Further extensions of precision medicine to behavior analysis: A demonstration using functional communication training

The potential applicability of concepts and methods of the paradigm of precision medicine to the field of applied behavior analysis is only beginning to be explored. Both precision medicine and applied behavior analysis seek to understand and classify clinical problems through identification of their causal pathways. Both aim to develop treatments directly targeting those causal pathways, which also requires an understanding of the mechanisms by which treatments produce change (treatment-action pathways). In the current study, we extend the data-analytic methods and concepts described by Hagopian et al. (2018) toward the identification of variables that predict response to functional communication training (FCT). We discuss emerging conceptual issues, including the importance of distinguishing predictive behavioral markers from predictor variables based on their purported involvement in the causal or treatment-action pathways. Making these discriminations is a complex undertaking that requires knowledge of these mechanisms and how they interact.     

Transformation to achieve a longitudinally stationary factor pattern matrix

Meredith's method of extracting a factorially invariant solution is adapted to longitudinal settings. An explorational estimation procedure is presented which attempts to identify the longitudinal factor components of an across occasion variance-covariance matrix. This is effected by transforming an initial factor pattern matrix to stationarity. The estimation is performed in two parts, the first employing a stepwise algorithm to ascertain the dimensionality and existence of the longitudinal components and the second being the direct estimation of the existing factor pattern.     

A note on structural models for the circumplex

Jöreskog (1974) developed a latent variable model for the covariance structure of the circumplex which, under certain conditions, includes a model for a patterned correlation matrix (Browne, 1977). This model is of limited usefulness, however, in that it employs a known matrix that is rank deficient for many problems. Furthermore, the model is inappropriate for the circumplex which contains negative covariances. This paper presents alternative models for the perfect circumplex and quasi-circumplex that avoids these difficulties, and that includes the important model for a patterned correlation circumplex matrix. Two numerical examples are provided.This research was supported in part by a grant from the Graduate School of the University of Minnesota. I wish to thank M. W. Browne for suggesting the final model presented in this paper. James Steiger and the Editor also made several valuable suggestions.     

A BEHAVIORAL SYSTEM FOR ASSESSING AND TRAINING CARDIOPULMONARY RESUSCITATION SKILLS AMONG EMERGENCY MEDICAL TECHNICIANS

Many deaths from cardiopulmonary arrest can be prevented by the prompt and effective administration of cardiopulmonary resuscitation (CPR). In this study, we examined the standard training program for teaching CPR to emergency medical technicians (EMTs). We developed an alternative experimental program whereby the behaviors involved in CPR were assessed easily and in greater detail. This assessment provided the basis for a system in which effective CPR skills were reinforced and problems were corrected. Subjects who were trained in CPR according to this experimental program performed more effectively than subjects in the standard program. In addition, retention (maintenance) measures indicated that experimental subjects continued to perform well, often more effectively than professionally employed EMTs.     

ON THE RELATIONSHIP BETWEEN SELF-INJURIOUS BEHAVIOR AND SELF-RESTRAINT

Many individuals who exhibit self-injurious behavior (SIB) also exhibit self-restraint. Three hypotheses about the determinants of self-restraint have been suggested: (a) Self-restraint is maintained by escape from or avoidance of aversive aspects of SIB, (b) self-restraint and SIB are members of the same functional class, and (c) self-restraint and SIB are functionally independent. This study examined a method by which the relationship between self-restraint and SIB may be investigated using functional analysis. Data were collected on the self-restraint and SIB exhibited by 5 mentally retarded males, while conditions suspected to maintain SIB were manipulated. Results suggested that self-restraint, like SIB, may be maintained by idiosyncratic contingencies. Implications of an understanding of self-restraint for the analysis and treatment of SIB are discussed, as are some general possibilities for future research.     

ANALYSIS OF THE EFFECTS OF TASK PREFERENCES,TASK DEMANDS,AND ADULT ATTENTION ON CHILD BEHAVIOR IN OUTPATIENT AND CLASSROOM SETTINGS

Two studies were conducted with children who displayed behavior problems to evaluate the effects of task preference, task demands, and adult attention on child behavior. In Study 1, we conducted brief functional analyses in an outpatient clinic to identify variables that facilitated appropriate behavior. For 8 of 10 children, distinct patterns of performance occurred; 3 children displayed improved behavior with changes in task demands, 1 child displayed improved behavior with a preferred task, and 4 children displayed improved behavior with changes in adult attention. In most cases, the children's parents carried out the assessments with adequate procedural integrity. In Study 2, we applied similar assessment methods to a classroom setting over an extended period of time. We identified independent variables controlling appropriate, on-task, and academic behavior for 2 children on two tasks, with slightly different treatment procedures across tasks for both children. In addition, the results of brief functional analyses for both children corresponded to the extended classroom assessments.     

GENTLE TEACHING AND APPLIED BEHAVIOR ANALYSIS: A CRITICAL REVIEW

In recent years, there has been a growing controversy surrounding gentle teaching. This paper explores the nature of this controversy with particular reference to the relationship between gentle teaching and applied behavior analysis. Advantages and disadvantages of this approach are discussed, and it is suggested that gentle teaching and applied behavior analysis need not be regarded as mutually exclusive approaches to working with persons with mental retardation.     

Choice in situations of time-based diminishing returns: immediate versus delayed consequences of action.

Pigeons chose between two schedules of food presentation, a fixed-interval schedule and a progressive-interval schedule that began at 0 s and increased by 20 s with each food delivery provided by that schedule. Choosing one schedule disabled the alternate schedule and stimuli until the requirements of the chosen schedule were satisfied, at which point both schedules were again made available. Fixed-interval duration remained constant within individual sessions but varied across conditions. Under reset conditions, completing the fixed-interval schedule not only produced food but also reset the progressive interval to its minimum. Blocks of sessions under the reset procedure were interspersed with sessions under a no-reset procedure, in which the progressive schedule value increased independent of fixed-interval choices. Median points of switching from the progressive to the fixed schedule varied systematically with fixed-interval value, and were consistently lower during reset than during no-reset conditions. Under the latter, each subject's choices of the progressive-interval schedule persisted beyond the point at which its requirements equaled those of the fixed-interval schedule at all but the highest fixed-interval value. Under the reset procedure, switching occurred at or prior to that equality point. These results qualitatively confirm molar analyses of schedule preference and some versions of optimality theory, but they are more adequately characterized by a model of schedule preference based on the cumulated values of multiple reinforcers, weighted in inverse proportion to the delay between the choice and each successive reinforcer.     

Factor analysis for clustered observations

Classical factor analysis assumes a random sample of vectors of observations. For clustered vectors of observations, such as data for students from colleges, or individuals within households, it may be necessary to consider different within-group and between-group factor structures. Such a two-level model for factor analysis is defined, and formulas for a scoring algorithm for estimation with this model are derived. A simple noniterative method based on a decomposition of the total sums of squares and crossproducts is discussed. This method provides a suitable starting solution for the iterative algorithm, but it is also a very good approximation to the maximum likelihood solution. Extensions for higher levels of nesting are indicated. With judicious application of quasi-Newton methods, the amount of computation involved in the scoring algorithm is moderate even for complex problems; in particular, no inversion of matrices with large dimensions is involved. The methods are illustrated on two examples.Suggestions and corrections of three anonymous referees and of an Associate Editor are acknowledged. Discussions with Bob Jennrich on computational aspects were very helpful. Most of research leading to this paper was carried out while the first author was a visiting associate professor at the University of California, Los Angeles.     

Dynamic factor analysis of nonstationary multivariate time series

A dynamic factor model is proposed for the analysis of multivariate nonstationary time series in the time domain. The nonstationarity in the series is represented by a linear time dependent mean function. This mild form of nonstationarity is often relevant in analyzing socio-economic time series met in practice. Through the use of an extended version of Molenaar's stationary dynamic factor analysis method, the effect of nonstationarity on the latent factor series is incorporated in the dynamic nonstationary factor model (DNFM). It is shown that the estimation of the unknown parameters in this model can be easily carried out by reformulating the DNFM as a covariance structure model and adopting the ML algorithm proposed by Jöreskog. Furthermore, an empirical example is given to demonstrate the usefulness of the proposed DNFM and the analysis.