On the validity of data produced by isolated and synthesized contingencies during the functional analysis of problem behavior

Retrospective consecutive controlled case series of outcomes for functional analyses of severe destructive behavior

Functional analysis methods allow clinicians to determine the variable(s) that maintain destructive behavior. Previous reviews of functional analysis outcomes have included large samples of published and unpublished data sets (i.e., clinical samples). The purpose of this review was to conduct a large retrospective consecutive controlled case series of clinical functional analyses. We sought to identify the prevalence of differentiation, procedural modifications for undifferentiated and differentiated cases, and identified function(s) of destructive behavior. In addition, we extended the existing literature by determining whether functional analysis differentiation and function varied when single or multiple behavior topographies were consequated in the functional analysis. We discuss our findings considering previously published functional analysis reviews, provide avenues for future research, and offer suggestions for clinical practice.

Long-term effectiveness and generality of practical functional assessment and skill-based treatment

There are several considerations to address when conducting functional communication training for challenging behavior in a school setting, such as the need for schedule thinning and maintenance across staff and the need to establish a variety of appropriate classroom skills. There are several strategies for conducting schedule thinning following functional communication training and for transferring effects across people or settings. However, there are few examples of these processes in natural settings with relevant caregivers and with long-term maintenance of effects. We implemented a functional assessment and skill-based treatment process with six children with autism in a specialized school setting and extended treatment until challenging behavior was reduced to near-zero levels across multiple staff and settings. Follow-up data indicate that effects were still observed 1 year posttreatment and the use of crisis procedures (e.g., physical restraint) was eliminated for all participants.

A Discussion of Positive Behavior Support and Applied Behavior Analysis in the Context of Autism Spectrum Disorder in the UK and Ireland

This article addresses the relationship between applied behavior analysis (ABA) and the emergence of positive behavior support (PBS) in context of autism spectrum disorder (ASD) in the UK and Ireland. Two overarching issues that are salient in this discussion are professional training and certification. To date, there has been a lack of standardized training or statutory requirements to practice PBS despite proponents insisting that its practice should be grounded in behavior analytic principles. Furthermore, there is an undercurrent of anti-ABA bias fueled by misinterpretation and unsubstantiated anecdotal claims used to promote an alternative "value based" approach to managing 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.

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.

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.

Multiple Isolated Functions of Problematic Behavior: A Case Study

Multiple isolated functions of problematic behavior are distinct from synthesized functions. Limited research has focused on the considerations of assessing and treating multiple isolated functions of problematic behavior. This case study utilized traditional functional analysis procedures to identify the functions of the targeted problematic behavior and a multiple baseline across functional contexts design to evaluate a function-based treatment. The nuances of assessing and treating multiple isolated functions are discussed.

Evaluating Preference for Functional and Nonfunctional Stimuli in the Treatment of Destructive Behavior

The effects of including nonfunctional stimuli that may appear in the natural environment during treatment remain unclear. The current study evaluated preference for differential reinforcement of communication (DRC) treatments with functional reinforcers only and a combination of functional and nonfunctional stimuli. Both treatment conditions resulted in a decrease in destructive behavior and an increase in the communication response for all participants. Two participants preferred the combined DRC condition, whereas one participant showed equal preference for the combined condition and one of the functional conditions.

Functional analysis of problem behavior: A 40-year review

Extensive reviews of functional analysis literature were conducted 10 (Beavers et al., 2013) and 20 (Hanley et al., 2003) years ago; we expanded this review to capture the vast and innovative functional analysis research that has occurred over the past decade. Our review produced 1,333 functional analysis outcomes from 326 studies on the functional analysis of problem behavior between June 2012 and May 2022. Some characteristics of functional analysis studies were similar across the current and previous two reviews (e.g., child participants, developmental disability diagnosis, use of line graphs depicting session means, differentiated response outcomes). Other characteristics deviated from the previous two reviews (e.g., increase in autistic representation, outpatient settings, use of supplementary assessments, the inclusion of tangible conditions, and multiple function outcomes; decrease in session durations). We update previously reported participant and methodological characteristics, summarize outcomes, comment on recent trends, and propose future directions in the functional analysis literature.

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.

The impact of criminal law regulation-based business environment optimization on entrepreneurial spirit and enterprise development

The purpose is to explore the impact of the business environment optimization by Criminal Law Regulation (CLR) on Entrepreneurial Spirit (ES) and Enterprise Development (ED) and to provide a reference for subsequent related research. Based on this, this work first makes a detailed analysis of the business environment and CLR. Second, the research hypotheses are put forward, and the conceptual model is proposed. At the same time, a Questionnaire Survey (QS) is designed to analyze the business environment, ES, and ED, and their relationships. Finally, a Structural Equation Model (SEM) is constructed and the CLR-optimized business environment is used as the intermediary variable to explore the impact of the business environment on ES and ED. Then, 200 QSs (recovering 192 valid ones) are distributed to investigate entrepreneurs' attitudes toward ES and ED in different regions. Statistical analysis and independent t-tests are performed on the survey results to judge the relationship between variables. The results of empirical analysis show that (1) The significance coefficient P of ES and ED is 0.005 < 0.01, and the scores of ES and ED of large enterprises are 132.7864 and 142.3243, respectively, which are the highest. Therefore, CLR-optimized business regulation has a significant positive impact on the ED. (2) The influence coefficient of CLR-optimized business regulation and ES is 0.60, and the influence coefficient of CLR-optimized business regulation and ED is 0.75. Therefore, CLR-optimized business regulation plays a positive role in the development of ES. CLR-optimized business regulation plays a regulating role between ES and ED. (3) CLR-optimized business regulation has a significant positive impact on the formation of ES. The policy enlightenment of this work mainly has three points. First, optimizing the business environment can stimulate and protect ES, thus improving the quality of economic growth. All regions should promote “mass entrepreneurship and innovation” and high-quality economic development by improving the convergence of economic policies and building a legal and market-oriented business environment. Second, all regions should implement dynamic and differentiated policies to optimize the business environment's spatial pattern in Chinese cities. Third, there is a need to further strengthen the construction of new infrastructure through cutting-edge information technologies, such as Fifth Generation (5G) mobile communication, Big Data, and Artificial Intelligence (AI).

Description and evaluation of a function-informed and mechanisms-based framework for treating challenging behavior

Individualization and iterative design are essential components of the assessment and treatment of challenging behavior. Currently, there are few validated frameworks for engaging in iterative processes. Due to the nature of single-case design, empirically rigorous evaluations of decision-tree processes are particularly prohibitive. Notwithstanding, evaluations are needed. In this paper we first describe a function-informed and mechanisms-based (FIMB) framework for selecting treatment components employed by a university-based practicum experience designed to expose pre-service practitioners to a valid treatment process for challenging behavior. Then, we share a completed retrospective consecutive case series across a 6-year period in which we conducted a technique analysis to identify which procedures were most commonly selected in the practicum, and the impact of those choices on client outcomes. The results suggest that the model can be highly effective for some, but not all, cases. Implications are discussed.

Further evaluation of functional analysis screening methods in early autism intervention

A goal of some functional analysis (FA) variations is to reduce assessment time while still maintaining efficacy. This may be especially important when conducting FAs in early intervention programs, where time is a crucial commodity. To that end, we evaluated a model for using the results of the no-interaction condition as a screening for behavioral function and to guide selection of FA test conditions with 20 participants (22 assessments) aged 3 to 7 years old. We used the no-interaction condition to develop hypotheses for both automatic reinforcement and socially mediated reinforcement. The outcome of the no-interaction condition guided the selection of test conditions for the remainder of the FA. We also incorporated methods from prior FA studies (e.g., divided attention) to modify the test conditions. We obtained differentiated results in 91% of assessments, all within 70 min and, as such, extended evidence that an FA can be completed in little time without sacrificing efficacy.

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 Reliability and Treatment Utility of the Practical Functional Assessment Process

Saini et al. (2019) urged caution with respect to the use of practical functional assessment (PFA) procedures to inform behavioral treatment when they found that responses to an open-ended caregiver interview were only somewhat reliable and showed moderate to weak correspondence with analog functional analyses. Because the practitioner's goal in conducting any functional assessment process is to inform the successful treatment of problem behavior, we replicated and extended Saini et al. by (a) evaluating the reliability of hypotheses gleaned from two independent PFA processes for each of four children, (b) conducting treatment informed by a randomly assigned PFA, and (c) determining the extent to which potentially different levels of reliability impacted the treatment utility of the PFA process. Results indicated that the reliability of the PFA process varied depending on the stringency with which it was evaluated. However, treatments developed from randomly determined PFA processes produced efficacious outcomes on problem behavior and targeted social skills that transferred to the context designed from the other PFA process in all evaluations, suggesting that the PFA has strong treatment utility despite parts of the process having ambiguous levels of reliability. We discuss implications for practitioners tasked with treating severe problem behavior.

Further comparison of isolated and synthesized contingencies in functional analyses

Recent research on functional analyses (FAs) has examined the extent to which problem behavior is maintained by single (isolated) or combined (synthesized) reinforcement contingencies. Outcomes of these analyses might differ depending on the sources of information that are used to inform contingencies included in test conditions. The purpose of the current study was to compare the outcomes of isolated FAs and synthesized contingency analyses (SCAs) with 3 participants. Conditions in both analyses were informed by interviews and both unstructured and structured observations. Problem behavior for all 3 participants was maintained by 1 or 2 isolated reinforcers. Results suggested false-positive SCA results for 2 participants. For 1 participant, a second isolated reinforcer was identified following the SCA, indicating the induction of a novel function. Implications for the use of isolated and synthesized consequences are discussed, as well as the predictive validity of the assessments that are used to inform them.

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.

Decreasing motor stereotypy with competing stimuli and tasks: Analysis of prompted engagement and response blocking

Competing stimulus assessments (CSAs) are used to empirically identify stimuli associated with low levels of problem behavior. For some individuals with automatically maintained behavior, it can be difficult to identify effective competing stimuli. Recent research shows that prompting engagement and response blocking can be employed during the CSA to obtain significant reductions in problem behavior. The purpose of the present study was to replicate and extend prior research on the use of these tactics not only with competing stimuli, but also competing tasks, which require the active completion of a discrete response or response sequence. In addition, the current study validated the results of these pretreatment assessments in an extended treatment analysis, and examined the isolated and combined effects of prompting and response blocking within a component analysis. Future research directions and implications for clinical practice are discussed.

Comparing paired-stimulus and multiple-stimulus concurrent-chains preference assessments: Consistency, correspondence, and efficiency

Concurrent-chains preference assessments have been used to assess preferences for leisure activities, teaching strategies, behavioral interventions, and other protracted events. This assessment model involves presenting an array of representative stimuli (e.g., pictures or colored cards), providing participants with an opportunity to select a representative stimulus from the array, arranging access to the associated activity, and then rank-ordering activities based upon their accumulated selection frequency across trials. The predominant model for presenting stimuli has been one in which all stimuli are presented in arrays simultaneously (i.e., a multiple-stimulus model). Activities selected repeatedly are identified as highly preferred and are then sequentially removed from the array to determine a preference hierarchy. The current study compared this approach with an alternative in which representative stimuli were presented to participants in paired arrays. Assessments conducted in the paired-array format were completed more rapidly than the multiple-stimulus format with a high degree of correspondence between preference rankings generated by both approaches.

Integration of experimental functional analysis procedural advancements: Progressing from brief to extended experimental analyses

Despite the utility of experimental functional analysis methodology, not all applications produce differentiated results. Factors such as interaction effects or methodological inefficiencies may compromise the likelihood of obtaining differentiated outcomes. Various studies have addressed methods to improve the efficiency of experimental functional analysis methodology (e.g., analysis of within-session responding). In the current study, we describe an updated model for progressing from brief to extended experimental analyses. The model incorporates several procedural refinements developed over the past 20+ years of experimental functional analysis research and additional conditions to confirm or annul findings. We present data for 20 participants who were referred for assessment and treatment of a variety of behavior problems (e.g., stereotypy, aggression, self-injury). We generally terminated the analyses when response patterns were consistent with established best-practice functional analysis methodology. Results showed conclusive interpretations were obtained for 100% of participants.