|Risk Reduction Strategies During Assessment and Treatment of Problem Behavior|
|Monday, May 28, 2018|
|11:00 AM–11:50 AM |
|Manchester Grand Hyatt, Grand Hall A|
|Area: DDA/AUT; Domain: Applied Research|
|Chair: Jennifer N. Fritz (University of Houston-Clear Lake)|
|CE Instructor: Jennifer N. Fritz, Ph.D.|
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.
|Instruction Level: Intermediate|
|Keyword(s): functional analysis, latency, precursors, problem behavior|
|Target Audience: |
Practitioners who assess and treat problem behavior
|Learning Objectives: 1. Describe the trial-based method of identifying precursors to problem behavior 2. Describe how to conduct a latency functional analysis 3. Describe some considerations for progressing from indirect to functional analysis of problem behavior to reduce risks associated with severe topographies of problem behavior|
|A Comparison of Methods for Identifying Precursors to Problem Behavior|
|Jennifer N. Fritz (University of Houston-Clear Lake), Kathryn Shepard (University of Houston-Clear Lake), KYLE DAWSON (University of Houston-Clear Lake), Leah Smith (University of Houston-Clear Lake), Kelsey Campbell (University of Houston-Clear Lake), Adriana Marsiglia (University of Houston-Clear Lake)|
|Abstract: A challenge of typical functional analyses (FA) is that multiple occurrences of the problem behavior must be observed to determine the function of problem behavior, which can increase risks to participants and therapists in the case of severe behavior. One approach to risk reduction is to conduct an FA of precursors to problem behavior (Smith & Churchill, 2002). Although caregivers often cannot identify precursors during open-ended interview, a trial-based method for identifying precursors has been shown to be highly effective in those cases (Fritz, Iwata, Hammond, & Bloom, 2013). However, the conditional probability analysis used to select precursors in the Fritz et al. study was time consuming and cumbersome, which could pose barriers to adoption by practitioners. The purpose of this study was to compare the effectiveness of a simplified, trial-based approach to selecting precursors, as well as evaluate the effects of a structured interview with caregivers to increase the likelihood that they could report potential precursors.|
A Decision-Making Model for Reducing Risk During Functional Analysis Procedures
|GABRIELLE VEGA (University of North Texas), Richard G. Smith (University of North Texas), Kathleen Ann Bayliss (University of North Texas)|
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.
Latency as Dependent Measure to Reduce Risk During Assessment and Treatment of Problem Behavior
|KELSEY CAMPBELL (University of Houston-Clear Lake), Jennifer N. Fritz (University of Houston-Clear Lake), Leah Smith (University of Houston-Clear Lake), Kyle Dawson (University of Houston-Clear Lake)|
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.