Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.

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45th Annual Convention; Chicago, IL; 2019

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Symposium #183
Navigating the Functional Analysis and Treatment Process for Three High-Risk Problem Behaviors: Aerophagia, Rumination, and Pica
Sunday, May 26, 2019
8:00 AM–8:50 AM
Hyatt Regency West, Lobby Level, Crystal Ballroom C
Area: DDA/CBM; Domain: Translational
Chair: Craig Strohmeier (Kennedy Krieger Institute)
Abstract: For some topographies of problem behavior such as aerophagia, rumination, and pica, the development of functional analysis procedures requires special consideration so that the problem behavior can be observed safely. Few strategies are available to help clinicians navigate the process of functional analysis and treatment of such behaviors, especially when they may be maintained by socially-mediated reinforcement. Three papers will be presented where functional analyses revealed that high-risk problem behaviors were maintained by attention. The first paper describes the functional analysis and treatment of aerophagia; a serious gastrointestinal disorder caused by excessive air swallowing. The second paper describes the functional analysis and treatment of rumination, or the regurgitation, chewing, and swallowing of food. The final paper describes the analysis and treatment of pica for a typically-developing girl. Pica involves the persistent ingestion of inedible objects. Each presentation highlights individualized function-based treatments that meet the idiosyncratic features of the problem behavior topography. Treatments resulted in a reduction in the rate of problem behavior to clinically significant levels. These case studies are discussed in the broader context of functional analysis and treatment of high-risk behaviors that require ongoing consultation with medical professionals and ancillary measurement procedures.
Instruction Level: Intermediate
 
Functional Analysis and Treatment of Aerophagia
(Applied Research)
MIRELA CENGHER (Kennedy Krieger Institute), Parwinder Kaur (Kennedy Krieger Institute), Suni Schwandtner (Kennedy Krieger Institute), Nicholas Ramazon (Kennedy Krieger Institute)
Abstract: Aerophagia is a gastrointestinal disorder caused by excessive air swallowing, resulting in abdominal distention, excessive belching, and flatulence. In extreme cases, aerophagia may cause serious medical complications such as arrhythmia and esophagus, stomach, and colon rupture. Limited research exists that describes functional analysis and function-based behavioral treatment of aerophagia. In the current study, we describe results of the functional analysis and behavioral treatment of aerophagia for a 16-year-old girl with intellectual disability. Furthermore, aerophagia is discussed in the broader context of functional analysis and treatment of high-risk challenging behavior that requires ongoing consultation with medical professionals and ancillary measurement procedures (i.e., abdominal circumference pre and post session). A unique aspect of the study is that we identified a socially-mediated function, which contrasts predominant behavioral conceptualizations that suggest aerophagia is maintained by automatic reinforcement. The treatment resulted in reduction in aerophagia to clinically significant levels. Implications for clinical practice are discussed.
 
Functional Analysis and Treatment of Rumination
(Applied Research)
MOLLY BUTTS (Trumpet Behavioral Health), Julia T. O'Connor (Kennedy Krieger Institute)
Abstract: The purpose of the current paper is to describe the functional analysis and treatment of rumination for a 15-year old female diagnosed with intellectual disability. Limited research has been conducted in the area of rumination. Specifically, there are few research articles that include a functional analysis and a function-based treatment. Currently, research has focused on rumination in relation to eating disorders (Delaney, Eddy, Hartmann, Becker, Murray, & Thomas, 2015), and a review of literature targeting rumination (Lang, et al., 2011). In the current paper, results of a functional analysis showed that rumination was maintained by access to attention. Based on the results of the functional analysis, a function-based treatment was developed. The treatment consisted of non-contingent attention, access to a DVD player, and competing items. Results demonstrated a significant reduction in rumination in relation to frequency and duration of rumination. A thorough description of the analysis, treatment, and results will be discussed, as well as recommendations for practice.
 
Analysis and Treatment of Socially-Maintained Pica in a Typically Developing Girl
(Applied Research)
EMILY NESS (Kennedy Krieger Institute ), Craig Strohmeier (Kennedy Krieger Institute), Nicholas Ramazon (Kennedy Krieger Institute), Julia T. O'Connor (Kennedy Krieger Institute)
Abstract: Pica involves the persistent ingestion of non-food and non-nutritive substances and may result in harmful consequences such as choking, poisoning, and even death. Most commonly, pica is observed in individuals diagnosed with intellectual and developmental disabilities where the cause is oftentimes reported as related to automatic reinforcement (Ashworth, Hirdes, & Martin, 2009). In this population, several well-established behavioral treatments are available for pica (Hagopian, Rooker, & Rolider, 2011). Less often reported in the literature are cases of pica in typically developing individuals. Moreover, many interventions for typically developing individuals who demonstrate pica involve treatment based on a medical conceptualization, despite mixed reports of success with medical interventions (e.g., Chishold & Martin, 1981). The current study describes the behavioral treatment of pica for a typically developing 3-year-old female. After the pre-treatment analysis indicated that pica was maintained by attention from caregivers, a multiple baseline across settings single-case experimental design demonstrated the effects of differential reinforcement, extinction, and a token economy treatment package to decrease rates of pica. Results illustrate the effectiveness of a behavioral intervention when traditional medical treatments may not lead to reductions in pica. Social validity of treatment procedures and generalization across caregivers are also discussed.
 

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