|Recent Advancements in Assessment, Treatment, and Outcomes for Challenging Behavior
|Saturday, May 28, 2022
|3:00 PM–4:50 PM
|Meeting Level 2; Room 258C
|Area: AUT/DDA; Domain: Applied Research
|Chair: Fabiola Vargas Londono (Marcus Autism Center)
|Discussant: Nathan Call (Marcus Autism Center)
|CE Instructor: Fabiola Vargas Londono, Ph.D.
|Abstract: Challenging behaviors (CB) in individuals with autism and intellectual disabilities can have serious deleterious consequences on the individual’s health, social interaction, and quality of life (e.g., Emerson & Einfeld, 2011). Therefore, research must continue to evaluate the efficacy and reliability of applied behavior analysis (ABA) interventions on reducing levels of CB in this population. This symposium consists of four presentations, followed by comments from Dr. Nathan Call. The first two talks examine the effectiveness and consistency of Functional Analysis. Holehan and colleagues examine isolated versus synthesized contingencies in functional analyses of precursor and target CB. Deshais and colleagues evaluate the sensitivity to environmental events and response allocation of CB on a longitudinal functional analysis of young children with autism. Follow by the evaluation of reinforcement durations in treatment of escape maintain CB. Kastner and colleagues compare fixed and incrementing reinforcement durations during task chaining in children with autism and CB. Last, Nuhu and colleagues evaluate the outcomes of ABA intervention through a retroactive chart review of individuals with severe CB. Overall, results will show the advances and understanding of assessment, treatment, and long-term outcomes of ABA intervention for reducing CB in individuals with autism and intellectual disabilities.
|Instruction Level: Intermediate
|Keyword(s): challenging behavior, developmental disabilities, functional analysis, treatment outcome
|Target Audience: The individual should have previous knowledge on:
Schedule of reinforcement
Functional Communication Training
|Learning Objectives: 1. At the conclusion of the presentation, participants will be able to describe the difference between using isolated versus synthesized contingencies during a Functional Analysis of precursor and target challenging behavior.
2. At the conclusion of the presentation, participants will be able to explain fixed reinforcement duration during task chaining for treatment of escape maintain problem behavior.
3. At the conclusion of the presentation, participants will be able to list behavior analytic interventions used to reduce challenging behavior in children and adolescents with autism spectrum disorder and other related developmental disabilities.
|Further Examination of Isolated Versus Combined Contingencies in Functional Analyses
|KATHLEEN HOLEHAN (Kennedy Krieger Institute), Claudia L. Dozier (The University of Kansas), Marissa E. Kamlowsky (The University of Kansas), Ky Clifton Kanaman (University of Kansas)
|Abstract: A major challenge of functional analysis (FA) methodology is the safety and efficiency of FAs (Iwata & Dozier, 2008). Therefore, researchers have proposed procedural and methodological refinements to FAs. A recent methodological refinement involves synthesized (i.e., combined) contingency analyses (SCAs; Hanley et al., 2014). We replicated and extended Holehan et al. (2020) by comparing the outcome of isolated versus synthesized contingencies in functional analyses of precursor and target problem behavior while using a reversal design to replicate effects, as well as to analyze potential iatrogenic effects (Retzlaff et al., 2020) for four young children. In addition, we examined within-session analyses of FA data to assess under what context precursor behavior or target problem behavior occurred (i.e., establishing operation on, establishing operation off) for isolated and synthesized contingencies. Next, we extended Tsami and Lerman (2019) by evaluating the extent to which FCT+EXT under synthesized contingencies generalized to the isolated contingencies shown to maintain precursor or target problem behavior for participants from Study 1. Results showed synthesized contingencies were not necessary to show functional relations between precursor or target problem behavior and environmental events for three of four participants. Additionally, intervention results showed synthesized FCRs did not generalize to all isolated variables.
Longitudinal Functional Analyses With Young Children With Autism Spectrum Disorder: A Pilot Investigation
|MEGHAN DESHAIS (Rutgers University), Eliana M. Pizarro (Our Lady of the Lake Children's Health Pediatric Development & Therapy Center), Brandon C. Perez (Trinity Christian College ), Timothy R. Vollmer (University of Florida)
A primary focus of the clinical treatment of young children with ASD is reducing problem behavior and increasing appropriate behavior. Longitudinal analysis of these responses in this population has not yet been accomplished. The goal of the current study was to pilot a method for conducting FAs on a longitudinal basis using an experimental arrangement consistent with ethical guidelines. More specifically, we sought to evaluate sensitivity to common environmental events and response allocation to problem or appropriate behavior over time in young children with ASD. To do so, we conducted trial-based FAs every 6-8 weeks with nine children diagnosed with ASD receiving early intervention services at a community-based clinic. Our proposed solution to the ethical concerns posed by conducting repeated FAs was to reinforce the first instance of either problem behavior or appropriate behavior during trial-based FAs. Findings and clinical implications will be discussed.
A Comparison of Fixed and Incrementing Reinforcement Durations During Task Chaining for Individuals With Escape Maintained Problem Behavior
|KENDALL MAE KASTNER (Marquette University ), Jeffrey H. Tiger (Marquette University), Margaret Rachel Gifford (Louisiana State University Shreveport)
Differential reinforcement of compliance (DRC), a common treatment for escape-maintained problem behavior, is typically initiated by reinforcing compliance on a dense schedule. The schedule of reinforcement for compliance is then progressively leaned via task chaining such that the individual is required to complete more work overtime, up to some socially acceptable terminal goal, before earning a break and access to reinforcement. Two variations of this procedure appear in the literature but have not been directly compared. One variation involves maintaining a fixed reinforcement duration as the work requirements increase; the other involves increasing the reinforcement duration incrementally, coinciding with increases in work requirements. The current study compared these procedures with three children with intellectual and developmental disabilities who exhibited problem behavior maintained by escape from instruction. Task chaining evoked less problem behavior when reinforcement durations increased incrementally for all three participants. These reductions in problem behavior allowed more rapid progress toward terminal goals.
|Comprehensive Evaluation of an Intensive Outpatient Program for Challenging Behavior
|NADRAT NUHU (Emory University), Alexis Constantin Pavlov (Marcus Autism Center), Alec M Bernstein (Emory University School of Medicine and Marcus Autism Center), Colin S. Muething (Marcus Autism Center), Joanna Lomas Mevers (Marcus Autism Center)
|Abstract: Behavior analytic interventions have substantial evidence supporting their use in reducing challenging behavior exhibited by children and adolescents with autism spectrum disorder and other related developmental disabilities. However, these studies often have relatively small sample sizes primarily consisting of younger children. In addition, research studies typically provide limited characterization data on participants. To date, few studies have provided large scale data on the impacts of behavior analytic interventions on addressing treatment resistant severe challenging behavior exhibited by older children. The purpose of the current study was to conduct a case review of patients seen in an intensive outpatient program over five years. The current study examined participant characterization data (e.g., adaptive functioning, cognitive functioning), indirect data (e.g., Behavior Problem Index) and direct observational data from treatment evaluations to assess the overall effectiveness of the treatment program. The clinical implications of study findings and the importance of participant characterization data will be discussed.