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| Using Pre-Treatment Screening and Assessments to Improve the Safety and Care of Children |
| Sunday, May 26, 2019 |
| 8:00 AM–9:50 AM |
| Swissôtel, Event Center Second Floor, Montreux 1-3 |
| Area: DEV/AUT; Domain: Translational |
| Chair: Charlene Agnew (Student) |
| Discussant: Kevin C. Luczynski (University of Nebraska Medical Center's Munroe-Meyer Institute) |
| CE Instructor: Charlene Agnew, Ph.D. |
| Abstract: Pre-Treatment screening and assessments are typically conducted to refine and individualize the treatment of problem behavior. Although conducting assessments has been known to improve treatment outcomes, extended periods of evaluation may place the child in a dangerous context and delay introduction of any intervention. In Study 1, a pre-treatment screening analysis determined that the toe walking of three participants was automatically maintained. This informed a treatment of auditory feedback using squeaker shoes with and without the paired delivery of edible items that improved the heel-to-toe gait of the participants. Study 2 reanalyzed functional analyses of problem behavior with an added response criterion (i.e., session terminated after 5 instances) that reduced session durations. The authors found that limited exposure to problem behavior could improve analytic efficiency without negatively impacting interpretations of control. Study 3 attempted to improve the safety of the functional analysis by comparing the size of the functional class (i.e., with or without the inclusion of less severe topographies of problem behavior). Results suggest that severe forms of problem behavior can be avoided during a functional analysis by including less dangerous topographies. Study 4 screened for risk factors to problem behavior to develop preventative strategies for emerging problem behavior. Preschool children were exposed to typical evocative settings (e.g., removal of attention, presence of work) in a trial-based format and treatments were designed before more severe topographies of problem behavior emerged. These studies support the need to ensure that our pre-treatment screening and assessments are safe and efficient. |
| Instruction Level: Intermediate |
| Keyword(s): Functional assessment, Pre-treatment screening, problem behavior, safety |
| Target Audience: BCBAs, BCBA-Ds, BCaBAs, licensed psychologists, and other behavior analytic providers who need to learn about assessing and treating problem behavior. |
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| The Use of Auditory Feedback and Conditioned Reinforcement to Decrease Toe Walking Among Children with Autism |
| (Applied Research) |
| HALLIE MARIE ERTEL (Florida Institute of Technology), David A. Wilder (Florida Institute of Technology), Ansley Catherine Hodges (Florida Institute of Technology), Rachel Thomas (Florida Institute of Technology) |
| Abstract: We replicated and extended previous research on the use of auditory feedback and conditioned reinforcement to decrease toe walking exhibited by three children with autism. After pre-treatment screening analyses suggested that toe walking was maintained by automatic reinforcement, we attached squeakers to the heels of each participants’ shoes. The squeakers provided auditory feedback when participants walked appropriately (i.e., with a heel-to-toe gait). For one participant, the auditory feedback itself produced increases in appropriate walking. For two other participants, edible items paired with the auditory feedback were necessary to increase appropriate walking and decrease toe walking. We then thinned the schedule of edible delivery. Finally, for two participants, we conducted intervention probes in a different setting and had a different experimenter or a caregiver conduct additional probes; intervention effects maintained. This study extends previous research by verifying that toe walking was sensitive to automatic reinforcement, by demonstrating that the squeakers themselves (without other intervention components) can be effective, and by demonstrating that the auditory feedback produced by the squeakers (before pairing with preferred items) can be effective for some children. |
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| Evaluation of Functional Analyses Retrospectively Truncated Based on Frequency of Problem Behavior |
| (Applied Research) |
| CATHERINE LARK (Marcus Autism Center), Mindy Christine Scheithauer (Marcus Autism Center) |
| Abstract: Functional analyses (FA) are the gold standard for assessing problem behavior and determining optimal treatments. Thus, research determining efficient methods for conducting FAs is important, as less time in assessment reduces the frequency of problem behavior occurring prior to treatment and allows for shorter admissions. The current presentation covers the results of a retrospective chart review that assessed the utility of abbreviating FA sessions based on frequency of problem behavior. The FA data from ten clients at a day treatment clinic for the assessment and treatment of severe problem behavior were re-analyzed using a cutoff criterion of five instances of targeted problem behavior. That is, full session FA results were compared to results when the session was “stopped” after 5 instances of problem behavior and the session was graphed based on data up until this point. There was correspondence between the function identified using full session data versus the truncated data for nine out of ten participants. Across participants, there was an average of 17% time saved and a 59% reduction in problem behavior in assessment. Implications and limitations of these results will be discussed in relation to the assessment and treatment of severe problem behavior and future research directions. |
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Evaluating the Severity of Problem Behavior During Functional Analysis |
| (Applied Research) |
| JOSHUA JESSEL (Queens College), Debra Rosenthal (Queens College) |
| Abstract: Functional analysis involves presenting putative reinforcers contingent on problem behavior to understanding the influence of environmental events and inform subsequent function-based treatment. Safety during a functional analysis of problem behavior is a common concern among clinicians and caregivers because a rich schedule of continuous reinforcement is programmed for the occurrence of problem behavior in the test condition. We conducted this study to determine if safety during a functional analysis could be improved by reinforcing a larger functional class of responses with less severe topographies. Participants were children with autism who exhibited severe forms of problem behavior such as self-injurious behavior, aggression, and property destruction. We conducted two functional analyses for each participant: one targeting multiple severe topographies of problem behavior and another targeting a collection of the severe topographies and less severe topographies reported to co-occur. The results suggest that opening the functional class to include less severe topographies can improve the safety of the functional analysis. |
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| Functional Analysis of Emerging Problem Behavior and Functional Skills in At-Risk Preschoolers |
| (Applied Research) |
| RIMA HAMAWE (California State University, Northridge), Emily Mary Tierman (California State University, Northridge), Sandy Jin (California State University, Northridge), Tara A. Fahmie (California State University, Northridge) |
| Abstract: Identifying emerging problem behavior is an important first step in preventing severe problem behavior and promoting the long-term wellbeing of children. The purpose of this study was to screen for behavioral risk factors in preschool students using functional analysis methodology. Modified trial-based functional analyses were conducted in a small-group play session by embedding specific establishing operations (removal of teacher attention, presence of work, restricted access to toys) that typically precede problem behavior in preschool classrooms. Data were collected on the occurrence of varying levels of problem behavior and functional skills. Review of video-taped sessions were used to refine behavioral measures. Results showed that, across students, problem behavior occurred most often during EOs for escape and attention, and minor to moderate problem behavior occurred more often than severe problem behavior. Furthermore, students engaged in a multitude of appropriate skills in the presence of EOs, and those skills could be classified along a continuum of complexity. Individual child profiles from the functional analysis were used to prescribe tailored intervention based on both form and function of behavior. Our discussion of this study will highlight implications of our preliminary results as well as procedural refinements that were used to address initial limitations. |
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