Function Of Problem Behavior Research Articles

Self-injurious behavior of children with autism in Vietnam: A cross sectional study

This study explored self-injurious behavior (SIB) of autistic children in Vietnam through a cross-sectional design. 60 informants, including 57 parents and 3 caregivers completed the questionnaire on problem behavior consisting of aggression, self-injury, stereotyping, property destruction, other problem behaviors and their functions. Results revealed that children experienced all mentioned problem behaviors, especially self-injurious behavior. The topographies of self-injurious behavior of the children included head-hitting, head-scratching, head-banging, hair-pulling, face-hitting, face-puncturing with a pen, ear-scratching, lip-picking, hand-biting, hand-scratching, hand-pinching, and belly-scratching. The most common area of self-injurious behavior is the head. The functions of these problem behaviors were expressed in four types (social positive reinforcement, social negative reinforcement, automatic positive reinforcement and automatic negative reinforcement). Social positive reinforcement appeared as a prominent function.  Out of these 57 children, 21 of them who were autistic with self-injurious behavior went through a functional assessment (FA) in which the four conditions known as attention, tangible items, escape from task/activities, automatic stimulation were tested. The results of functional analysis (FA) further indicated the correspondence between the FAST-R and FA outcome on function of problem behavior, especially self-injurious behavior. Results also showed that the prominent function of these self-injurious behaviors was social function. It means self-injurious behaviors usually occur within a condition of social interaction, especially, in this present study, in the tangible condition. The antecedent of self-injurious behavior is the removal of tangibles (e.g. food, preferred items). This paper contributes to our knowledge of self-injurious behavior of children with autism in Vietnam where empirical research of this field was still very rare.&nbsp

Assessment and treatment of problem behavior maintained by escape from attention

AbstractThis study describes the assessment and treatment of problem behavior for two participants whose functional analysis results identified escape from attention as the function of problem behavior. Treatment involved functional communication training to teach an appropriate alternative behavior that produced escape from attention. Additionally, in both cases, we expanded treatments by using graduated exposure to attention to facilitate increases in social interaction while maintaining low levels of problem behavior. We discuss findings as they relate to (a) functional analysis procedures to identify escape from attention as a function for problem behavior, (b) treatment strategies to reduce problem behavior, and (c) treatment strategies aimed at decreasing escape from, and avoidance of, social interaction for individuals who demonstrate this problem behavior function.

Evaluating the utility of interview-informed synthesized contingency analyses in informing the treatment of problem behavior among children with autism spectrum disorder

ABSTRACT Although functional analysis is a widely researched tool for determining behavioral function, traditional formats are associated with limitations that often preclude their incorporation into practice. The interview-informed synthesized contingency analysis (IISCA) was developed to address such limitations. This study investigated the effectiveness and efficiency of the IISCA in determining the function of problem behavior for three non-vocal children with autism spectrum disorder and intellectual disabilities in a school setting. The effectiveness of the skill-based treatment process associated with the IISCA was also evaluated, as were the acceptability of these treatment procedures and the fidelity with which they were implemented. The IISCAs yielded differentiated outcomes immediately for two participants and following a secondary analysis for the third participant. Assessment results informed the design of treatments involving functional communication training and delay- and denial-tolerance training evaluated using a changing-criterion design. Implications and limitations are discussed and recommendations for future research are offered.

Efektivitas functional communication training dalam meningkatkan perilaku meminta pada anak dengan autism spectrum disorder

The current study aims to examine the effectiveness of functional communication training to increase asking behavior by exchanging pictures for children with an autism spectrum disorder. The participant in this study is a 6-years old girl with a diagnosis of Autism Spectrum Disorder with Intellectual Impairment. This study uses a single-subject design consisting of A-B-A phases. Functional communication training is implemented using the most-to-least prompting technique which is divided into 8 sessions. The result depicts that 84% of participants increase their ability to perform requesting behavior by exchanging pictures of the trials given. Furthermore, after the implementation of functional communication training, there is an increase in the frequency of requesting behavior by exchanging pictures at post-test (average 74%) and at follow-up (average 82%). Implications of this study indicate the importance of considering the function of problem behavior in training the appropriate communicative responses for children with an autism spectrum disorder.

Collateral Effects of Behavioral Treatment for Problem Behavior on Caregiver Stress.

When individuals with autism and intellectual and developmental disabilities exhibit severe problem behavior, assessment and treatment are often warranted. Parents of such individuals are at high risk for developing parenting stress. In this study, 194 parents completed the Parenting Stress Index-Short Form at their child's time of admission to and discharge from inpatient or outpatient treatment for severe problem behavior. Parent stress was examined in relation to rate and function of child problem behavior as determined via functional analysis. Repeated measures analyses of variance were conducted, and differential effects were observed when child participants exhibited an attention, automatic, or mands function for problem behavior. These findings highlight the importance of considering function of problem behavior in relation to parenting stress.

Training Special Education Teachers to Select and Implement Appropriate Procedural Variations of Functional Communication Training

Training teachers to select and implement appropriate function-based interventions may reduce their reliance on behavior specialists and other support staff to help manage their students’ problem behavior in the classroom. Most prior studies on this type of training evaluated outcomes by measuring teachers’ verbal report rather than their implementation of interventions. The purpose of this study was to replicate and extend prior research by training teachers to identify the putative function of problem behavior via assessment of descriptive data, to select the appropriate procedural variation of functional communication training (FCT), and to implement FCT accurately in role play. Five special education teachers participated. Results suggested that behavioral skills training (BST) was highly effective for all participants. These findings have important implications for disseminating behavior-analytic interventions into settings with limited resources.

Function-Based Approach to Designing an Instructional Environment

Teachers are faced with the challenge of selecting interventions that are most likely to be effective and best matched to the function of problem behavior. This article will define aspects of the instructional environment and describe a decision-making logic to select environmental variables. A summary of commonly used function-based interventions will be provided through two students: one who engages in problem behavior to access peer attention and another who engages in problem behavior to escape work tasks.

Correspondence between the results of functional analyses and brief functional analyses

ABSTRACTPurpose: This study sought to examine the correspondence between brief functional analyses and more thorough functional analyses as described in the model of functional assessment proposed by Vollmer et al.1 Methods: A panel of trained clinicians indicated the presence/absence of specific functions of problem behavior based on graphic results from brief functional analyses and functional analyses conducted with 19 participants. These conclusions were compared across assessments. Results: The functions identified by the panel based on results of brief functional analyses had low correspondence with those of the more thorough functional analysis conducted with the same participants. Conclusions: Although brief-functional analyses appear regularly in clinical practice and the literature, findings from this study suggest that results may differ from those of more thorough functional analyses. Additional study is necessary to determine the cause of discrepant results between these two methodologies.

Function-Based Modification of Check-In/Check-Out to Influence Escape-Maintained Behavior

ABSTRACTPrior research has suggested Check-In/Check-Out (CICO) effectiveness is linked to the function of problem behavior. Though effective for students whose misbehavior occurs to gain attention, findings are equivocal for behavior that occurs to escape academic tasks. The purpose of this study was to therefore evaluate a modification to CICO, wherein students were permitted to escape portions of a supplemental assignment contingent upon appropriate behavior. Participants included two elementary students, both of whom were exposed to three conditions as part of an alternating treatments single-case design, including baseline, traditional CICO, and CICO-escape. Visual and statistical analyses indicated that relative to both baseline and traditional CICO, the modified CICO procedure was moderately to highly effective in promoting academic engagement and decreasing disruptive behavior for both students.

The Impact of Universal Teacher Practices and Function-based Behavior Interventions on the Rates of Problem Behaviors among At-risk Students

The call for effective instructional and classroom management is frequent within the professional literature. However, type, amount, and sequence of strategies sufficient to impact rates of problem behavior are often missing or listed with limited guidance on differentiation based on student pattern of problem behavior. The purpose of this study was to examine the impact of universal teacher practices on general education students exhibiting problem behaviors, and the impact of such practices on specific students given the function of problem behavior. Specifically, this study was interested in exploring the extent to which universal teacher practices, when applied for all students in the classroom, impacted student behavior in general education settings. Additionally, this study was interested in examining the additive effect of combining both targeted classroom supports in the form of universal teacher practices and functional behavioral assessment-based interventions through a multiple-baseline design. Results indicated that when universal teacher practices are applied, rates of problem behaviors decrease based on the function of behavior. Implications for practice and research are discussed.

Evaluating Competing Reinforcement Contingencies on Off-Task Behavior in a Preschooler with Intellectual Disability: A Data-Based Case Study

Off-task behaviors are often maintained by escape from instructional activities. However, attention is typically inseparable from escape-related consequences imposed by teachers. Testing consequent conditions separately in a typical functional analysis in these instances could lead to inconclusive results. Therefore, it may be important to manipulate both positive and negative reinforcement contingencies simultaneously to parse out possible attention versus escape functions. The purpose of this study was to evaluate an escape condition combined with two contingent attention conditions for off-task behavior in a 4-year-old preschool girl. Data from the escape and the escape + directives conditions did not conclusively demonstrate attention was a maintaining variable for off-task behavior. However, there was a differentiated effect of providing escape + differential attention + engagement stimuli when compared to the escape + physical proximity during the academic demand. Thus, academic demand may have served as a setting event for off-task behavior, but the behavior occurred more frequently when escape + physical proximity was provided during the activity. Contrastingly, adding escape + differential attention + engagement stimuli during the academic demand appeared to compete with the value of escape for off-task behavior. Implications for assessing multiple functions of problem behavior and designing effective treatment packages by practitioners are discussed.

EVALUATION OF THE RATE OF PROBLEM BEHAVIOR MAINTAINED BY DIFFERENT REINFORCERS ACROSS PREFERENCE ASSESSMENTS

The rates of problem behavior maintained by different reinforcers were evaluated across 3 preference assessment formats (i.e., paired stimulus, multiple-stimulus without replacement, and free operant). The experimenter administered each assessment format 5 times in a random order for 7 children with developmental disabilities whose problem behavior was maintained by attention, tangible items, or escape. Results demonstrated different effects related to the occurrence of problem behavior, suggesting an interaction between function of problem behavior and assessment format. Implications for practitioners are discussed with respect to assessing preferences of individuals with developmental disabilities who exhibit problem behavior.

Practical issues in effective behavioral intervention development.

There is a consensus in the behavioral literature that treatments based on the results of a functional assessment are more effective than treatments that are selected arbitrarily (e.g., Carr & Durand, 1985; Paclawskyj, Kurtz, & O'Connor, 2004). By identifying the functional reinforcers that maintain problem behavior, practitioners can design interventions that are more efficient (i.e., it narrows the list of potential interventions to choose from) and more effective. Linking treatments to functional assessment results has become standard clinical practice and has found its way into the language of federal and state legislation. This has been a positive and robust change in the behavioral intervention process. While the concept of linking treatment to function has logical appeal, practical issues arise when implementing these strategies in applied settings. In many cases, staff and caregivers may not know how to link assessment to treatment or the main components of effective function-based intervention. In other words, some care providers may complete a functional behavioral assessment (as is often required by law), but the assessment not translate into a function-based intervention due to a skill deficit on the part of the practitioner designing the intervention (i.e., they do not know how to select an appropriate treatment based on the results). Furthermore, the implementation of treatment may be affected by the level of training and expertise among direct care staff members and on-site supervisors. In many applied settings, direct care staff often do not receive proper training to effectively implement behavior intervention plans. In some cases, the primary procedure for training a staff member is to provide them with a written description of the procedure (i.e., the behavior plan). These concerns about the adequacy of staff/caregiver can have significant deleterious effects from a clinical standpoint, as improper implementation may result in negative outcomes for, not only the learner, but for staff and caregivers as well. Other practical implementation issues may involve the way treatment effectiveness is evaluated itself in applied settings. A thorough analysis of the maintaining mechanisms of the problem behavior is the cornerstone of the intervention, but uncovering functions alone is not enough to ensure an effective intervention. The real life challenges presented by implementation can be addressed with judicious assessment, sensitive treatment, and systems analysis. In many cases, treatments are evaluated using a wait and see approach, where practitioners tell direct care providers to implement an intervention and hope for a positive outcome. Taking a no is good news approach to intervention is not particularly systematic and likely leads to the propagation of ineffective intervention practices. The current manuscript will briefly review information related to the use of functional assessment procedures and common intervention strategies for different functions of problem behavior. We will then discuss some of the barriers to effective treatment implementation, particularly issues related to staff/parent training and systems issues as they relate to evaluating the effectiveness of treatments Functional Assessment The purpose of a functional assessment is to determine the cause, or the function, of challenging behavior. There are three primary types of functional assessment: indirect models (e.g., interviews, rating scales), descriptive analysis (e.g., ABC data), and functional analysis (e.g., environmental manipulations). These procedures are used to determine the antecedents that trigger maladaptive behavior and the reinforcement contingencies that maintain the behavior. Operant behavior can be categorized as being mediated by social reinforcement or automatic reinforcement. Socially-mediated problem behavior can be divided into social positive and social negative reinforcement. …

Using Analogue Functional Analysis to Measure Variations in Problem Behavior Rate and Function After Psychotropic Medication Changes: A Clinical Demonstration

Individuals with intellectual and developmental disabilities are often prescribed psychotropic medication to treat behaviors such as aggression and self-injury. Evaluation of these medications is often based on caregiver report or changes in frequency of behavior. The purpose of this research was to characterize the rate and function of problem behavior within an analogue functional analysis for three individuals diagnosed with autism as they experienced psychotropic medication changes. Results revealed that problem behavior, in terms of rate and function, were different across the various drugs prescribed. These data suggest that medication changes did not only produce changes in the rate of behavior but also in its function; that is, in behavioral parlance, medications can become motivating operations. This finding is lending support for the usefulness of conducting functional assessments throughout psychotropic medication changes. The importance of monitoring functional changes of target behavior is that concurrent behavioral interventions may have to be adjusted in accordance with those altered functional properties. Recommendations regarding future directions for research and implications of this line of research for treatment are discussed.

Differential Effects of a Tier Two Behavior Intervention Based on Function of Problem Behavior

The purpose of this study was to investigate the effectiveness of a tier two daily behavior card intervention and differential effects based on function of problem behavior. The participants were 36 elementary school students nominated for additional intervention beyond universal School-Wide Positive Behavior Support. Measures included standardized behavior rating scales and rate of office discipline referrals before and after 8 weeks of intervention. A multivariate analysis of variance was used, and results showed statistically significant differences in response to intervention based on teacher-identified function of problem behavior. Results are discussed in terms of considering function of behavior in selecting tier two interventions and implementing a three-tier response to intervention model.

Reading Skills and Function of Problem Behavior in Typical School Settings

The authors examined the relation between variables maintaining problem behavior and reading performance for elementary-age students. Participants were 51 students in Grades 4, 5, and 6 who had received two or more office discipline referrals in 2003-2004. Students were grouped by teacher-indicated function of problem behavior. The prevalence of behavioral function for students in general and special education is reported, and differences were determined for the number of discipline referrals and oral reading fluency rates. Chi-square analysis indicated differences in base rates of function between students in general and special education. Multivariate analysis of variance indicated significant differences in oral reading fluency by function of problem behavior, and follow-up analyses indicated significantly lower fluency scores for students whose indicated function was escape from academic tasks. These findings provide evidence for a coercion model in the classroom. The results are discussed in terms of the relevance of using functional behavior assessment and behavior support with general education populations.

Longitudinal Functional Analysis of Problem Behavior during an Atypical Neuroleptic Medication Cross-over Evaluation for an Adolescent with Developmental Disabilities

This quasi-longitudinal descriptive case study evaluated problem behavior for an adolescent boy with developmental disabilities via repeated functional behavioral analysis (FBA) probes during a blinded cross-over from the atypical neuroleptic Risperdal (Risperidone) to Seroquel (Quetiapine). The repeated FBA probes showed no medication differences for the frequency or function of problem behavior. A second study was completed following a school placement change with repeated FBA probes and a stable medication regimen. In this context, problem behavior was negatively reinforced in the form of escape from task demands. School staff subsequently implemented a function-based treatment decreasing problem behavior during treatment sessions. Implications for collaboration between health care providers and behavioral specialists in the design of comprehensive interventions for problem behavior are discussed.

Beyond treatment of individual behavior problems: an effective residential continuum of care for individuals with severe behavior problems

AbstractWe report on one component of a residential continuum of care designed to integrate children and adolescents with severe behavior problems into community residential and educational placements. The continuum featured three components: a behavior stabilization unit, campus apartments, and community group homes. Data are reported for a 5‐year period, during which 116 children and adolescents were admitted to a behavior stabilization program for treatment of severe self‐injury, aggression, and/or property destruction, and non‐compliance. Additional problems for some admissions included stereotypy, feeding disorders, sleeping disorders, seizure disorders, and other medical conditions. Archival data were collected retrospectively on age, gender, length of stay, prescribed medications, function of problem behaviors, acuity level of behavioral interventions, and discharge site. Analysis of data indicated (1) the behavior stabilization unit was successful in reducing occurrence of severe behavior problems, and increasing adaptive behaviors, (2) Seventy‐three individuals were able to successfully transition to a campus apartment program that had been designed as a step‐down program from the behavioral stabilization unit, and (3) Sixty‐seven individuals were able to transition to community group homes. The benefits of a residential continuum of care for individuals with severe behavior problems are discussed. Copyright © 2007 John Wiley & Sons, Ltd.

THE EFFECTS OF REINFORCEMENT MAGNITUDE ON FUNCTIONAL ANALYSIS OUTCOMES

The duration or magnitude of reinforcement has varied and often appears to have been selected arbitrarily in functional analysis research. Few studies have evaluated the effects of reinforcement magnitude on problem behavior, even though basic findings indicate that this parameter may affect response rates during functional analyses. In the current study, 6 children with autism or developmental disabilities who engaged in severe problem behavior were exposed to three separate functional analyses, each of which varied in reinforcement magnitude. Results of these functional analyses were compared to determine if a particular reinforcement magnitude was associated with the most conclusive outcomes. In most cases, the same conclusion about the functions of problem behavior was drawn regardless of the reinforcement magnitude.

Measurement Properties of Indirect Assessment Methods for Functional Behavioral Assessment: A Review of Research

Indirect assessment instruments used during functional behavioral assessment, such as rating scales, interviews, and self-report instruments, represent the least intrusive techniques for acquiring information about the function of problem behavior. This article provides criteria for examining the measurement properties of these instruments designed to identify functional relations and reviews 46 studies examining the use and interpretation of the Motivation Assessment Scale (Durand & Crimmins, 1992) or the Functional Assessment Interview (O'Neill et al., 1997). Results indicate at least three inadequacies in the research: (a) insufficient attention paid to evidence based on instrument content and informant response processes, (b) minimal evidence indicating consumer satisfaction and the singular or unique effects of instrument data on intervention development, and (c) excessive emphasis on research designs and measurement properties that assume stability in behavior—environment interactions across contexts.