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| Process Outcomes from Assessment and Treatment of Challenging Behavior: Outcomes Across Assessment, Treatment, and Delivery Models |
| Sunday, May 30, 2021 |
| 6:00 PM–6:50 PM |
| Online |
| Area: AUT; Domain: Applied Research |
| Chair: Kyle Dawson (University of Nebraska Medical Center's Munroe-Meyer Institute) |
| CE Instructor: Kyle Dawson, M.A. |
| Abstract: Behavior analysts employ empirically validated assessments to identify the environmental variables maintaining challenging behavior and select efficacious treatments to reduce challenging behavior. During an admission behavior analysts begin with an intake evaluation to determine dosage and type of service necessary for an individual and this is followed by the functional behavior assessment process, often employing indirect, direct, and experimental analysis. This process enables the clinician to generate hypotheses related to behavioral function and to develop operational definitions. The current symposium provides attendees with information for consideration throughout an admission for treatment of challenging behavior. In the first presentation we provide a thematic analysis of parent descriptions of challenging behavior during the intake process. In the second presentation we review a comparison of caregiver-implemented treatment outcomes for caregivers randomly assigned to descriptive assessment only versus descriptive assessment plus FA groups. Last, we examine FA outcomes from a large clinical sample using a retrospective consecutive case series to determine the prevalence of various behavioral functions and FA compositions The studies included in this symposium will collectively aid service providers in decision-making when providing assessment and treatment for challenging behavior. |
| Instruction Level: Advanced |
| Keyword(s): Caregiver Report, Functional Analysis, Telehealth, Treatment Outcomes |
| Target Audience: Requires understanding of assessment of functional relations between problem behavior and reinforcement and methodology for arranging contingencies to increase adaptive behavior and reduce destructive behavior |
| Learning Objectives: At the conclusion of the presentation, participants will be able to: (1) identify FA outcomes and determine prevalence of behavioral function; (2) identify uses of qualitative information of client behavior; (3) examine various outcome measures of service delivery models. |
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| Parent Perception of Problem Behavior: A Thematic Analysis of Parent Descriptions of Problem Behavior |
| NADRATU NUHU (Emory University, Marcus Autism Center), Joanna Lomas Mevers (Marcus Autism Center), Alexis Constantin Pavlov (Marcus Autism Center), Nathan Call (Marcus Autism Center) |
| Abstract: Children with developmental disorders are at increased risk of presenting with challenging behaviors (Kanne & Mazurek, 2011; Jang, Dixon, Tarbox, & Granpeesheh, 2011; Emerson et al., 2001). To date it researchers have established that interventions employing applied behavior analysis (ABA) techniques are effective at reducing the rates of challenging behaviors in these individuals (National Standards Report, 2009). Caregivers seeking ABA services for children that engage in challenging behaviors typically initiate the process by receiving an intake to assess their child’s presenting challenging behaviors and their associated concerns. Referrals for the assessment and treatment of severe challenging behaviors are typically based on caregiver report. While observations are crucial, qualitative information received from parents are vital in determining the level of services an individual may need (Scheithauer et al., 2018). This project focuses on coding caregiver descriptions of their child's challenging behavior at the initial intake meeting for reoccurring themes that may provide insight to caregiver perceptions of their child’s challenging behaviors. Caregiver reported a number of concerns regarding the impact of their child’s problem behavior on the family (e.g., damage to property, emergence of mental health problems, and limited family involvement in the community). |
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Evaluating Functional Behavioral Assessment Formats Through Treatment Outcomes |
| ALEC M BERNSTEIN (Marcus Autism Center, Children's Healthcare of Atlanta; Department of Pediatrics, Emory University School of Medicine), Nathan Call (Marcus Autism Center), David P. Wacker (The University of Iowa), Matthew O'Brien (The University of Iowa), Loukia Tsami (University of Houston - Clear Lake), Dorothea C. Lerman (University of Houston-Clear Lake), Kelly M. Schieltz (University of Iowa), Colin S. Muething (Marcus Autism Center) |
| Abstract: Functional behavioral assessments (FBAs) include indirect assessments, descriptive assessments, and functional analyses (FAs). Behavior analysts have demonstrated questionable validity of indirect and descriptive assessments by comparing the identified function from these assessments to the function identified from an FA. Nonetheless, behavior analysts have also reported far more use of indirect and descriptive assessments relative to an FA. Thus, a more socially significant measure of validity across FBAs may be the comparison of treatment outcomes. We randomly assigned participants to one of two groups: descriptive assessment only or descriptive assessment and FA. We then trained and coached caregivers to implement all procedures. Based off the function identified by the terminal assessment, caregivers implemented functional communication training. We describe results in terms of correspondence between assessment and treatment outcomes and implications for deriving treatments from non-FA assessment methods. |
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| Ten Years of Outcomes from Clinical Functional Analyses of Challenging Behavior |
| JESSIE WEBER (University of Nebraska Medical Center), Billie Retzlaff (Intermediate School District #917), Katherine Brown (Utah State University), Alyssa Hurd (Utah State University), Heather Anderson (University of Nebraska Medical Center) |
| Abstract: Since Iwata et al. (1984/1992) described a functional analysis (FA) methodology for determining the environmental variables that maintain a target behavior, a large body of research has shown that treatments developed based on FA outcomes can significantly reduce destructive behavior across a variety of topographies and demographics (i.e., Beavers et al., 2013; Horner et al., 2014; Brosnan & Healy, 2010; Campbell, 2003). The purpose of this study is to provide to the literature by examining FA outcomes from a large clinical sample using a retrospective consecutive case series to determine the prevalence of various behavioral functions. Additionally, we evaluated outcomes across FAs that include a single versus multiple topographies. By using a consecutive case series, we circumvent some of the issue with publication bias because we included all cases which underwent common procedures and protocols specific to one university-affiliated severe behavior clinic as opposed to previous reviews which only included published datasets. The current research found around 70% of FAs identified at least one function of the target behavior. This percentage is less than has been observed in reviews of published FAs (e.g., 94% of FAs differentiated as reported by Beavers et al. [2013]) or than reported by Mueller et al. (2011) in public schools (i.e., 90% differentiation). Another important finding from our review was the high prevalence of control, at least in part, of target behaviors by access to tangibles. Out of 245 FAs included, 40% of the FAs included at least partial control by access to tangible items. This increasing trend could potentially be related to an increase of exposure to technological tangible items (e.g., iPad) which in our clinical experience often appear to be potent reinforcers which are difficult to satiated on (e.g., when you satiate on a specific application, you can switch to another). Our sample included only those individuals referred for intensive services and therefore also limits the generality of our findings with regards to individuals who may be exhibiting less severe, although still challenging, behavior. |
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