False-positive tangible outcomes of functional analyses

Functional analysis (FA) methodology is the most precise method for identifying variables that maintain problem behavior. Occasionally, however, results of an FA may be influenced by idiosyncratic sensitivity to aspects of the assessment conditions. For example, data from several studies suggest that inclusion of a tangible condition during an FA may be prone to a false-positive outcome, although the extent to which tangible reinforcement routinely produces such outcomes is unknown. We examined susceptibility to tangible reinforcement by determining whether a new response was acquired more readily when exposed to a tangible contingency relative to others commonly used in an FA (Study 1), and whether problem behavior known not to have a social function nevertheless emerged when exposed to tangible reinforcement (Study 2). Results indicated that inclusion of items in the tangible condition should be done with care and that selection should be based on those items typically found in the individual's environment.     

Using dual-criteria methods to supplement visual inspection: Replication and extension

The dual-criteria and conservative dual-criteria methods effectively supplement visual analysis with both simulated and published datasets. However, extant research evaluating the probability of observing false positive outcomes with published data may be affected by case selection bias and publication bias. Thus, the probability of obtaining false positive outcomes using these methods with data collected in the course of clinical care is unknown. We extracted baseline data from clinical datasets using a consecutive controlled case-series design and calculated the proportion of false positive outcomes for baseline phases of various lengths. Results replicated previous findings from Lanovaz, Huxley, and Dufour (2017), as the proportion of false positive outcomes generally decreased as the number of points in Phase B (but not Phase A) increased using both methods. Extending these findings, results also revealed differences in the rate of false positive outcomes across different types of baselines.     

Prevalence of renewal of problem behavior: Replication and extension to an inpatient setting

Individuals with intellectual and developmental disabilities who exhibit problem behavior often receive behavioral assessment and treatment in specialized inpatient and outpatient clinics. However, problem behavior sometimes reemerges as a function of changes in contexts and stimulus conditions, such as returning to the home environment. This reemergence is called renewal. Recently, Muething et al. (2020) found that renewal occurred in over half (67%) of cases from an outpatient clinic. Their sample was obtained exclusively from an outpatient setting and despite the applied relevance of renewal, its clinical prevalence in other populations is unknown. Accordingly, we replicated Muething et al.’s procedures and analyzed renewal in 37 inpatient treatment applications across 34 cases via consecutive‐controlled case series. Renewal was present in 59% of cases; however, we found that renewal occurred in only 24% of context changes compared to 42% reported by Muething et al. Various factors related to the prevalence of renewal were evaluated.     

ASSESSING THE UTILITY OF A DEMAND ASSESSMENT FOR FUNCTIONAL ANALYSIS

We evaluated the utility of an assessment for identifying tasks for the functional analysis demand condition with 4 individuals who had been diagnosed with autism. During the demand assessment, a therapist presented a variety of tasks, and observers measured problem behavior and compliance to identify demands associated with low levels of compliance or high levels of problem behavior (low‐probability demands) and demands associated with high levels of compliance or low levels of problem behavior (high‐probability demands). Results showed that clearer functional analysis outcomes were obtained for 3 of the 4 participants when low‐probability rather than high‐probability demands were used.     

Noncontingent reinforcement for the treatment of severe problem behavior: An analysis of 27 consecutive applications

Noncontingent reinforcement (NCR) is a commonly used treatment for severe problem behavior displayed by individuals with intellectual and developmental disabilities. The current study sought to extend the literature by reporting outcomes achieved with 27 consecutive applications of NCR as the primary treatment for severe problem behavior. All applications of NCR were included regardless of treatment outcome to minimize selection bias favoring successful cases. Participants ranged in age from 5 to 33 years. We analyzed the results across behavioral function and with regard to the use of functional versus alternative reinforcers. NCR effectively treated problem behavior maintained by social reinforcement in 14 of 15 applications, using either the functional reinforcer or alternative reinforcers. When we implemented NCR to treat problem behavior maintained by automatic reinforcement, we often had to add other treatment components to produce clinically significant effects (five of nine applications). Results provide information on the effectiveness and limitations of NCR as treatment for severe problem behavior.     

Functional analysis of self-injurious behavior and its relation to self-restraint

Some individuals who engage in self-injurious behavior (SIB) also exhibit self-restraint. In the present study, a series of three functional analyses were conducted to determine the variables that maintained a participant's SIB, one without restraint items available, one with a preferred and effective form of self-restraint (an airplane pillow) available noncontingently, and one with this item delivered contingent on SIB. Results suggested that SIB was reinforced by escape and by access to self-restraint materials, self-restraint appeared to be maintained by automatic reinforcement, and continuous access to highly preferred restraint materials effectively suppressed SIB.