Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.


50th Annual Convention; Philadelphia, PA; 2024

Event Details

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Symposium #196
CE Offered: BACB — 
From Theory to Practice: Incorporating Trauma-Informed Care Into the Assessment and Treatment of Problem Behavior
Sunday, May 26, 2024
8:00 AM–9:50 AM
Convention Center, 100 Level, 104 AB
Area: DDA/AUT; Domain: Translational
Chair: Phoebe Elizabeth MacDowell (Queens College & The Graduate Center, City University of New York)
Discussant: Johanna Staubitz (Vanderbilt University)
CE Instructor: Phoebe Elizabeth MacDowell, M.Ed.

Over several decades, researchers and clinicians have attempted to identify the function(s) of problem behavior through functional analyses to develop effective interventions. Past methods included evoking fully escalated problem behavior in multiple analogue conditions of isolated reinforcement contingencies. These methods led applied researchers to address concerns that may impact practical application such as safety and efficiency. For example, the interview-informed synthesized contingency analysis (IISCA) involves a process that is relatively quick to complete and reinforces non-dangerous precursors to problem behavior. The elements of safety and efficiency were eventually considered within the larger framework of trauma-informed care (TIC; Rajaraman et al., 2022). The guiding principles of TIC include (a) acknowledging trauma and its impact, (b) ensuring safety and trust, (c) choice and shared governance, and (d) emphasizing skill building. These principles have informed the development of specific assessment and treatment procedures. In this symposium we will discuss how TIC has influenced research in the assessment and treatment of problem behavior. We will review 20 years of functional analysis outcomes (Study 1), identify procedural modifications to pre-treatment assessments (Study 2), discuss the incorporation of TIC within skill-based treatment (Study 3), and consider the treatment utility of the novel performance-based IISCA (Study 4).

Instruction Level: Intermediate
Keyword(s): Functional Analysis, Problem Behavior, Safety, Trauma-Informed
Target Audience:

Necessary prerequisite skills for the audience include: an understanding of functional analyses and function-based interventions.

Learning Objectives: At the conclusion of the presentation, participants will be able to: (1) discuss the recent history of functional analyses; (2) identify procedural modifications to pre-treatment assessments; (3) incorporate trauma-informed care within behavioral assessments and intervention.

Predicting and Managing Risk During Functional Analysis of Problem Behavior

(Applied Research)
FLORIANA CANNIELLO (Neapolisanit Rehabilitation Center), Luigi Iovino (Neapolisanit Center), Rosaria Benincasa (Neapolisanit Rehabilitation Center), Maria Gallucci (AIAS Onlus sez.Nola), Salvatore VITA (Neapolisanit Rehabilitation Center), Gregory P. Hanley (FTF Behavioral Consulting), Joshua Jessel (Queens College, City University of New York)

Maintaining participant safety and managing risk during the assessment and treatment of severe problem behavior is of upmost importance. The performance-based interview-infomed synthesized contingency analysis (IISCA; Luigi et al. 2022) is a functional analysis format that incorporates an interview with caregivers asking questions about problem behavior to avoid dangerous escalation. We introduced additional questions during the interview to more readily identify participants who are prone to escalation to better predict and manage risk (Canniello et al. 2023). The performance-based IISCA was conducted for eleven individuals and we found that the percentage of dangerous problem behavior and the probability of a burst was correlated with reports of quick escalation. The results suggests that questions regarding escalation speed from minor to more severe instances of problem behavior may be particularly helpful for predicting any safety concerns. Future researchers may want to consider other procedural modifications to the functional analysis to ensure individuals feel physically and emotionally secure when safety concerns are anticipated.


A Research Synthesis of the Interaction Between Behavioral Assessment and Intervention of Challenging Behavior

TESS FRUCHTMAN (Temple University), Joshua Jessel (Queens College, City University of New York), Art Dowdy (Temple University), Adithyan Rajaraman (Vanderbilt University Medical Center), Reem Muharib (Texas State university ), Felipe Magalhães Lemos (Luna ABA)

Challenging behavior (e.g., aggression, self-injurious behavior) can adversely affect the trajectory and quality of an individual’s life. Historically, pharmacological and behavioral approaches are the most recommended interventions for challenging behavior (Newcomb & Hagopian, 2018; Valdovinos, 2019). Using a behavioral approach, putative reinforcers of challenging behavior are identified using a functional analysis to inform subsequent treatment. Multiple functional analysis formats exist (e.g., interview-informed synthesized contingency analysis [IISCA], standard, brief) and behavioral interventions informed by functional analysis formats have resulted in improvements of challenging behavior across copious individuals. However, the treatment validity of each of these formats has yet to be compared. The authors synthesized functional analysis-informed outcomes from a 20-year review of the literature to determine the magnitude of effect of subsequent intervention for each functional analysis format. Additionally, moderating variables (e.g., diagnosis, language ability) were evaluated to identify the bounds of functional analysis-informed intervention. The authors investigated the difference in treatment outcomes informed by the IISCA with treatments informed by other formats because of the contrast with the IISCA procedures and components. This presentation will present outcomes that compare the intervention effects of different functional analysis formats, with an emphasis on the IISCA compared to other formats.

Incorporating a Trauma-Informed Framework in the Assessment and Treatment of Problem Behavior
(Applied Research)
PHOEBE ELIZABETH MACDOWELL (Queens College & The Graduate Center, City University of New York), Tess Fruchtman (Temple University), Joshua Jessel (Queens College, City University of New York), Bai Pan (Queens College, City University of New York), Shauntae McLeod (Queens College, City University of New York)
Abstract: Many autistic individuals are likely to have experienced adverse childhood events that could contribute to trauma. The prevalence only increases for those of whom exhibit problem behavior. Therefore, it seems important for behavioral assessment and treatment procedures to be designed within a trauma-informed framework. We incorporated the trauma-informed framework into the practical functional assessment (PFA) and skill-based treatment (SBT) model for three autistic children admitted to a university-based, outpatient clinic. Problem behavior was assessed during a functional analysis that allowed assent to be withdrawn at any time, delivered preferred events prior to escalation in dangerous problem behavior, and programmed evocative and preferred events to be completely controlled by the participants’ behavior. The treatment informed by the functional analysis taught a host of different skills (communication, toleration, and cooperation) while providing words of encouragement during nondangerous problem behavior and avoiding the use of extinction for dangerous problem behavior. The PFA/SBT model incorporating the trauma-informed framework resulted in the eventual elimination of problem behavior with caregivers implementing generality sessions for two of the three participants. In addition, all caregivers reported the process to be safe, acceptable, and helpful to their situation.

Evaluating the Generality and Maintenance of the Skill-Based Treatment Informed by the Performance-Based Interview-Informed Synthesized Contingency Analysis (IISCA)

(Applied Research)
AARON LEYMAN (queens college, CUNY), Joshua Jessel (Queens College, City University of New York), Phoebe Elizabeth MacDowell (Queens College & The Graduate Center, City University of New York), Tess Fruchtman (Temple University)

Behavioral intervention for problem behavior often relies on the results of a functional analysis to identify environmental contributors. Multiple functional analysis formats have been developed to improve qualities of the process such as practicality, efficiency, and safety. More recently, the performance-based, interview-informed synthesized contingency analysis (IISCA) was developed as a functional analysis format that incorporates a trauma-informed framework. The performance-based IISCA (a) introduces evocative events following periods of calm to reduce dangerous escalation, (b) includes moment-to-moment measures of problem behavior to allow for ongoing visual analysis of data, and (c) maintains measures of positive affect. We conducted this study to evaluate the treatment utility of the performance-based IISCA when it is used to inform a skill-based treatment. The performance-based IISCA was conducted for the problem behavior of three autistic children before teaching communication, toleration, and cooperation during skill-based treatment in the home setting. Problem behavior was reduced for all participants across different therapists and across time (one, two, three-month maintenance probes). The results support the generality and longevity of treatment informed by the performance-based IISCA.




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