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Abstract

Functional analysis is the most precise method of identifying variables that maintain self-injurious behavior (SIB), and its use may lead to more effective treatment. One criticism and potential limitation of a functional analysis is that it may unnecessarily expose individuals to a higher risk of injury (Betz & Fisher, 2011). The purpose of this study was to determine if there were higher levels and severity of injury during the functional analysis than outside the functional analysis. We conducted a retrospective records review of 99 participants admitted to an inpatient unit for the treatment of SIB. The results showed that injury rates were relatively low across all situations and that when injuries occurred, they were usually not severe. These findings suggest that the functional analysis of SIB is relatively safe when appropriate precautions are taken.

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... Furthermore, modifications to standard FA methodology may need to be addressed to decrease harm, if it is determined that an FA is feasible (see below). However, it is important to consider that the reason an FA is considered is because the individual already regularly engages in the challenging behavior in their daily life and likely contacts contingencies that are programmed in an FA (Kahng et al., 2015). ...
... Determining whether the target individual will be at greater risk during the FA than they normally experience throughout a typical day presents an additional consideration of risk mentioned by Hanley (2012). Best practice in FA methodology involves various procedures (e.g., programming S d s to enhance discriminated responding, providing reinforcers on a continuous schedule, and providing consequences for lower intensity behavior or attempts at behavior; see additional information below) that are specifically included to produce lower levels of target challenging behavior as those observed in the everyday environment (Kahng et al., 2015). Thus, the occurrence of the target challenging behavior in an FA may not expose the individual or others to any greater risk of injury than what occurs outside of the FA. ...
... Thus, the occurrence of the target challenging behavior in an FA may not expose the individual or others to any greater risk of injury than what occurs outside of the FA. To empirically evaluate whether challenging behavior is more dangerous inside or outside of an FA, Kahng et al. (2015) reviewed records of 99 participants admitted for the assessment and treatment of SIB to determine the amount and severity of injuries sustained within versus outside of the FA context using a severity index scale (i.e., Self-Injury Trauma [SIT] Scale; Iwata, Pace, Kissel, et al., 1990). Results showed that although the rate of injury during the FA was relatively higher than outside of the FA, levels were low regardless of the context. ...
Chapter
Functional analysis (FA) methodology is a well-established standard for identifying the precise conditions that evoke and maintain problem behavior, thus leading to effective, function-based interventions (Beavers et al., 2013; Hanley et al., 2003; Hagopian et al., 2013). Although considered best practice, many behavior analysts report not conducting FAs prior to intervention due to implementation barriers including potential safety concerns and insufficient time (Oliver et al., 2015; Roscoe et al., 2015). Over the past two decades, a tremendous amount of research has been conducted to address these and other commonly reported barriers to FA implementation (e.g., JABA Special Issue on FA methodology, 2013, volume 46, issue 1). The outcomes of these studies suggest methodological refinements that offer a wide range of solutions to previously described barriers, resulting in an overall improved approach toward conducting FAs in practice. The purpose of this chapter is to provide an overview of FA methodology, review best practice considerations for designing and conducting FAs, provide recommendations for analyzing FA outcomes, and review procedural modifications that can be applied to address implementation challenges in various contexts and situations.
... However, this should not limit whether or not an FA is conducted. Kahng et al. (2015) reviewed records of 99 inpatients who engaged in SIB and found that conducting FAs on SIB was relatively safe when appropriate precautions were taken. It has been suggested by multiple researchers and clinicians that conducting an FA is best practice when determining the function of problem behavior including SIB (Hanley, Iwata, & McCord, 2003;Kahng et al., 2015, Vollmer et al., 2009). ...
... Kahng et al. (2015) reviewed records of 99 inpatients who engaged in SIB and found that conducting FAs on SIB was relatively safe when appropriate precautions were taken. It has been suggested by multiple researchers and clinicians that conducting an FA is best practice when determining the function of problem behavior including SIB (Hanley, Iwata, & McCord, 2003;Kahng et al., 2015, Vollmer et al., 2009). ...
... We suggest having predetermined session termination criteria in place throughout assessments and treatments. Kahng et al. (2015) conducted a review to examine injuries related to functional analysis of SIB as compared to other settings. They found that injuries were still relatively infrequent and were rarely severe. ...
Preprint
Self-Injurious Behavior in Children with Intellectual and Developmental Disabilities: Current Practices in Assessment and Treatment
... However, this should not limit whether or not an FA is conducted. Kahng et al. (2015) reviewed records of 99 inpatients who engaged in SIB and found that conducting FAs on SIB was relatively safe when appropriate precautions were taken. It has been suggested by multiple researchers and clinicians that conducting an FA is best practice when determining the function of problem behavior including SIB (Hanley, Iwata, & McCord, 2003;Kahng et al., 2015, Vollmer et al., 2009). ...
... Kahng et al. (2015) reviewed records of 99 inpatients who engaged in SIB and found that conducting FAs on SIB was relatively safe when appropriate precautions were taken. It has been suggested by multiple researchers and clinicians that conducting an FA is best practice when determining the function of problem behavior including SIB (Hanley, Iwata, & McCord, 2003;Kahng et al., 2015, Vollmer et al., 2009). ...
... We suggest having predetermined session termination criteria in place throughout assessments and treatments. Kahng et al. (2015) conducted a review to examine injuries related to functional analysis of SIB as compared to other settings. They found that injuries were still relatively infrequent and were rarely severe. ...
Chapter
Self-injurious behavior (SIB) is a behavior which produces physical injury to the individual’s own body. Common forms of SIB include, but are not limited to, head banging, biting, scratching, skin picking, hair pulling, pinching, and eye gouging. Among individuals with intellectual and developmental disabilities (IDD), there is a higher prevalence of SIB in children than in adults. Proper measurement (e.g., frequency and duration) and assessment (i.e., direct and indirect) of SIB are needed prior to starting treatment. In this chapter, we review the assessment and treatment procedures found to be effective in reducing and eliminating SIB in children with IDD.
... Although the standard functional analysis has proven useful in understanding the contingencies that contribute to problem behavior through numerous publications over the years, researchers have highlighted several critical issues and barriers in the use of the standard functional analysis in various clinical and socially relevant contexts. Many practitioners report not conducting functional analyses because of (a) lack of time, space, materials, assistance, training, administrative and/or family approval, insurance funding; (b) belief that functional analyses are unnecessary or are not useful; and (c) concerns over safety of children, clients, and caregivers (Hanley, 2012;Kahng et al., 2015;Oliver et al., 2015). Given these difficulties, the duration of the standard functional analysis and the strict procedures may not make it applicable in certain settings (Hanley, 2012;Scott et al., 2000). ...
... In addition to the use of variations in functional analysis methods we discussed before, there are other recommendations for reducing risk. For example, Kahng et al. (2015) ioral termination criteria to eliminate the possibility of dangerous levels of escalation, (b) using only highly trained personnel in the implementation of functional analysis, (c) ensuring that severe SIB is stopped promptly, and (d) provide staff with protective equipment. To predict and manage risk during functional analysis, Canniello et al. (2023) introduced additional questions to the open-ended IISCA interview that could be asked to identify participants who are prone to severe bursts of problem behavior. ...
... Despite the exceptional benefits of conducting the traditional FA and the strong evidence base supporting this approach, the traditional FA is not without limitations, and it is unlikely that a traditional FA can be used in every scenario (Dozier et al. 2023;Roscoe et al. 2015). For example, depending on the severity of the behavior, the risk of injury might be greater during an FA compared to an individual's natural environment (though injuries were found to be rare and minor in a study conducted in an inpatient unit; see Kahng et al. 2014). Further, clinicians might not have the time, space, or training necessary to conduct a traditional FA (e.g., Oliver, Pratt, and Normand 2015). ...
Article
Full-text available
Researchers have developed and evaluated procedural modifications to the functional analysis (FA) to improve its efficiency and safety while maintaining its precision. A contemporary FA modification is the interview‐informed synthesized contingency analysis (IISCA) or practical functional assessment (PFA). Nearly all of the extant dissemination efforts related to the IISCA/PFA support this approach, with little attention to its drawbacks and limitations. Further, the IISCA/PFA has been widely disseminated and seems to have been readily adopted by many clinicians as the nonpareil FA. However, researchers and clinicians should be aware of several lingering issues and considerations to have a more balanced understanding of the IISCA/PFA (e.g., the conditions under which this approach should be considered). Accordingly, we outline the strengths of the IISCA/PFA, considerations surrounding various factors (e.g., the dissemination tactics), ideas for future research, and how the discussion on this topic should move forward.
... Over the past 40 years, functional analysis research has largely, and importantly, focused on improvements related to efficacy (e.g., novel test conditions; Schlichenmeyer et al., 2013;efficiency (e.g., synthesized functional analysis; Fiani & Jessel, 2022;Hanley et al., 2014), practicality (e.g., latency-based functional analysis; Thomason-Sassi et al., 2011), and safety (e.g., Kahng et al., 2015). Reviews of functional analyses reveal refinements to methodology that have generated best-practice recommendations (Beavers et al., 2013;Hanley et al., 2003;Melanson & Fahmie 2023). ...
Article
Full-text available
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.
... Practitioners may also consider the segment on safety provided in Melanson and Fahmie (2023) as they also directly apply to adults. They include (a) a consideration of injuries in and out of the FA conditions (David et al., 2014;Kahng et al., 2015), (b) evaluating the potential for a precursor FA analysis (Fritz et al., 2013), and (c) finding ways to more objectively measure injuries to staff. ...
Article
Functional analysis (FA) methodology has been deemed the best practice in the field of applied behavior analysis. The data collected in an FA allows behavior analysts to develop the most effective and ethical behavior interventions. With the diagnosis for individuals with autism on the rise along with the forecast of adults who will need support, it may be time to take stock of the available literature. The purpose of this review was to evaluate the behavior analytic research over the last 25 years (1997–2022) on FA and treatment for adults who engage in severe problem behavior. Utilizing specific inclusion and exclusion criteria resulted in the identification of 28 articles. These articles were examined across participant characteristics, target behavior, FA type, FA settings, interventions, generalization, and maintenance. Implications on adult FA and treatment are discussed along with recommendations for practitioners who desire to support this population.
... Multiple recommendations for reducing risk during the functional analysis have been suggested in the research literature. For example, Kahng et al. (2015) advised clinicians to (a) establish a medical and behavioral termination criterion to eliminate escalation to dangerous levels, (b) incorporate only well-trained personnel implementing functional analysis procedures, (c) ensure the blocking of more severe self-injury, and (d) make protective equipment available to staff. Other recommendations include using brief session durations (Northup et al., 1991;Wallace & Iwata, 1999) and the targeting of less dangerous problem behavior that precedes any escalation (i.e., precursors) of which places the individuals and clinicians at risk of harm (e.g., Smith & Churchill, 2002;Warner et al., 2020). ...
Article
Maintaining participant safety during the assessment of problem behavior is of upmost importance. The performance-based, interview-informed synthesized contingency analysis (IISCA) is a functional analysis that incorporates an open-ended interview with caregivers. We introduced additional questions to the interview to identify participants who are prone to escalation. We found that the percentage of dangerous problem behavior and the probability of a burst were correlated with reports of quick escalation. The results suggest that questions regarding escalation speed may be helpful for predicting any safety concerns. Researchers should consider procedural modifications when safety concerns are anticipated to ensure individuals feel physically secure.
... Results showed relatively equal levels of responding at all points, suggesting that the child's experience in the functional analysis did not influence their overall level of problem behavior in their typical school setting. Kahng et al. (2015) analyzed data from 99 individuals referred to an inpatient unit for the treatment of SIB and compared injury reports occurring during vs. outside of the functional analysis. Their results showed that the total number of injuries was lower during the functional analysis (M = 0.8) compared with outside of the functional analysis (M = 1.9), but the rate of injury during the functional analysis (0.98 reports per hour) was considerably higher (.011 reports per hour). ...
Article
Full-text available
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.
... Da kan en av de nyere variantene i kombinasjon med bruk av forløpere til, eller tidlige tegn på, atferden vaere et bedre alternativ enn full klassisk EFA. Fordeler og ulemper ved EFA-metoder er drøftet i en rekke artikler (Arntzen, 2014;Beavers & Iwata, 2014;Kahng et al., 2015;Torve & Larsen, 2020). ...
Article
Full-text available
Funksjonelle analyser er et samlebegrep for forskjellige metoder for å kartlegge årsaker til atferd. Spørreundersøkelser fra USA har vist at klinikere i hovedsak bruker indirekte og deskriptive metoder. Målet med vår spørreundersøkelse var å finne hvilke metoder klinikere i Norge bruker forut for behandling av utfordrende atferd. 209 klinikere fra ti ulike Facebookgrupper eller sider gjennomførte et internettbasert spørreskjema. De ble spurt om faglig bakgrunn, sin kjennskap til funksjonelle analyser, hvilke metoder de bruker, og synspunkter på bruk av funksjonelle analyser. Resultatene viser at deskriptive analyser alene, eller kombinert med indirekte analyser, brukes mest. De viser også at klinikere mener at deskriptive analyser kombinert med indirekte, og eksperimentelle kombinert med deskriptive eller indirekte, gir best informasjon. Vi drøfter funnene i relasjon til funn fra tilsvarende undersøkelser. Nøkkelord. Funksjonelle analyser, klinikere, spørreundersøkelse, utfordrende atferd
... Although it may seem counterintuitive to conduct an assessment designed to evoke problem behavior, functional analyses are only conducted with individuals whose problem behavior is already occurring at levels that warrant assessment. In the first evaluation of the safety of functional analyses, Kahng et al. (2015) compared rates of injury and injury severity during and outside of functional analysis sessions with individuals with severe problem behavior admitted to an inpatient hospital. Results indicated that injuries were relatively infrequent in both contexts and that the rate of injury during functional analyses was only slightly higher than the rate of injury outside of functional analyses (0.098 vs. 0.011 injuries per hour, respectively). ...
... Therefore, individuals for whom we see high-risk behavior in the FA, an analog environment, are also engaging in high-risk behavior outside of the FA, in their daily natural settings. Notably, Kahng et al. (2015) compared the rates and severity of injuries during FA versus outside of an FA for individuals who were admitted to an inpatient hospital unit for severe problem behavior and found that the total number of injuries reported outside the FA were higher than during the FA. In addition, when injuries did occur, the severity of those injuries was similar outside and during the FA. ...
Chapter
A distinguishing feature between behavior analysis and behavior modification is the primacy of discovering and understanding variables that control behavior under natural conditions. Functional analysis (FA) refers to both the process for identifying the controlling variables or problem behavior and a methodology for experimentally examining these variables in a systematic manner. FAs are the most valid and scientifically rigorous method of functional assessment and have become the nonpareil assessment procedure for identifying the maintaining variable(s) of problem behavior. While the FA methodology described by Iwata et al (1982/1994) may represent a standard procedural approach, there are many modifications that clinicians can leverage within the FA to address concerns that may arise when attempting to assess and severe problem behavior. Ultimately, although the procedure of the FA can be modified, the process of experimentally identifying variables that give rise to and maintain behavior remains the same—and remains the most effective form of behavioral assessment for severe problem behavior.
... It may also seem counterintuitive to provide reinforcers for problem behavior, especially after problem behavior has already been successfully treated. However, it is possible to safely evoke problem behavior in clinical settings with highly trained staff in situations where evoking problem behavior could ultimately lead to better treatment outcomes (see Kahng et al., 2015). One potential option to translate this procedure is to conduct such research using protective equipment with the individual who displays problem behavior or to pair the S D associated with diminishing returns with multiple other stimuli and contexts (e.g., Hackenberg & Joker, 1994). ...
Article
Full-text available
Behavioral treatments are an effective means for reducing or eliminating problem behavior. However, these treatments may lose their effectiveness when implemented over extended periods of time due to challenges that arise during community care. When challenged, relapse of problem behavior can occur in several forms (e.g., resurgence, renewal). There is a preponderance of basic, translational, and applied research explicating factors that contribute to and tactics for mitigating resurgence and renewal. However, much less is knowing about a third form of relapse likely to be encountered in clinical practice: reinstatement. Reinstatement is the recurrence of a previously reinforced but currently eliminated response resulting from the independent or dependent presentation of the response's reinforcer. Thus, we conducted a proof-of-concept demonstration of a novel procedure rooted in behavioral economics to mitigate reinstatement using a translational-treatment model. In short, we increased the unit price of a reinforcer for a target response by exposing that response to a geometric progressive ratio schedule of reinforcement and paired that increase of unit price with a distinct stimulus. Results indicated that the novel procedure mitigated reinstatement. Areas for future research and preliminary implications for clinical practice are discussed.
... Professionals can experience difficulties implementing functional analyses with low-rate behaviors, multiple topographies, multiple functions, constantly changing reinforcers, or covert challenging behaviors (Hanley, 2012). Furthermore, functional analyses raise some ethical dilemmas for evoking potentially dangerous behaviors for the purpose of assessment while other less restrictive, more efficient, and safer alternatives could potentially achieve the same outcomes (Kahng et al., 2015;Weeden et al., 2010). ...
Article
Open-Ended Functional Assessment Interviews have limited empirical support for their concurrent validity with functional analysis. To address this issue, we conducted a study wherein 176 independent behavior analysts relied on data collected using Open-Ended Functional Assessment Interviews to identify the function of challenging behavior in four children with autism. Then, we compared the results of their analyses with those of a traditional functional analysis. Our results showed that the conclusions drawn by behavior analysts using the Open-Ended Functional Assessment Interviews corresponded with the outcomes of functional analyses in 74% of cases. These findings suggest that the Open-Ended Functional Assessment Interview may inform functional analyses to develop initial hypotheses.
... Concerns surrounding time and resources likely arise from the fact that multielement FAs take, on average, approximately two and a half hours to produce differentiated results (Saini et al., 2020). Even if a BCBA® has the time and resources to spend on these analyses, they may be reluctant to expose individuals to conditions designed to occasion PB for multiple hours given the short-term increases in the rate of PB and possible injuries that can occur during FAs (Kahng et al., 2014). Furthermore, researchers have suggested that traditional FA outcomes may not reflect the results that are typically obtained in clinical practice . ...
Article
Although functional analysis is a widely researched tool for determining behavioral function, traditional formats are associated with limitations that often preclude their incorporation into practice. The interview-informed synthesized contingency analysis (IISCA) was developed to address such limitations. This study investigated the effectiveness and efficiency of the IISCA in determining the function of problem behavior for three non-vocal children with autism spectrum disorder and intellectual disabilities in a school setting. The effectiveness of the skill-based treatment process associated with the IISCA was also evaluated, as were the acceptability of these treatment procedures and the fidelity with which they were implemented. The IISCAs yielded differentiated outcomes immediately for two participants and following a secondary analysis for the third participant. Assessment results informed the design of treatments involving functional communication training and delay- and denial-tolerance training evaluated using a changing-criterion design. Implications and limitations are discussed and recommendations for future research are offered.
... Dangerous problem behavior was less likely to be observed when the contingency class was opened. Figure 4 provides an overview of the occurrences of dangerous problem behavior during Study 1 and Study 2. Although reducing the rate of dangerous problem behavior is likely to improve safety, future researchers should also incorporate direct measures of injury when possible (Kahng et al., 2015). Safety was also increased as reported by the caregivers. ...
Article
Full-text available
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.
... That is, the contingencies during the IISCA evoked only mild instances while the dangerous behavior within the same functional class was more likely to emerge during the extended periods of delays to reinforcement. Future researchers may want to evaluate safety during the entire process of the practical functional assessment and skill-based treatment by measuring each precursor or dangerous topography separately or by including other measures such as injury reports completed by medical professionals (Kahng et al., 2015). Doing so could help identify (a) periods when more staff members or safety equipment will be needed to prevent injury or exposure to harm and (b) points in the treatment that require reducing thinning steps or increased access to reinforcement to ensure the successful completion of the treatment while avoiding bursts of dangerous behavior. ...
Article
Full-text available
A practical functional assessment format was recently developed that informed a skill-based treatment for the problem behavior of children diagnosed with autism spectrum disorder. Since its inception there have been multiple replications of the procedures; however, the comprehensive model has rarely been applied to populations with more complex comorbid disorders and severe problem behavior such as those diagnosed with anxiety or depression. We conducted the current study to systematically replicate the entire practical functional assessment and skill-based treatment model with two participants diagnosed with multiple mental health disorders admitted to a severe behavior outpatient unit. The practical functional assessment identified reinforcers that were provided contingent on increasingly complex forms of communication. Problem behavior remained low for both participants after reinforcement was thinned by increasing a response requirement of completing difficult tasks. Furthermore, the results were socially validated by the parents and teachers and the treatment was extended to the home setting. K E Y W O R D S functional analysis, functional communication, mental health disorders, synthesized contingencies, tolerance training
... Articles satisfying these parameters appearing in selected journals (Table 1) within the targeted publication range met criteria for inclusion regardless of population, intervention, or other features of the targeted studies. Excluded articles reviewed clinical records (e.g., Kahng et al., 2015) or topics without explicitly referencing supporting literature or research. Book reviews, editorials, opinion pieces, and topic reviews not identified as literature reviews also met criteria for exclusion. ...
Article
Literature reviews allow professionals to identify effective interventions and assess developments in research and practice. As in other forms of scientific inquiry, the transparency of literature searches enhances the credibility of findings, particularly in regards to intervention research. The current review evaluated the characteristics of search methods employed in literature reviews appearing in publications concerning behavior analysis (n = 28) from 1997 to 2017. Specific aims included determining the frequency of narrative, systematic, and meta-analytic reviews over time; examining the publication of reviews in specific journals; and evaluating author reports of literature search and selection procedures. Narrative reviews (51.30%; n = 630) represented the majority of the total sample (n = 1,228), followed by systematic (31.51%; n = 387) and meta-analytic (17.18%; n = 211) reviews. In contrast to trends in related fields (e.g., special education), narrative reviews continued to represent a large portion of published reviews each year. The evaluated reviews exhibited multiple strengths; nonetheless, issues involving the reporting and execution of searches may limit the validity and replicability of literature reviews. A discussion of implications for research follows an overview of findings.
... Once the function(s) of SIB is identified via FA, the information is used to inform treatments matched to the function. Additionally, because the individual's safety is of utmost concern, safety standards exist, and response blocking and protective equip ment are sometimes used during FA sessions Kahng et al., 2015). Al though SIB may temporarily increase in frequency during the FA test conditions, this ef fect is temporary and does not appear to affect the individual's behavior after FA sessions have concluded (Call et al., 2017;Shabani et al., 2013). ...
Chapter
Individuals with autism spectrum disorder (ASD) and other intellectual and neurodevelopmental disabilities are at increased risk for engaging in one or more types of problem behavior (e.g., aggression, property destruction, self-injury). Self-injurious behavior (SIB), the focus of the current chapter, refers to behaviors that produce (or could produce) physical injury to an individual's own body and is common among individuals with ASD. SIB poses immediate and long-term risks for the individuals and their caregivers. This chapter summarizes the prevalence and developmental course of SIB in individuals with ASD, as well as research on the etiology, diagnosis, assessment, and evidence-based treatments for SIB. Case examples and suggestions for future research are provided.
... Although FAs of problem behavior have been demonstrated to be safe when conducted in inpatient settings with trained therapists (Kahng et al., 2015), it is important to consider how best to prevent injuries to both the client and staff when reinforcing aggressive behavior within these sessions. As mentioned above, protective equipment for staff and clients can be essential for providing services in inpatient or residential settings. ...
Chapter
Individuals with intellectual and developmental disabilities often display problem behaviors, including aggression. Sometimes, aggression, or other problem behaviors, can become so severe that more intensive supports and treatment are necessary. In such cases, individuals may undergo assessment and treatment of aggression in inpatient and residential settings. In this chapter, we describe a general assessment and treatment process for aggressive behaviors that may be well suited for inpatient and residential settings. Recommendations for improving client outcomes through assessment modifications, staff and caregiver training, and treatment generalization are also discussed.
... Results showed relatively equal levels of responding at all points, suggesting that the child's experience in the functional analysis did not influence their overall level of problem behavior in their typical school setting. Kahng et al. (2015) analyzed data from 99 individuals referred to an inpatient unit for the treatment of SIB and compared injury reports occurring during vs. outside of the functional analysis. Their results showed that the total number of injuries was lower during the functional analysis (M = 0.8) compared with outside of the functional analysis (M = 1.9), but the rate of injury during the functional analysis (0.98 reports per hour) was considerably higher (.011 reports per hour). ...
Article
We reviewed studies that used environmental enrichment as treatment for problem behavior maintained by automatic reinforcement. A search of behavior analytic journals produced 71 publications with a total of 265 applications of environmental enrichment used alone or in conjunction with alternative behavior manipulations (e.g., prompting, reinforcement) and problem behavior manipulations (e.g., blocking, restraint). Environmental enrichment, as a sole intervention, was efficacious in 41% of the sample. Alternative behavior manipulations, problem behavior manipulations, and a combination of both improved the overall efficacy of environmental enrichment. We discuss factors that may influence the efficacy of environmental enrichment, current trends in research on this topic, and implications for both practitioners and researchers.
... Iwata et al. 1994;Herzinger & Campbell 2007). Functional analysis (FA) of problem behaviour (Iwata et al. 1982) is currently considered best practice for identifying the function of SIB (Kahng et al. 2015). The functions of SIB, as determined in an FA, are divided into two broad classes: socially reinforced SIB (i.e. the reinforcer for SIB is mediated by another person) and automatically reinforced SIB (i.e. the reinforcer for SIB is not mediated by another person). ...
Article
Background Limited research has examined how the functions of self‐injurious behaviour (SIB) relate to the production of injuries and the location, type or severity of those injuries. Methods Clinical and medical records were coded for 64 individuals hospitalised for SIB. When injuries were present, the physical properties of SIB and injuries were assessed across groups of individuals with automatically and socially maintained SIB. Results Injuries were observed for 35 of the individuals who engaged in SIB. Individuals who engaged in a single form of SIB were more likely to have injuries (P < .05). Individuals with SIB maintained by automatic reinforcement had significantly more severe injuries to the head than those in the social group (q < .05, P = .0132, H = 12.54). Conclusion Although results are preliminary, the results provide evidence that the function of SIB may influence the severity and location of injuries produced.
... Once the function(s) of SIB is identified via FA, the information is used to inform treatments matched to the function. Additionally, because the individual's safety is of utmost concern, safety standards exist, and response blocking and protective equip ment are sometimes used during FA sessions Kahng et al., 2015). Al though SIB may temporarily increase in frequency during the FA test conditions, this ef fect is temporary and does not appear to affect the individual's behavior after FA sessions have concluded (Call et al., 2017;Shabani et al., 2013). ...
Chapter
Individuals with autism spectrum disorder (ASD) and other intellectual and neurodevelopmental disabilities are at increased risk for engaging in one or more types of problem behavior (e.g., aggression, property destruction, self-injury). Self-injurious behavior (SIB), the focus of the current chapter, refers to behaviors that produce (or could produce) physical injury to an individual’s own body and is common among individuals with ASD. SIB poses immediate and long-term risks for the individuals and their caregivers. This chapter summarizes the prevalence and developmental course of SIB in individuals with ASD, as well as research on the etiology, diagnosis, assessment, and evidence-based treatments for SIB. Case examples and suggestions for future research are provided.
... Future research should incorporate direct measures or post-hoc ratings of intensity to evaluate the analytic conditions under which response intensity decreases across FAs. It is possible that delivering consequences under an FR1 contingency affects the overall rate of behavior as well as the intensity of the behavior, as has been suggested previously by Kahng et al. (2015). For example, Rooker (2010, Experiment 4) measured force of responding of different topographies of aggression in four participants during FA sessions. ...
Article
We observed changes in the rates of response topographies during the demand condition of functional analyses for participants who demonstrated problem behavior maintained by escape. Over the course of the functional analysis for each participant, the number of topographies decreased from the first to the last session. Additionally, after the first session of the demand condition the rate of responding for one topography increased or remained at high levels while the rates of all other topographies decreased. The implications of these results when conducting functional analysis are discussed.
... Once the function(s) of SIB is identified via FA, the information is used to inform treatments matched to the function. Additionally, because the individual's safety is of utmost concern, safety standards exist, and response blocking and protective equip ment are sometimes used during FA sessions Kahng et al., 2015). Al though SIB may temporarily increase in frequency during the FA test conditions, this ef fect is temporary and does not appear to affect the individual's behavior after FA sessions have concluded (Call et al., 2017;Shabani et al., 2013). ...
... Thus, the individual is not being exposed to situations he or she does not already experience on a day-to-day basis. A study conducted by Kahng et al. (2015) demonstrated that individuals with SIB were only slightly more likely to sustain an injury during a functional analysis when compared to typical daily activities. Functional analyses may lead to effective interventions because the treatment can be based on known functional properties of the SIB rather than being based on a priori assumptions, potentially spurious correlations (St. ...
... gr. Cabrera, en prensa;Cannella-Malone, Sabielny y Tullis, 2015;Kodak, Argott y Kisamore, 2015;Kahng, Hausman, Fisher, et al., 2015;O'Mea, 2013;Ribes, 2012;Chumacero, Camacho e Irigoyen, 2010;Pulido, Hernández, Peña, Ponce y Rebolledo, 2010;Ortega y Plancarte, 2010;McIlvane, 2009;Arroyo y Mares, 2009;Hernández, Bazán y Corral, 2009;Alós, Lora y Moriana, 2008;López y Guevara, 2008;Guevara, Mares, Rueda, et al., 2005;Mares, Guevara, Rueda, Rivas, y Rocha, 2004;Serna, 2004;Rubio y Santoyo, 2004;Ayala, Chaparro, Fulgencio, et al., 2001;Galindo, Bernal, Hinojosa, et al., 1990). ...
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Se hace un análisis general de la relación que se estableció entre el Análisis Conductual Aplicado (ACA) y la Educación Especial (EE) cuando las técnicas del ACA se aplicaron con éxito en la atención de personas con problemas de conducta, alteraciones del sistema nervioso y alteraciones sensoriales con el objetivo de establecer habilidades adaptativas, sociales y académicas. Se identifica que a pesar de que las técnicas del ACA aún son vigentes y se reportan casos de éxito al emplearlas, su relación con la EE se ha visto debilitada. En el presente trabajo se señalan algunos elementos que generaron tal separación entre el ACA y la EE, entre ellos destacan: las formas de regulación y los modelos de atención por los que ha transitado la Educación Especial, la sobresimplificación al interpretar los conceptos y procedimientos propuestos desde el ACA, la imprecisión en el establecimiento de programas de reforzamiento, la poca exigencia y claridad al aplicar algunas de las Técnicas de Modificación de Conducta, las críticas provenientes de otras teorías y la imprecisión en la identificación de reforzadores. Se concluye enfatizando la necesidad de que la EE recurra a propuestas de atención basadas en evidencia científica, actualizando sus formas de intervención sin perder su orientación multi e interdisciplinaria.
... Baer et al. strongly objected to using verbal reports as a substitute for direct observation, so according to a strict application of the BWR framework, this research must be considered uninformative, despite the fact that it has led to Effective strategies for preventing injuries (e.g., Finney, Christophersen, Friman, Kalnins, Maddux, Peterson, Roberts, & Wolraich, 1993). Or at least apparently effective strategies, because the primary dependent variable in intervention research is the number of child injuries (e.g., see Kaung, Hausman, Fisher, Donaldson, Cox, Lugo, & Wiskow, 2014), and injuries are not behavior per se but rather a byproduct of behaviors and environments that place children at risk (see Johnston & Pennypacker, 1980, for a critique of measuring behavior products instead of behavior). Thus, according to a strict application of the BWR framework, this research can support no confident conclusions about improvements in child welfare. ...
Article
A seven-­‐dimension framework, introduced in an iconic article by Baer, Wolf, and Risley, has become the de facto gold standard for identifying "good" work in applied behavior analysis. By examining the framework's historical context we show how its overarching attention to social relevance arose and then subsequently fueled the growth of applied behavior analysis. Ironically, however, in contemporary use the framework serves as a bottleneck that prevents many socially important problems from receiving adequate attention in applied behavior analysis research. The core problem lies in viewing the framework as a conjoint set in which "good" research must reflect all seven dimensions at equally high levels of integrity. We advocate a bigger-­‐tent version of applied behavior analysis research in which, to use Baer and colleagues' own words, "The label applied is determined not by the procedures used but by the interest society shows in the problem being studied." Because the Baer-­‐Wolf-­‐Risley article expressly endorses the conjoint-­‐set perspective and devalues work that falls outside of the seven-­‐dimension framework, pitching a big tent may require moving beyond that article as a primary frame of reference in defining ABA's research agenda.
... None of the participants experienced injuries, minor or otherwise, during either analysis. Our results are in general agreement with Kahng et al. (2015), who found similar levels of injury from SIB during traditional FAs as during other times of the day outside the FA sessions. ...
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Researchers typically modify individual functional analysis (FA) conditions after results are inconclusive (Hanley, Iwata, & McCord, 2003). Hanley, Jin, Vanselow, and Hanratty (2014) introduced a marked departure from this practice, using an interview-informed synthesized contingency analysis (IISCA). In the test condition, they delivered multiple contingencies simultaneously (e.g., attention and escape) after each occurrence of problem behavior; in the control condition, they delivered those same reinforcers noncontingently and continuously. In the current investigation, we compared the results of the IISCA with a more traditional FA in which we evaluated each putative reinforcer individually. Four of 5 participants displayed destructive behavior that was sensitive to the individual contingencies evaluated in the traditional FA. By contrast, none of the participants showed a response pattern consistent with the assumption of the IISCA. We discuss the implications of these findings on the development of accurate and efficient functional analyses.
Chapter
This chapter focuses on behavioral disorders in young children with autism spectrum disorder (ASD), highlighting the importance of early identification, thorough assessment, and intervention for challenging behaviors. While not core to the diagnosis of ASD, the frequent co-occurrence of these behaviors is discussed. Further, the importance of comprehensive assessment of challenging behaviors is emphasized, including not only an understanding of the function of the behavior but also potential organic or psychiatric factors. Empirically supported interventions are reviewed, aiming to improve the quality of life for children with ASD and their families.
Chapter
Problem behavior includes aggression, destructive behavior, self-injury, pica, elopement among many other forms. Problem behavior is associated with poor quality of life for the individual and their caregivers, risks of injury, reduced learning opportunities, restrictive behavior management practices, and increased costs. Applied Behavior Analysis (ABA) had a 65-year or so history of research and practice in treating problem behavior and has continued to evolve over time. One consistent feature has been the use of pre-treatment assessments to determine the function of the problem behavior and to direct non-restrictive treatment. A wide range of assessment methods have now been developed to do this. Contemporary ABA is characterized by a range of new and not so new social concerns, including minimizing the use of punishment and extinction and reducing other negative experiences, broadening the range of measures of program effectiveness to address outcomes such as happiness and quality of life, diversity, equity, and inclusion, negative perceptions of ABA, and scaling up dissemination of evidence-based ABA in typical services.
Chapter
Many individuals diagnosed with intellectual and developmental disabilities engage in challenging behaviors such as aggression and self-injury. These behaviors may interfere with the quality of life of the individual and their families. Although biological factors may contribute to the development of challenging behavior, research has shown that the environment plays a significant role in developing all behaviors, including challenging behavior. Thus, the current chapter highlights the importance of understanding how consequences impact the development of challenging behavior and provides a discussion of the functional behavior assessment process used to isolate potential environmental factors contributing to the challenging behavior. This includes a review of indirect assessments, descriptive assessments, and functional analysis methods followed by a review of common treatments for reducing challenging behavior, including antecedent manipulations, extinction procedures, and differential reinforcement.
Article
Despite the efficacy of functional analyses in identifying the function of challenging behavior, clinicians report not always using them, partly due to safety concerns. Understanding how researchers employ safeguards to mitigate risks, particularly with dangerous topographies like self‐injurious behavior (SIB), is important to guide research and practice. However, the results of a scoping review of functional analyses of self‐injurious behavior conducted by Weeden et al. (2010) revealed that only 19.83% of publications included protections. We extended the work of Weeden et al. to determine whether reporting has improved. We observed increases in all but two types of protections reviewed by Weeden et al. Additionally, we included new protections not reported by Weeden et al. In total, 69.52% of the studies included at least one protective procedure and 44.39% specified that the protections were used for safety. It appears that reporting has increased since Weeden et al. called for improved descriptions of participant protections.
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Individuals with intellectual and developmental disabilities are at a heightened risk of engaging in self-injurious behavior (SIB) that can result in significant harm to their physical health. This is especially true for automatically maintained SIB that is not sensitive to social reinforcement. This chapter discusses considerations for addressing SIB, particularly when automatically maintained. Treating clinicians should engage a multidisciplinary team and define appropriate safeguards for assessment and treatment to reduce the occurrence and likelihood of injuries due to SIB. A thorough assessment is needed to inform essential components of treatment to produce long-lasting and therapeutic reductions in SIB. It is similarly critical to monitor safeguards to ensure SIB or mitigation strategies (e.g., protective equipment) do not cause additional harm. To avoid possible side effects, clinicians should begin with reinforcement-based procedures before considering more restrictive procedures in collaboration with the larger treatment team.
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Protective equipment, encompassing specialized devices or clothing like gloves, helmets, and padding, plays a vital role in safeguarding individuals from harm associated with severe destructive behavior. This chapter provides an overview of critical safety and ethical considerations associated with assessing the need for and deploying the use of protective equipment. Prevailing policies and regulations governing restraint and seclusion are presented. Additionally, we identify a range of protective equipment that can be used to mitigate potential harm resulting from various types and topographies of severe destructive behavior. A review of the existing literature on the use of protective equipment in the assessment and treatment of severe destructive behavior is provided, emphasizing the evaluation of efficacy and ethical implications. This chapter concludes with recommendations for the judicious implementation and rigorous evaluation of protective equipment, ensuring a secure and effective approach to managing potential harm.
Article
기능 기반 중재는 문제 행동을 중재하는데 있어 효과적인 것으로 증명된 근거 기반 중재법이다. 그러나 문제 행동의 기능을 알아내는 것과 관련하여 안전 및 윤리적 문제가 발생할 수 있다. 이 연구는 이러한 문제점을 보완하기 위해 사용될 수 있는 전조행동 기반 다중 스케쥴 기능적 의사소통 훈련(FCT)의 효과를 연구하였다. 연구대상은 심각한 자해행동을 보이는 자폐 스펙트럼 장애를 가진 15세 고등학생이다. 시간 순차적 연관성을 나타내는 통계지표의 하나인 Yule’s Q를 사용하여 자해행동에 대한 전조행동을 확인한 후, 전조행동의 기능을 알아내기 위해 기능 분석(FA)을 실시하였다. FA 결과를 바탕으로 전조행동에 대해 FCT 및 강화 스케줄 약화 중재를 시행하였다. 중재 결과, 기능적 의사소통 반응이 증가함에 따라 성공적으로 전조행동의 감소와 함께 자해행동도 감소하였다. 이러한 결과는 문제행동을 다루는데 있어 강조되고 있는 주 접근인 근거중심, 기능기반 중재가 안전 등의 문제를 야기할 수 있는 심각한 문제행동중재에 있어서도 가능하도록 현 현실적 대안을 제시한다.
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Functional assessment checklists and experimental functional analysis have become standard practice in applied behavior analysis. This chapter incudes an overview of existing methods and how they are utilized in various applied contexts. We discuss the standard functional analysis model first described by Iwata et al. (1982/1994) and significant variations on the standard model, such as trial-based functional analysis, interview-informed synthesized contingency analysis, among others. We also comment on the strengths and weaknesses of these methods and how they can complement one another during clinical decision-making. The article also discusses methods of analyzing functional assessments and assessment informed treatment. Finally, we discuss barriers and criticism of functional assessment and how these can be addressed by behavior analysts.KeywordsFunctional assessmentFunctional analysisDescriptive analysisInformant methodsClinical decision-makingDifferential reinforcementMotivating operationsSchool-based assessment
Chapter
Behaviors occur in chains. Upon analysis of a given challenging behavior, the response rarely occurs without the appearance of lesser problematic behaviors linked to the target behavior. In many instances, these may also be viewed as maintaining behaviors. This chapter covers the literature on this topic, along with strategies on how to identify and treat these responses.KeywordsPrecursor behaviors Precursor assessments Precursor functional analysis Precursor-based treatment
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The final step to completing a functional behavior assessment is to conduct an experimental functional analysis. In 1994, Iwata and colleagues developed the first approach to identifying functional properties of challenging behavior, and since this time, this experimentally controlled analysis has become the gold-standard assessment for developing behavior reduction programs. A functional analysis consists of test and control sessions. The motivating operation, discriminative stimuli, and consequences are systematically arranged in the test and control conditions to test specific hypotheses regarding behavior function (e.g., attention maintained). During the group supervision meeting, your supervisees will develop functional analysis condition protocols to facilitate their understanding of the variables manipulated across test and control conditions. You will also teach your supervisees how to analyze functional analysis results. You will provide abundant opportunities for your supervisee to role-play conducting a functional analysis before they conduct the assessment with their client.KeywordsFuncational analysis (FA)Challenging behavior Motivating operations Discriminative stimuli Attention-maintained challenging behavior Tangible-maintained challenging behavior Escape-maintained challenging behavior Automatically maintained challenging behaviorMultielement design
Chapter
There is strong evidence supporting the use of functional behavioral assessment (FBA) to identify effective treatments to address a wide variety of challenging behaviors. Behavior analysts and psychologists conducting FBAs are engaging in assessment behavior that is explicitly addressed in the ethical codes of the American Psychological Association (APA), Behavior Analyst Certification Board (BACB), and National Association of School Psychologists (NASP). Professionals engaging in FBA must keep in mind a number of considerations to ensure that their assessment practice is aligned with the ethical guidelines of professional organizations. This chapter discusses issues related to informed consent, professional competence, the principle of do no harm, and client right to effective treatment in the context of FBA. In addition, the chapter presents alternatives to traditional functional analysis (FA) that may address ethical concerns. Finally, the chapter presents ethical considerations for use of FBA in schools.
Chapter
This chapter frames functional assessment as a broad class of methods for understanding challenging behavior and mental health disorders. We outline how various researchers define this group of methods in the literature and review theoretical and applied rationale for these methods. The specific type of functional assessment protocol used and its application will often need to vary in line with a number of factors, such as (a) the nature of the challenging behavior, (b) population studied, (c) who does the assessment, and (c) where the assessment occurs. Various studies will be described to exemplify the varying types, applications, and rationale for the use of different functional assessment methods. Functional assessment is a foundational aspect of contemporary interventions for supporting individuals with challenging behaviors and mental health disorders. Practitioners working with such individuals therefore require the competences necessary to implement functional assessments and interpret the resulting assessment data.
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ABC narrative recordings and Open-Ended Functional Assessment Interviews have limited empirical support for their concurrent validity with functional analysis. To address this issue, we conducted a study wherein 187 independent behavior analysts relied on data collected using ABC recordings and Open-Ended Functional Assessment Interviews to identify the function of challenging behavior in four children with autism. Then, we compared the results of their analyses with those of a traditional functional analysis. The analyses of the ABC recordings and of the Open-End Functional Assessment Interviews matched those of the functional analyses in 47% and 71% of cases, respectively. These findings suggest that the Open-Ended Functional Assessment Interview may perform better than the ABC narrative recording to develop hypotheses on the functions of challenging behavior.
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This chapter describes a systematic approach to assessment of the person engaging in self-injurious behavior, including developmental, medical, behavioral, psychological, psychiatric, and contextual issues. The chapter shows how the integrated biobehavioral model of the development of self-injury presented in Chap. 3 can be used to structure an assessment of the critical factors and processes involved in maintaining an individual’s self-injury. Topics include diagnosis of physical/medical and psychiatric conditions related directly or indirectly to self-injury, functional behavioral assessment, and assessment of Pavlovian processes, overactivity/impulsivity, and arousal and anxiety. Emphasis is placed on methods (including interviews, rating scales, structured observations, and brief functional analyses) applicable in outpatient/consulting contexts, although more extended assessments feasible in residential treatment settings are also considered. The chapter describes a method for assessment of the processes predominant in maintaining SIB in the individual case, relating these to options for intervention, and using assessment results to develop an intervention plan.
Article
A proportion of children and adults in Canada are identified as having an intellectual or developmental disability (I/DD). Moreover, the prevalence of autism spectrum disorder (ASD) in Canadian children has increased substantially over the past decade. Research has shown that these populations have a greater likelihood to engage in severe destructive behavior such as self‐injury and aggression, which places them at risk for exposure to intrusive interventions and denial of services. Functional behavior assessment (FBA) is an assessment strategy that takes the environmental variables responsible for the development and maintenance of destructive behavior into consideration and has shown to be the most informative for developing effective treatments for destructive behavior. We conducted a nation‐wide survey that queried behavior‐analyst practitioners working in the I/DD and ASD service sectors about their beliefs and use of FBA in clinical practice. We compared the results of this survey with similar surveys conducted in the United States. The results indicated that most Canadian practitioners are conducting some type of FBA; however, many of these assessments are not comprehensive and missing important components of the assessment process. We discuss the implications of these findings, as well as the barriers to implementing FBA in practice.
Article
Researchers have developed precursor functional analyses to provide an alternative, and presumably safer, format for functional analysis of severe problem behavior. When researchers use functional analysis contingencies for precursor behaviors, it is possible to infer functional characteristics about severe problem behaviors based on patterns of less severe precursor behaviors, permitting practitioners to complete the assessment with less risk to clients, practitioners, or others. The current paper discusses recent advances in the development and validation of precursor identification, and offers suggestions and future directions for investigating and implementing precursor functional analyses. We propose a decision‐making model, in which practitioners integrate procedures to identify precursors into the functional‐analysis process, to expedite the analysis of severe problem behaviors.
Article
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Purpose of review: This review summarises the recent trends in research in the field of self-injurious behaviour in people with intellectual disability and autism spectrum disorder. Recent findings: New data on incidence, persistence and severity add to studies of prevalence to indicate the large scale of the clinical need. A number of person characteristics have been repeatedly identified in prevalence and cohort studies that: can be considered as risk markers (e.g. stereotyped behaviour, autism spectrum disorder) and indicate possible causal mechanisms (e.g. sleep disorder, anxiety). Studies have started to integrate traditional operant learning paradigms with known person characteristics and reviews and meta-analyses of applied behaviour analytic procedures can now inform practice. Summary: Despite these positive developments interventions and appropriate support falls far short of the required need. Expansions in applied research are warranted to develop and evaluate innovative service delivery models that can translate knowledge of risk markers and operant learning paradigms into widespread, low cost routine clinical practice. Alongside this, further pure research is needed to elucidate the direction of causality of implicated risk factors, in order to understand and intervene more effectively in self-injury.
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Examines research conducted during the past 3 decades on behavioral approaches to self-injurious behavior (SIB), with special emphasis on the use of functional assessment and its relationship to treatment selection and outcome. Results of this analysis indicate that research on behavioral approaches to the treatment of SIB shows a marked increase in the use of functional assessments, particularly functional analyses, and that this trend has occurred primarily during the past decade. Results of such assessments, when aggregated, indicate that most SIB appears to be maintained by social contingencies. When functional assessments are used as the basis for intervention, treatment procedures are more likely to consist of reinforcement than punishment. Finally, the effectiveness of reinforcement-based interventions is enhanced when they are implemented in conjunction with functional assessments. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
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This study describes the use of an operant methodology to assess functional relationships between self-injury and specific environmental events. The self-injurious behaviors of nine developmentally disabled subjects were observed during periods of brief, repeated exposure to a series of analogue conditions. Each condition differed along one or more of the following dimensions: (1) play materials (present vs absent), (2) experimenter demands (high vs low), and (3) social attention (absent vs noncontingent vs contingent). Results showed a great deal of both between and within-subject variability. However, in six of the nine subjects, higher levels of self-injury were consistently associated with a specific stimulus condition, suggesting that within-subject variability was a function of distinct features of the social and/or physical environment. These data are discussed in light of previously suggested hypotheses for the motivation of self-injury, with particular emphasis on their implications for the selection of suitable treatments.
Article
This study describes the use of an operant methodology to assess functional relationships between self-injury and specific environmental events. The self-injurious behaviors of nine developmentally disabled subjects were observed during periods of brief, repeated exposure to a series of analogue conditions. Each condition differed along one or more of the following dimensions: (1) play materials (present vs absent), (2) experimenter demands (high vs low), and (3) social attention (absent vs noncontingent vs contingent). Results showed a great deal of both between and within-subject variability. However, in six of the nine subjects, higher levels of self-injury were consistently associated with a specific stimulus condition, suggesting that within-subject variability was a function of distinct features of the social and/or physical environment. These data are discussed in light of previously suggested hypotheses for the motivation of self-injury, with particular emphasis on their implications for the selection of suitable treatments.
Article
Ethical guidelines for behavior analysts state that functional assessment should be used before implementing treatment plans. In this paper, we discuss the ethical implications of this position using self-injurious behavior in people with developmental disabilities as a focus. Evidence is reviewed that suggests that treatment based on results of a functional assessment is likely to be more effective, less likely to be considered restrictive, more likely to be perceived as socially valid, and also focuses on principles of a constructional approach to behavior change. Alongside this generally positive evidence, there are ethical problems with the validity of some assessment methods, their potential lack of clarity, and the intensive resources required by a functional assessment. Effective, socially valid, and constructional interventions for self-injury might also be developed using preventative interventions. The balance of all of these ethical issues needs to be considered in the design of any treatments for self-injurious behavior.
Article
Default technologies evolve from failure. Within the realm of human behavior, technologies based on the use of aversive contingencies can be conceptualized as default technologies because they come into play when natural contingencies or positive reinforcement fail to produce a desired behavioral outcome. Historical as well as contemporary events suggest that it is a mistake for behavior analysts to advocate for the adoption of aversive technologies. We must, however, continue to play a leading role in the development of such technologies so that they will be used in an appropriate manner. Furthermore, the eventual elimination of aversive technologies will be possible only through continued, careful, and experimental analysis of the contexts of failure in which they are born.
Article
This study examined the reporting of participant protections in studies involving functional analysis and self-injurious behavior and published from 1994 through 2008. Results indicated that session termination criteria were rarely reported and other specific participant safeguards were seldom described. The absence of such information in no way indicates that functional analysis procedures were unethical or otherwise inappropriate, although the fact that participants emitted many self-injurious responses in some studies where no protections were described and no rationale for requiring such a large sample of behavior was provided is cause for concern. Future publications would benefit from the inclusion of clear and detailed specifications of participant protections.
Article
A method is described for classifying and quantifying surface tissue damage caused by self-injurious behavior. The Self-Injury Trauma Scale permits differentiation of self-injurious behavior according to topography, location of the injury on the body, type of injury, number of injuries, and estimate of severity. Fifty pairs of independently scored records were subjected to interrater reliability analyses, and the following mean (median) percentage agreement scores were obtained: overall agreement, 97% (98%); location of injury, 99% (100%); type of injury, 96% (100%); number of injuries, 89% (100%); and severity of injury, 94% (100%). Percentage agreement also was calculated for three summary scores: Number Index, 90%; Severity Index, 92%; and Estimate of Current Risk, 100%. Potential applications and limitations of the scale are discussed.
Article
Iwata, Dorsey, Slifer, Bauman, and Richman (1982) presented the first comprehensive and standardized methodology for identifying operant functions of aberrant behavior. This essay discusses the significance functional analysis has had for applied behavior analysis. The methodology has lessened the field's reliance on default technologies and promoted analysis of environment-behavior interactions maintaining target responses as the basis for selecting treatments. It has also contributed to the integration of basic and applied research. Future directions for this research are suggested.
Article
We compared results of descriptive and functional analyses of problem behavior for 12 participants whose descriptive data have been reported previously (Thompson & Iwata, 2001). Results indicated that in only 3 of the 12 cases was problem behavior maintained by the consequence observed most frequently during the descriptive analysis. Attention was the most common consequence for problem behavior during descriptive analyses for 8 of the 12 participants; however, maintenance of problem behavior by attention was evident for only 2 of these 8 participants.
Toward a functional analysis of self-injury The Self-Injury Trauma (SIT) Scale: A method for quantifying surface tissue damage caused by self-injurious behavior
  • B A Iwata
  • M F Dorsey
  • K J Slifer
  • K E Bauman
  • G S Richman
Iwata, B. A., Dorsey, M. F., Slifer, K. J., Bauman, K. E., & Richman, G. S. (1994). Toward a functional analysis of self-injury. Journal of Applied Behavior Analysis, 27, 197–209. doi: 10.1901/jaba.1994.27-197 (Reprinted from Analysis and Intervention in Developmental Disabilities, 2, 3–20, 1982) Iwata, B. A., Pace, G. M., Kissel, R. C., Nau, P. A., & Farber, J. M. (1990). The Self-Injury Trauma (SIT) Scale: A method for quantifying surface tissue damage caused by self-injurious behavior. Journal of Applied Behavior Analysis, 23, 99–110. doi: 10.1901/jaba. 1990.23-99