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.

Prioritizing choice and assent in the assessment and treatment of food selectivity.

Food selectivity affects up to 72% and 45% of individuals with and without disabilities, respectively, and there is a need for interventions that rely on positive, unrestrictive strategies. We evaluated an assessment and treatment package for food selectivity for young children with developmental disabilities that prioritized caregiver collaboration, client autonomy, and did not rely on restrictive procedures (e.g. escape extinction). The process involved: (a) collaborating with caregivers on the selection of foods and design of the children's functional analyses; (b) indirectly and directly measuring food preferences prior to treatment; (c) evaluating the sensitivity of mealtime problem behavior to environmental variables through an interview-informed synthesized contingency analysis (IISCA); and (c) incorporating the assessment results into a progressive treatment process consisting of choice-making opportunities and differential reinforcement of successive approximations to consumption. Children also had the ability to opt in and out of treatment sessions. The treatment was effective in increasing consumption of nonpreferred foods and successfully extended to caregivers. Practical implications and directions for future research are discussed.

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.

Minimizing Escalation by Treating Dangerous Problem Behavior Within an Enhanced Choice Model.

To address dangerous problem behavior exhibited by children while explicitly avoiding physical management procedures, we systematically replicated and extended the skill-based treatment procedures described by Hanley, Jin, Vanselow, and Hanratty (2014) by incorporating an enhanced choice model with three children in an outpatient clinic and two in a specialized public school. In this model, several tactics were simultaneously added to the skill-based treatment package to minimize escalation to dangerous behavior, the most notable of which involved offering children multiple choice-making opportunities, including the ongoing options to (a) participate in treatment involving differential reinforcement, (b) "hang out" with noncontingent access to putative reinforcers, or (c) leave the therapeutic space altogether. Children overwhelmingly chose to participate in treatment, which resulted in the elimination of problem behavior and the acquisition and maintenance of adaptive skills during lengthy, challenging periods of nonreinforcement. Implications for the safe implementation of socially valid treatments for problem behavior are discussed.

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.

Toward trauma-informed applications of behavior analysis.

Despite a growing acknowledgement of the importance of understanding the impacts of trauma on therapeutic approaches across human service disciplines, discussions of trauma have been relatively infrequent in the behavior analytic literature. In this paper, we delineate some of the barriers to discussing and investigating trauma in applied behavior analysis (ABA) and describe how the core commitments of trauma-informed care could be applied to behavior analysis. We then provide some examples of how trauma-informed care might be incorporated into ABA practice. We conclude by suggesting opportunities to approach trauma as a viable avenue for behavior analytic research and argue that omitting trauma-informed care from ABA could be detrimental not only to the public perception of ABA, but to the effectiveness of our assessment and treatment procedures.

Understanding the effects of prompting immediately after problem behavior occurs during functional communication training.

When reported, the methods for prompting functional communication responses (FCRs) following problem behavior during functional communication training (FCT) vary. Some researchers have prompted the FCR immediately following problem behavior but doing so may inadvertently strengthen problem behavior as the first link in an undesirable response chain. This study investigated the effects of prompting FCRs following problem behavior during FCT with 4 children who exhibited severe problem behavior. Problem behavior remained low and FCR rates were near optimal when prompts were delivered immediately following problem behavior for 2 participants. Delaying prompts following problem behavior was instrumental for FCR acquisition for 1 participant but led to escalation of problem behavior for a 2nd participant. The conditions under which immediate prompts following problem behavior may improve or worsen FCT are discussed.

On the generality of preference for contingent reinforcement.

Reinforcers can be delivered dependent on or independent of responding. Both human and nonhuman animals have shown a preference for contexts involving contingent reinforcement, but the generality of this phenomenon to humans and its implications have not yet been described. We present an integrative summary of studies evaluating preference for contingent versus noncontingent reinforcement, including (a) study participants, reinforcer types, response topographies, and contexts; (b) outcomes; (c) potential variables influencing preference outcomes; and (d) suggestions regarding research to expand behavior analysts' ability to design preferred contexts.

An Evaluation of "Balance": a Home-Based, Parent-Implemented Program Addressing Emerging Problem Behavior.

Programs that prevent the development of severe problem behavior in young children with autism spectrum disorder (ASD) are critically needed. We describe a program designed to do this, and we report on a preliminary evaluation of its effects with four 3- and 4-year-old children with ASD. Parents served as the primary implementers, with twice-weekly coaching from a Board Certified Behavior Analyst. Direct measures and Aberrant Behavior Checklist scores reflected decreases in emerging problem behavior. Direct measures also reflected increases in child communication, social, and cooperation skills, and parents rated the process as highly acceptable. A randomized controlled trial will be required to evaluate the extent to which the program prevents the development of problem behavior in young children with ASD. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40617-020-00490-3.

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.

A preference analysis of reinforcer variation and choice.

Reinforcement procedures are the cornerstone of behavioral interventions. Previous research has focused on manipulating parameters of reinforcement including quality, magnitude, and rate. In this study, we sought to better understand ways to implement reinforcer choice and variation, and to assess preference for these parameters. Across 10 participants with and without disabilities, we assessed preference for varied reinforcement conditions, as well as choice of reinforcers in a concurrent-chains arrangement. Most participants preferred varied reinforcement conditions and subsequently, choice of reinforcers, over a previously preferred varied reinforcement condition. Implications for reinforcement arrangement in teaching situations are discussed.

Functional communication training: From efficacy to effectiveness.

Functional communication training (FCT; Carr & Durand, 1985) is a common function-based treatment in which an alternative form of communication is taught to reduce problem behavior. FCT has been shown to result in substantial reductions of a variety of topographically and functionally different types of problem behavior in children and adults (efficacy). The extent to which these reductions maintain in relevant contexts and result in meaningful changes in the lives of those impacted (effectiveness) is the focus of this paper. This review evaluates the degree to which FCT has been established as an evidence-based practice in psychology (EBPP) according to the definition set out by the American Psychological Association's 2005 Presidential Task Force on Evidence-Based Practice. Our review finds overwhelming evidence in support of FCT as an efficacious treatment but highlights significant limitations in support of its effectiveness. In order to also be recognized as an EBPP, future research on FCT will need to focus more closely on issues related to home, school, and community application, feasibility, consumer satisfaction, and more general and global changes for the individual.

Mand compliance as a contingency controlling problem behavior: A systematic review.

Bowman et al. (1997) described a dynamic contingency in which severe problem behavior was evoked by adult noncompliance with a variety of child mands, which occurred at high rates, and was reinforced by adult compliance with subsequent mands. They discovered this phenomenon with 2 children for whom standard functional analyses were inconclusive. In recent years, similar contingencies have been shown to influence problem behavior, but the manner in which they have been arranged and described has varied across studies. The purpose of this literature review is to (a) describe contingencies involving mand compliance and the circumstances under which they have been evaluated, (b) summarize procedural variations in analysis and treatment, and (c) discuss what is known and yet to be discovered about the contingency as it relates to problem behavior. Future research focused on improving technology for analyzing and treating problem behavior suspected to be sensitive to mand compliance is discussed.

Does teaching an omnibus mand preclude the development of specifying mands?

When problem behavior is controlled by a synthesized reinforcement contingency, a simple omnibus mand that yields access to all reinforcers simultaneously has been shown to effectively replace problem behavior. The question arises as to whether teaching an omnibus mand will preclude the acquisition of specifying mands for each of the combined reinforcers. In this study, after 3 students diagnosed with autism acquired an omnibus mand ("My way, please") that yielded all identified reinforcers simultaneously, specifying mands (e.g., "All done," "May I have my toys?" "Play with me") were taught to yield each individual reinforcer (e.g., escape, tangibles, attention). Problem behavior was immediately eliminated for all children, and the omnibus mand was acquired quickly. Teaching an omnibus mand did not preclude acquisition of specifying mands for any learner and instead allowed for the acquisition of specifying mands once problem behavior had been effectively reduced.

On the Standardization of the Functional Analysis.

The functional analysis procedures described in the seminal Iwata et al. (1982/1994) study are prominent in the applied behavior analytic literature, having been replicated hundreds of times over the past 30 years (Beavers, Iwata, & Lerman, 2013; Hanley, McCord, Iwata, 2003). However, the extent to which particular components of this functional analysis model have become more or less prominent over time is not clear from these literature reviews. We therefore conducted a review of the functional analysis literature between the years of 1965 and 2016 to determine the trends in the usage of particular components over time and to determine if the published literature reflects a standardization of the manner in which functional analyses of problem behavior are conducted. Furthermore, we discuss whether or not this standardization of a functional analysis model is currently necessary.

Toward accurate inferences of response class membership.

In their review of synthesis within the functional analysis (FA) literature, Slaton and Hanley (2018) reported that most synthesized contingency analyses have included multiple topographies of problem behavior in the reinforcement contingency class. This leaves the question of whether one, some, or all forms of problem behavior are sensitive to the synthesized reinforcement contingencies in published analyses. To address this ambiguity, all topographies of problem behavior that were reported by caregivers to co-occur with the most concerning problem behavior were analyzed for 10 participants. We implemented extinction across one or more forms of problem behavior to determine whether all forms reported to co-occur were sensitive to the same synthesized reinforcement contingency. For nine of 10 participants, the most concerning topographies were sensitive to the same synthesized reinforcement contingencies as the less concerning topographies (results were inconclusive for one). Implications for inferring response class membership from single analyses are discussed.

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.

Nature and scope of synthesis in functional analysis and treatment of problem behavior.

Functional analysis (FA) of problem behavior typically includes the contingent delivery of a single reinforcer following problem behavior. However, the FA literature also includes examples of analyses that have delivered multiple reinforcers, arranged multiple establishing operations in one or more test conditions, or both. These analyses have been successfully applied under heterogeneous conditions over several decades and with various synthesized establishing operations and reinforcers, but their qualitative details, outcomes, and contributions to the literature have never been described in a comprehensive manner. The purpose of the current review is to: (a) identify articles that have reported the use of synthesized FAs or treatments; (b) describe the nature and scope of synthesis as it has been applied in the FA literature; (c) analyze outcomes of synthesized FAs and treatments to determine general benefits and disadvantages of synthesis; and (d) offer recommendations for future areas of research.

Shaping complex functional communication responses.

Response efficiency plays an important role in the initial success of functional communication training (FCT). Although low-effort functional communication responses (FCRs) have been shown to be most effective in replacing problem behavior; more developmentally advanced FCRs are favored later in the treatment process. Attempts to teach these more complex FCRs, however, often lead to the resurgence of problem behavior. In this study, we provide a detailed description of an effective shaping process applied within a changing criterion design to develop complex FCRs from simple FCRs without resurgence of problem behavior. Four children with various language and intellectual abilities participated in this study. A practical shaping procedure, suitable for typical teaching contexts, is described for two participants in Experiment 1. The necessity and efficacy of the shaping process are demonstrated with the participants in Experiment 2. Implications for practice and research are discussed.

Interview-informed functional analyses: A comparison of synthesized and isolated components.

Hanley, Jin, Vanselow, and Hanratty (2014) described a functional analysis (FA) format that relied on a synthesis of multiple contingencies described by caregivers during open-ended interviews. These interview-informed synthesized contingency analyses (IISCA) provided effective baselines from which to develop socially validated treatments, but the synthesis precluded a precise understanding of individual contingencies influencing problem behavior. We conducted IISCAs and standard FAs (Iwata, Dorsey, Slifer, Bauman, & Richman, 1982/1994) for nine children with autism to evaluate the likelihood of differentiation given a number of synthesized versus isolated variables. The IISCA was differentiated for all. The standard FA was differentiated for four; this number increased to six when we included precursors in the standard FA. We then compared treatments based on sets of differentiated analyses for four children. Treatment based on the IISCA was effective for all four; treatments based on the standard FA were effective for two. The role of synthesis in analysis is discussed.