THE WIDENING WORLD OF FUNCTIONAL ASSESSMENT: COMMENTS ON FOUR MANUALS AND BEYOND

An escalating number of materials have been published recently on the topic of functional assessment and assessment‐based behavioral interventions. We review four manuals that purport to provide practical guidance for conducting functional assessment. An examination of these manuals yields encouraging evidence that the field of behavioral support has made notable progress in adopting a functional (behavior‐analytic) approach to unwanted behaviors. The content of the manuals, considered in the context of emerging perspectives in behavioral support, suggests a number of important issues and directions that should be addressed by future functional assessment research and practice.     

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.     

Preliminary evidence on the use of telehealth in an outpatient behavior clinic

Previous studies have shown that telehealth can be an effective way to deliver behavior‐analytic services. In this study, we provided a demonstration of the use of telehealth to assess and initiate treatment of problem behavior in an outpatient clinic. We coached parents of children with autism via telehealth to conduct functional analyses during 1 appointment that lasted 1 hr and subsequently coached them as they implemented functional communication training during 3 subsequent appointments (15 min each). Social functions were identified for most children, and problem behavior was reduced by an average of 65.1%.     

国外有关自我伤害功能模型的研究述评

自我伤害行为是指在没有自杀动机的情况下,个体反复地改变或伤害自己的身体组织,但不具致命性。在简要对自我伤害行为界定的基础上,对目前国外较有影响力的自伤功能模型,即环境功能模型、驱力功能模型、情绪管理功能模型、边界功能模型、体验回避功能模型进行了总结。未来的研究需要进一步加强功能测量方面的探讨。     

Functional assessment: Contributions and future directions

Functional assessment is at once redefining the standards for clinical interventions and reemphasizing the importance of studying basic behavioral mechanisms. This commentary describes one perception of what we are learning from current research on functional assessment and suggests directions for the future.     

Functional analysis methodology: Some closing comments

Functional analysis methodologies have emerged as powerful tools in research on the assessment and treatment of severe behavior disorders. Although the defining feature of these approaches is the systematic identification of environmental determinants of behavior, research methodology has varied widely with respect to the arrangements used to demonstrate experimental control as well as the types of variables subject to analysis. This commentary summarizes methodological and conceptual issues that have been raised in current research and offers some suggestions for their resolution.     

Efficiency in functional analysis of problem behavior: A quantitative and qualitative review

Originating in the mid-1960s, functional analysis (FA) has become the gold standard method for understanding the environmental variables that come to shape and maintain problematic behaviors such as aggression, self-injury, and property destruction. Over the decades, a number of studies have refined FA methods, attempting to improve the overall efficiency of the analysis through experimental design and procedural modifications. In the present review, we used ongoing visual-inspection criteria and basic probability theory to compare and analyze levels of efficiency across FA types. The multielement design and synthesized contingency analyses were about equally efficient with respect to the mean number of sessions conducted per function tested, and the trial-based and synthesized contingency analyses were the 2 most efficient with respect to the mean duration per function tested. We discuss the implications of these findings in the broader context of efficiency and provide recommendations for maximizing efficiency during an FA. We also discuss other qualitative procedural details that may influence the overall efficiency of an FA.     

Comparison of single and multiple functional communication training responses for the treatment of problem behavior

Two functional communication training (FCT) conditions without extinction were compared to treat the problem behavior of a child with developmental disabilities. The individual was taught to emit a single FCT response to obtain one of six items delivered in a randomized order or multiple FCT responses that specified the exact item. Results showed that only the FCT-multiple condition reduced problem behavior and maintained alternative mands.     

Treating elopement without extinction in a preschool setting

Elopement is a prevalent and dangerous behavior that is common with children with autism spectrum disorder (ASD). Due to safety, logistics, and effort on the part of stakeholders, recent research has emphasized the need for treatments that do not include extinction or response blocking. Using a multiple-baseline-across-functions design, we successfully decreased elopement with functional communication training, without additional treatment components, for one function but needed to add an additional treatment component (response blocking) for the second function for a 4 year-old boy with ASD who engaged in elopement in a preschool setting. We highlight contributions to the literature on elopement as well as directions for future research.     

Impact of language on behavior treatment outcomes

Resurgence of problem behavior following effective functional communication training (FCT) can occur if the functional communication response contacts extinction. For children from dual-language households, extinction may unintentionally occur due to language variations among communication partners. In the current study, the experimenters evaluated the effect of language on FCT outcomes. Participants were 3 children with autism who engaged in problem behavior and whose parents reported Spanish as the primary home language. The experimenters conducted FCT in the English language followed by probes in the Spanish language. Results suggest that functional communication responses (FCRs) learned in the first language (English) may lead to resurgence of problem behavior when English FCRs do not contact reinforcement in the untaught language (e.g., Spanish). Two of the participants required additional teaching in the secondary language (Spanish), while the third participant eventually emitted Spanish FCRs in the Spanish condition without explicit teaching.     

Utility of extinction-induced response variability for the selection of mands

Functional communication training (FCT; Carr & Durand, 1985) is a commonly used differential reinforcement procedure for replacing problem behavior with socially acceptable alternative responses. Most studies in the FCT literature consist of demonstrations of the maintenance of responding when various treatment components (e.g., extinction, punishment) are present and absent (e.g., Fisher et al., 1993; Wacker et al., 1990). Relatively little research on FCT has (a) evaluated the conditions under which alternative responses are acquired or (b) described procedures with technological precision. Thus, additional research on a cogent technology for response acquisition appears to be warranted. In the current study, we evaluated the efficacy of exposing problem behavior to extinction for inducing response variability as a tool for selecting an alternative response during FCT. Once participants engaged in appropriate alternative responses, the reinforcer identified in the functional analysis as maintaining problem behavior was delivered contingent on the alternative behavior. Results showed that exposing problem behavior to extinction was a useful method for producing alternative behaviors during FCT.     

Evaluating the effects of functional communication training in the presence and absence of establishing operations

We conducted functional analyses of aberrant behavior with 4 children with developmental disabilities. We then implemented functional communication training (FCT) by using different mands across two contexts, one in which the establishing operation (EO) that was relevant to the function of aberrant behavior was present and one in which the EO that was relevant to the function of aberrant behavior was absent. The mand used in the EO-present context served the same function as aberrant behavior, and the mand used in the EO-absent context served a different function than the one identified via the functional analysis. In addition, a free-play (control) condition was conducted for all children. Increases in relevant manding were observed in the EO-present context for 3 of the 4 participants. Decreases in aberrant behavior were achieved by the end of the treatment analysis for all 4 participants. Irrelevant mands were rarely observed in the EO-absent context for 3 of the 4 participants. Evaluating the effectiveness of FCT across different contexts allowed a further analysis of manding when the establishing operations were present or absent. The contributions of this study to the understanding of functional equivalence are also discussed.     

DOES FUNCTIONAL COMMUNICATION TRAINING COMPETE WITH ONGOING CONTINGENCIES OF REINFORCEMENT? AN ANALYSIS DURING RESPONSE ACQUISITION AND MAINTENANCE

We examined the effectiveness of functional communication training (FCT) in reducing self-injurious behavior (SIB) and in shaping an alternative (communicative) response while SIB continued to be reinforced. Following a functional analysis of 3 individuals' SIB, we attempted to teach an alternative response consisting of a manual sign to each individual, using the reinforcer that maintained SIB. When FCT was implemented without extinction, SIB remained at baseline rates for all participants, and none of the participants acquired the alternative response. When extinction was added to the training procedure, SIB decreased and manual signing increased for all participants. To determine if signing, when established, would compete with SIB when both were reinforced, extinction was then withdrawn. Signing was maintained and SIB occurred at low rates for 2 individuals, but SIB returned to baseline rates for the 3rd individual, necessitating the reimplementation of extinction. These results suggest that it may be difficult to establish alternative behaviors if inappropriate behavior continues to be reinforced, but that, when established, alternative behavior might compete successfully with ongoing contingencies of reinforcement for inappropriate behavior.     

Internet-Delivered Exposure-Based Cognitive-Behavioral Therapy for Adolescents With Functional Abdominal Pain or Functional Dyspepsia: A Feasibility Study

Functional abdominal pain (FAP) and functional dyspepsia (FD) are common in adolescents and associated with low quality of life. Exposure-based cognitive-behavioral therapy (CBT) is efficient for adult and adolescent irritable bowel syndrome (IBS), but has never been evaluated for adolescent FAP/FD. The aim of this study was to evaluate the feasibility and potential efficacy of a novel disorder-specific Internet-delivered CBT (Internet-CBT) for adolescents with FAP or FD, using an uncontrolled open pilot including 31 adolescents. The Internet-CBT consisted of 10 weekly online modules, which focused mainly on exposure to abdominal symptoms. Parents received modules to help them reduce unhelpful parental behaviors. Participants reported the treatment to be credible, and an overall satisfaction with the treatment. Data attrition rate was low (7%) and adherence to treatment was acceptable. We saw a significant and large effect on the primary outcome, pain intensity, at posttreatment (d = 1.20, p < .001) that was further improved after 6 months (d = 1.69, p < .001). Participants also made significant and large improvements on gastrointestinal symptoms (d = 0.84, p < .001) and quality of life (d = 0.84, p < .001) that were sustained or further improved at follow-up 6 months after treatment. This study demonstrated that exposure-based Internet-CBT, tailored for adolescents with FAP or FD, is a feasible treatment that potentially improves pain intensity, gastrointestinal symptoms, and quality of life.     

A DEMONSTRATION OF INDIVIDUAL PREFERENCE FOR NOVEL MANDS DURING FUNCTIONAL COMMUNICATION TRAINING

Preference for mand topography was evaluated for 2 individuals with developmental disabilities who exhibited problem behavior. The results of a functional analysis showed that each participant's problem behavior was maintained by social reinforcement. Participants were taught two novel mand topographies for the same functional reinforcer, and each proved to be effective in reducing problem behavior. Finally, preference for mand topography was assessed within a concurrent‐schedules design. Results indicated that functional communication training was an effective treatment, regardless of the mand used, and that each participant demonstrated a preference for one mand topography relative to the other.     

Extraversion modulates functional connectivity hubs of resting‐state brain networks

Personality dimension extraversion describes individual differences in social behaviour and socio‐emotional functioning. The intrinsic functional connectivity patterns of the brain are reportedly associated with extraversion. However, whether or not extraversion is associated with functional hubs warrants clarification. Functional hubs are involved in the rapid integration of neural processing, and their dysfunction contributes to the development of neuropsychiatric disorders. In this study, we employed the functional connectivity density (FCD) method for the first time to distinguish the energy‐efficient hubs associated with extraversion. The resting‐state functional magnetic resonance imaging data of 71 healthy subjects were used in the analysis. Short‐range FCD was positively correlated with extraversion in the left cuneus, revealing a link between the local functional activity of this region and extraversion in risk‐taking. Long‐range FCD was negatively correlated with extraversion in the right superior frontal gyrus and the inferior frontal gyrus. Seed‐based resting‐state functional connectivity (RSFC) analyses revealed that a decreased long‐range FCD in individuals with high extraversion scores showed a low long‐range functional connectivity pattern between the medial and dorsolateral prefrontal cortex, middle temporal gyrus, and anterior cingulate cortex. This result suggests that decreased RSFC patterns are responsible for self‐esteem, self‐evaluation, and inhibitory behaviour system that account for the modulation and shaping of extraversion. Overall, our results emphasize specific brain hubs, and reveal long‐range functional connections in relation to extraversion, thereby providing a neurobiological basis of extraversion.     

脑的四个功能系统学说

本文根据实验事实 ,讨论脑内评估 -情绪的功能系统。在此基础上 ,发展鲁利亚的脑的三个功能系统学说 ,提出脑的四个功能系统学说 ,认为脑内存在包括评估 -情绪功能系统在内的四个互相紧密联系的功能系统 ,人的各种行为和心理活动是这四个功能系统相互作用和协同活动的结果     

Providing noncontingent,alternative, functional reinforcers during delays following functional communication training

Functional Communication Training (FCT) involves arranging extinction for problem behavior and reinforcement for a more desirable, functionally equivalent, communicative response (FCR). Although effective under ideal arrangements, the introduction of delays to reinforcement following the FCR can result in increased problem behavior. Austin and Tiger (2015) showed that for individuals whose problem behavior was sensitive to multiple sources of reinforcement, providing access to alternative, functional reinforcers during delays mitigated this increase in problem behavior during delay fading. The current study replicated the procedures of Austin and Tiger with 2 individuals displaying multiply controlled problem behavior. Providing alternative functional reinforcers reduced problem behavior during 10-min delays for both participants without requiring delay fading.