A Comparison of Methods for the Functional Assessment of Stereotypic Behavior

Three functional assessment methods were conducted with four adults with severe to profound mental retardation who exhibited stereotypic behavior. We compared the results of an informant assessment using the MAS, an A-B-C direct observation assessment, and a functional analysis in which variables were manipulated in four experimental conditions. The results of the A-B-C observations and the MAS indicated a sensory function of the stereotypic behavior for all subjects. The functional analysis results were more ambiguous, with a different pattern of results for each subject. These results are discussed with regard to the practicality and utility of each functional assessment procedure conducted in an applied setting.

The Relationship between Stereotypic Behavior and Peer Social Interaction for Children with Severe Disabilities

The purpose of this study was to examine the collateral relationship between engagement in social interaction with peers and the occurrence of stereotypic behavior for two children with severe disabilities. Peers without disabilities were taught to make social initiations to two children with autism and other severe disabilities who engaged in high rates of stereotypic behavior. When the peers made social initiations and the children with disabilities increased their engagement in social interaction, collateral decreases occurred in their stereotypic behavior. Within an ABAB design, the functional relationship between these variables was demonstrated. Implications of these findings for designing interventions for promoting social integration and their possible effects on stereotypic behavior are noted.

The Changing Character of Behavioral Assessment and Treatment: A Historical Introduction and Review of Functional Analysis Research

This paper presents a brief introduction to the historical development of functional analysis as an important pretreatment assessment and analysis strategy for treating academic and social behavior problems. Studies considered to be seminal or influential are reviewed to highlight the historical and contemporary refinement of functional analysis methodologies. Conclusions are presented in terms of functional analysis' conceptual and methodological impact on behavioral assessment and treatment, and its advancement into various human service sectors concerned with the care of individuals with special needs.

Classroom Intervention for Illness-Related Problem Behavior in Children With Developmental Disabilities

There is growing evidence of an association between physical illness and problem behavior in children with developmental disabilities. Such behavior can compromise school performance. Therefore, the purpose of the present study was to evaluate, using a group design, the effectiveness of medical intervention alone ( N = 11) versus behavioral plus medical intervention ( N = 10) for illness-related problem behavior in a school setting. Following intervention, the behavioral plus medical intervention group showed lower levels of problem behavior and completed more academic tasks than did the medical intervention alone group. The results are discussed with respect to the concept of illness and pain as a setting event for problem behavior. The need for research to develop algorithms that allow one to select the best combination of medical and behavioral interventions for specific illnesses and contexts is noted.

Evaluating function-based Social Stories™ with children with autism

Social Stories™ are often used with children with autism to provide information about appropriate behaviors in specific contexts. Although Social Stories™ often target reduction of problem behavior, there is limited research evaluating function-based Social Stories™ based on the results of experimental functional analyses. This study used a brief functional analysis to assist in developing a Social Story™ that matched the function of the target behavior for two boys with autism. The differential effects of a Social Story™ that matched the function of the behavior, a Social Story™ that did not match the function of the behavior, and a Social Story™ that described baseline were compared in an alternating treatments design. Results indicated that (a) the function-based Social Story™ plus functional communication training (FCT) was effective in decreasing target problem behavior and increasing target mands for both participants, (b) both participants selected the function-based Social Story™ during treatment preference evaluations, and (c) both participants maintained low levels of target problem behavior and maintained target mands when the Social Stories™ were removed.

Behavioral intervention for problem behavior in children with fragile X syndrome

Parents and professionals typically report problem behavior as a significant concern for children with fragile X syndrome. In the present study, the authors explored whether behaviorally based interventions would result in a reduction in problem behavior and an improvement in quality of life for 3 children with fragile X syndrome and their families. A multiple baseline design was used to demonstrate intervention effects for specific high-priority contexts (i.e., bedtime, running errands, and toileting). A multicomponent intervention plan was developed to teach the parents and child to effectively cope with the particular context. After intervention, there were substantial improvements in problem behavior and family quality of life within the given contexts. Results of this study demonstrated the effectiveness of behavioral intervention for children with fragile X syndrome.

Challenging Behaviours and Severe Learning Disabilities: Recent Developments in Behavioural Analysis and Intervention

Recent years have witnessed the gradual emergence of a technology of nonaversive behavioural support for people with severe learning disabilities and seriously challenging behaviours. Three key aspects of these developments are reviewed, including: the functional perspective to analysis and intervention; the incorporation of the analysis and modification of setting events into behavioural practice; and the use of experimental techniques to conduct functional analyses of the contextual control of challenging behaviours. Attention is drawn to the practical implications and limitations of these developments.

The development and factor structure of the Functional Assessment for multiple causaliTy (FACT)

Since behavioral intervention is linked to the findings of a functional assessment, the reality of behaviors maintained by multiple functions is a frequent and troublesome issue for clinicians and researchers. Current methods of functional assessment provide little help in the way of providing information useful for prioritizing intervention strategies for problematic behaviors maintained by multiple functions. In an effort to account for this deficiency, we developed the Functional Assessment for multiple CausaliTy (FACT). The FACT is an informant-based, forced-choice measure designed to identify the most prominent function associated with the occurrence of problem behaviors. In the present study, we describe the factor structure and internal consistency of the FACT. Suggestions are provided for future validation strategies.

Intensive positive behavior supports for adolescents with acquired brain injury: long-term outcomes in community settings

BACKGROUND

Based on the technologies of applied behavior analysis and person-centered planning, positive behavior support is a process for designing and implementing proactive behavioral interventions with the goal of positive lifestyle changes.

PARTICIPANTS

The two adolescents who received the intensive, longitudinal, multicomponent intervention had experienced escalating behavior challenges over several years after brain injury in early childhood.

MAIN OUTCOME MEASURES

Quantitative data included episodes of aggression and property destruction. Qualitative data included intensity of supports, family involvement, peer relationships, medication regime, vocational status, educational status, community access, and self-help skills.

RESEARCH DESIGN

A long-term, natural-environment, case-study method was used.

RESULTS

The targeted challenging behaviors were reduced to zero. In addition, the participants' domains of activity increased and self-management improved even as supports were systematically withdrawn.

CONCLUSIONS

These results illustrate the potential for successfully treating extreme chronic behavior disorders after childhood brain injury.

Functional communication training using assistive devices: recruiting natural communities of reinforcement

We evaluated the effectiveness of functional communication training (FCT) as an intervention for the problem behavior exhibited by 5 students with severe disabilities both in school and in the community. Following an assessment of the function of their problem behavior, the students were taught to use assistive communication devices in school to request the objects and activities that presumably were maintaining their behavior. Multiple baseline data collected across the students indicated that not only did the students use their devices successfully, but the intervention also reduced their problem behavior. In addition, data from community settings showed generalization to untrained community members. These results replicate other successful efforts to use FCT with individuals having limited communication skills, and demonstrate the value of teaching skills to recruit natural communities of reinforcement in order to generalize intervention effects to meaningful nontraining environments.

The Motivation Assessment Scale: reliability and construct validity across three topographies of behavior

The psychometric properties of the Motivation Assessment Scale (MAS) were examined. Specifically, reliability, internal consistency, and construct validity were estimated using 90 ratings of different problem behaviors among 86 individuals with mental retardation. Data were analyzed under conditions of (a) three topographies of problem behavior and (b) two methods of calculation. Although reliability and internal consistency were generally poor, the results depended upon the above conditions. Factor analysis revealed that the four factors of the MAS differed from the subscale structure obtained in this study, proposed by the authors of the MAS. Thus, the construct validity of this scale was ambiguous. It is concluded that the MAS should be employed in conjunction with other instruments to assess the functional characteristics of problem behavior with individuals who have mental retardation.

Preference, choice, and persons with disabilities: a synopsis of assessments, interventions, and future directions

A recent revolution in service delivery for persons with developmental disabilities encompasses increased client independence and improved quality of life. Specifically, care providers have focused on client expressions of preference, choice-making, and choice availability as key elements of study in this new revolution. We review and critique the primary methods of assessing preference and choice for persons with disabilities, including interviews and questionnaires, pictorial presentations, technological apparati, and direct observation. We also provide an overview of the burgeoning literature on intervention programs designed to enhance choice for this population, such as giving more choice to clients, teaching choice-making skills, and improving staff member skills regarding choice availability. Finally, we provide a synopsis of the future directions in this area that should receive the most attention from researchers and caregivers.

The form and function of challenging behaviours

Aspects of the topography and behavioural function underlying the challenging behaviours of all people with learning disabilities and challenging behaviour (n = 70) in a defined geographical area were investigated. Results indicated that: (1) more severe challenging behaviours were shown by people with more severe disabilities; (2) a significant minority (44%) of people showed more than one form of challenging behaviour, this rising to 79% among people with more severe challenging behaviours; and (3) cross-sectional analyses revealed specific clusters of problematic, aggressive and self-injurious behaviours. Analysis of information derived from the Motivation Assessment Scale (MAS) indicated that (5) the most common functions of challenging behaviours appeared to be 'self-stimulation' (for self-injury, destructiveness and 'other' challenging behaviours) and securing the attention of carers (for aggressive behaviours). However, (6) parametric analyses failed to identify any consistent relationships between the form and function of an individual's challenging behaviour for aggressive, destructiveness and 'other' challenging behaviours, but (7) clients with self-injurious behaviour were significantly more likely to score highly on the 'self-stimulation' sub-scale than other sub-scales of the MAS. Finally, (8) significant consistency of behavioural functions across different forms of challenging behaviours shown by the same individual were found for the two combinations of aggressive-destructive behaviours and self-injury-'other' behaviours.

Interrater reliability of the Motivation Assessment Scale: failure to replicate with aggressive behavior

The Motivation Assessment Scale (MAS) was used to identify the variables maintaining aggressive behaviors exhibited by 18 adolescents and adults with severe to profound intellectual disability. Each client was rated by two staff members. A variety of measures were calculated to assess interrater reliability. Pearson coefficients across the 18 pairs of raters ranged from -.667 to .722 with an overall correlation of .034. Five of the 12 positive correlations were significant at the .05 level. Correlations across each of the 16 questions of the MAS ranged from -.337 to .425. None of these correlations were significant. Similarly low reliability was obtained when percentage of agreement measures were calculated, although 8 of the 18 pairs of raters (44.44%) did agree on the source of reinforcement maintaining the client's aggressive behavior. These results suggest that for some individuals the MAS may not represent a viable alternative to more formal functional analysis procedures.

Assessing the functions of aberrant behaviors: a review of psychometric instruments

Reviewed the psychometric properties, treatment utility, and conceptual basis of psychometric instruments used to identify the functions of aberrant behaviors in people with developmental disabilities. The instruments reviewed are the Motivational Assessment Scale (Durand & Crimmins, 1992), the Motivation Analysis Rating Scale (Weisheler, Hanson, Chamberlain, & Thompson, 1985), the Functional Analysis Interview Form (O'Neill, Horner, Albin, Storey, & Sprague, 1990), and the Functional Analysis Checklist (Van Houten & Rolider, 1991). Recurrent problems in this area include the lack of replicability of the reliability of these instruments, difficulties in summarizing the information from these assessment devices, difficulties in translating the assessment into treatment packages, strong individual differences in the functions of behavior problems, and, finally, issues relating to the concurrent validity, both across these instruments and across other assessment methods.

Empirically derived consequences: a data-based method for prescribing treatments for destructive behavior

Behavioral treatments are often prescribed on the basis of a functional assessment. However, in a significant number of cases, functional assessment results are equivocal or suggest that internal stimuli are maintaining the behavior. In this investigation, we evaluated an alternative data-based assessment that may be useful in such cases. This assessment was used to identify reinforcers and punishers based on the reinforcement assessment procedure described by Pace, Ivancic, Edwards, Iwata, and Page (1985). We then assessed whether empirically derived reinforcers and punishers could be combined to treat the destructive behaviors of two clients. For both clients, the rates of destructive behavior decreased markedly. The results suggest that empirically derived consequences may be useful in decreasing destructive behavior when a functional assessment is inconclusive or is consistent with the hypothesis that the behavior is stereo-typic and maintained by internal stimuli.

The relationship between functional assessment and treatment selection for aggressive behaviors

Functional assessment seeks to elucidate the variables controlling a maladaptive behavior. Based on such an assessment, effective treatments can be designed that focus on replacing that maladaptive behavior with a functionally equivalent adaptive prosocial behavior. This technique has been promoted as an effective means of improving treatments by increasing the focus on skill development and reducing the use of aversive and restrictive procedures. The literature for the behavioral treatment of aggression for persons with mental retardation or developmental delays was examined from 1979 through 1990. During that period the use of functional assessment and skill training increased; however, the increased use of functional assessment did not result in the reduced use of intrusive procedures. Potential reasons for these results are discussed, and a call for an increased emphasis on functional assessment methodology is made.

Severe problem behaviors related to social interaction. 1: Attention seeking and social avoidance

Studies concerning the functional analysis of severe problem behaviors have suggested that it is important to identify the different categories of stimuli that control problem behavior because each has unique treatment implications. The present study explored the differential effects of adult attention on the severe problem behaviors of two groups of children with developmental disabilities. A third group of nonproblem children was examined for comparison purposes. Children participated in three experimental conditions in which the level of adult attention was manipulated: noncontingent high attention, noncontingent low attention, and contingent attention. Results validated the existence of two groups of children who differed as to their social orientation: (a) One group of children commonly initiated social interactions and was most likely to exhibit problem behaviors under conditions of low adult attention, and (b) the other group of children rarely initiated social interactions and exhibited frequent problem behaviors under conditions of high adult attention. Implications of these data for escape and attention theories of child problem behavior are discussed, as are the applied implications for reinforcer assessment and teaching strategies.

Factor structure of the Motivation Assessment Scale for persons with mental retardation

The rating scale used to assess the motivators of maladaptive behaviors in persons with mental retardation was the Motivation Assessment Scale. In the current study, we validated the factor structure of the scale on a sample of 118 subjects with predominately severe or profound mental retardation. They exhibited deviant behaviors such as self-injurious and tantrum behavior, aggression, and passivity. The results of the factor analysis with varimax rotation validated the assumptions of the developers of the scale that the motivators could be grouped into sensory, escape, attention, and tangible reinforcers. These four subscales are easily interpretable and should continue to provide valuable information.

Functional communication training to reduce challenging behavior: maintenance and application in new settings

We evaluated the initial effectiveness, maintenance, and transferability of the results of functional communication training as an intervention for the challenging behaviors exhibited by 3 students. Assessment indicated that escape from academic demands was involved in the maintenance of the challenging behaviors. Social attention was also implicated as controlling the behavior of 1 student. The intervention involved teaching alternative assistance-seeking and attention-getting phrases to the students in an effort to replace challenging behavior with these verbal equivalents. Multiple baseline data collected across the 3 students indicated that not only did the intervention substantially reduce challenging behavior but also that these results transferred across new tasks, environments, and teachers, and were generally maintained from 18 to 24 months following the introduction of functional communication training. These results are discussed in light of recent efforts to develop effective interventions for severe challenging behavior and to understand the processes underlying transfer and maintenance of intervention effects.

The effects of response efficiency on functionally equivalent competing behaviors

Three experiments addressed the role of response efficiency in the application of functional equivalence training. Functional equivalence training includes conducting a functional assessment of the problem behavior. Variables that predict and maintain the problem behavior are defined, and socially appropriate, functionally equivalent skills are identified and taught. The logic is that if the learner has a socially appropriate way to achieve the same function, he or she will be less likely to use problem behaviors. This study examined the role of response efficiency in functional equivalence training. Response efficiency was examined in terms of three variables: (a) physical effort, (b) schedule of reinforcement, and (c) the time delay between presentation of the discriminative stimulus and reinforcer delivery. Each of the three experiments involved a person who performed a set of problem behaviors and a functional assessment of the problem behaviors. A socially appropriate alternative response was taught, but this new response was less efficient than the problem behavior on one of the efficiency variables (effort, schedule, delay in time). The new behaviors did not compete successfully with the problem behaviors until a new, more efficient, alternative behavior was taught. These results are discussed in terms of our understanding of response covariation and the need in applied contexts to include response efficiency in any functional analysis assessment.

A component analysis of functional communication training across three topographies of severe behavior problems

We evaluated the separate treatment components of a functional communication training program for 3 severely handicapped persons who each displayed different topographies of aberrant behavior. Following a functional analysis of maintaining conditions for inappropriate behavior (self-injury, stereotypy, aggression), each participant was trained to emit a communicative response that functioned to solicit reinforcement. For 2 participants, consequences (time-out or graduated guidance) for inappropriate behavior were also included. Treatment continued until the participants emitted the communicative response independently and no occurrences of inappropriate behavior were observed for at least two sessions. Following treatment, the separate contributions of the treatment components for communicative responding and for inappropriate behavior were evaluated with a reversal design. The results indicated that both sets of treatment components were necessary for maximal control over aberrant behavior. These results are discussed in relation to the efficiency, history, and control over reinforcement of both appropriate and inappropriate responses.