A survey of functional behavior assessment methods used by behavior analysts in practice

Distance-Based Collaborations for Assessing and Treating Challenging Behavior

An interview-informed synthesized contingency analysis (IISCA; Hanley et al. in J Appl Behav Anal 47:16-36, 2014) and related skill-based treatment process can result in socially valid outcomes for clients exhibiting severe challenging behavior when implemented by professionals and then transferred to parents (e.g., Santiago et al. in J Autism Dev Disord 46:797-811, 2016). However, many families do not have access to professionals trained to implement functional analyses or function-based treatments (Deochand & Fuqua Behav Anal Pract 9:243-252, 2016). Experimenters in the present study coached three parents of children with autism exhibiting severe challenging behavior through implementing an IISCA and resulting skill-based treatment process through distance-based collaborative consulting. All parents achieved differentiated functional analyses, taught their children to emit functional replacement skills, and reduced challenging behavior relative to baseline.

Evaluating an Excel-based tool for interpreting functional analyses: A functional analysis decision support system

When applied to functional analysis results, structured visual inspection criteria have resulted in improvements in the levels of agreement between raters as well as earlier identification of the function of challenging behavior. However, multistep criteria can be difficult to apply in real time, which could be a barrier to widespread adoption in practice. This study evaluated a Microsoft-Excel-based functional analysis decision support system (FADSS), which could aid behavior analysts with interpreting functional analysis results. Final overall agreement between the FADSS and post hoc visual inspection was high at 95%. Final overall agreement between the post hoc results generated by FADSS and ongoing results generated by FADSS was acceptable at 81%, representing a 50% increase in efficiency. These results indicate that FADSS could aid behavior analysts when interpreting functional analysis results in real time.

Exploratory Time-Series Analysis of Consecutive Case Series Data: A Quality Improvement and Adherence Study of a Behavior Analytic Service Provider

Program evaluation is an essential practice for providers of behavior analytic services, as it helps providers understand the extent to which they are achieving their intended mission to the community they serve. A proposed method for conducting such evaluations, is through the use of a consecutive case series design, for which cases are sequentially gathered following the onset of a specific occurrence. Given the sequential nature in which data are collected within a consecutive case series, analytic techniques that adopt a time-series framework may be particularly advantageous. Although such methods are commonly used for program evaluation in medicine and economics, their application within the field of applied behavior analysis is largely absent. To serve as a model for providers undertaking evaluation efforts, I conducted a program evaluation of an outpatient severe behavior clinic, in which I employed quasi-experimental methods using an interrupted time-series analysis.

Toward Maximizing Assessment Efficiency: A Synthesized Trial-Based Functional Analysis and Competing Stimulus Assessment

Despite the success of the standard functional analysis (FA), some limitations to conducting an FA in practice include time, resources, ecological relevance, and safety, which have led to the development of procedural adaptations such as trial-based and synthesized FA formats. The purpose of this case study was to identify the function(s) of self-injurious behavior (SIB) for a 3-year-old female with developmental disabilities using a brief trial-based FA with ecologically relevant synthesized contingencies, based on caregiver input, to minimize opportunities for SIB. We identified that positive physical attention likely functioned, at least in part, as a reinforcer for SIB, in less than 42 min. Overall harm to the child as a result of the synthesized trial-based FA was minimal, and the caregiver viewed the modified conditions favorably. We then assessed the role of competing stimuli on SIB rates with the child's mother and identified two potential items that may compete with attention as a reinforcer for SIB. Our findings highlight the utility and importance of individualized assessment as the first step in the safe treatment of severely challenging behavior.

A concise review of the correspondence between the traditional functional analysis and alternative assessment formats

The functional assessment of challenging behavior (e.g., self-injurious behavior) has evolved over many years of research and practice. This concise review summarizes the positive predictive value, negative predictive value, accuracy, sensitivity, and specificity of common procedural adaptations reported to improve functional assessment safety and efficiency. We conclude with suggestions for clinicians and researchers.

Using Risk Ratios to Quantify Potential Behavior-Environment Relations

Behavior-environment functional relations are the units of explanation in applied behavior analysis (ABA). Whether hypothesized experimentally or descriptively, quantification of putative functional relations improves our ability to predict and influence behavior. Risk ratios are an accessible, straightforward quantitative analysis that can serve this purpose. They have been employed to great effect in other fields (e.g., medicine, public health), but are rarely used within ABA. In this tutorial, we describe risk ratios and how they are calculated, discuss why risk ratios are well suited for quantifying behavior-environment relations, and illustrate their utility and applicability across five demonstrations from real clinical cases. Recommendations for the use of risk ratios in research and practice are discussed.

A comparative effectiveness trial of functional behavioral assessment methods

Clinicians report primarily using functional behavioral assessment (FBA) methods that do not include functional analyses. However, studies examining the correspondence between functional analyses and other types of FBAs have produced inconsistent results. In addition, although functional analyses are considered the gold standard, their contribution toward successful treatment compared with other FBA methods remains unclear. This comparative effectiveness study, conducted with 57 young children with autism spectrum disorder, evaluated the results of FBAs that did (n = 26) and did not (n = 31) include a functional analysis. Results of FBAs with and without functional analyses showed modest correspondence. All participants who completed functional communication training achieved successful outcomes regardless of the type of FBA conducted.

We Still Have a Lot to Learn

Use of contingent electric skin shock in the treatment of severe problem behavior has been criticized on the grounds that (a) it is not necessary because function-based procedures using positive reinforcement are just as effective; (b) it violates contemporary ethical standards; and (c) it lacks social validity. There are good reasons to challenge these claims. The meaning of "severe problem behavior" is imprecise and we should be cautious in our claims about how to treat it. It is not clear that reinforcement-only procedures are sufficient because they are commonly paired with psychotropic medication, and there is evidence that some instances of severe behavior may be refractory to reinforcement-only procedures. Ethical standards, as expressed by the Behavior Analysis Certification Board and the Association for Behavior Analysis International, do not prohibit punishment procedures. Social validity is a complex concept that can be understood and measured in multiple, potentially conflicting ways. Because we still have a lot to learn about these matters, we should be more skeptical of sweeping claims such as the three enumerated above.

Using Direct and Indirect Functional Assessments to Guide the Selection of Individualized Academic Interventions

When teachers work with students exhibiting academic failure, they may look to factors outside of instruction such as a student's home life or perceived disability as explanations. Placing the locus of control outside of the instructional context becomes a convenient way to escape culpability for unsatisfactory outcomes. A more functional approach to addressing academic deficits allows educators to determine environmental factors responsible for the lack of progress and then create interventions designed to address these functions of academic failure. Although experimental analyses serve as the gold standard for evaluating functional relations between behavior and environment, educators may not always have the ability to systematically test all behavior-environment relations. Indirect assessments provide one means to develop hypotheses about environment-behavior relations that can then be validated with experimental analyses. In this study, researchers developed an indirect tool (Academic Diagnostic Checklist - Beta; ADC-B) based on the function of academic performance deficits (Daly et al. in School Psychology Review 26:554, 1997) and validated the use of the ADC-B by comparing interventions that were suggested (indicated) and those non-suggested (contraindicated) by the ADC-B. Researchers used the ADC-B with four participants and found that for three of the four participants, the suggested intervention was the most efficacious at improving accuracy with the target skills. One limitation is that we did not evaluate the full technical adequacy of the ADC-B, which should be a focus of future research.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10864-023-09511-x.

A systematic review of the correspondence between descriptive assessment and functional analysis

Clinicians report that they often rely on descriptive assessments when developing behavior-reduction plans despite literature suggesting that functional analysis is the most rigorous assessment method. Further, research comparing the outcomes of descriptive assessments and functional analyses is mixed, with some studies showing low correspondence and others showing high correspondence. Such persistent use of descriptive assessments suggests that they may yield useful information despite inconsistent correspondence with functional analyses. A more fine-grained analysis of the relation between descriptive assessments and functional analyses may elucidate variables affecting their utility. We conducted a review of 48 studies that included descriptive assessments and functional analyses and evaluated several measures of correspondence between each pair of assessments. Results indicated that descriptive assessments had exact correspondence with functional analyses in 50% of comparisons. Results also suggested that descriptive assessments were more likely to accurately identify and predict the absence of a function relative to the presence of a function and that structured descriptive assessments were more likely to accurately predict functions.

Impact of a Training Package to Improve the Effectiveness of Descriptive Assessment Data

Identifying the maintaining contingencies of problem behavior can lead to effective treatment that reduces the occurrence of problem behavior and increases the potential for the occurrence of alternative behaviors. Many studies use descriptive assessments, but results vary in effectiveness and validity. Comparative research further supports the superior utility of analog functional analyses over descriptive assessments, but clinicians continue to report the consistent use of descriptive assessments in practice. Direct training on the recording of descriptive assessments as well as the process for interpreting the results are limited. The absence of research-based guidance leaves clinicians to interpret the results as they see fit rather than following best practice guidelines for this critical activity. This study examined the potential impact of direct training on several components of descriptive assessment: the recording of narrative antecedent-behavior-consequence data, interpretation of the data, and the selection of a function-based treatment. Implications for training and practice are reviewed.

A Competing Stimuli Intervention Package to Treat Automatically Reinforced Destructive Behavior

Behaviors maintained by automatic reinforcement are often more difficult to treat due to difficulty with identifying the relevant maintaining variable(s). One common intervention to treat automatically maintained behavior includes competing stimuli. Competing stimuli promote item engagement which may replace challenging behavior (i.e., response competition). Competing stimuli have shown to be a widely successful intervention across diverse topographies of challenging behavior; however, few studies have evaluated the use of competing stimuli on destructive behavior. The purpose of the current study was to treat automatically maintained destructive behavior with a competing stimuli intervention package for an adolescent with developmental disabilities. Results showed a decrease in destructive behavior when access to competing stimuli was a component of an intervention package in a clinic setting. Also, preliminary data are provided showing treatment effects when caregivers implemented the intervention. Due to the complexity of the final intervention package, recommendations for clinicians are provided which focus on improving feasibility, practicality, and sustainability of treatment components.

A Scoping Review of the Healthcare and Hygiene Literature for Individuals with Intellectual and Developmental Disabilities

OBJECTIVES

Previous reviews highlight the similarities in teaching healthcare and hygiene routines to individuals with and without intellectual and developmental disabilities. Additionally, similar interventions are used when interfering behaviors occur. Although these routines are topographically distinct, there are enough similarities to suggest effective procedures for one routine may be used to inform another. This scooping review aims to identify effective teaching and intervention procedures for healthcare and hygiene routines specifically for individuals with intellectual and developmental disabilities. We also evaluated the extent to which functional analyses were conducted; a dimension not included in previous reviews.

METHODS

Eligible articles targeted compliance or tolerance within the context of a defined healthcare or hygiene routine as a dependent variable and used an experimental design with a demonstration of experimental control. Articles were identified through PsycINFO, PubMed, and Academic Search Premier databases. Additionally, a hand search of five related journals was conducted. Data were collected on dependent variables, functional analyses, baseline contingencies, teaching procedures, and additional experimental components.

RESULTS

A total of 52 articles met inclusion criteria. Most experiments produced positive outcomes. The findings show all experiments involved a treatment package with multiple components. The most common teaching procedures were graduated exposure and DRA. A lack of functional analyses and social validity was noted.

CONCLUSIONS

Component analyses are needed to identify the most effective and efficient procedures. Pyramidal training to teach medical professionals how to provide preventative pyramidal training should be explored.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s41252-022-00249-7.

On the validity of interpreting functional analyses of inappropriate mealtime behavior using structured criteria

Visual inspection is the traditional method behavior analysts use to interpret functional-analysis results. Limitations of visual inspection include lack of standardized rules, subjectivity, and inconsistent interrater reliability (Fisch, 1998). To address these limitations, researchers have developed, evaluated, and refined structured criteria to aid interpretation of functional analyses of destructive behavior (Hagopian et al., 1997; Roane et al., 2013; Saini et al., 2018). The current study applied the structured criteria Saini et al. (2018) described to functional analyses of inappropriate mealtime behavior. We assessed its predictive validity and evaluated its efficiency relative to 3 post hoc visual inspection procedures. Validity metrics were lower than those in Saini et al. however, ongoing visual inspection increased the efficiency of functional analyses by more than 30%. We discuss these findings relative to the procedural differences between functional analyses of destructive behavior and inappropriate mealtime behavior.

Training behavior analysts to conduct functional analyses using a remote group behavioral skills training package

Behavioral skills training (BST) is a well-established procedure used to train individuals how to perform a variety of complex skills. Previous research has used BST to train parents, teachers, and clinicians how to conduct a variety of clinical procedures, including functional analysis of problem behavior. Although this procedure has been demonstrated to be very effective, it can be time consuming and resource intensive. In the present study, 13 behavior analysts were trained to conduct functional analyses of problem behavior. All participants were employees of a multistate early intervention clinic. This staff training was conducted fully remotely, and trainers acted as child role-play partners. Participants experienced baseline, an instruction/discussion component, a post-instruction probe, group BST, and a post-BST probe. For 5 participants, in-situ probes were also conducted. All participants achieved mastery and in-situ errors were low.

An evaluation of trial-based functional analyses of inappropriate mealtime behavior

Functional analyses allow clinicians to develop treatment targeting the variables maintaining a child's inappropriate mealtime behavior (Bachmeyer et al., 2019). Extended functional analyses can be inefficient, potentially delaying the onset of treatment. Researchers have suggested a trial-based functional analysis can increase assessment efficiency (Saini, Fisher, et al., 2019). This study compared trial-based functional analyses to extended functional analyses to determine the variables maintaining inappropriate mealtime behavior. We compared the efficiency and acceptability and evaluated treatments informed by the analyses. Exact correspondence between analyses was low (29%); however, most treatments indicated by the trial-based functional analyses (80%) resulted in improvements in the child's target behavior. The trial-based functional analysis required 71% less time than the extended functional analysis, and caregivers found analyses equally acceptable. Future researchers should continue refining trial-based functional analysis procedures to provide an efficient assessment that leads to efficacious treatment.

Partially Automated Training for Implementing, Summarizing, and Interpreting Trial-Based Functional Analyses

Trial-based functional analysis (TBFA) is an accurate and ecologically valid assessment of challenging behavior. Further, there is evidence to suggest that individuals with minimal exposure to behavior analytic assessment methodology (e.g., parents, teachers) can quickly be trained to conduct TBFAs in naturalistic settings (e.g., schools, homes). Notwithstanding, the response effort associated with training development can be prohibitive and may preclude incorporation of TBFA into practice. To address this, we developed a partially automated training package, intended to increase the methodology's accessibility. Using a multiple-probe across skills design, we assessed the degree to which the package increased caregiver accuracy in (a) implementing TBFAs, (b) interpreting TBFA outcomes, and (c) managing TBFA data. Six caregivers completed this study and all demonstrated proficiency following training, first during structured roleplays and again during assessment of their child's actual challenging behavior.

Evaluating the Potential for Correspondence Between Brief Functional Analysis and Interview-Informed Synthesized Contingency Analysis Procedures

School Psychologists regularly conduct Functional Behavior Assessment (FBA), though, most FBA are completed using indirect procedures, which are inadequate for creating function-based interventions relative to experimental measures, such as functional analysis (FA). However, traditional FA may be considered arduous in the school setting. Alternative procedures like brief functional analysis (BFA) and interview informed synthesized contingency analysis (IISCA), may be as effective and more efficient than FA. Limited research exploring the correspondence of these procedures exists. The current study used an alternating treatment design across eight school aged children to compare control and test conditions for each measure. A within subjects approach was also used to compare the results of BFA and IISCA. Correspondence across the two measures was 54.17%. With average correspondence yielding just over half, the results indicate the two FA methods did not reliably identify the same function. Implications for practice are discussed.

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.

Formative applications of ongoing visual inspection for trial-based functional analysis: A proof of concept

Trial-based functional analysis (TBFA) possesses many strategic advantages which make it an ideal candidate for adoption in applied settings. Notwithstanding, some aspects of the analysis remain underdeveloped, including structured guidelines for interacting with obtained data reliably in formative and summative ways. The purpose of this study was to adapt existing ongoing visual-inspection (OVI) criteria to match the idiosyncrasies of TBFA and then to assess their practical utility in applied settings. Thus, we first drafted OVI criteria appropriate for trial-based FA (i.e., TB-OVI). Then, we trained 5 caregivers to conduct TBFAs of their children's challenging behavior and to react to their data as they obtained it, using the TB-OVI criteria as their guide. Finally, we validated interpretations of TBFA outcomes based on TB-OVI criteria through effective intervention. Across 5 participants and 7 opportunities, function-based interventions successfully eliminated challenging behavior.

Randomized controlled trial of seminar-based training on accurate and general implementation of practical functional assessments

General and long-term outcomes of functional analysis training have not yet been reported. Within a randomized control trial, we trained 18 behavior analytic practitioners to interview caregivers, design and then conduct a personalized analysis as a part of a practical functional assessment (PFA). Participants were randomly assigned to groups, and those who experienced the seminar prior to conducting PFA with a confederate demonstrated more component skills than those who were provided the same materials but did not experience the seminar (mean scores: 87%, 36% respectively). Participants who experienced the seminar considered the training valuable and reported greater confidence in their ability to achieve control in an analysis. Several participants then conducted a PFA with a client who engaged in SPB. Results showed that skills transferred to these authentic applications. Results suggest that a seminar-based training can increase practitioners' ability to functionally analyze problem behavior and leads to subsequent analytic activity.

On the Occurrence of Dangerous Problem Behavior during Functional Analysis: An Evaluation of 30 Applications

Functional analyses are often conducted by behavior analysts to understand the environmental variables contributing to an individual's problem behavior to better inform treatment implementation. While functional analyses are integral for designing function-based interventions, they often arrange contingencies to evoke and reinforce dangerous problem behavior. In Study 1 we reviewed 22 functional analyses with open-contingency classes including non-dangerous topographies of problem behavior and we found that participants were more likely to exhibit the non-dangerous behavior in 82% of the applications. We then conducted a single-subject comparison of closed and open-contingency classes with four additional participants in Study 2. Our results suggest that the functional analyses with the open-contingency class reduced the likelihood of observing dangerous problem behavior.

A comparison of function- and nonfunction-based extinction treatments for inappropriate mealtime behavior

Previous literature supports the use of functional analyses to prescribe treatments for children with feeding disorders (Bachmeyer et al., 2009). Nevertheless, clinicians often train caregivers to use healthy contingencies, independent of whether those contingencies are function based. However, it is unclear whether including nonfunction-based contingencies differentially affects inappropriate mealtime behavior. In the current investigation, the caregivers of 3 children with feeding disorders provided escape from bites and drinks and attention following inappropriate mealtime behavior. Results of a functional analysis showed escape from bites or drinks, but not attention, reinforced inappropriate mealtime behavior. We then tested the effects of escape extinction when the feeder either provided or withheld attention following inappropriate mealtime behavior. Inappropriate mealtime behavior decreased and acceptance increased when the feeder implemented escape extinction independent of whether they provided or withheld attention. We discuss the implications of including nonfunction-based components in the treatment of pediatric feeding disorders.

A comparison of brief and extended session duration functional analyses

Many behavior analysts do not conduct a functional analysis (FA) prior to treatment in a clinical setting (e.g., Roscoe et al., 2015). When asked for an explanation, respondents commonly report that an FA is too time consuming. One way to address this perceived constraint is to evaluate the utility of an abbreviated FA with 5-min session durations. In the current study, 2 independent FAs, 1 with 5-min sessions and 1 with 10-min sessions, were conducted for the problem behavior of 5 individuals diagnosed with autism spectrum disorder (ASD). For all participants, the 5- and 10-min session duration FAs yielded the same identified function of problem behavior: escape from demands. A brief differential reinforcement of alternative behavior (DRA) analysis was subsequently conducted and found to be effective at decreasing problem behavior and increasing an appropriate communication response across participants. These findings demonstrate the utility of conducting an FA using briefer session durations followed by a brief DRA analysis.

Using ranked survey data in education research: Methods and applications

Researchers and practitioners in education and school psychology regularly use ranked data to drive student- and systems-level decision-making. These types of data can be derived from assessments of individual preferences among researchers and practitioners, assessments of preferences among stakeholders including parents and children, and rankings of students on academic and social-emotional competency. However, the analysis of ranked data in education and psychology has typically been limited to simple approaches such as the examination of mean ranks assigned to items. This paper unifies a collection of classical methodologies, as well as proposes new techniques, for analyzing ranked data used across disciplines and applies the methods to data generated in school psychological research. The scope of the paper is to serve as a roadmap for researchers in education and school psychology who seek to more fully leverage information contained in ranked data. These methodologies include descriptive analyses, visualizations, tests of uniformity, cluster analyses, and predictive models. We demonstrate these techniques on the survey data of Fefer, DeMagistris, and Shuttleton (2016) and illustrate how using a broader set of tools can yield improved insights by researchers and practitioners.

Evaluation of a Brief Family-Centered Service Provision Model for Treating Children's Severe Behavior: A Retrospective Consecutive Case Series Analysis

This article serves as an initial program evaluation of a service provision model for providing applied behavior analysis services to families with severe behavior needs. A retrospective consecutive case series design was used to evaluate the effectiveness, feasibility, and cost of the model. We analyzed records for all families served through the model from summer 2017 to fall 2018. A total of 55 families received services, with 87% of children having autism and 63% having an intellectual disability. Within-participant single-case experimental designs were used to evaluate the clinic's assessment procedures, and caregiver interviews were used to evaluate the feasibility and effectiveness of developed and implemented treatments. Conclusive assessment results were obtained for approximately 69% of children. For families that received treatment, 92% reported improved child behavior. Intent-to-treat analyses that included families that withdrew from services prior to receiving treatment indicated that 61% of families experienced improved child behavior. Assessment and treatment outcomes for families that attended all appointments are commensurate with those of other similar clinics reported in the literature; however, the percentage of families that withdrew from services is substantially higher. For families adhering to the clinic's services, children's challenging behavior may be effectively assessed and treated through brief outpatient contacts utilizing services based on applied behavior analysis.

Rationale, Development, and Description of a Brief Family-Centered Service Provision Model for Addressing Children's Severe Behavior

For families with children with autism that engage in severe behavior, the American Academy of Pediatrics recommends that functional assessment and management of environmental variables contributing to severe behavior occur prior to the prescription of psychopharmacologic treatment. Despite the inclusion of this recommendation in guidance articles published in pediatric journals for more than a decade, access to such services may not be feasible, in particular for families living in rural and geographically isolated communities. Given that families often view pediatricians as their first line of professional guidance for addressing challenges surrounding child development, the inaccessibility of appropriate services for managing healthcare is a concern for many pediatricians. To address this issue, a brief family-centered service provision model was developed through a collaboration between healthcare providers at a university-based hospital and Applied Behavior Analysis program faculty of the affiliated university. The hospital served many families living in rural areas of the state; therefore, the model utilized research-based practices with evidence of ecological validity for providing function-based assessment and treatment services. Within this manuscript we present a description of the model and its current implementation at a university-based hospital. For a data-based evaluation of the clinic and model, we refer readers to https://osf.io/qx8ak.

Toward the Development of a Functional Analysis Risk Assessment Decision Tool

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.

The Role of Professional Training Experiences and Manualized Programs in ABA Providers' Use of Parent Training With Children With Autism

Parent training, in which providers teach parents intervention strategies to promote their children's skill acquisition and/or behavior management, is considered a best practice in the treatment for children with autism spectrum disorder (ASD) and yet is underutilized in community settings. The present study examined the role of training experiences and manual use in promoting the use of parent training by community providers who serve children with ASD. Applied behavior analysis (ABA) providers (N = 1,089) from across the United States completed self-report questionnaires online. The total number of professional training experiences related to parent training significantly predicted the extensiveness of providers' use of parent training. Receiving supervision in parent training, being trained in a specific parent training approach, taking a course related to parent training, and participating in self-guided learning (e.g., webinar) were unique predictors of parent training extensiveness. While only 15% of ABA providers used manualized parent training programs, using a manual was also a unique predictor of parent training extensiveness. Parallel multiple mediator analyses demonstrated that family-, provider-, and organization-level barriers all partially mediated the relationship between number of training experiences and parent training extensiveness; only provider- and organization-level barriers mediated the relationship between manual use and parent training extensiveness. Recommendations for training and supporting providers at the pre-service and in-service levels are discussed as a means of increasing access to parent training for children with ASD in community settings.

Using e-learning modules to teach ongoing-visual inspection of functional analyses

Despite the effectiveness of function-based treatments, most clinicians do not conduct functional analyses (FA). The time required to conduct an FA is a major barrier preventing their use. One way to increase FA efficiency is to discontinue the analysis as soon as it has produced clear results. Saini et al. (2018) evaluated a structured procedure for ongoing-visual inspection of FAs and found that it produced accurate interpretations while averaging 40% fewer sessions than author interpretation. This study evaluated the efficacy of an e-learning module for training registered behavior technicians (RBTs) to implement ongoing visual inspection of FAs. Following training, 5 of the 6 participants showed mastery of ongoing visual inspection, and the final participant did so with the addition of supplemental procedures. We discuss how this training may increase the efficiency of FAs by teaching individuals who are less experienced in FA methodology when to seek supervision from a supervising Board Certified Behavior Analyst® (BCBA).

Do Functional Analyses Probe Learning Histories, Or Create Them? An Exploratory Investigation

During functional analysis (FA), therapists arrange contingencies between potential reinforcers and problem behavior. It is unclear whether this fact, in and of itself, facilitates problem behavior's acquisition of new (false-positive) functions. If problem behavior can come under the control of contingencies contrived between it and known reinforcers for which there is no direct history, then outcomes of reinforcer analysis (RA) should perfectly predict FA outcomes. This study evaluated the degree to which RA outcomes corresponded with FA outcomes for eight participants referred to a university-based outpatient clinic for problem behavior. For 75% (6 of 8) of participants, correspondence was imperfect. These findings appear to support the construct validity of contemporary interpretations of FA data.

Advances in Our Understanding of Behavioral Intervention: 1980 to 2020 for Individuals Diagnosed with Autism Spectrum Disorder

There are three branches of science of behavior analysis [i.e., experimental analysis of behavior, behavior analysis, and applied behavior analysis (ABA)]. ABA can be defined as a systematic approach to understanding behavior of social interest. For the past 40 plus years, researchers have evaluated ABA and ABA based procedures (e.g., behavioral intervention) as they relate to individuals diagnosed with autism spectrum disorder (ASD) and have implemented behavioral intervention in clinical settings for individuals diagnosed with ASD. In this paper, we discuss some of the pivotal contributions in the field of ABA in research and clinical practice. Additionally, we provide recommendations for the science and clinical practice of behavioral intervention in the next 40 years.

A Preliminary Evaluation of Interrater Reliability and Concurrent Validity of Open-Ended Indirect Assessment

Indirect assessments are a commonly used component of functional behavior assessment by behavior analysts in practice who work with individuals with severe behavior disorders. Although used frequently, closed-ended indirect assessments have repeatedly been shown to have low to moderate interrater reliability and poor concurrent validity with functional analysis. Recently, the use of open-ended interviews has become more commonly adopted in applied clinical practice, despite no studies evaluating the psychometric properties of such assessments. In the present study, we evaluated the interrater reliability and concurrent validity of an open-ended functional assessment interview. We compared the results of two open-ended indirect assessments conducted with a common caregiver and subsequently conducted functional analyses in an attempt to validate hypotheses generated from the interviews. Interrater agreement for the open-ended interviews was higher than previous research on closed-ended interviews (75%); however, concurrent validity with functional analysis was relatively poor (50%). We discuss these findings in the context of assessment and treatment for severe behavior disorders, as well as best practice methods during functional behavior assessment.

Interview-Informed Synthesized Contingency Analysis (IISCA): Novel Interpretations and Future Directions

The functional analysis (FA) methodology was developed to provide an empirical basis for understanding the reinforcers contributing to the maintenance of problem behavior. Previous research has demonstrated that multiple formats have been established to address some areas, such as practicality, efficiency, and safety. We reviewed the research on a new replication and extension of the standard FA format, the interview-informed synthesized contingency analysis (IISCA) and its subsequent treatment. We discuss the efficiency and effectiveness of the IISCA across various populations, settings, topographies of problem behaviors, and maintaining functions across 17 studies. Common treatment trends, novel developments, and other critical intervention components are also reviewed. We provide suggestions for future directions and guidelines for practitioners when considering the use of the IISCA.

Agreement Between Structured Descriptive Assessments and Functional Analyses Conducted Over a Telehealth System

This study examined whether experimental functional analyses (FAs) conducted by parents at home with coaching via telehealth would produce differentiated results, and compared these results to the functions identified from structured descriptive assessments (SDAs) also conducted by parents at home via telehealth. Four boys between the ages of 4- and 8-years old with intellectual and developmental disabilities and their parents participated. All assessments were conducted in the children's homes with their parents serving as intervention agents and with coaching from remote behavior therapists using videoconferencing technology. Parent-implemented FAs produced differentiated results for all 4 children in the study. Overall, analyzing antecedent-behavior (A-B) and behavior-consequence (B-C) relations from the SDA videos identified only half of the functions identified by the FAs. For children whose SDA results were differentiated, analyzing A-B relations correctly identified 4 of 5 functions. Analyzing B-C relations correctly identified 5 of 6 functions identified by the experimental FA, but overidentified attention for all children. Implications for conducting functional analyses and interpreting structured descriptive assessment via telehealth are discussed.

A translational evaluation of potential iatrogenic effects of single and combined contingencies during functional analysis

Recent research suggests that combining putative reinforcers for problem behavior into a single, synthesized contingency may increase efficiency in identifying behavioral function relative to traditional functional analysis (FA). Other research suggests potential shortcomings of synthesized contingency analysis (SCA), such as the potential for false-positive outcomes. In prior comparisons of traditional FAs and SCAs, investigators could not ascertain with certainty the true function(s) of the participants' problem behavior for use as the criterion variable. We conducted a translational study to circumvent this limitation by training a specific function for a surrogate destructive behavior prior to conducting a traditional FA and SCA. The traditional FA correctly identified the previously established function of the target response in all six cases and produced no iatrogenic effects. The SCA produced differentiated results in all cases and iatrogenic effects (i.e., an additional function) in three of six cases. We discuss these findings in terms of the mechanisms that may promote iatrogenic effects.

The Big Four: Functional Assessment Research Informs Preventative Behavior Analysis

Current practice guidelines suggest that the assessment and treatment of challenging behavior should consist of conducting a functional behavior assessment following the onset of problem behavior. This assessment process can include indirect and direct assessment, as well as manipulation of variables to determine function. The purpose of this article is to outline a proposal that would add prevention practices to early intervention guidelines for problem behavior. Based on decades of research, the suggestion is to proactively teach children at risk for problem behavior to navigate four of the most common conditions that have been demonstrated to occasion problem behavior. Prevention is made a possibility because a large body of research examining the conditions under which challenging behavior occurs has been reliably replicated. Preventative approaches are an emerging phenomenon and reflect a progression in the practice of behavior analysis. Prevention may lead to acquisition of prosocial behavior before problems arise, to expedited and enhanced treatment, to increased access to favorable learning environments, and, we hope, to improvement in the quality of life for many children at risk for the development of problem behavior.

Evaluating the boundaries of analytic efficiency and control: A consecutive controlled case series of 26 functional analyses

We conducted this study to determine if the efficiency of the functional analysis could be improved without detrimental effects on control. In Experiment 1, we reanalyzed functional analyses conducted for the problem behavior of 18 children. We analyzed rates of problem behavior during the first 5 min and first 3 min of the original 10-min sessions and evaluated if changes in the level of control over problem behavior by the programmed contingency were evident from the analyses of shorter session duration. In Experiment 2, we conducted 8 consecutive functional analyses with 3-min sessions to further evaluate the utility of brief session durations. We found that control over problem behavior was demonstrated when conducting functional analyses with sessions as brief as 3 min.

The Future of Verbal Behavior: Together Is Better

Prior editorials have addressed the question "Where do we go from here?" This is a reasonable query as an incoming editorial team considers new perspectives and initiatives that may further benefit the journal. I will address two important highlights of the revised mission statement of The Analysis of Verbal Behavior aimed at actively encouraging diversity of thought in publications and focusing on narrowing the gap between applied research and practice.

Reliability and Validity of Indirect Assessment Outcomes: Experts versus Caregivers

Clinicians often conduct indirect assessments (IAs; e.g., Durand & Crimmins, 1988; Iwata, DeLeon, & Roscoe, 2013; Matson & Vollmer, 1995) such as questionnaires and interviews with caregivers to gain information about the variables influencing problem behavior. However, researchers have found poor reliability and validity of IAs with respect to determining functional variables. There are numerous variables that might influence the efficacy of IAs as an assessment tool, one of which is the skill set of the person completing the IA. For example, it may be possible to increase the validity and reliability of IAs by having individuals with certain skill sets such as a background in behavior analysis and FBA ("experts") complete them. Thus, the purpose of this study was to compare the reliability (i.e., agreement with respect to function and specific IA questions) and validity (i.e., agreement between the outcome of IAs and a functional analysis) of IAs completed by caregivers and "experts" for each of eight children who emitted problem behavior. We found that experts were more likely than caregivers to agree on IA outcomes with respect to (a) overall interrater agreement, (b) item-by-item agreement, and (c) the highest-rated function(s) of problem behavior. Experts were also more likely to correctly identify the function(s), based on comparisons of the results of the IAs and FAs. In addition, caregivers were more likely to (a) disagree on hypothesized functions and (b) identify multiple incorrect functions. The use of experts for completing IAs could have significant impact on their utility and provide a novel method for more rapidly completing the FBA process and developing a function-based treatment.