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

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.

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.

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.