Association for Behavior Analysis International

Children's Postinfectious Autoimmune Encephalopathy (CPAE) is a condition where an infection triggers an autoimmune reaction which can affect neurological function, mood, and behavior. It has been suggested that behavioral interventions may decrease the frequency of disruptive, aggressive, or oppositional behaviors in children diagnosed with CPAE disorders, despite the onset of symptoms relating to bio-behavioral influence (Thienemann et al., 2017). The current study was threefold: 1.) The Function of Behavior - Medical Screening Tool (FOB-MED) was utilized in a clinic setting to determine a hypothesized function of a child’s behavior diagnosed with CPAE and Autism Spectrum Disorder. 2.) A brief functional analysis (BFA) of challenging behavior was conducted to confirm the function identified by the FOB-MED, and 3.) function-based treatment was provided in the home setting with care providers. Data demonstrated the frequency of challenging behaviors pre and post interventions. The current study examines the impact of both biological and behavioral interventions for a child dually diagnosed with CPAE and ASD, adding to the limited available research for this population.

The Children's Postinfectious Autoimmune Encephalopathy (CPAE) Center of Excellence at The University of Arizona assesses children for Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Syndrome Associated with Streptococcal Infection (PANDAS). Although medical treatments can be crucial in alleviating symptoms, research has suggested that psychological and behavioral interventions are also beneficial both in the acute and chronic stages of illness, due to the bio-behavioral influences that arise (Thienemann et al., 2017). A total of 62 children are summarized, with 48 children (ages 4 to 17) receiving a diagnosis of PANS/PANDAS/CPAE. The Function of Behavior – Medical Screening Tool (FOB-MED), a brief screener for medical settings, was utilized to determine the function of patients’ behaviors for efficiency. Data indicated comparable functions of behavior (i.e. attention, tangible/preferred activities, escape, and automatic) across groups (see table) with some variations. The current data indicates that children with a PANS/PANDAS diagnosis may benefit from comparable, function-based interventions as other children. Treatment acceptability data were also collected via the TARF-R. Thus, the FOB-MED can assist practitioners with screening and identifying functions of challenging behavior, and more effectively provide brief treatment recommendations to families in primary care settings.

The Function of Behavior – MEDICAL Screening Tool (FOB-MED) was developed to streamline a functional behavior assessment administered by medical professionals. A functional analysis can take approximately two hours for a professional to conduct (Roane, Ringdahl, & Falcomata, 2015), but the FOB-MED only takes fifteen minutes to complete and can identify hypothesized function of behavior (i.e. escape, automatic, tangible, attention). It is administered by a medical professional (i.e. nurse, nurse practitioner, pediatrician) in interview format and consists of eight questions. In the current study, after the FOB-MED was administered, a functional analysis was conducted to establish comparative validity between the results (FOB-MED results to an in-vivo Functional Analysis of challenging behavior). The results for children in diverse medical settings were compared. These initial results indicate matched functions (validity) between the hypothesized function from the FOB-MED and the confirmed function through an in-vivo functional analysis. As validity data for the FOB-MED tool is established over time, the tool can be used in medical settings by primary care professionals to help focus efforts on function-based intervention.

Several studies have related neuropsychological impairments with behavioral, cognitive, emotional and personality disorders derived from chronic drug-use. Research on executive functions has contributed to the neuropsychological understanding of the frontal lobe. The damage of this area implies problems in the control and regulation of behavior. Therefore, the objective of this study was to compare performance patterns in three cognitive tasks (Shifting, Updating and Inhibition) and six tasks of delay discounting of monetary gains and losses considering three magnitudes (3000, 6000, 9000) for each condition in adolescents and adults with moderate and severe dependence and their contrast with control group. We worked with 20 adolescents and 20 adults (20 drug-users and 20 controls), the control subjects were in school environments, while the clinical sample was in treatment centers for problems of drug use and behavior. A positive correlation was found among delay discounting gains, shifting and updating tasks, whereas inhibition task and delay discounting of losses were correlated. A magnitude effect was found for the delay discounting gains and not for the losses in both groups. Low performance was observed in the shifting, updating tasks, and steeply delay discounting in drug users. These findings suggest that discounting tasks could be associated with the same executive function process as shifting and updating tasks, which converts the discount into an objective indicator that could suggests alterations of the frontal lobe.

Tinnitus affects approximately 1 in 10 Americans. However, traditional treatment approaches have shown limited efficacy. This study combines the concepts of lateral inhibition and positive reinforcement learning in an innovative way to alleviate tinnitus. Lateral inhibition is a phenomenon where neurons activated by their characteristic frequency will not only exhibit enhanced excitatory response to that frequency, but will also have an inhibitory influence on surrounding neurons. Lateral inhibition-based mechanisms have been targeted for modulating tinnitus perception and N1m response to the tinnitus frequency.The purpose of this study is to evaluate the effects of providing positive reinforcement to tinnitus subjects when they respond to sound stimuli centered 1/8th octave away from their tinnitus frequency. We hypothesize that this training will reinforce neuroplasticity and provide relief from tinnitus. Preliminary behavioral and neural data are presented.