|Evaluating Direct Observation Measurement Systems and Outcomes of Visual Analysis to Inform and Improve the Assessment and Treatment of Challenging Behavior
|Sunday, May 26, 2019
|3:00 PM–4:50 PM
|Hyatt Regency West, Lobby Level, Crystal Ballroom B
|Area: DDA/AUT; Domain: Applied Research
|Chair: Mindy Christine Scheithauer (Marcus Autism Center)
|Discussant: William H. Ahearn (New England Center for Children)
|CE Instructor: William H. Ahearn, Ph.D.
Direct observation and visual analysis are cornerstones of treating challenging behavior and this symposium evaluates novel methods in this domain. Two studies targeted assessment, with the first comparing assessments with different goals and measurement systems and the second evaluating visual analysis decision making. Specifically, one study evaluated correspondence between a concurrent operant analysis (measuring choice allocation) and a multielement functional analysis (measuring challenging behavior) and conducted treatment comparisons for cases of non-correspondence. The next study evaluated the number of sessions required in extended alone or ignore assessments to make valid conclusions about whether challenging behavior is automatically maintained based on visual analysis of the rate of behavior across sessions. The other studies evaluate direct observation and visual analysis in treatment contexts, one focused on observations across contexts and the other comparing treatments with measurement of various dimensions of behavior. For the observations across contexts, the authors demonstrate whether a treatment for stereotypy shown effective in controlled contexts is also efficacious in naturalistic settings. The next study also targeted repetitive movements, but compared the success of two treatments (blocking and manual guidance) using three behavioral measurements, demonstrating that some measurement systems may be more sensitive in detecting treatment differences.
|Instruction Level: Intermediate
|Keyword(s): direct observation, problem behavior, repetitive behavior, visual analysis
Professionals working with children who exhibit challenging behavior.
|Learning Objectives: 1. Attendees will describe the difference between a concurrent operant and multielement functional analysis 2. Attendees will identify the number of extended alone/ignore sessions required to make reliable clinical decisions 3. Attendees will describe why it is important to evaluate the effects of treatments across contexts 4. Attendees will identify why it may be useful to measure multiple dimensions of behavior when evaluating treatment outcomes
Comparisons Between Functional Analysis and Concurrent Operant Analysis Outcomes in the Assessment of Problem Behavior
|JESSICA TORELLI (Vanderbilt University), Emily Weaver (Vanderbilt University), Nealetta Houchins-Juarez (Vanderbilt University), Blair Lloyd (Vanderbilt University), Joseph Michael Lambert (Vanderbilt University)
We evaluated the extent to which the results of a response-guided concurrent operant analysis (COA) framework assessing relative preference for attention, tangible, and escape corresponded with results of functional analyses (FA) of problem behavior across six children with or at risk for disabilities. For each participant, we conducted a COA using a simultaneous treatments design, followed by a multi-element FA. In cases where the two assessments did not fully correspond, we used an alternating treatments design to compare the effects of interventions based on each assessment outcome on rates of problem and appropriate behavior. Finally, for cases in which at least one effective intervention was identified, we used a concurrent chain procedure to evaluate participant preference among effective interventions. COA results partially corresponded with FA results (i.e., COA identified one of multiple functions of problem behavior) for all six participants. Treatment results varied by participant. For one participant, both treatments were equally effective; for two participants, neither treatment was effective; and for three participants either the FA- or COA-based treatment was more effective. Participants for whom a superior treatment was identified showed a consistent preference for the more effective intervention.
Comparing Decisions Regarding Whether Challenging Behavior is Automatically Maintained Based on Assessments of Varying Lengths
|MINDY CHRISTINE SCHEITHAUER (Marcus Autism Center), Stephanie Liollio (Marcus Autism Center), Seung Ju Lee (Emory University )
Several studies have evaluated functional analysis (FA) methods for identifying whether challenging behavior is maintained by automatic reinforcement. Queirim et al. (2013) found that extended alone sessions conducted prior to a multielement FA correctly identified whether challenging behavior was maintained by automatic reinforcement. However, it is unclear how many sessions are needed in this type of an assessment to make confident conclusions. In this study, we conducted a retrospective consecutive case series analysis from clients with intellectual or developmental disabilities that completed extended alone or ignore sessions as part of a day treatment admission for challenging behavior. Using visual analysis, we compared decisions regarding whether challenging behavior was automatically maintained based on data from the first three and six sessions of the assessment to decisions made when all available clinical data were presented. Results from the first 20 cases suggest that reliability between decisions made following three data points compared to all available clinical data was poor, but increased dramatically with the first six data points. This suggests that at least six consecutive sessions with alone/ignore contingencies may be required to draw conclusions about automatically-maintained challenging behavior. Results are discussed in the context of maximizing assessment efficiency.
|A Naturalistic Approach to the Treatment of Stereotypy
|HALEY STEINHAUSER (The New England Center for Children; Western New England University), Rebecca Foster (Western New England University), Riley Fergus (New England Center for Children ), William H. Ahearn (New England Center for Children)
|Abstract: Stereotypy treatment often involves decelerative methods, but Colón, Ahearn, Clark, and Masalsky (2012) demonstrated that reinforcement of alternative verbal behavior can decrease stereotypy. Similar to this approach, we targeted stereotypy by first reinforcing verbal and social behavior in contexts that mimicked the typical flow of a classroom. Verbal behavior was targeted in two contexts, with one context approximating academic programming and the other providing incidental opportunities for established verbal responses. An interactive leisure context expanded on existing social skills, and an independent leisure context provided incidental opportunities for established play skills. We measured appropriate behavior and stereotypy across all contexts prior to redirection. Data from two participants will be presented. With the first participant, we observed desirable levels of appropriate behavior and low levels of stereotypy in both verbal behavior contexts. Stereotypy remained problematic in the leisure contexts, requiring stereotypy redirection. Context-specific redirection suppressed stereotypy significantly in one of the contexts and response interruption and redirection decreased stereotypy in the other context. Interobserver agreement was calculated for a minimum of 30% of sessions across all conditions and was an average of 90% or above.
Implications of Three Measures to Determine Treatment Effectiveness for the Repetitive Body Movements of an Adult With Autism
|NICOLE SCHUIERER (Alpine Learning Group), Cortney DeBiase (Alpine Learning Group), Kathryn E. Cerino Britton (The Alpine Learning Group), Jaime DeQuinzio (Alpine Learning Group), Bridget A. Taylor (Alpine Learning Group)
The participant was a 19-year-old with autism who engaged in high rates of repetitive body movements (RBM) that interfered with and was responsible for the loss of paid employment. We chose two vocational tasks (i.e., cleaning a table and rolling napkins) that the participant performed independently at the job site and that typically took approximately 5- 8 minutes to complete. We used a multi-element design across these tasks to compare the effects of blocking and manual guidance on the number of RBM in, the duration of task completion, and the rate of RBM. Duration of task completion for both tasks decreased, but more so for cleaning the table when manual guidance was used. The frequency of RBM reduced dramatically for both conditions and remained low. Taken together, these two measures imply that both blocking and manual guidance were equally effective. Alternatively the rate of RBM, indicated that blocking was the more effective procedure. Taken collectively, we decided to continue with manual guidance as that was the more effective procedure for decreasing the duration of task completion. Results support the importance of using more than one measurement to determine intervention effects.