Functional analysis and treatment of self-injurious behavior in young children a summary of 30 cases

The assessment and treatment of self-injurious behavior (SIB) has received much attention in the literature; however, few studies have focused on early intervention for this behavior. In the current study, functional analyses with developmentally appropriate modifications were conducted in an outpatient clinic with 30 children (aged 10 months to 4 years 11 months) to assess SIB and problem behavior in its early stages. The reported mean age of SIB onset was 17 months, and head banging was the most prevalent topography. Functional analyses identified sources of reinforcement for SIB in 62.1% of cases; with the inclusion of all forms of problem behavior, sources of reinforcement were identified for 87.5% of cases. Function-based treatments were developed for 24 cases, with functional communication training prescribed most often (70.8% of cases). Implications of these findings for the development of early intervention programs for SIB are discussed.     

Functional analysis in public schools: a summary of 90 functional analyses

Several review and epidemiological studies have been conducted over recent years to inform behavior analysts of functional analysis outcomes. None to date have closely examined demographic and clinical data for functional analyses conducted exclusively in public school settings. The current paper presents a data-based summary of 90 functional analyses conducted in public school settings from 2006 through 2009 for 69 students. Specifically, we present data on gender, age, race, diagnosis, topography of target behaviors, number of conditions, duration of sessions, duration of analysis, functional outcomes, setting, and person serving the role of therapist. Results suggest that functional analyses in schools are possible, practical, and produce results that are comparable to those in past research.     

Efficacy of functional analysis for informing behavioral treatment of inappropriate mealtime behavior: A systematic review and meta‐analysis

Children diagnosed with a feeding disorder often exhibit inappropriate mealtime behavior such as throwing or swiping food, which can exacerbate feeding difficulties during treatment. We conducted a meta‐analysis of 86 behavioral treatments for inappropriate mealtime behavior from 23 studies to assess the extent to which treatments based on a pretreatment functional analysis were more efficacious than those treatments not based on a functional analysis. Procedural escape extinction and attention extinction for inappropriate mealtime behavior, as well as differential reinforcement for food acceptance or consumption, represented the most common treatments independent of whether a functional analysis was conducted. No difference was detected between treatments that were and were not based on a functional analysis, and mean effect size across measures was identical (79%). The requirement of a pretreatment functional analysis for inappropriate mealtime behavior is equivocal given that standard care often includes efficacious treatment components that are not informed by a functional analysis.     

The effects of different adults as therapists during functional analyses

The differential effects of caregivers and inpatient staff members as therapists on behavior were evaluated within a reversal design. Results indicated that problem behaviors were higher in the presence of caregivers relative to inpatient staff. These results are discussed in terms of how antecedent stimuli can affect functional analysis outcomes.     

Effects of computer‐based training on procedural modifications to standard functional analyses

Few studies have evaluated methods for training decision‐making when functional analysis data are undifferentiated. The current study evaluated computer‐based training to teach 20 graduate students to arrange functional analysis conditions, analyze functional analysis data, and implement procedural modifications. Participants were exposed to training materials using interactive software during a 1‐day session. Following the training, mean scores on the posttest, novel cases probe, and maintenance probe increased for all participants. These results replicate previous findings during a 1‐day session and include a measure of participant acceptability of the training. Recommendations for future research on computer‐based training and functional analysis are discussed.     

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.     

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.     

Classroom application of a trial-based functional analysis

We evaluated a trial-based approach to conducting functional analyses in classroom settings. Ten students referred for problem behavior were exposed to a series of assessment trials, which were interspersed among classroom activities throughout the day. Results of these trial-based functional analyses were compared to those of more traditional functional analyses. Outcomes of both assessments showed correspondence in 6 of the 10 cases and partial correspondence in a 7th case. Results of the standard functional analysis suggested reasons for obtained differences in 2 cases of noncorrespondence, which were verified when portions of the trial-based functional analyses were modified and repeated. These results indicate that a trial-based functional analysis may be a viable assessment method when resources needed to conduct a standard functional analysis are unavailable. Implications for classroom-based assessment methodologies and future directions for research are discussed.     

Parent‐implemented brief functional analysis and treatment with coaching via telehealth

We evaluated the use of parent‐implemented brief functional analyses in the home with coaching delivered via telehealth. Parents of 7 children with autism conducted functional analyses of their child's challenging behavior. For 4 participants, the brief functional analysis provided information regarding the function of the child's challenging behavior. A full functional analysis indicated a social function for 1 participant. The brief functional analysis yielded false positive results and subsequent assessment indicated an automatic function for another participant. The final participant did not engage in sufficient rates of challenging behavior to provide information regarding the function of the child's challenging behavior. Treatment evaluations occurred with 4 participants; these evaluations provided support for the results of the functional analysis. Together with previous research, the results indicate that parent‐implemented brief functional analyses, followed by additional assessment as needed, may be an effective method for assessing and treating challenging behavior via telehealth.     

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.     

Effects of idiosyncratic stimulus variables on functional analysis outcomes.

As the methods for the functional analysis of problem behavior have continued to develop, there has been a greater focus on the specificity of controlling variables, both antecedents and consequences. Accelerating research interest in the role of antecedents reveals that a large array of stimulus variables can influence the rate of problem behavior. Indeed, the variety of these stimuli is so great that it is sometimes possible to overlook specific stimulus variables during initial assessment. The present study shows that a failure to identify these very specific (idiosyncratic) stimulus variables is serious because their presence can systematically alter the outcomes of functional analyses that are designed to assess the motivation of problem behavior. Guidelines are therefore discussed concerning when to suspect that idiosyncratic stimuli might be acting to influence assessment data, thereby promoting a search for additional stimulus variables whose identification can aid in improving the design of functional analysis conditions.     

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.     

The significance and future of functional analysis methodologies

Iwata, Dorsey, Slifer, Bauman, and Richman (1982) presented the first comprehensive and standardized methodology for identifying operant functions of aberrant behavior. This essay discusses the significance functional analysis has had for applied behavior analysis. The methodology has lessened the field's reliance on default technologies and promoted analysis of environment-behavior interactions maintaining target responses as the basis for selecting treatments. It has also contributed to the integration of basic and applied research. Future directions for this research are suggested.