|Practical Skills for Clinicians and Caregivers to Enhance the Functional Analysis and Treatment of Problem Behavior
|Sunday, May 29, 2022
|12:00 PM–12:50 PM
|Meeting Level 2; Room 251
|Area: DDA/CBM; Domain: Applied Research
|Chair: Craig Strohmeier (Kennedy Krieger Institute and Johns Hopkins University School of Medicine
|CE Instructor: Craig Strohmeier, Psy.D.
Successful functional analysis and treatment of problem behavior requires that both clinicians and caregivers develop and implement several practical skills. For clinicians, accurate visual inspection of data is necessary for interpreting functional analysis results and deriving effective treatments. Clinicians must also be equipped with skills to analyze caregiver-child interactions, and apply conceptually systematic strategies to increase desirable (treatment-consistent) caregiver behaviors. Finally, long-term effectiveness of a behavior plan centers on teaching caregivers generalizable skills that will help them maintain adherence to the plan, particularly when approaching contexts that have historically evoked problem behavior. This symposium includes three presentations that describe clinician and caregiver skills that are critical for effective assessment and treatment of problem behavior. The first presentation reviews results from an investigation of the reliability of visual inspection for multielement functional analysis graphs. The second presentation describes a revised contingency analysis of desirable and undesirable caregiver behavior as it relates to child problem behavior. The third presentation describes contextual behavioral strategies to decrease the likelihood that caregivers will reinforce problem behavior and increase the likelihood of adherence with behavior plans.
|Instruction Level: Intermediate
|Keyword(s): Caregiver behavior, Functional analysis, Treatment adherence, Visual inspection
Behavior analysts who conduct functional analysis of problem behavior, use visual inspection to identify function of problem behavior, implement treatments for problem behavior, and work with caregivers to help them implement treatments for problem behavior.
|Learning Objectives: At the conclusion of the presentation, participants will be able to: (1) describe the importance of visual analysis when interpreting single-subject design data for clinical and research purposes; (2) describe four variables that might contribute to agreement or disagreement on the presence of experimental control within a data set; (3) describe the contingencies that support desirable and undesirable caregiver behavior; (4) describe 2-3 potential solutions for increasing desirable caregiver behavior during the treatment of problem behavior; and (5) describe at least two contextual behavioral strategies to decrease accommodation of problem behavior and shape caregiver behavior related to treatment adherence.
|Consistent Visual Analysis of Multielement Data
|MARGARET RACHEL GIFFORD (Louisiana State University Shreveport), Jeffrey H. Tiger (Marquette University), Mike Harman (Briar Cliff University), Kendall Mae Kastner (Marquette University )
|Abstract: Experts in visual analysis were given 33 graphical displays of hypothetical data depicted in a multielement experimental design and asked to indicate (a) the presence or absence of experimental control and (b) the degree of experimental control displayed on a 1-100 scale. Each depicted figure systematically varied the number of data paths, the number of data paths elevated above the control, the mean difference between affected test and control conditions, and variability within conditions. The dichotomous indicator of the presence or absence of experimental control corresponded across all permutations of data examined. Rater’s indicated degree of experimental control on a 1-100 scale also correlated across all data sets. Thus, we observed a high degree of correspondence not only in respondents’ identification of experimental control in these figures, but also in their identification of relatively strong and weak demonstrations of experimental control. This supports the reliability of visual analysis as an evaluative tool for these designs amongst expert raters.
|Negative Reinforcement of Caregiver Behavior: A Contingency Analysis and Function-Based Solutions
|JACQUELINE ROGALSKI (New England Center for Children; Western New England University), Eileen M. Roscoe (The New England Center for Children)
|Abstract: Problem behavior can function as an aversive event that establishes escape from problem behavior as a reinforcer for caregiver behavior. Often, negatively reinforced caregiver behavior is countertherapeutic in that it reinforces problem behavior. For example, caregivers can quickly escape from attention-maintained aggression by delivering contingent attention. This cycle of reinforcement poses a concerning barrier to the effective treatment of problem behavior. The purpose of this talk is threefold. First, we extend existing literature in this area by discussing how contingencies of negative reinforcement affect desirable caregiver behavior (treatment adherence), and how that contingency interacts with the variables supporting undesirable caregiver behavior. Second, implications of this revised contingency analysis as it relates to caregiver treatment of problem behavior are discussed. And finally, we use the contingency analysis as a guide to propose and discuss conceptually systematic treatments for undesirable caregiver behavior. Solutions are informed by three main areas of research: function-based treatments for negatively reinforced problem behavior, research on treatments using concurrent operant schedules without extinction, and research on mitigating resurgence.
Contextual Behavioral Informed Strategies to Reduce Accommodation of Severe Problem Behavior and Increase Caregiver Adherence With Behavior Plans
|CRAIG STROHMEIER (Kennedy Krieger Institute and Johns Hopkins University School of Medicine)
Conducting a functional analysis and implementing derived treatments can produce effective behavior plans for severe problem behavior such as self-injury, aggression, and disruptive behavior. Nonetheless, skills training and an effective plan may not be sufficient to produce caregiver adherence. Low levels of treatment adherence may persist because caregiver responses that reinforce problem behavior also produce negative reinforcement for the caregiver response through immediate problem behavior cessation. This presentation describes a contextual behavioral informed approach to a) target the negative maintaining contingencies supporting caregiver reinforcement of problem behavior (accommodation) and, b) increase adherence with behavior plans. First, the presentation reviews the borrowed concept of family accommodation as a useful way to discuss, and conceptualize, the maladaptive pattern of interactions across caregivers and children who demonstrate persistent severe problem behavior. Second, a description of the intervention components highlights the mechanisms aimed at undermining the contingencies that maintain accommodation while providing caregivers with new treatment-related committed actions that are sensitive to positive changes in caregiver-child interactions. Finally, a multiple baseline evaluation demonstrates the effectiveness of this intervention strategy across two parents of a child with severe problem behavior.