|Evaluating the Efficacy and Effectiveness of Treatments for Severe Problem Behavior|
|Sunday, May 28, 2017|
|10:00 AM–11:50 AM |
|Convention Center Mile High Ballroom 2B|
|Area: AUT/DDA; Domain: Applied Research|
|Chair: Jacqueline N. Potter (Cohasset Public School District)|
|Discussant: Louis P. Hagopian (Kennedy Krieger Institute)|
|CE Instructor: Mahshid Ghaemmaghami, Ph.D.|
The present symposium explores new areas of treatment and provides a review of the efficacy and effectiveness of established treatments for severe problem behavior. In Study 1, the boss-hat protocol was implemented and destructive behavior was observed to decrease by an average of 96% across cases. Results of this study emphasize the importance of function-based treatment even when the function may momentarily fluctuate. Study 2 provides an updated review of behavioral treatments for self-injurious behavior and examined current treatment trends. Study 3 focused on the effectiveness of functional communication training (FCT) with contingency-based reinforcement thinning with 25 outpatient clinical cases in which the IISCA was applied during the assessment period. Results showed at least a 90% reduction in problem behavior across cases. Study 4 focused on the efficacy and effectiveness of FCT in published research to date as well as whether or not FCT has been established as an evidenced-based practice in the general field of psychology.
|Instruction Level: Intermediate|
|Keyword(s): FCT, IISCA, Multiple Schedule, Self-Injury|
The Boss Hat: Treating Destructive Behavior Reinforced by Increased Caregiver Compliance With the Child's Mands
|TODD M. OWEN (University of Nebraska Medical Center's Munroe-Meyer Institute), Wayne W. Fisher (University of Nebraska Medical Center's Munroe-Meyer Institute), Henry S. Roane (SUNY Upstate Medical University), Jessica Akers (University of Nebraska Medical Center's Munroe-Meyer Institute), William Sullivan (SUNY Upstate Medical University)|
Standard functional analyses (FA) sometimes do not identify momentary fluctuations in the function of destructive behavior (Bowman et al., 1997). In such cases, individuals may mand for the reinforcer that is currently most preferred, and destructive behavior may be evoked if this mand is not reinforced. In the current study, following inconclusive standard FAs, we conducted a mand analysis with a test condition in which mands produced reinforcement only following destructive behavior and a control condition in which mands produced reinforcement throughout. We then evaluated a function-based treatment colloquially referred to as the boss-hat protocol in which we provided differential or time-based reinforcement of mands in accordance with multiple or chained schedules that included reinforcement-schedule thinning to practical levels. By treatments end, destructive behavior decreased by an average of 96% from baseline rates across all cases. We discuss these results relative to the importance of matching treatments for destructive behavior to operant functions even when those functions fluctuate from one moment to the next.
Self-Injurious Behavior:A Review of the Literature,2001-2016
|LESLEY A. SHAWLER (Endicott College), Samantha Russo (Eden Autism, Endicott College), SungWoo Kahng (University of Missouri; Endicott College), Michael F. Dorsey (Endicott College), Melissa Rae Goodwin Romanowsky (Endicott College)|
Self-injurious behavior (SIB) has been defined as behavior that produces physical injury to the own individualï¿½s body (Tate & Baroff, 1966) and is a common behavior exhibited by individuals with intellectual and developmental disabilities (IDD). However, overall rates of SIB among those with IDD are varied. Many treatments have been studied to reduce SIB, with applied behavior analytic treatments showing robust efficacy. For example, Kahng et al. reviewed peer-reviewed studies on the behavioral treatment of SIB exhibited by individuals with IDD from 1964-2000. Their results showed that behavioral interventions are highly effective at decreasing SIB, particularly when based on the results of a functional assessment. The purpose of the current study is to update and extend the review by Kahng et al. We reviewed and analyzed the current treatment trends for SIB exhibited by individuals with IDD from 2001-2016. More specifically, treatment trends as they compared to Kahng and et al.ï¿½s original review will be discussed.
Achieving Socially Significant Reductions in Problem Behavior Following the Interview-Informed Synthesized Contingency Analysis
|JOSHUA JESSEL (Child Study Center), Einar T. Ingvarsson (Child Study Center; University of North Texas), Rachel Metras (Child Study Center; University of North Texas), Hillary Kirk (Child Study Center), Ruth Whipple (Child Study Center)|
Jessel, Hanley, and Ghaemmaghami (2016) recently evaluated the results of 30 interview-informed, synthesized contingency analyses (IISCAs) and found them to be an effective tool for identifying the functions of problem behavior across a wide variety of topographies, participants, and locations. However, Jessel et al. did not include data on the effectiveness of the corresponding treatments. In the current study, we collected and summarized 25 additional outpatient clinical cases, from analysis to treatment, in which the IISCA was applied during the assessment period. The IISCA identified socially mediated functions of problem behavior, which informed personalized treatments of functional communication training (FCT) with contingency-based reinforcement thinning. At least 90% reduction in problem behavior was obtained for every participant by the end of the treatment evaluation. The assessment and treatment process was socially validated by caregivers who rated the procedures highly acceptable and helpful, and the improvement in their childs behavior highly satisfactory.
|Functional Communication Training: From Efficacy to Effectiveness|
|MAHSHID GHAEMMAGHAMI (University of the Pacific; Western New England Uni), Gregory P. Hanley (Western New England University), Joshua Jessel (Child Study Center; Western New England University)|
|Abstract: Functional communication training (FCT; Carr & Durand, 1985) is a common function-based treatment in which an alternative form of communication is taught to reduce problem behavior. FCT has been shown to result in substantial reductions of a variety of topographically and functionally different types of problem behavior in children and adults. The extent to which these reductions maintain in relevant contexts and result in socially meaningful changes in the lives of those impacted will be the focus of this paper. The goal of this review is to determine the degree to which the efficacy and the effectiveness of FCT have been demonstrated in the published research to date and whether FCT has been established as an evidence-based practice in psychology according to the definition set out by the American Psychological Association’s 2005 Presidential Task Force on Evidence-Based Practice.|