|Scaling the Science: Bridging the Clinical Gap Between Indirect Assessment and Functional Analysis for Outpatient Populations
|Sunday, May 24, 2020
|10:00 AM–10:50 AM
|Walter E. Washington Convention Center, Level 1, Salon B
|Area: CBM; Domain: Applied Research
|Chair: Matthew L. Edelstein (Kennedy Krieger Institute)
|CE Instructor: Matthew L. Edelstein, Psy.D.
As the field of behavior analysis continues to grow, increasing numbers of practitioners seek to apply best practices across different clinical populations. A growing need exists to apply the scientific literature to the context of short term and resource-limited outpatient clinical settings. The research presented will provide preliminary evidence for modified assessment (i.e. indirect functional interview, preference, and contingency analyses) procedures targeting pediatric outpatient populations with diverse diagnostic and demographic characteristics. Study 1 replicated a study by Hoffman and colleagues (2018) which used pictures of app icons to conduct preference assessments on a tablet device. Preliminary results suggest that the procedure identified clear preferences and had high rates of social validity. Study 2 evaluated the utility of a structured functional interview (SFI) in identifying function later confirmed by contingency analyses. Results suggested a high match rate between variables identified in the functional interview and the analog analyses. Study 3 compared the SFI to the Questions About Behavioral Function (QABF) questionnaire across variables related to clinical utility and social validity. Results indicated the SFI scored higher on both domains. The current research adds to the growing literature documenting important modifications to increase accessibility of best practices in community settings.
|Instruction Level: Intermediate
|Keyword(s): Contingency analysis, Functional interview, Preference assessment
Behavior therapists, behavior analysts, psychologists, educators
|Learning Objectives: 1. Participants will be able to express their understanding of indirect and direct functional assessment methodologies 2. Participants will be able to generalize their previous knowledge of preference assessment methods to include the use of electronic devices 3. Participants will be able to incorporate social validity components into their clinical practice
Generalizing Preference Assessment Methodology Using Electronic Leisure Devices
|ASHLEY BOYLE (Kennedy Krieger Institute), Kaitlin M Gould (University of Massachusetts Boston), Jaime Benson (Kennedy Krieger Institute), Susan K. Perkins-Parks (Kennedy Krieger Institute), Matthew L. Edelstein (Kennedy Krieger Institute)
Research has established the importance of evaluating individual preference for apps and games prior to implementing function-based interventions. With the increase in use of electronic devices as part of children’s leisure activities, these devices are frequently incorporated into practice as putative reinforcers. The purpose of the present study was to evaluate the application of preference assessment methodology (i.e., Multiple Stimulus Without Replacement; MSWO) to apps on a single device. Participants were neurotypical, elementary-aged children whose families are participating in behavioral parent-training at an outpatient clinic. This study replicates procedures described by Hoffman and colleagues (2018). Picture icons of apps (4) were presented to participants to select as part of typical MSWO procedures (selecting an icon provides access to the corresponding app; match to sample validation conducted prior to MSWO). Preliminary data indicate stability with the participant’s first choice selection across three MSWO rounds and variability for the remaining three apps. Additionally, procedures were efficient and feasible (total duration for three MSWO rounds: 20 minutes) and were rated highly in a parental social validity measure (4.7 out of 5.0). Findings have implications to increase the use of efficient MSWO procedures when evaluating children’s preferences for apps on electronic devices.
Evaluation of a Structured Interview and Synthesized Contingency Analysis to Improve Efficient Functional Assessment
|KAITLIN M GOULD (University of Massachusetts Boston), Matthew L. Edelstein (Kennedy Krieger Institute), Alicia Sullivan (Kennedy Krieger Institute), Rachel Bradley (Kennedy Krieger Institute)
Research has demonstrated the essential link between experimental functional assessment and effective treatments; however, the amount of time required by these types of analyses can be prohibitive in many outpatient settings. In addition, emerging research has shown that synthesized contingency analyses may provide sufficient precision to lead to meaningful treatment outcomes. This study examined a structured functional interview (SFI) to gather targeted and essential information, including (a) operational definitions of the target behavior, (b) precursor behaviors, (c) antecedents to the target behavior, and (d) consequences of the target behavior. We utilized these essential components of the SFI to inform subsequent contingency analyses, which included either single or synthesized contingencies. The goal of the study was to validate the use of the SFI by comparing data gathered from the interview to the observations from the contingency analysis. Preliminary data support the use of this functional interview to design targeted contingency analyses, with a strong match rate in precursor behavior, antecedents, consequences, and functions. Future research will include replications as well as function-matched treatment analysis.
A Comparison of Indirect Methods for Generating a Functionally Informed, Socially Valid Understanding of Challenging Behavior
|RACHEL BRADLEY (Kennedy Krieger Institute), Amanda Moen (Kennedy Krieger Institute), Renee Smucker (Kennedy Krieger Institute), Jaime Benson (Kennedy Krieger Institute), Susan K. Perkins-Parks (Kennedy Krieger Institute), Matthew L. Edelstein (Kennedy Krieger Institute)
Experimental functional analysis (EFA) is the established “gold standard” for identification of functional variables maintaining problem behavior. However, EFAs can be impractical or even contraindicated for use in high volume outpatient settings. Indirect functional assessments are a sustainable alternative to EFAs (Tarbox et al, 2009) in that they may be a more efficient use of clinical time while preserving the integrity of patient care. The current study compared an evidence-based indirect assessment, the Questions About Behavioral Function (QABF), to a Structured Functional Interview (SFI). Results of the pilot study suggest that caregivers reported the SFI to be a more thorough assessment of their child’s behavior than the QABF. The SFI also scored higher on levels of caregiver acceptability, as indicated by a social validity measure administered following each assessment. Initial results further suggest that differences in the sensitivity and specificity of either measure were less than 50%. Follow-up contingency analyses generated differentiated rates of problem behavior between test and control conditions for 100% of participants, suggesting a higher level of precision in identification of functional variables for the SFI than for the QABF. Implications and future directions are discussed.