|Using Large-N Designs and Quantitative Analyses to Study Behavioral Treatments for Problem Behavior|
|Sunday, May 27, 2018|
|8:00 AM–9:50 AM |
|Manchester Grand Hyatt, Harbor Ballroom AB|
|Area: DDA/PRA; Domain: Translational|
|Chair: Mindy Christine Scheithauer (Marcus Autism Center; Emory University School of Medicine)|
|Discussant: David M. Richman (Texas Tech University)|
|CE Instructor: David M. Richman, Ph.D.|
Function-based treatments for problem behavior are well studied using single-subject designs, but there is less research using larger samples. While single-subject designs are an important cornerstone of behavior analysis, larger sample sizes allow us to answer different questions and disseminate results to novel audiences. Two of the studies in this symposium analyze resurgence and relapse in clinical populations. These concepts are well studied in basic research but the prevalence in applied settings is unclear. These studies used consecutive-case review designs to answer this question and identify the prevalence in patients undergoing treatment for problem behavior. The third study also used a consecutive case series design to analyze treatment results for inappropriate sexual behavior, which is an incredibly problematic, but understudied, topography. By using a large-N design, the researchers were able to assess treatment efficacy in a format that easily disseminates to professionals outside of our field. The last talk focuses on a literature review for automatically-maintained problem behavior. In using this large sample found in past research, they identified trends in assessment that may predict the types of treatment components necessary. The implications of use of large-N designs in these projects allowed for solving novel and important research questions.
|Instruction Level: Intermediate|
|Keyword(s): case series, meta-analysis, problem behavior, treatment|
|Target Audience: |
Professional clinicians and researchers in the field of psychology and behavior analysis who work with children who engage in problem behavior. I also believe this presentation qualified for psychology CEUS (PSY), but this was not an option listed above.
|Learning Objectives: Attendees will describe how resurgence and relapse might affect treatment outcomes with children who engage in problem behavior. Attendees will identify the most commonly used assessment and treatment strategies for individuals with inappropriate sexual behavior. Attendees will describe the importance of considering functional analysis outcomes for automatically-maintained problem behavior when selecting treatment strategies.|
Resurgence During Thinning Steps in a Multiple Schedule of Reinforcement
|ALEXIS CONSTANTIN PAVLOV (Marcus Autism Center; Emory University School of Medicine), Colin S. Muething (Marcus Autism Center; Emory University School of Medicine), Joanna Lomas Mevers (Marcus Autism Center; Emory University School of Medicine), Nathan A. Call (Marcus Autism Center; Emory University School of Medicine)|
A consecutive controlled case-series design (Hagopian, Rooker, Jessel, & DeLeon, 2013) was used to examine resurgence of problem behavior during implementation of a multiple schedule of reinforcement and during subsequent thinning steps. Multiple schedules signal the availability of reinforcement by correlating a unique stimulus with the presence or absence of reinforcement following a targeted response (Saini, Miller, Fisher, 2014). Resurgence was defined as the occurrence of problem behavior at a rate that exceeded levels observed during baseline or the prior multiple-schedule thinning step in at least one of the next 10 sessions (Volkert, Lerman, Call, & Trosclair-Lasserre, 2009). Data were collected from clients of an intensive day treatment program over an eight year period whose treatment for problem behavior included a multiple schedule component. Resurgence was coded after the multiple schedule was introduced and following each subsequent thinning step. Data were collected on a variety of different participant characteristics including: age, topography of problem behavior(s) (e.g., aggression, self-injury, pica), and confirmed function(s) of problem behavior. Implications for thinning the schedule of reinforcement in a multiple schedule will be discussed.
Prevalence of Renewal During Generalization of Treatments for Problem Behavior
|COLIN S. MUETHING (Marcus Autism Center; Emory University School of Medicine), Nathan Call (Marcus Autism Center; Emory University School of Medicine), Seth B. Clark (Marcus Autism Center), Joanna Lomas Mevers (Marcus Autism Center; Emory University School of Medicine), Rodrick Leary (Marcus Autism Center)|
This study used a consecutive controlled case-series design (Hagopian, Rooker, Jessel, & DeLeon, 2013) to examine the prevalence of renewal when treatments for problem behavior were generalized. Renewal is defined as the reemergence of a previously extinguished response when the stimulus context changes (Kelley, Liddon, Ribeiro, & Greif, 2015). For example, when renewal is applied to the treatment of problem behavior, problem behavior is initially observed in the home. Next, treatment is implemented in a different setting and problem behavior decreases or extinguishes. Finally, when treatment is generalized back to the home, problem behavior may reemerge. This treatment relapse effect has significant implications for clinicians generalizing treatments for problem behavior. Data were analyzed from all clients over a six year period who were admitted to a day treatment program for the treatment of problem behavior. Renewal was coded if problem behavior was observed at a rate in the first 10 sessions in the new stimulus context higher than that of the 10 sessions preceding generalization. Data were also collected on participant and treatment characteristics including: topography(s) of problem behavior, identified function(s) of problem behavior and treatment components. Implications for the treatment of problem behavior and generalization are discussed.
|Assessment and Treatment for Inappropriate Sexual Behavior in Individuals With Intellectual and Developmental Disabilities|
|CLARE LIDDON (University of North Florida), Erica Lozy (Louisiana State University), Griffin Rooker (Kennedy Krieger Institute)|
|Abstract: Inappropriate sexual behavior is a response class performed within an environment that deems the behavior unacceptable by societal standards (Davis et al., 2015). Inappropriate sexual behavior is problematic because of the potential negative consequences and is commonly exhibited by individuals with intellectual and developmental disabilities. However, because of the sensitive nature and ethical challenges in this area, little empirical support exists for behavioral interventions. Therefore, the purpose of the current studies was to evaluate assessment and treatment procedures for inappropriate sexual behavior for individuals with intellectual and developmental disabilities. More specifically, we examined records of functional analysis outcomes and treatment evaluations for inappropriate sexual behavior. Treatment selection and function of inappropriate sexual behavior are discussed. Davis, T. N., Machalicek, W., Scalzo, R., Kobylecky, A., Campbell, V. . . . Sigafoos, J. (2016). A review and treatment selection model for individuals with developmental disabilities who engage in inappropriate sexual behavior. Behavior Analysis in Practice, 9, 389-402.|
|Predicting Treatment Effects for Problem Behavior Maintained by Automatic Reinforcement: A Quantitative Review|
|JENNIFER N. HADDOCK (Johns Hopkins School of Medicine, Kennedy Krieger Institute ), Brian A. Iwata (University of Florida)|
|Abstract: Results of recent research suggest that patterns of responding during functional analyses (FAs) of self-injurious behavior maintained by automatic reinforcement predict the efficacy of reinforcement-based treatment procedures. However, it remains unclear whether this finding holds true for all topographies of problem behavior maintained by automatic reinforcement. Thus, to replicate and extend these findings, we conducted a quantitative review of published FA and treatment data sets for all topographies of problem behavior maintained by automatic reinforcement. Data from 142 participants in 83 studies indicated that relative levels of responding during automatic reinforcement test and control conditions of FAs predicted the effects of subsequent interventions based on antecedent (i.e., noncontingent reinforcement, or environmental enrichment) but not consequent (i.e., differential reinforcement, extinction, punishment) or combined (i.e., multi-component) manipulations. These results indicate that control condition responding during FAs of automatically reinforced problem behavior may have prescriptive value. General recommendations for research and practice will be discussed.|