Toward the Development of a Functional Analysis Risk Assessment Decision Tool.

Abstract

Risk-benefit analyses are essential in the decision-making process when selecting the most effective and least restrictive assessment and treatment options for our clients. Clinical expertise, informed by the client's preferences and the research literature, is needed in order to weigh the potential detrimental effects of a procedure against its expected benefits. Unfortunately, safety recommendations pertaining to functional analyses (FAs) are scattered or not consistently reported in the literature, which could lead some practitioners to misjudge the risks of FA. We surveyed behavior analysts to determine their perceived need for a risk assessment tool to evaluate risks prior to conducting an FA. In a sample of 664 Board Certified Behavior Analysts (BCBAs) and doctoral-level Board Certified Behavior Analysts (BCBA-Ds), 96.2% reported that a tool that evaluated the risks of proceeding with an FA would be useful for the professional practice of applied behavior analysis. We then developed an interactive tool to assess risk, which provides suggestions to mitigate the risks of an FA and validity recommendations. Subsequently, an expert panel of 10 BCBA-Ds reviewed the tool. Experts suggested that it was best suited as an instructional resource for those learning about the FA process and as a supporting resource for early practitioners' clinical decision making.