and d) demonstrations of parent-conducted treatment and generalization. General considerations for scientist-practitioners will also be highlighted.

Instruction Level: Intermediate
Keyword(s): combined functions, escape-maintained behaviors, idiosyncratic functions, mand compliance
Target Audience:

Participants should have some basic knowledge or familiarity with functional analysis methodology and research. Participants should have knowledge of typical function(s) of problem behaviors. Participants should have a basic understanding of how function-based treatments are derived from functional analysis results

Learning Objectives: 1. Describe the possible methods for proceeding from undifferentiated multielement outcomes to more individualized analyses. 2. Identify some possible alternatives to the typical functional analysis test conditions following inconclusive results. 3. Describe how functional analysis results inform individualized function-based treatments and discuss the importance of accurate behavior function identification to produce effective treatments. 4. Understand the importance and relevance of the controlled consecutive case series design as it relates to research and practice.
 
Functional Analysis and Treatment of Combined and Co-Occurring Mands Functions
BENJAMIN R. THOMAS (Kennedy Krieger Institute and Johns Hopkins University School of Medicine), Julia T. O'Connor (Kennedy Krieger Institute and Johns Hopkins University School of Medicine )
Abstract: Caregiver’s compliance with a child mands can be an idiosyncratic maintaining consequence for problem behavior (Bowman, Fisher, Thompson, & Piazza, 1997). Traditional functional analysis (FA) approaches, however, do not always include a mands condition, and as such, this function can be overlooked. This may lead to inconclusive assessment results or treatment failures. This study presents the functional analysis and treatment evaluation of problem behavior maintained, in part, by caregiver’s compliance with the child’s mands. Participants included Maggie, a 14-yr-old girl with Autism Spectrum Disorder, and Jane, a 12-yr-old girl with 22Q11.2 Deletion syndrome. Maggie’s initial FA results were undifferentiated, whereas Jane’s indicated escape and tangible functions. In both cases, this led to minimal treatment gains. Subsequent analyses revealed a combined escape + mands function for Maggie, and a mands function within co-occurring tangible and escape functions for Jane. Following the mands analyses, function-based interventions consisting of functional communication training, extinction, signaled availability, and schedule thinning resulted in more than an 80% reduction in problem behavior that maintained in generalization contexts. Discussion will focus on identifying combined and co-occurring mands functions within assessment and treatment data, as well as potential modifications to the mands analysis procedures.
 

Toward an Efficient Technology of Explicit Generalization for Compliance With Mands Treatment

LESLEY A. SHAWLER (Kennedy Krieger Institute Johns Hopkins University School of Medicine), Laura Senn (Kennedy Krieger Institute and Johns Hopkins University School of Medicine ), Kerri McCorkell (Kennedy Krieger Institute ), Craig Strohmeier (Kennedy Krieger Institute and Johns Hopkins University School of Medicine )
Abstract:

When the traditional functional analysis produces inconclusive findings, this may warrant the need for additional analysis. One such analysis includes a test to determine whether an individual’s problem behavior may be maintained by adult compliance with mands (Bowman et al., 1997). The current study included a mands analysis and subsequent function-based treatment to reduce problem behavior exhibited by an adolescent with Down syndrome. Uniquely, his caregiver implemented all procedures, in the family’s home, with coaching by trained therapists using a telehealth model. Telehealth allowed access to relevant stimuli and naturally occurring contingencies, in which we could systematically train his caregiver to implement the treatment package. Results demonstrated that problem behavior decreased to low rates, functional communication increased, and his caregiver implemented the treatment with high fidelity across trained contexts. We conducted systematic probes across various contexts with some limited treatment generalization by his caregiver, initially. Following additional training with his caregiver to relevant stimuli and contexts, she demonstrated generalization of the treatment package, overall, which maintained for up to 4 months post-treatment. This case study provides preliminary findings on a systematic method to use telehealth to train caregivers to generalize a function-based treatment to relevant contexts.

 
Identification and Evaluation of a Dependent Variable in the Same Response Class as Target Behavior
LAURA SENN (Kennedy Krieger Institute and Johns Hopkins University School of Medicine), Julia T. O'Connor (Kennedy Krieger Institute and Johns Hopkins University School of Medicine ), Kerri McCorkell (Kennedy Krieger Institute)
Abstract: Past research has outlined potential methods for identifying and evaluating potential idiosyncratic functions of behavior beyond those tested during a traditional functional analysis (access to attention, escape from demands, or access to tangibles). The current study not only required this adjustment, but also presented the issue of evaluating severe problem behavior that occurred infrequently. Despite occurring infrequently, these behaviors posed a significant threat to the client and property, set the potential for serious negative social consequences, and created a barrier to the client’s long-term goals for himself. To address this, therapists identified other behaviors that appeared to occur in the same response class based on their correlation with occurrence of severe behavior. This allowed for the identification of escape from rapid demands as a function for behavior and evaluation of a function-based treatment. Treatment included DRA (functional communication response), signaled availability, and extinction of inappropriate behaviors within the functional response class targeted. Treatment concluded with generalization to the participant’s caregivers and home environment.
 
Assessment and Treatment of Problem Behavior Maintained by Escape from Attention: A Summary of 29 Cases
MIRELA CENGHER (UMBC), Michelle D. Chin (Kennedy Krieger Institute and Johns Hopkins School of Medicine ), Patricia F. Kurtz (Kennedy Krieger Institute and Johns Hopkins School of Medicine )
Abstract: The purpose of this controlled consecutive case series analysis was to evaluate outcomes of functional analysis (FA) and treatment procedures for problem behavior maintained by escape from attention (EA). Twenty nine individuals who had received inpatient or outpatient services for severe problem behavior and whose FAs included an EA test condition participated. An EA function was identified for 24 of the 29 participants. Aggression, followed by SIB, were the most prevalent forms of problem behavior demonstrated by participants with an EA function. We analyzed the initial multielement FAs that did not include an EA condition in participants for whom this function was subsequently identified, in order to establish predictive markers for EA. The following predictive markers were identified: high rates of problem behavior in the escape from demands condition and low rates of problem behavior in the attention condition. Finally, function-based treatments were implemented for 13 participants with an EA function; 84% of cases demonstrated a reduction of problem behavior of 80% or more relative to baseline. The most effective interventions included extinction and reinforcement-based procedures. Implications for research and clinical practice are discussed.
 

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