Association for Behavior Analysis International

Assessment and treatment of severe behavior disorders carries inherent risk to the client and/or staff due to the topography and/or magnitude of the target behavior. The studies presented in this symposium will address modifications to assessment procedures and treatment strategies to reduce the occurrence of severe behavior and increase the safety of the clinical process. Specifically, the approach of identifying precursors to problem behavior and placing reinforcement contingencies on precursors during functional analysis, rather than severe problem behavior, will be addressed, as well as strategies involving latency as the dependent measure during assessment and treatment. The first presentation will address a simplified, trial-based approach for selecting precursors for further assessment, as well as evaluate the effects of a structured indirect assessment for caregivers to nominate potential precursors. The second presentation will describe a model of progressing through assessment strategies (i.e., multiple-respondent anecdotal assessment, trial-based precursor analysis, functional analysis of precursor behavior, and functional analysis of severe behavior only when necessary) to develop a function-based intervention while minimizing the occurrence of severe problem behavior. Finally, the third presentation will evaluate the use of latency as the dependent measure during functional analyses in an outpatient setting, as well as during treatment to reduce risk.

Practitioners who assess and treat problem behavior

Functional analysis provides a well-validated methodology for assessing environmental influences on severe problem behavior; however, standard functional analyses pose potential risk because they involve procedures specifically designed to evoke severe behavior. Previous studies have examined strategies to improve the efficiency of and reduce risks related to the functional analysis process. The purpose of the present series of studies was to develop and evaluate a decision-making framework in which a series of evidence-based assessments and analyses is implemented in a systematic, escalating fashion, until sufficient evidence to form a function-based intervention is obtained. The model incorporates several evidence-based procedures, including multiple-respondent anecdotal assessment, trial-based precursor analysis, functional analysis of precursor behavior, and, if necessary, functional analysis of severe behavior. These assessments are arranged in a series, such that procedures that are least likely to produce large amounts of severe behavior are presented before those that are increasingly likely to result in severe behavior. When data permit the development of a hypothesis about the operant contingency maintaining problem behavior, that hypothesis can be tested using a test-control analysis using either noncontingent or differential reinforcement as a control/treatment.

4. One challenge to typical functional analyses (FAs) is that repeated occurrence of the problem behavior is required to determine the function of the behavior, which can pose risks to the client or therapist in the case of severe or dangerous behavior. Previous research has demonstrated that results of latency FA typically correspond with the results of a standard FA (Thomason-Sassi, Iwata, Neidert, & Roscoe, 2011). In fact, correspondence was shown in 90% of cases in that study. This outcome was significant because the use of latency as a dependent measure resulted in fewer instances of problem behavior. However, the assessments were conducted in a setting (and potentially therapists) familiar to the participants. The purpose of this study is to determine the extent to which similar results are obtained in an outpatient setting where unfamiliar therapists typically work with the client in a novel setting. In addition, treatment including functional communication training (FCT) and noncontingent reinforcement (NCR) using latency as a dependent measure will be evaluated to determine whether latency corresponds with rate and the extent to which typical treatment sessions might be modified to further reduce risks posed by severe problem behavior.