Association for Behavior Analysis International

Trauma-informed care (TIC) is an approach to health and human service delivery initially conceptualized to address the unique needs of individuals exposed to trauma. In recent years, a growing number of behavior analysts have acknowledged the importance of aligning intervention procedures with principles of TIC, recognizing that the client populations with whom many behavior analysts work are likely to be at increased risk of experiencing traumatic events (e.g., abuse, neglect). In this symposium, we present data from four evaluations of trauma-informed approaches to behavior analytic intervention. We first share outcomes from a systematic literature review that informed the development of a framework outlining function-based intervention procedures that are consistent and inconsistent with TIC. Presenters then describe procedures and outcomes of a variety of behavior-change programs that incorporate procedures aligned with TIC to promote skill development and increased autonomy, while also avoiding any procedures that could potentially result in re-traumatization. These programs varied widely with respect to client characteristics, intervention contexts, behavior change goals, and programmed procedures. Taken together, outcomes demonstrate the promise of trauma-informed approaches to behavior analytic service delivery.

The target audience for this session includes practicing behavior analysts who oversee behavior change programs that address challenging behavior. Audience members should be competent in selecting, designing, and implementing behavior change interventions. The session is particularly relevant for practitioners who support individuals who have experienced trauma, though this is not required.

Traumatic experiences are associated with the development of externalizing challenging behaviors — a common characteristic of students with emotional/behavioral disorders (EBD; Rasche et al., 2016). Ironically, the same externalizing behaviors can put students at risk for re-traumatization, and further exacerbation of these challenges (Rajaraman et al., 2022). The National Child Traumatic Stress Network (2017) recommends that schools implement function-based interventions (FBIs) consistent with trauma-informed care. While the promise of FBIs for students with EBD has been documented (McKenna et al., 2016), the extent to which they align with principles of trauma-informed care remains unknown. We conducted a systematic review of FBI studies including students with EBD to evaluate the extent to which these interventions incorporate critical elements of a trauma-informed approach. Using systematic search and screening procedures, we identified 56 articles that evaluated FBIs for elementary students with EBD. We used an iterative process to identify FBI procedures consistent and inconsistent with trauma-informed care and then explored the extent to which interventions incorporated these procedures. Results highlight areas of both alignment and misalignment between FBI procedures and trauma-informed care. Implications for research and practice with respect to incorporating trauma-informed procedures in FBIs for students with EBD will be discussed.

The Preschool Life Skills curriculum (PLS; Hanley et al., 2007) teaches critical learning and social skills to preschool-aged children, with a growing body of research demonstrating its effectiveness across typically developing and autistic children in school and home settings. Although developed for young children, older children with multiple adverse childhood experiences (ACEs) frequently have the same early-learner skills deficits targeted by the program. The current study partially replicated Hanley et al.’s (2007) PLS training model with two typically developing male participants, who were receiving trauma-informed, behaviourally based services in South Wales. The two boys, aged 9 and 11, had both experienced multiple ACEs and were living in shared family care or foster care. Skill development was assessed using a multiple-baseline across skills design for both participants, and showed that both children learned the skills quickly and maintained them at follow up. We will discuss the applicability of the PLS curriculum for children with trauma histories, as well as the trauma-informed adaptations to ensure that safety, shared governance, and choice were built into the training process. We also will address future directions in using skill-based approaches when working with children that have experienced childhood trauma and how to promote generality to other settings.