Teacher-Conducted, Latency-Based Functional Analysis as Basis for Individualized Levels System in a Classroom Setting

Exploring factors that influence the efficacy of functional communication training

Understanding factors that influence the efficacy of functional communication training has both practical and conceptual benefits. The current study extended research in this area by exploring data from 95 consecutive applications of functional communication training with extinction across two independent clinics. We selected candidate predictor variables based on conceptual analysis, conducted preliminary exploratory analyses, and then selectively applied quantitative methods that are used in precision medicine to examine their accuracy and predictive utility. Treatment outcomes were better when challenging behavior was maintained by a single function than they were when it was maintained by multiple functions; however, these differences were most apparent among cases with an escape function. We also analyzed within-session responding to explore the potential influence of unprogrammed establishing operations on decrements in treatment efficacy. Our within-session measure only distinguished responders from nonresponders when escape was one of the multiple functions. Additional research is needed to validate these findings with an independent sample and to address a number of clinical conceptual issues.

Telehealth replication of the trial-based ongoing visual-inspection criteria

Trial-based functional analyses are valid assessments for identifying functions of problem behavior; however, there is little guidance in the literature on interpreting the resultant data from such assessments. The current study sought to extend Standish, Bailey, et al. (2021) by incorporating their trial-based ongoing visual-inspection criteria into a formative assessment process during a telehealth-based consultation for parents seeking treatment for their child's problem behavior. The results showed that parent-implemented trial-based functional analyses guided by the trial-based ongoing visual-inspection criteria resulted in an efficient assessment-to-intervention progression and that the treatments were both effective and socially valid.

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.

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.

Evaluation of an Individualized Levels System to Increase Consumption for an Adolescent with Food Refusal

A levels system is an intervention that uses a combination of behavioral principles, such as differential reinforcement and response cost, in order to increase appropriate behaviors and simultaneously decrease problem behaviors. Within a levels system, an individual must meet a pre-determined behavioral criterion in order to gain access to various levels of reinforcement. For example, engaging in higher rates of inappropriate behavior will result in access to highly preferred items or activities, while higher rates of inappropriate behavior will access to lesser preferred activities. Although levels systems have been applied in group settings, as well as in the individual treatment of severe problem behavior, their use has not been explored in the treatment of food refusal. The current study implemented a levels system to target increasing the variety and volume of food consumed by a 12-year-old female diagnosed with fetal alcohol spectrum disorder (FASD) effects, mild intellectual disability, and attention-deficit/hyperactivity disorder (ADHD). At the end of her admission, the participant had increased her variety consumed at an age-appropriate volume significantly, as well as the volume of food consumed.

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.

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.

Functional Communication Training and Most-To-Least Prompting as Treatments for Problem Behavior

Functional communication training (FCT) is a treatment for problem behavior in which the learner is taught a communicative behavior that fulfills the same function as the problem behavior. Although effective, when FCT is used to request breaks from work, limitations include increased time spent in breaks and reduced task-related responding. An alternative treatment is most-to-least prompting (MTL) of a task in which a therapist provides the most helpful prompts for task-related responding (e.g., physical guidance) and gradually reduces the amount of help (e.g., visual prompt and then verbal) until the learner responds independently. We evaluated FCT and MTL in a multiple treatments design with an 11-year-old girl with severe developmental disabilities. Both treatments reduced problem behavior from baseline levels, and academic responding was greater during MTL than during FCT. MTL is an errorless teaching approach conceptualized as an abolishing operation that reduces the aversiveness of a task and makes escape less valuable.

A Call for Discussion About Scope of Competence in Behavior Analysis

The field of behavior analysis has defined its scope of practice through credentialing and licensure efforts. However, scope of competence in behavior analysis has received little discussion. Scope of competence refers to activities that the individual practitioner can perform at a certain criterion level (e.g., the functional analysis is conducted accurately and safely, a skill acquisition program includes critical program components and establishes accurate stimulus control). Given the successful efforts of behavior analysts in growth and recognition of the field, it is time for a robust conversation about scope of competence for the field of behavior analysis. This discussion can clarify how behavior analysts self-evaluate their own scope of competence and how they might expand their scope of competence if the needs of consumers require practitioners to expand into new areas.

Individualized Levels System and Systematic Stimulus Pairing to Reduce Multiply Controlled Aggression of a Child With Autism Spectrum Disorder

Research has shown that physical aggression is common in individuals with autism spectrum disorder (ASD). Interventions for multiply controlled aggression may be complex and difficult to implement with fidelity. As a result, the probability of treatment efficacy for this class of behavior may suffer. We designed an individualized levels system to reduce the physical aggression of an 11-year-old female with ASD. We then employed a systematic stimulus pairing procedure to facilitate generalization. Results suggest individualized levels systems can suppress multiply controlled aggression and that systematic stimulus pairing is an effective way to transfer treatment effects from trained therapists to caregivers.