|Functional Analysis of Problem Behavior: A Context for Assessment and Treatment Innovation
|Monday, May 25, 2020
|8:00 AM–9:50 AM
|Walter E. Washington Convention Center, Level 1, Salon H
|Area: DDA/CBM; Domain: Translational
|Chair: Craig Strohmeier (Kennedy Krieger Institute)
|Discussant: John C. Borrero (University of Maryland, Baltimore County)
|CE Instructor: Craig Strohmeier, Psy.D.
Functional analyses (FAs) aim to identify reinforcers related to problem behavior and provide a baseline context for treatment evaluation. In this symposium, the first paper presents a review of the literature on compliance with mands, which is a behavior function sometimes demonstrated by individuals with moderate to advanced language repertoires. The second paper describes a controlled consecutive case series (CCCS) for the escape from attention function, which, while common as a possible behavioral phenotype in some genetic conditions, is not traditionally assessed in FAs. The third paper illuminates the heterogeneous nature of aggressive behavior (e.g. severity, topography, function), with an emphasis on response patterns that occur across FA test and control conditions. The final paper describes a CCCS analysis of two methods for thinning multiple schedules to derive more practical and efficient treatments. A terminal probe method, designed to minimize unnecessary steps in the schedule thinning process, is compared with the more traditional progressive thinning method. Across papers, we illustrate how FA provides context for innovation in the assessment and treatment of problem behavior. This context can inform a fined-tuned assessment approach that is generalizable across a wide range of populations and derives effective interventions.
|Instruction Level: Intermediate
|Keyword(s): Functional Analysis
|Mand Compliance as a Contingency Controlling Problem Behavior
|ADITHYAN RAJARAMAN (University of Maryland, Baltimore County), Gregory P. Hanley (Western New England University)
|Abstract: Bowman, Fisher, Thompson, and Piazza (1997) described a dynamic environment-behavior relation in which a child’s problem behavior was evoked by adult noncompliance with a variety of child mands, which occurred at high rates, and reinforced by adult compliance with subsequent mands. They discovered this phenomenon with two children with autism for whom traditional functional analyses involving generic reinforcement contingencies yielded inconclusive results. In recent years, similar dynamic contingencies have been shown to influence problem behavior, but the manner in which they have been arranged and described has varied across studies. The purpose of this review is to (a) describe the various contingencies involving compliance with mands and their prevalence in the literature, (b) summarize procedural variations, and (c) discuss what is known and yet to be discovered about the contingency as it relates to the analysis and treatment of problem behavior. Future research focused on improving technology for functionally analyzing and treating individuals who engage in severe problem behavior suspected to be sensitive to mand compliance will be discussed.
|Assessment and Treatment of Problem Behavior Maintained by Escape from Attention: A Summary of 29 Cases
|MIRELA CENGHER (University of Maryland, Baltimore County), Michelle D. Chin (The Kennedy Krieger Institute), Patricia F. Kurtz (Kennedy Krieger Institute)
|Abstract: The purpose of this controlled consecutive case series analysis was to evaluate outcomes of functional analysis (FA) and treatment procedures for problem behavior maintained by escape from attention (EA). Twenty nine individuals who had received inpatient or outpatient services for severe problem behavior and whose FAs included an EA test condition participated. An EA function was identified for 24 of the 29 participants. Aggression, followed by SIB, were the most prevalent forms of problem behavior demonstrated by participants with an EA function. We analyzed the initial multielement FAs that did not include an EA condition in participants for whom this function was subsequently identified, in order to establish predictive markers for EA. The following predictive markers were identified: high rates of problem behavior in the escape from demands condition and low rates of problem behavior in the attention condition. Finally, function-based treatments were implemented for 13 participants with an EA function; 84% of cases demonstrated a reduction of problem behavior of 80% or more relative to baseline. The most effective interventions included extinction and reinforcement-based procedures. Implications for research and clinical practice are discussed.
|Aggressive Behavior: What do We Know and Where Should We Go?
|NICOLE LYNN HAUSMAN (Kennedy Krieger Institute), Louis P. Hagopian (Kennedy Krieger Institute), Molly K Bednar (Kennedy Krieger Institute), Madeleine Guell (Kennedy Krieger Institute), Elissa Spinks (Kennedy Krieger Institute), John Falligant (Kennedy Krieger Institute/Johns Hopkins University School of Medicine), Michael P. Kranak (Kennedy Krieger Institute, Johns Hopkins University School of Medicine), Jasmeen Kaur (Kennedy Krieger institute )
|Abstract: Individuals with intellectual and developmental disabilities (IDD) are at increased risk for displaying aggression (Allen, 2000; McClintock, et al., 2003). Aggression is associated with social isolation, increased use of restrictive treatments, and restrictive placements (e.g., Hodgetts et al., 2013). Previous research suggests that aggression is a heterogeneous phenomenon that may vary across multiple dimensions such as severity, topography, and behavioral function, the latter of which has been the primary focus of behavior analytic research (e.g., Beavers, et al., 2003; Fitzpatrick et al., 2016). The purpose of this presentation is to review the existing literature on aggressive behavior and describe an ongoing project aimed at better understanding variables that may differentially impact risks associated with this behavior (e.g., severity, topography, function, temporal patterning). Preliminary data outlining response patterns of aggression evident by rate of responding during EO present and EO absent phases of FA test conditions will be presented.
|Effective, Efficient, and Practical Use of Multiple Schedules in the Treatment of Problem Behavior: A Comparison of Progressive Schedule Thinning and a Terminal Probe Method
|CRAIG STROHMEIER (Kennedy Krieger Institute), Mirela Cengher (University of Maryland, Baltimore County), Michelle D. Chin (The Kennedy Krieger Institute)
|Abstract: Several studies describe the use of multiple schedules to thin reinforcement schedules during the treatment of problem behavior. An empirically derived approach for adjusting the multiple schedule (i.e. discriminative stimulus and S-Delta components) can inform an efficient process of schedule thinning that omits unnecessary steps. In the current study, we used a controlled consecutive case series analysis to compare two methods of schedule thinning: a terminal probe method (n = 34) and the more traditional progressive schedule thinning process (n=25). Participants included 59 children who received services at an outpatient clinic for the functional analysis and treatment of problem behavior. Preliminary findings indicated that in 22/34 applications, the terminal probe method yielded terminal S-Delta times that met or exceeded 80% of session time, in comparison to 2/25 applications in the progressive schedule thinning group. Additionally, in 30/34 applications, the terminal probe method produced terminal S-Delta times that exceeded five minutes, in comparison to 2/25 applications in the progressive schedule thinning group. We describe the terminal probe method, between and within subject analyses, implications of findings, and recommendations for practice.