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.     

A translational evaluation of potential iatrogenic effects of single and combined contingencies during functional analysis

Recent research suggests that combining putative reinforcers for problem behavior into a single, synthesized contingency may increase efficiency in identifying behavioral function relative to traditional functional analysis (FA). Other research suggests potential shortcomings of synthesized contingency analysis (SCA), such as the potential for false-positive outcomes. In prior comparisons of traditional FAs and SCAs, investigators could not ascertain with certainty the true function(s) of the participants' problem behavior for use as the criterion variable. We conducted a translational study to circumvent this limitation by training a specific function for a surrogate destructive behavior prior to conducting a traditional FA and SCA. The traditional FA correctly identified the previously established function of the target response in all six cases and produced no iatrogenic effects. The SCA produced differentiated results in all cases and iatrogenic effects (i.e., an additional function) in three of six cases. We discuss these findings in terms of the mechanisms that may promote iatrogenic effects.     

Coping With Vicarious Trauma in the Aftermath of a Natural Disaster

This study documents the vicarious psychological impact of the 2010 earthquake in Haiti on Haitians living in the United States. The role of coping resources—family, religious, and community support—was explored. The results highlight the importance of family and community as coping strategies to manage such trauma. Este estudio documenta el impacto psicológico vicario que tuvo el terremoto de 2010 en Haití sobre los residentes haitianos que viven en Estados Unidos. Se explora el papel de los recursos de afrontamiento—apoyo familiar, religioso y comunitario. Lo resultados destacan la importancia de la familia y la comunidad como estrategias de afrontamiento para superar un trauma de esas características.     

Enacting Remembrance: Turning Toward Memorializing September 11th

The memorial at the site of the former World Trade Center will open on the tenth anniversary of 9/11 to help us commemorate, honor, educate, and mourn. Memorializing is an act that involves shared memory and collective grieving—aiming also to restore severed communal bonds and dismantled cultural ideals. As such, it is a form of cultural renewal that can transform traumatized mourners into an ethical community of memory. The active rituals of memorial activity utilize both inscribed and non-inscribed practices to help survivors of mass trauma manage fear, disorganization, and helplessness as well as sorrow. To bear witness to horrific events and the suffering they induced is a moral act. To do so together with people who may have seen the events of 9/11 from other perspectives, while also remembering one’s own vision of what mattered, may mean learning to tolerate multiple conflicting narratives about the events’ meanings. It is time to turn our attention from the memorial to memorializing.     

Predictive validity and efficiency of ongoing visual‐inspection criteria for interpreting functional analyses

Prior research has evaluated the reliability and validity of structured criteria for visually inspecting functional‐analysis (FA) results on a post‐hoc basis, after completion of the FA (i.e., post‐hoc visual inspection [PHVI]; e.g., Hagopian et al., 1997). However, most behavior analysts inspect FAs using ongoing visual inspection (OVI) as the FA is implemented, and the validity of applying structured criteria during OVI remains unknown. In this investigation, we evaluated the predictive validity and efficiency of applying structured criteria on an ongoing basis by comparing the interim interpretations produced through OVI with (a) the final interpretations produced by PHVI, (b) the authors’ post‐hoc interpretations (PHAI) reported in the research studies, and (c) the consensus interpretations of these two post‐hoc analyses. Ongoing visual inspection predicted the results of PHVI and the consensus interpretations with a very high degree of accuracy, and PHAI with a reasonably high degree of accuracy. Furthermore, the PHVI and PHAI results involved 32 FA sessions, on average, whereas the OVI required only 19 FA sessions to accurately identify the function(s) of destructive behavior (i.e., a 41% increase in efficiency). We discuss these findings relative to other methods designed to increase the accuracy and efficiency of FAs.     

An historical commentary on the physiological effects of music: Tomatis, Mozart and neuropsychology

This article provides an overview of the theoretical underpinnings of the Tomatis Method, along with a commentary on other forms of sound/music training and the need for research. A public debate was sparked over the “Mozart Effect.” This debate has turned out to be unfortunate because the real story is being missed. The real story starts with Alfred Tomatis, M.D., scientist and innovator. Dr. Tomatis was the first to develop a technique using modified music to stimulate the rich interconnections between the ear and the nervous system to integrate aspects of human development and behavior. The originating theories behind the Tomatis Method are reviewed to describe the ear’s clear connection to the brain and the nervous system. The “neuropsychology of sound training” describes how and what the Tomatis Method effects. Since Dr. Tomatis opened this field in the mid 20th century, no fewer than a dozen offshoot and related systems of training have been developed. Though each new system of treatment makes clains of effectiveness, no research exists to substantiate their claims. Rather, each simplified system bases its “right to exist and advertise” on the claimed relationship to Tomatis and his complex Method. Research is desperately needed in this area. The 50 years of clinical experience and anecdotal evidence amassed by Tomatis show that sound stimulation can provide a valuable remediation and developmental training tool for people of all ages. Offshoot systems have watered down the Tomatis Method without research to guide the decisions of simplifying the techniques and equipment.     

Using e-learning modules to teach ongoing-visual inspection of functional analyses

Despite the effectiveness of function-based treatments, most clinicians do not conduct functional analyses (FA). The time required to conduct an FA is a major barrier preventing their use. One way to increase FA efficiency is to discontinue the analysis as soon as it has produced clear results. Saini et al. (2018) evaluated a structured procedure for ongoing-visual inspection of FAs and found that it produced accurate interpretations while averaging 40% fewer sessions than author interpretation. This study evaluated the efficacy of an e-learning module for training registered behavior technicians (RBTs) to implement ongoing visual inspection of FAs. Following training, 5 of the 6 participants showed mastery of ongoing visual inspection, and the final participant did so with the addition of supplemental procedures. We discuss how this training may increase the efficiency of FAs by teaching individuals who are less experienced in FA methodology when to seek supervision from a supervising Board Certified Behavior Analyst® (BCBA).     

Group CBT for Externalizing Disorders in Urban Schools: Effect of Training Strategy on Treatment Fidelity and Child Outcomes

Public schools are an ideal setting for the delivery of mental health services to children. Unfortunately, services provided in schools, and more so in urban schools, have been found to lead to little or no significant clinical improvements. Studies with urban school children seldom report on the effects of clinician training on treatment fidelity and child outcomes. This study examines the differential effects of two levels of school-based counselor training: training workshop with basic consultation (C) vs. training workshop plus enhanced consultation (C +) on treatment fidelity and child outcomes. Fourteen school staff members (counselors) were randomly assigned to C or C +. Counselors implemented a group cognitive behavioral therapy protocol (Coping Power Program, CPP) for children with or at risk for externalizing behavior disorders. Independent coders coded each CPP session for content and process fidelity. Changes in outcomes from pre to post were assessed via a parent psychiatric interview and interviewer-rated severity of illness and global impairment. Counselors in C + delivered CPP with significantly higher levels of content and process fidelity compared to counselors in C. Both C and C + resulted in significant improvement in interviewer-rated impairment; the conditions did not differ from each other with regard to impairment. Groups did not differ with regard to pre- to- posttreatment changes in diagnostic severity level. School-based behavioral health staff in urban schools are able to implement interventions with fidelity and clinical effectiveness when provided with ongoing consultation. Enhanced consultation resulted in higher fidelity. Enhanced consultation did not result in better student outcomes compared to basic consultation. Implications for resource allocation decisions with staff training in EBP are discussed.