BRIEF REPORT: LATENCY FUNCTIONAL ANALYSIS OF ELOPEMENT

Approaches for Treating Multiply Controlled Problem Behavior

A portion of problem behavior is maintained by multiple reinforcement contingencies. Treating multiply controlled problem behavior may be more complex than treating problem behavior maintained by a single contingency. Several approaches for addressing multiply controlled problem behavior have been described in the literature. The purpose of this review is to provide practitioners with an overview of function-based approaches for addressing multiply controlled problem behavior. In particular, we present guidelines for functional analysis and treatment. We also describe strengths and limitations of published treatment approaches and discuss strategies for mitigating these limitations. Finally, we describe areas for future research.

Reliability and validity of using structured visual-inspection criteria to interpret latency-based functional analysis outcomes

Prior research has evaluated the reliability and validity of structured visual inspection (SVI) criteria for interpreting functional analysis (FA) outcomes (Hagopian et al., 1997; Roane et al., 2013). We adapted these criteria to meet the unique needs of interpreting latency-based FA outcomes and examined the reliability and validity of applying SVI criteria to 43 previously published latency-based FA datasets. Overall, raters agreed on SVI-determined FA outcomes (98% of functions and 95% of cases) and these outcomes corresponded well to the interpretations provided by the authors of these 43 datasets (94% of functions and 88% of cases), indicating a high degree of reliability and concurrent validity. Our findings suggest that the use of SVI criteria may (a) serve as an objective aid in the identification of behavioral function(s), (b) produce high levels of agreement among expert raters, and (c) serve as a useful resource when teaching students how to interpret latency-based FA outcomes.

A Feasibility Randomized Clinical Trial of a Structured Function-Based Intervention for Elopement in Children with Autism Spectrum Disorder

Elopement is a common and dangerous concern in autism spectrum disorder (ASD). There is evidence that behavior analytic treatments can successfully treat elopement, but the research is limited due to small samples and treatment components varying across studies. The current study evaluated the feasibility of studying a manualized intervention for elopement, based on strategies from single-subject research, in a randomized clinical trial with 24 individuals with ASD. Results demonstrated that recruitment was feasible; the manual was acceptable to parents; and therapists followed the manual with high-integrity. Initial efficacy results measured by the Aberrant Behavior Checklist, Clinical Global Impression Scale, and a Home Elopement Safety Checklist suggested improvement in the treatment group that should be studied in future research.

An Investigation of Functional Communication Training and Schedule Thinning Using a Multiple Schedule on Elopement to Access Stereotypy

Individuals diagnosed with autism spectrum disorder (ASD) who engage in stereotypy may also emit a prior, temporally contiguous, high-risk response to access stereotypic behaviors. For example, the participant in this study who was diagnosed with ASD engaged in a chained response that included elopement, often in unsafe locations, to access light switch flipping. Previous research indicates that functional communication training (FCT) with delay fading is a viable approach to reduce chained problem behavior. In this study, we extended previous research by (a) evaluating the generalized effect of FCT and schedule thinning using multiple schedule technology for an automatically maintained chained response, and (b) evaluating whether intervention effects maintained in the participant's optimal context. Results for the participant suggested that FCT with schedule thinning mitigated high-risk chained responding across settings and discrimination training using a multiple schedule assessment effectively signaled available and unavailable times for the participant to emit the chained response which matched the participant's natural schedule parameters.

Response latency as a measure of behavior in the assessment of elopement

Elopement is a common form of problem behavior but is relatively underrepresented in the functional analysis literature. One barrier to assessing elopement experimentally is the need to retrieve the subject following an instance of elopement. This retrieval confounds programmed session contingencies when the goal is to obtain repeated measurement of free-operant behavior. The current study evaluated latency to elopement as an alternative to free-operant measurement. We first compared response latency to allocation in 5-min sessions and then measured latency alone in a trial-based format. The identified reinforcers matched across both data analysis modalities in the session-based assessments, and the trial-based functional analysis showed a significant time savings in identifying the function of behavior over a session-based assessment. Results indicated that elopement serves idiosyncratic social functions in young children with intellectual and developmental disabilities, and that a latency-based assessment saves time while yielding equally clear results.

Systematic Review of Functional Analysis and Treatment of Elopement (2000-2015)

Elopement is a dangerous behavior that is emitted by a large proportion of individuals with intellectual and developmental disabilities. Functional analysis and function-based treatments are critical in identifying maintaining reinforcers and decreasing elopement. The purpose of this review was to identify recent trends in the functional analysis and treatment of elopement, as well as determine the efficacy (standardized mean differences) of recent treatments. Over half of subjects' elopement was maintained by social positive reinforcement, while only 25% of subjects' elopement was maintained by social negative reinforcement. Elopement was rarely maintained by automatic reinforcement, and none of the studies in the current review evaluated treatments to address automatically maintained elopement. Functional communication training was the most common intervention regardless of function. Results are discussed in terms of clinical implications and directions for future research.

Clinical outcomes of behavioral treatments for elopement in individuals with autism spectrum disorder and other developmental disabilities

The external validity of behavioral treatments for elopement (i.e. leaving supervision without permission) remains unclear because studies to date include only small samples ( n = 1–3). This study quantified the overall effectiveness of behavioral treatments for elopement by retrospectively examining treatment data from all patients seen for the treatment of elopement at an intensive day treatment clinic ( n = 11), irrespective of treatment success. Reductions in elopement from baseline to the final treatment for each participant demonstrate that behavioral intervention is a highly effective treatment for elopement, as determined by the large effect size (Cohen’s d = 1.18).