An Evaluation of the Relative Effectiveness of Function-Based Consequent and Antecedent Interventions in a Preschool Setting

Although there is substantial functional behavioral assessment (FBA) literature suggesting that function-based interventions are effective for improving problem behavior, only a limited number of studies have examined the effectiveness of function-based antecedent versus consequent interventions. Additionally, although there has been a recent increase in the number of studies conducted in the K–12 school setting, only a limited number of studies have included children in the preschool setting. The present study extends existing literature by examining the effectiveness of function-based antecedent versus consequent interventions for reducing problem behavior and increasing appropriately engaged behavior for preschool children without cognitive disabilities. Following an FBA of 4 children, the effectiveness of a function-based antecedent (i.e., noncontingent reinforcement [NCR]) was compared with a function-based consequent (i.e., differential reinforcement of alternative behavior [DRA]) intervention using an alternating treatments design. Results indicated that both function-based NCR and DRA were effective for decreasing problem behavior and increasing appropriately engaged behavior, with function-based NCR being more effective than DRA for 2 of 4 participants.     

A comparison of the relative efficacy of self-control therapy and a behavioral problem-solving therapy for depression in children

Twenty-nine children 9 to 12 years old who were identified as moderately to severely depressed using the Children's Depression Inventory were randomly assigned to either a self-control, behavioral problem-solving, or waiting list condition. The self-control treatment focused on teaching children self-management skills. The behavioral problem-solving therapy consisted of education, self-monitoring of pleasant events, and group problem solving directed toward improving social behavior. Subjects were assessed pre-and posttreatment and at 8-week follow-up with multiple assessment procedures and from multiple perspectives. At posttreatment, subjects in both active treatments reported significant improvement on self-report and interview measures of depression while subjects in the waiting list condition reported minimal change. Results were maintained at follow-up. The general success of the experimental treatments was discussed and recommendations for further treatment components were provided.Second authorship on this article is shared by Drs. Reynolds and Kaslow. The authors would like to thank Mr. Ed Guzwieski, Principal, and the teachers of Oregon Middle School for their cooperation with this study. The authors also would like to thank Mary Wysopal for conducting the posttreatment and follow-up interviews, and Carol Fairbanks for rating the audiotapes.     

Functional analysis and treatment of problem behavior of elderly adults in long-term care

Functional analyses were conducted for the problem behavior of 3 older adults in a long-term care setting. Two of the problem behaviors were maintained by attention, and a third was maintained by escape from demands. Function-based interventions were implemented that resulted in decreases in problem behavior in each case. Implications for the use of functional analysis and function-based interventions in the field of gerontology are discussed.     

FUNCTIONAL ASSESSMENT,CURRICULAR REVISION,AND SEVERE BEHAVIOR PROBLEMS

An adolescent female with multiple handicaps and a long history of severely disruptive behavior participated in a functional assessment linked directly to specific revisions in her school curriculum. During Phase 1, reversal designs were used to test hypotheses pertaining to antecedent and auricular influences on problem behavior. During Phase 2, a multiple baseline across afternoon and morning time periods demonstrated that the auricular revisions were effective in eliminating severely disruptive behavior and increasing on-task responding. Data also showed that inappropriate “psychotic” speech was reduced and appropriate social interactions were increased. Follow-up results showed that the changes were maintained throughout the school year. Questionnaire data provided social validation of the procedures and outcomes. The findings are discussed in relation to their implications for functional assessment, individualized curricula, and positive programming for students with disabilities and serious behavior problems.     

A Review of Functional Analysis Methods Conducted in Public School Classroom Settings

The use of functional behavior assessments (FBAs) to address problem behavior in classroom settings has increased as a result of education legislation and long-standing evidence supporting function-based interventions. Although functional analysis remains the standard for identifying behavior–environment functional relations, this component is rarely included in FBAs in practice. To address this research-to-practice gap, we searched the FBA literature to identify studies including functional analyses (FAs) conducted in students’ usual classrooms and implemented by school personnel in public school settings. FAs were defined broadly as assessments involving systematic manipulation of one or more antecedent or consequent variable to evaluate environmental influences on student problem behavior. We identified 39 studies including FAs for 88 participants. All studies were coded with regard to FA approaches and procedures as well as student, classroom, and implementer characteristics. In addition, we evaluated the extent to which FA methods in the study sample aligned with previous recommendations to address practical barriers to implementation. Results revealed a range of FA approaches that varied according to student and classroom characteristics, as well as several strategies to address implementation barriers that have been under-utilized in classroom-based FAs to date.     

The Effects of a Daily Behavior Report Card Intervention: Inclusion of a Peer Mediator

Daily Behavior Report Cards (DBRCs) have been found to decrease disruptive behaviors of children with attention-deficit/hyperactivity disorder, intellectual and developmental disorders, and typically developing students. However, although previous studies indicate that peers can assist with the implementation of a variety of interventions (e.g., Check in check out), teachers are often the implementer of DBRCs. In addition, it appears that no studies evaluating DBRCs have included a functional assessment. Thus, the purposes of this study were to assess the effects of a peer-mediated DBRC on disruptive classroom behaviors, determine whether peers could implement their portion of the intervention procedures with high integrity, and assess whether DBRC was effective independent of the functional reinforcer for disruptive behavior. In this study, peer-mediated DBRC led to a decrease in disruptive behavior and an increase in on-task behavior for all three target students who were at risk for EBD. The peer mediators also implemented the DBRC procedures with high integrity. Furthermore, DBRC was effective at suppressing disruptive behavior independent of their presumed functional reinforcer. However, it does appear that different portions of the intervention likely addressed the hypothesized functions of problem behaviors of all three participants.

     

Effects of Prevent-Teach-Reinforce on Academic Engagement and Disruptive Behavior

This study assessed the effectiveness of prevent-teach-reinforce (P-T-R), a functional behavioral assessment-based intervention for students with behavior problems, using an A-B-A-B design with follow-up. Participants included three students in kindergarten, fourth grade, and fifth grade in a rural Midwestern school district. P-T-R interventions were implemented with fidelity by all teachers and P-T-R was associated with mean decreases in disruptive behavior for all participants with Tau-U effect sizes ranging from minimal to strong. All three participants demonstrated mean increases in academic engagement with strong effect sizes. P-T-R interventions were associated with moderate to high levels of perceived social validity. Implications for consistent and efficient FBA-based interventions in schools are discussed.     

The Student Guided Functional Assessment Interview: An Analysis of Student and Teacher Agreement

Functional assessment strategies are used to guide the treatment of problem behavior with individuals who have severe disabilities. Also, researchers have extended functional assessment applications to individuals with emotional and behavioral disabilities. One such extension is the use of students as informants in the functional assessment process. The present study assessed an interview tool designed to elicit information directly from students regarding their problem behaviors. We examined agreement between students and their teachers. Results showed high agreement on the causes and functions of problem behavior with mixed agreement on support plan recommendations.     

Evaluation of a class wide teaching program for developing preschool life skills

Recently, nonmaternal center-based child care has been linked to problem behavior in young children (National Institute of Child Health and Human Development, 2003). In response, a comprehensive program to promote prosocial skills was evaluated in a classroom of 16 children between the ages of 3 and 5 years. Classroom observations were conducted during evocative situations to determine the likelihood of problem behavior (noncompliance, vocal or motor disruptions, aggression) and preschool life skills. A classwide teaching program was then implemented in a staggered manner across instruction following, functional communication, delay tolerance, and friendship skills. These four categories of preschool life skills, which included two to four related skills, were selected for classwide teaching because they were either identified by educators as important for early school success, have often been taught following functional assessments of more severe problem behavior, or both. Skills were taught on a classwide basis during typically scheduled activities (circle, free play, transitions, meals) via instructions, modeling, role play, and feedback. A multiple probe design showed that the program resulted in an 74% reduction in problem behavior and a more than four-fold increase in preschool life skills. Similar beneficial effects of the program were evident in questionnaire data gathered prior to and at the close of the evaluation. Finally, the teachers who implemented the program reported overall high levels of satisfaction with the classwide teaching program, the target skills, and the results. Implications for the design of early childhood experiences for preempting the development of serious problem behavior are discussed.     

A Comparison of Function-Based Differential Reinforcement Interventions for Children Engaging in Disruptive Classroom Behavior

This study provides a direct comparison of differential reinforcement of other behavior (DRO) and differential reinforcement of alternative behavior (DRA). Participants included three children in center-based classrooms referred for functional assessments due to disruptive classroom behavior. Functional assessments included interviews and brief functional analyses. An alternating treatments design was used to evaluate the relative effectiveness of function-based DRO and DRA interventions. Results indicated that both intervention procedures effectively reduced disruptive behavior, but the DRA procedure consistently resulted in greater reductions in disruptive behavior across all participants. Results are discussed in terms of directions for future functional assessment and intervention research as well as implications for applied practice.     

Stimulus-seeking behavior in hyperactive and nonhyperactive children

Auditory and visual stimulus-seeking behavior was measured in hyperactive and nonhyperactive youngsters. The design controlled for motor activity level. The results indicate that hyperactive children preferred auditory stimulation more than the control children. There were no differences in stimulus-seeking preferences in the visual modality. The groups did not differ in motor activity. It was concluded that abnormally high needs for stimulation are important in hyperactivity.The authors would like to express their appreciation to James Fogarty, Superintendent, Walter Galvin, Principal, and the many teachers, students, and parents of the Greene Avenue Learning Center of BOCES II in Sayville, New York for their cooperation and support in this study. We would also like to thank Susan O'Leary, Ph.D. Director of the Point of Woods Laboratory School and the students and parents for participation and support in this study.     

Attention and social problem solving as correlates of aggression in preschool males

This study examined the relationship between two cognitive processing variables-attention and social problem solving-and aggression in preschoolage boys. The 43 participants were administered two selective attention tasks that assess children's tendency to focus on aggressive versus cooperative social situations, the Preschool Interpersonal Problem Solving Test developed by Shure and Spivack, and the information and block design subtests of the Wechsler Preschool and Primary Scale of Intelligence. Aggressive behavior was measured by teacher ratings and observational data. Results indicated that, in contrast to their nonaggressive peers, aggressive preschool boys tend to focus their attention on aggressive social interactions in their environment. They also provide aggressive solutions to hypothetical interpersonal conflict situations more often than their less aggressive peers. Intelligence does not appear to play a mediating role in these relationships. Implications of these results for understanding and remediating aggressive behavior in young boys are discussed.This study is based upon data collected as part of the author's doctoral dissertation submitted to the Institute of Child Development, University of Minnesota. It was supported, in part, by a Bush Fellowship from the University of Minnesota. I would like to thank the parents, teachers, and children of the New Life Day Care and Joyce Child Care Centers in Minneapolis, and the Jack and Jill Preschool and Children's Home Society Day Care in St. Paul for their cooperation. I would also like to thank Judith List, Michael Reiner, and David Michell for help in stimulus preparation; Sally Westby, Andrea Easter, and Allyson Pearling for help with data collection; and W. Andrew Collins and Daniel Keating for their assistance throughout the study.     

Contextual Intervention for Caregiver Non-Adherence With Behavioral Intervention Plans

The extent to which parents and other caregivers implement behavioral interventions with integrity has an important impact on treatment effectiveness. This article considers popular interventions that train caregivers and improve treatment integrity in applied behavior analysis. After considering these interventions a contextual approach is described, whereby the function of caregiver non-adherence is considered. In particular, interventions aimed at manipulating setting factors are reviewed. The examples of respite and social support groups are provided as function-based interventions to improve caregiver adherence to behavioral recommendations. Implications for more contextual, coordinated, and comprehensive function-based behavioral services are provided.     

Topographies and functions of emerging problem behavior and appropriate requests in neurotypical preschoolers

The current study builds on a small but growing body of research evaluating the formal and functional characteristics of emerging problem behavior before it becomes harmful and requires costly treatment. The researchers tested 21 preschool children's sensitivity to establishing operations that commonly precede severe problem behavior. Sensitivity tests were embedded in a small group play context to optimize safety, efficiency, and ecological validity. The tests screened several levels of problem-behavior severity as well as the presence of adaptive alternatives (i.e., communication) to problem behavior. Overall, outcomes suggested sources of reinforcement for minor- and moderate-severity problem behavior in 86% of children. Only 17% of children exhibiting problem behavior also engaged in appropriate requests in the same condition(s) as problem behavior. The present data are compared to published functional analyses of severe behavior. The results are discussed as a preliminary step towards a function-based model of risk identification and behavioral prevention of severe problem behavior.     

A comparison of performance feedback procedures on teachers' treatment implementation integrity and students' inappropriate behavior in special education classrooms

This study examined the extent to which treatment integrity of 4 special education teachers was affected by goal setting, performance feedback regarding student or teacher performance, and a meeting cancellation contingency. Teachers were trained to implement function-based treatment packages to address student problem behavior. In one condition, teachers set a goal for student behavior and received daily written feedback about student performance. In a second condition, teachers received daily written feedback about student performance as well as their own accuracy in implementing the intervention and would be able to avoid meeting with a consultant to practice missed steps by implementing the intervention with 100% integrity. This latter package increased treatment integrity the most above baseline levels. Higher levels of treatment integrity were significantly correlated with lower levels of student problem behavior for 3 of the 4 teacher-student dyads. Three of the 4 teachers also rated both feedback procedures as highly acceptable. Implications for increasing and maintaining treatment integrity by teachers via a consultation model 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.     

Relative efficacy of methylphenidate and behavior modification in hyperkinetic children: An interim report

Children reported to be hyperactive in school and with behavior difficulties at home were randomly assigned to methylphenidate, behavior therapy and placebo, or behavior therapy with methylphenidate for an 8-week period. Rating scales were obtained from teachers and parents. Independent blind observers rated childrens' classroom behavior on a weekly basis. A behavior therapy program was implemented in the home and at school. Methylphenidate dosage was individualized. Ratings of behavior deviance were significantly reduced by all treatments. However, a significant advantage for the groups receiving methylphenidate was found over the group receiving behavior therapy and placebo. No significant differences between methylphenidate alone and methylphenidate combined with behavior therapy were obtained. Global ratings of improvement done by teachers favored the combined treatment of behavior therapy and methylphenidate over behavior therapy and placebo. No differences among treatments were found in the mothers' global ratings of improvement. The results indicate that though all three treatments were effective, methylphenidate was significantly superior to behavior therapy alone.This study was supported in part by grant MH 18579, and by grant No. 3-621 from the Long Island Jewish-Hillside Medical Center. The authors wish to thank the behavior therapists, Drs. Jeffrey Felixbrod and Marion Pheterson, as well as Ms. Patricia Ramsey, who was responsible for data analysis.     

A Comparison of Results and Acceptability of Functional Behavioral Assessment Procedures with a Group of Middle School Students with Emotional/Behavioral Disorders (E/BD)

There is currently controversy over the validity and applicability of functional behavioral assessment (FBA) procedures with students with emotional/behavioral disorders (E/BD). A set of FBA procedures, including teacher and student interviews and direct classroom observations, were carried out with eight students with disabilities (7 classified E/BD, one classified LD). Results indicated that when all three methods (teacher/student interviews, classroom observations) yielded a ranking for a function they agreed 64% of those occasions. For those situations in which there was overall disagreement there was agreement between teacher interview and classroom observations most of the time. Social validity data indicated that both students and teachers felt that the assessment procedures were a useful and productive process.     

Translating multiple assessment techniques into an intervention selection model for classrooms

Translating current research to school-based clinical practice highlights issues not often encountered in laboratory settings. With the assistance of a consultant, teachers conducted functional analyses, brief multielement treatment comparisons, and controlled treatment evaluations under naturalistic conditions in the classroom. Teachers also provided input on treatment selection. Treatment integrity data collected throughout the study suggested that teachers implemented analyses and treatments with high integrity. The functional analysis outcomes combined with effectiveness and acceptability data led to the selection of interventions that reduced problem behavior in the classrooms for each of 3 children.