Achieving socially significant reductions in problem behavior following the interview‐informed synthesized contingency analysis: A summary of 25 outpatient applications

Jessel, Hanley, and Ghaemmaghami (2016) reported the results of 30 interview‐informed, synthesized contingency analyses (IISCAs) and found the IISCAs to be an effective tool for identifying the functions of problem behavior across a variety of topographies, participants, and settings. Jessel et al. did not, however, include data on the effectiveness of the corresponding treatments. In the current study, we collected and summarized 25 additional applications, from analysis to treatment, in which the IISCA was applied in an outpatient clinic. The IISCA identified various social functions of problem behavior, which informed personalized treatments of functional communication training with contingency‐based reinforcement thinning. A 90% or greater reduction in problem behavior was obtained for every participant by the end of the treatment evaluation. The assessment and treatment process was socially validated by caregivers who rated the procedures highly acceptable and helpful, and the improvement in their child's behavior highly satisfactory.     

Interview‐informed synthesized contingency analyses: Thirty replications and reanalysis

The speed with which a functional analysis (FA) provides a convincing demonstration of the variables that influence problem behavior may be termed efficiency. Multiple FA formats have been developed to improve analytic efficiency while the core components of the Iwata, Dorsey, Slifer, Bauman, and Richman (1982/1994) procedures are maintained. We attempted to illustrate an alternative efficient process for conducting FAs of problem behavior that relied on modifying those core components. In Study 1, we describe 30 applications of the interview‐informed synthesized contingency analysis (Hanley, Jin, Vanselow, & Hanratty, 2014), which required an average of 25 min of analysis. The first sessions of these analyses were reanalyzed in Study 2 to determine if contingencies that controlled problem behavior could be identified in only 3 to 5 min. This was the case in 80% of analyses.     

Does analysis brevity result in loss of control? A consecutive case series of 26 single‐session interview‐informed synthesized contingency analyses

A believable demonstration of control over problem behavior is a necessary component of the functional analysis process. Control during a functional analysis has traditionally been defined in a binary manner: Differentiated outcomes point to an identifiable function and undifferentiated outcomes do not. However, it might be beneficial to characterize control as strong, moderate, or weak in order to evaluate the strength of evidence for experimental control during an efficient functional analysis format that requires only a single session. We analyzed the levels of control using 26 single‐session interview‐informed synthesized contingency analyses (IISCAs). Although shorter session duration (i.e., first 3 or 5 min of each session) tended to reduce the level of control, the majority of single‐session IISCAs resulted in evidence indicating strong levels of control when data from the full 10‐min session were included in the analysis.     

Interview‐informed functional analyses: A comparison of synthesized and isolated components

Hanley, Jin, Vanselow, and Hanratty (2014) described a functional analysis (FA) format that relied on a synthesis of multiple contingencies described by caregivers during open‐ended interviews. These interview‐informed synthesized contingency analyses (IISCA) provided effective baselines from which to develop socially validated treatments, but the synthesis precluded a precise understanding of individual contingencies influencing problem behavior. We conducted IISCAs and standard FAs (Iwata, Dorsey, Slifer, Bauman, & Richman, 1982/1994) for nine children with autism to evaluate the likelihood of differentiation given a number of synthesized versus isolated variables. The IISCA was differentiated for all. The standard FA was differentiated for four; this number increased to six when we included precursors in the standard FA. We then compared treatments based on sets of differentiated analyses for four children. Treatment based on the IISCA was effective for all four; treatments based on the standard FA were effective for two. The role of synthesis in analysis is discussed.     

Comparisons of standardized and interview-informed synthesized reinforcement contingencies relative to functional analysis

We compared the functions of problem behavior identified by (a) a functional analysis (FA), (b) an interview-informed synthesized contingency analysis (IISCA) that was informed by the results of an open-ended interview and a structured observation, and (c) a standardized-synthesized contingency analysis (SSCA) in which we synthesized three common functions of problem behavior across 12 individuals in a controlled consecutive case series. We then compared outcomes across assessments. The FA was sufficient in identifying the variables maintaining problem behavior for 11 of the 12 participants, replicating the findings of Fisher, Greer, Romani, Zangrillo, and Owen (2016). Error type (i.e., false positives, false negatives) and error prevalence were similar across functions identified by the IISCA and the SSCA, calling into question the utility of the open-ended interview and the structured observation that informed the IISCA.     

Evaluation of a trial-based interview-informed synthesized contingency analysis

We evaluated the viability of an interview-informed synthesized-contingency analysis (IISCA) conducted in a trial-based format with 3 children with autism spectrum disorders who engaged in problem behavior. We compared results to those from typical trial-based and traditional functional analyses and found high degrees of correspondence. The trial-based IISCA format took the least amount of time to conduct and was associated with the lowest frequencies of problem behavior. Results are discussed in terms of merits of each of the 3 types of functional analysis arrangements and directions for future research.     

Comparisons of synthesized and individual reinforcement contingencies during functional analysis

Researchers typically modify individual functional analysis (FA) conditions after results are inconclusive (Hanley, Iwata, & McCord, 2003). Hanley, Jin, Vanselow, and Hanratty (2014) introduced a marked departure from this practice, using an interview‐informed synthesized contingency analysis (IISCA). In the test condition, they delivered multiple contingencies simultaneously (e.g., attention and escape) after each occurrence of problem behavior; in the control condition, they delivered those same reinforcers noncontingently and continuously. In the current investigation, we compared the results of the IISCA with a more traditional FA in which we evaluated each putative reinforcer individually. Four of 5 participants displayed destructive behavior that was sensitive to the individual contingencies evaluated in the traditional FA. By contrast, none of the participants showed a response pattern consistent with the assumption of the IISCA. We discuss the implications of these findings on the development of accurate and efficient functional analyses.     

Response latency as a measure of behavior in the assessment of elopement

Elopement is a common form of problem behavior but is relatively underrepresented in the functional analysis literature. One barrier to assessing elopement experimentally is the need to retrieve the subject following an instance of elopement. This retrieval confounds programmed session contingencies when the goal is to obtain repeated measurement of free‐operant behavior. The current study evaluated latency to elopement as an alternative to free‐operant measurement. We first compared response latency to allocation in 5‐min sessions and then measured latency alone in a trial‐based format. The identified reinforcers matched across both data analysis modalities in the session‐based assessments, and the trial‐based functional analysis showed a significant time savings in identifying the function of behavior over a session‐based assessment. Results indicated that elopement serves idiosyncratic social functions in young children with intellectual and developmental disabilities, and that a latency‐based assessment saves time while yielding equally clear results.     

Outcome summaries of latency‐based functional analyses conducted in hospital inpatient units

Latency‐based functional analysis (FA) may be a viable alternative to the standard, rate‐based, FA when frequently evoking problem behavior is not advisable. We conducted 18 latency‐based FAs of the problem behavior of children diagnosed with autism in inpatient hospital settings and identified functional relations during 44.4% (8 of 18) of latency‐based FAs. Implications for conducting FAs of severe problem behavior are discussed.     

Generality of the practical functional assessment and skill‐based treatment among individuals with autism and mental health disorders

A practical functional assessment format was recently developed that informed a skill‐based treatment for the problem behavior of children diagnosed with autism spectrum disorder. Since its inception there have been multiple replications of the procedures; however, the comprehensive model has rarely been applied to populations with more complex comorbid disorders and severe problem behavior such as those diagnosed with anxiety or depression. We conducted the current study to systematically replicate the entire practical functional assessment and skill‐based treatment model with two participants diagnosed with multiple mental health disorders admitted to a severe behavior outpatient unit. The practical functional assessment identified reinforcers that were provided contingent on increasingly complex forms of communication. Problem behavior remained low for both participants after reinforcement was thinned by increasing a response requirement of completing difficult tasks. Furthermore, the results were socially validated by the parents and teachers and the treatment was extended to the home setting.     

WITHIN‐SESSION TRANSITIONS IN CHOICE: A STRUCTURAL AND QUANTITATIVE ANALYSIS

The present study used within‐session transitions between two concurrent schedules to evaluate choice in transition. Eight female Long‐Evans rats were trained to respond under concurrent schedules of reinforcement during experimental sessions that lasted 22 hr. The generalized matching equation was used to model steady‐state behavior at the end of each session, while transitional behavior that emerged following the change in reinforcement schedules was modeled using a logistic equation. The generalized matching and logistic equations were appropriate models for behavior generated during single‐session transitions. A local analysis of behavior on the two response alternatives during acquisition was used to determine the source of preference as revealed in response ratios. The number of “low‐response” visits, those containing three to five responses, remained stable. Preference ratios largely reflected a sharp increase in the number of visits with long response bouts on the rich alternative and a decrease in the number of such visits to the leaner alternative.     

Evaluating the boundaries of analytic efficiency and control: A consecutive controlled case series of 26 functional analyses

We conducted this study to determine if the efficiency of the functional analysis could be improved without detrimental effects on control. In Experiment 1, we reanalyzed functional analyses conducted for the problem behavior of 18 children. We analyzed rates of problem behavior during the first 5 min and first 3 min of the original 10-min sessions and evaluated if changes in the level of control over problem behavior by the programmed contingency were evident from the analyses of shorter session duration. In Experiment 2, we conducted 8 consecutive functional analyses with 3-min sessions to further evaluate the utility of brief session durations. We found that control over problem behavior was demonstrated when conducting functional analyses with sessions as brief as 3 min.     

Precursor behavior and functional analysis: A brief review

Researchers have developed precursor functional analyses to provide an alternative, and presumably safer, format for functional analysis of severe problem behavior. When researchers use functional analysis contingencies for precursor behaviors, it is possible to infer functional characteristics about severe problem behaviors based on patterns of less severe precursor behaviors, permitting practitioners to complete the assessment with less risk to clients, practitioners, or others. The current paper discusses recent advances in the development and validation of precursor identification, and offers suggestions and future directions for investigating and implementing precursor functional analyses. We propose a decision‐making model, in which practitioners integrate procedures to identify precursors into the functional‐analysis process, to expedite the analysis of severe problem behaviors.     

Affirming Control by Multiple Reinforcers via Progressive Treatment Analysis

It is common to isolate reinforcement contingencies across several test conditions in functional analyses of problem behavior; however, synthesizing all reinforcement contingencies in a single test condition may also have merit and even be necessary in some cases. Following a differentiated functional analysis, which relied on an interview‐informed synthesized test condition, functional communication training (FCT) was applied across the three suspected contingencies of reinforcement, partly in an attempt to understand the relevance of each. Communication responses were acquired for all three reinforcers, and problem behavior ceased only when all contingencies were addressed via FCT, suggesting that problem behavior was controlled by multiple contingencies of reinforcement. These analyses suggest that control by multiple contingencies of reinforcement can be understood during the treatment development process following a highly efficient functional analysis. Copyright © 2015 John Wiley & Sons, Ltd.     

Applying mixed‐effects modeling to single‐subject designs: An introduction

Behavior analysis and statistical inference have shared a conflicted relationship for over fifty years. However, a significant portion of this conflict is directed toward statistical tests (e.g., t‐tests, ANOVA) that aggregate group and/or temporal variability into means and standard deviations and as a result remove much of the data important to behavior analysts. Mixed‐effects modeling, a more recently developed statistical test, addresses many of the limitations of more basic tests by incorporating random effects. Random effects quantify individual subject variability without eliminating it from the model, hence producing a model that can predict both group and individual behavior. We present the results of a generalized linear mixed‐effects model applied to single‐subject data taken from Ackerlund Brandt, Dozier, Juanico, Laudont, & Mick, 2015, in which children chose from one of three reinforcers for completing a task. Results of the mixed‐effects modeling are consistent with visual analyses and importantly provide a statistical framework to predict individual behavior without requiring aggregation. We conclude by discussing the implications of these results and provide recommendations for further integration of mixed‐effects models in the analyses of single‐subject designs.     

Assessing the generality and durability of interview‐informed functional analyses and treatment

Due to the limited research demonstrating socially valid outcomes of function‐based treatments in ecologically relevant environments (Santiago, Hanley, Moore, & Jin, 2016), we replicated and extended the effects of the interview‐informed functional analysis and skill‐based treatment procedure described by Hanley, Jin, Vanselow, and Hanratty (2014) with two children diagnosed with autism in a home setting. The assessment and treatment was implemented by a home‐based service provider and treatment was extended to the participants’ parents. Following the interview‐informed functional analyses, we taught the participants functional communication responses and to engage in less‐preferred activities when functional communication outcomes were delayed. We observed large reductions in problem behavior following the introduction of the function‐based treatment. The effects extended to novel settings, stimuli, and caregivers and the results maintained at 6‐week follow‐ups.     

ABOLISHING AND ESTABLISHING OPERATION ANALYSES OF SOCIAL ATTENTION AS POSITIVE REINFORCEMENT FOR PROBLEM BEHAVIOR

Three participants whose problem behavior was maintained by contingent attention were exposed to 45‐min presessions in which attention was withheld, provided on a fixed‐time (FT) 15‐s schedule, or provided on an FT 120‐s schedule. Following each presession, participants were then tested in a 15‐min session similar to the social attention condition of an analogue functional analysis. The results showed establishing operation conditions increased problem behavior during tests and that abolishing operation conditions decreased problem behavior during tests.     

Retrospective analysis of changes in response topographies of escape‐maintained aggressive behavior during functional analyses

We observed changes in the rates of response topographies during the demand condition of functional analyses for participants who demonstrated problem behavior maintained by escape. Over the course of the functional analysis for each participant, the number of topographies decreased from the first to the last session. Additionally, after the first session of the demand condition the rate of responding for one topography increased or remained at high levels while the rates of all other topographies decreased. The implications of these results when conducting functional analysis are discussed.     

Parent‐conducted rapid assessment of attention types for the treatment of attention‐maintained problem behavior

When praise is not a reinforcer for alternative behavior in the treatment of attention‐maintained problem behavior, further pretreatment assessments are warranted to develop an effective treatment. The current study reports a replication of the pretreatment rapid assessment of attention types (RAAT) procedures, implemented by the parents of a 19‐year‐old female with attention‐maintained problem behavior. After administering staff and parent‐conducted RAATs, a parent‐implemented treatment, (a) produced clinically significant decreases in problem behavior, and (b) confirmed that the RAAT identified an attention‐type that served as a reinforcer for appropriate alternative behavior. This study extends the findings of Strohmeier et al. by reporting results of a parent‐conducted RAAT and treatment evaluation. The findings highlight the practical importance of pretreatment assessment of attention‐types, with emphasis on caregiver involvement, to develop effective treatments for attention‐maintained problem behavior.     

Evaluating the effects of physical reactions on aggression via concurrent‐operant analyses

Under naturally occurring conditions, the individual who is the target of aggression is likely to physically react to evade the aggressor and avoid physical harm. Like other forms of attention that occur following problem behavior, physical reactions may maintain problem behavior. However, evaluating the effects of physical reactions is complicated by issues related to therapists' ability to consistently and safely control their reactions, which may prove difficult to achieve in functional analyses. We evaluated the utility of a concurrent‐operant analysis to test behavioral sensitivity to physical reactions. The results suggest that the concurrent‐operant analysis may be useful when therapists cannot consistently refrain from responding contingent on problem behavior in the control condition of a more typical functional analysis.