CHAPTER Functional Behavior Assessment Stephanie M. Peterson and Nancy A. Neef LEARNING OBJECTIVES • Name the functions that problem behavior can serve. • Describe the role functional behavior assessment plays in preventing problem behavior and developing interventions for problem behavior. • State the different methods of conducting a functional behavior assessment. • State the primary characteristics of and rationale for conducting a descriptive assessment. • Describe various methods for gathering descriptive assessment data and under what circumstances each is appropriate. • Given a set of descriptive data, interpret the data to form a hypothesis regarding the possible function of problem behavior. • State the primary characteristics of and rationale for conducting a functional analysis as a form of functional behavior assessment. • Describe how to conduct a functional analysis. • Given a set of data from a functional analysis, interpret the data to determine the function of problem behavior. When it is time to wash hands before lunch. Stella turns the handles of the faucet and places her hands under the running water, but Flo screams and tantrums. The teacher is confused about why Stella performs so well in this context and Flo performs so poorly. Consequently, she is at a loss as to how to respond when Flo screams and tantrums. The crying and tantrums could occur for a variety of reasons. To understand why they are occurring, the teacher could perfomn a functional behavior assessment of Flo's problem behaviors. This assessment may provide information valuable for creating an effective behavior intervention. Consistent with the scientific precept of determinism described in Chapter 1, behaviors— including problem behaviors—are lawfully related to other events in the environment. Functional behavior assessment (FBA) enables hypotheses about the relations among specific types of environmental events and behaviors. Specifically, FBA is designed to obtain information about the purposes (functions) a behavior serves for a person. This chapter describes the basis for FBA. its role in the intervention and prevention of behavior difficulties, and alternative approaches to functional assessment. We will revisit Flo's problem behavior throughout this chapter to illustrate. FUNCTIONS OF BEHAVIOR Evidence from decades of research indicates that both desirable and undesirable behaviors, whether washing hands or screaming and tantrumming, are learned and maintained through interaction with the social and physical environment (see Schlinger & Normand. 2013, for a review). As explained in Chapters 11 and 12, these behavior-environment interactions are described as positive or negative reinforcement contingencies. Behaviors can be strengthened by either "getting something" or "getting out of something." FBA is used to identify the type and source of reinforcement for challenging behaviors as the basis for intervention efforts designed to decrease the occurrence of those behaviors. FBA can be thought of as a reinforcer assessment of sorts. Tt identifies the reinforcers currently maintaining problem behavior. Those rein-forcers might be positive or negative social reinforcers provided by someone who interacts with the person, or automatic reinforcers produced directly by the behavior itself. The idea behind FBA is that if these reinforcement contingencies can be identified, then interventions can be designed to decrease problem behavior and increase adaptive behavior by altering these contingencies. FBA fosters proactive, positive interventions for problem behavior. Although reinforcement contingencies are discussed in other chapters, a brief review of their role in FBA is warranted. Positive Reinforcement Social Positive Reinforcement (Attention) Problem behavior often results in immediate attention from others, such as head turns; surprised facial expressions; reprimands; attempts to soothe, counsel, or distract; and so on. These reactions can positively reinforce problem behavior (even if 678 Chapter 27 • Functional Behavior Assessment 679 inadvertently), and the problem behavior is then more likely to occur in similar circumstances. Problem behavior maintained by positive reinforcement in the form of reactions from others can often occur in situations in which attention is otherwise infrequent, whether because the person does not have a repertoire to gain attention in desirable ways or because others in the environment are typically otherwise occupied. Tangible Reinforcement Many behaviors result in access to reinforcing materials or other stimuli. Just as pressing a button on the television remote changes the channel to a desired television show, problem behaviors can produce reinforcing outcomes. A child may cry and tantrum until a favorite television show is turned on; stealing another child's candy produces access to the item taken. Problem behaviors may develop when they consistently produce a desired item or event. This often occurs because providing the item temporarily stops the problem behavior (e.g., tantrum), although it can have the inadvertent effect of making the problem behavior more probable in the future under similar circumstances. Automatic Positive Reinforcement Some behaviors do not depend on the action of others to provide an outcome; some behaviors directly produce their own reinforcement. For example, thumb sucking might be reinforced by physical stimulation of either the hand or the mouth. Hand flapping while looking at a light might be reinforced by the visual stimulation of :he light being blocked and revealed, as the hand flapping might iimulate a flashing light. Swinging a tennis racket correctly as t tennis ball approaches and hits the head of the racket might »e reinforced by the "pop" sound the ball makes when it hits he "sweet spot" of the racket. Placing hands under the faucet night be reinforced by the warm sensation of water on the skin. V behavior is assumed to be maintained by automatic reinforcement mly after social reinforcers have been ruled out (e.g., when the ehavior occurs even when the individual is alone). egative Reinforcement ocial Negative Reinforcement (Escape) any behaviors are learned as a result of their effectiveness in ter-i nating or postponing aversive events. Hanging up the phone ter-nates interactions with a telemarketer; completing a task or chore minates requests from others to complete it or the demands assorted with the task itself. Problem behaviors can be maintained in isame way. Behaviors such as aggression, self-injurious behav-(SIB), and bizarre speech may terminate or avoid unwanted eractions with others. For example, noncompliance postpones ! lagemcnt in a nonpreferred activity, and disruptive classroom lavior often results in the student being sent out of the class-»m, thereby allowing escape from instructional tasks or teacher 'ands. All of these behaviors can be strengthened by negative ^"rcement to the extent that they enable the individual to escape lv°id difficult or unpleasant tasks, activities, or interactions. tornatic Negative Reinforcement jWsive stimulation, such as a physically painful or uncom-a°'e condition, is a motivating operation that makes its termination reinforcing. Behaviors that directly terminate aversive stimulation are therefore maintained by negative reinforcement that is an automatic outcome of the response. Automatic negative reinforcement can account for behaviors that are either appropriate or harmful. For example, putting calamine lotion on a poison ivy rash can be negatively reinforced by alleviation of itching, but intense or prolonged scratching that breaks the skin can be negatively reinforced in the same manner. Some forms of SIB may distract from other sources of pain, which may account for their correlation with specific medical conditions (e.g., DeLissovoy, 1963). Function Versus Topography Several points can be made from the previous discussion of the sources of reinforcement for behavior. It is important to recognize that environmental influences do not make distinctions between desirable and undesirable topographies of behavior; the same reinforcement contingencies that account for desirable behavior can also account for undesirable behavior. For example, Stella, the child who washes and dries her hands before lunch, has probably received praise for doing so. Flo, the child who frequently engages in tantrums in the same situation, may have received attention (in the form of reprimands). Both forms of attention have the potential to reinforce the respective behaviors. Likewise, the same topography of behavior can serve different functions for different individuals. For example, tantrums may be maintained by positive reinforcement in the form of attention for one child and by negative reinforcement in the form of escape for another child (e.g., Kennedy, Meyer, Knowles, & Shukla, 2000). Because different behaviors that look quite different can serve the same function, and behavior of the same form can serve different functions under different conditions, the topography, or form, of a behavior often reveals little useful information about the conditions that account for it. Identifying the conditions that account for a behavior (its function), in contrast, suggests what conditions need to be altered to change the behavior. Assessing the function of a behavior can therefore yield useful information with respect to intervention strategies that are likely to be effective. ROLE OF FUNCTIONAL BEHAVIOR ASSESSMENT IN INTERVENTION AND PREVENTION FBA and Intervention If a causal relation between environmental events and a problem behavior can be determined, and that relation can be altered, the problem behavior will occur less often. Interventions informed by FBA primarily consist of three strategic approaches: alter antecedent variables, alter consequent variables, and teach alternative behaviors. Alter Antecedent Variables FBA can identify antecedents that might be altered so the problem behavior is less likely to occur. Altering the antecedents 680 Part 10 • Functional Assessment for problem behavior can change and/or eliminate either (a) the motivating operation for problem behavior or (b) the discriminative stimuli that trigger problem behavior. For example, the motivating operation for tantrums when Flo is asked to wash her hands before lunch could be modified by changing the characteristics associated with lunch so that the avoidance of particular events is no longer reinforcing. Depending on the function of the tantrums, this might involve initially reducing table-setting demands, altering seating arrangements to minimize taunts from a sibling or peer, or reducing snacks before lunch and offering more preferred foods during lunch. Alternatively, if the FBA shows that running water is the discriminative stimulus that triggers problem behavior when Flo is asked to wash her hands, she might be given a waterless antibacterial hand gel instead. In this case, the discriminative stimulus for problem behavior has been removed, thereby decreasing problem behavior. Alter Consequent Variables FBA can also identify a source of reinforcement to be eliminated for the problem behavior. For example, an FBA that indicates Flo's tantrums are maintained by social negative reinforcement (avoidance or escape) suggests a variety of treatment options, which, by altering that relation, are likely to be effective. Flo's tantrums can be placed on extinction by ensuring that the rein-forcer (e.g., avoidance of the activities associated with setting the table for snack or lunch) no longer follows problem behavior (tantrums). Another approach could be to provide the reinforcer for alternative behaviors instead of for the problem behavior. Finally, the schedule might be modified so that hand washing follows—and thereby provides escape from—an event that is even less preferred. Teach Alternative Behaviors FBA can also identify the source of reinforcement to be provided for appropriate replacement behaviors. Alternative appropriate behaviors that have the same function (i.e., produce the same reinforcer) as tantrums could be taught. For example, if Flo's tantrums are maintained by escaping lunchtime activities, she might be taught to touch a card communicating "later" after washing her hands, to produce a delay in being seated at the lunch table. FBA and Default Technologies Interventions based on an FBA may be more effective than those selected without consideration of behavioral function (e.g., Ervin et al., 2001; Iwata et al., 1994b). Understanding why a behavior occurs often suggests how it can be changed for the better. In contrast, premature efforts to treat problem behavior before seeking an understanding of the purposes it has for a person can be inefficient, ineffective, and, in some cases, harmful. For example, suppose that a time-out procedure is implemented in an attempt to attenuate Flo's tantrums when she is asked to wash her hands before lunch. Flo is removed from the hand-washing activity to a chair in the corner of the room. It may be, however, that the events typically following hand washing (those associated with lunch time, such as the demands of arranging chairs or setting the table or interactions with others) are aversive for Flo, and tantrumming has allowed her to avoid those events. In this case, the intervention would be ineffective because it has done nothing to alter the relation between tantrums and the consequence of avoiding the aversive events associated with lunch. In fact, the intervention may exacerbate the problem if it produces a desired outcome for Flo. If stopping the hand-washing activity and having Flo sit on a chair as "time-out" for tantrumming enables her to avoid the aversive lunchtime events—or to escape them altogether—tantrums may be more likely under similar circumstances in the future. When the time-out intervention proves unsuccessful, other interventions might be attempted. Without understanding the function that the problem behavior serves, however, the effectiveness of those interventions cannot be predicted. At best, a trial-and-error process of selecting and implementing interventions without consideration of behavioral function can be lengthy and inefficient. At worst, such an approach may cause the problem behavior to become more frequent or severe. As a result, caregivers might resort to increasingly intrusive, coercive, or punishment-based interventions, which are often referred to as default technologies. FBA can decrease reliance on default technologies and contribute to more effective interventions in several ways. When FBAs are conducted, reinforcement-based interventions are more likely to be implemented than are those that include punishment (Pelios, Morren, Tesch, & Axelrod, 1999). In addition, the effects of interventions based on FBAs are likely to be more durable than those that do not take the function of problem behavior into account. If contrived contingencies are superimposed on unknown contingencies that are maintaining the behavior, their continuation is often necessary to maintain improvements in the behavior. If those superimposed contingencies are discontinued, the behavior will continue to be influenced by the unchanged operative contingencies. FBA and Prevention By furthering understanding of the conditions under which certain behaviors occur, FBA can also contribute to the prevention of difficulties. Although problem behavior may be suppressed without regard to its function by using punishment procedures, additional behaviors not subject to the punishment contingencies may emerge because the motivating operations for problem behavior remain. For example, contingent loss of privileges might eliminate tantrums that occur whenever Flo is asked to wash her hands, but it will not eliminate avoidance as a reinforcer or the conditions that establish avoidance as a reinforcer. Thus, other behaviors that result in avoidance, such as aggression, property destruction, or running away may develop. These unintended effects are less likely to occur with interventions that address (rather than override or compete with) the reinforcing functions of problem behavior. On a broader scale, the accumulation of FBA data may further assist in prevention efforts by identifying the conditions that pose risks for the future development of problem behaviors. Preventive efforts can then focus on those conditions. For example, based on data from 152 analyses of the reinforcing functions of self-injurious behavior (SIB), Iwata and colleagues (1994b) found that escape from task demands or other aversive stimuli accounted for the behavior in the largest proportion of cases. The authors speculated that this outcome might have Chapter 27 • Functional Behavior Assessment 681 been an unintended result of a move toward providing more aggressive treatment. For example, if Flo tantrums when she is required to wash her hands, the teacher might assume that she does not know how to wash her hands. The teacher might decide to replace playtime with a period of intensive instruction on hygiene. Rather than decreasing problem behavior, such interventions may exacerbate it. The data reported by Iwata and colleagues suggest that preventive efforts should be directed toward modifying instructional environments (such as providing more frequent reinforcement for desirable behavior, opportunities for breaks, or means to request and obtain help with difficult tasks) so that they are less likely to function as sources of aversive stimulation (motivating operations) for escape. OVERVIEW OF FBA METHODS FBA methods can be classified into three types: (a) functional (experimental) analysis, (b) descriptive assessment, and (c) indirect assessment. The methods can be arranged on a continuum with respect to considerations such as ease of use and the type and precision of information they yield (see Figure 27.1). Selecting the method or combination of methods that will best suit a particular situation requires consideration of each method's advantages and limitations. We discuss functional analysis and its variations first because descriptive and indirect methods of functional assessment developed as an outgrowth of functional analysis. As noted later, functional analysis is the only FBA method that allows practitioners to confirm hypotheses regarding functional relations between problem behavior and environmental events. Functional (Experimental) Analysis Basic Procedure Functional analysis procedures were first pioneered by lwata, Dorsey, Slifer, Bauman, and Richman (1994a). In a functional analysis, antecedents and consequences representing those in the person's natural environment are arranged so that their separate effects on problem behavior can be observed and measured. This type of assessment is often referred to as an analog because antecedents and consequences similar to those occurring in the natural routines are presented in a systematic manner, but the analysis is not conducted in the context of naturally occurring routines. Analog conditions are often used because they allow the behavior analyst to better control the environmental variables that may be related to the problem behavior than can be accomplished in naturally occurring situations. Analogs refer to the arrangement of variables rather than the setting in which assessment occurs. Research has found that functional analyses conducted in natural environments (e.g., classroom settings) often yield the same (and. in some cases, clearer) results compared to those conducted in simulated settings (Noell, VanDerHeyden, Gatti, & Whitmarsh, 2001). Functional analyses (FA) typically comprise four conditions: three test conditions—contingent attention, contingent escape, and alone—and a control condition, in which problem behavior is expected to be low because reinforcement is freely available and no demands are placed on the individual (see Table 27.1). However, it should be understood that there is no "standard" FA. FAs should be flexible and individualized. The practitioner can implement myriad conditions to address C E £ i= Q_ o3 E thesized Antecedent Behavior Consequence "nction Escape from when Flo is d washing prompted to wash her hands in preparation for lunch, . . she screams continued pre- and tan- sentation of trums, hand washing which is and lunch followed activities, by... CASE EXAMPLES ILLUSTRATING THE FBA PROCESS FBA is a highly idiosyncratic process. It is unusual for any two FBAs to be exactly the same because each person presents with a unique set of skills and behaviors, as well as a unique history of reinforcement. FBA requires a thorough understanding of behavioral principles to parcel out the relevant information from interviews and ABC assessments, to form relevant hypotheses, and to test those hypotheses. Beyond these skills, a solid understanding of behavioral interventions (e.g., differential reinforcement procedures, schedules of reinforcement, and tactics for promoting maintenance and generalization) is needed to match effective treatments to the function of challenging behavior. Furthermore, it is important for the practitioner to keep abreast of the current literature in functional analysis and treatment of problem behavior, because the evidence base is constantly evolving. This can seem like a daunting process. In an attempt to demonstrate the application of FBA across the idiosyncratic differences in people, we present an array of case examples that illustrate its utility in developing interventions that render the problem behavior ineffective, irrelevant, or inefficient. Marie—Brief Functional Analysis Gathering Information, Interpreting Information, and Forming Hypotheses Marie was an 8-year-old girl with autism who had been referred to a behavior analyst for an evaluation of severe problem behavior, specifically aggression toward her family members. Her insurance covered 3 hours of "ABA therapy" per week, which she was receiving from a community mental health agency social worker. Her mother and sister attended every session. 694 Pari 10 • Functional Assessment The only behavior analyst with the skills necessary to consult on this case was 150 miles away at a local university, so the behavior analyst helped the agency staff conduct the functional analysis via teleconsultation. The behavior analyst began by conducting a Functional Assessment Interview with Marie's mother, who reported that aggression occurred in a variety of settings, toward children and adults, and typically occurred when Marie did not get what she wanted, usually a preferred toy. Aggression also took place during her therapy sessions when the therapist was talking to Marie's mother, updating her on the session. However, aggression toward her on-site therapist had recently decreased. The behavior analyst then collected some ABC data during a play session with Marie's mother and younger sister, as well as during her ABA therapy session at the clinic. The ABC data showed a pattern of aggression when Marie's preferred items were removed. In addition, the ABC data indicated that the consequence that most often followed aggression was Marie's mother or sister relinquishing the item back to Marie. Based on the descriptive data, it was hypothesized that Marie's aggression could be maintained by access to tangibles. Testing Hypotheses Due to the limited number of hours per week Marie received services, a brief functional analysis was conducted to determine the function of Marie's aggression. The consulting behavior analyst trained Marie's therapist to conduct the assessment via teleconsultation, and was available during the assessment to provide coaching and feedback. Four 5-min functional analysis conditions (free play, attention, demand, and tangible) were conducted, and aggression occurred only in the tangible condition. During each session, the behavior analyst scored the occurrence of problem behavior using a 10-sec partial interval recording procedure. During the contingency reversal, the number of requests was also recorded. The functional analysis results are shown in Figure 27.5. After the first four conditions, the behavior analyst coached the on-site therapist on how to implement functional communication training (FCT) to teach Marie to ask for the tangible item. This was selected as a replacement behavior because it matched the function of the problem behavior and could efficiently compete for the reinforcer. During three 5-min training sessions, requests increased and aggression dropped to zero. The behavior analyst instructed the on-site therapist to conduct a contingency reversal by implementing a second tangible functional analysis condition. During this reversal, aggression increased to 50% of intervals, and requesting decreased from 11 to 2 occurrences. Upon reinstatement of FCT, aggression returned to zero and requesting returned to the previous treatment level. All functional analysis and treatment conditions were completed in a 60-min appointment with Marie's therapist, mother, and sister present. Developing an Intervention During the brief FA, functional communication training (FCT; teaching appropriate requesting) was shown to be an effective treatment for decreasing aggression. It matched the function and was more efficient than the problem behavior in obtaining access Free Attention Demand Tangible Functional Communication Training Tangible FCT "l I-1-1-r-I-T--1-1-r 1 2 3 4 S 6 7 8 9 Sessions Figure 27.5 Results from the brief functional analysis for Marie. The graph depicts the percentage of 10-sec intervals in which problem behavior occurred (left y-axis) and the number of independent mands (right y-axis) in each condition. Marie's case example contributed by Rebecca Eldrige and Nathan VanderWeele. Chapter 27 • Functional Behavior Assessment 695 to the tangible item. During a follow-up meeting, the behavior analyst, the on-site therapist, and Marie's mother met to develop the treatment plan. Marie's mother was concerned about the times that she would need to say "no" to Marie when Marie was asking for preferred items and was worried that aggression would result. The behavior analyst worked with the team to develop a treatment plan that included initially delivering the item each time Marie requested it until aggression had decreased to zero for three consecutive 30-min sessions. When Marie was regularly making requests without aggression, a program to teach waiting for the preferred item was introduced. To gain access to the preferred item, Marie had to wait (without aggression) for 1 to 60 seconds after requesting it. Once waiting was mastered, Marie was taught to complete a task while while waiting. She could then earn the preferred item only after the task was complete. The behavior analyst and on-site therapist then taught Marie's mother to implement the procedure, which she did successfully. Carson—Trial-based Functional Analysis Gathering Information, Interpreting Information, and Forming Hypotheses Carson, a 10-year-old boy with a chromosomal deletion disorder, was receiving special education services in the general education classroom. He displayed several problem behaviors—most notably, talking to peers during group instruction, yelling out answers, and running around the room. These behaviors occurred only in the general education classroom. They had increased in intensity, resulting in more time spent in the resource room, away from the general education setting. Consequently, Carson was missing valuable instruction time and falling behind in the curriculum. The behavior analyst assigned to Carson's case was asked to complete an FBA in order to design an intervention plan that would increase the time he spent in the general education classroom and decrease his disruptive behavior. After obtaining consent from Carson's parents to conduct an FBA, the behavior analyst conducted a Functional Assessment Interview with Carson's teachers and paraprofessionals. From the interview, it appeared that Carson's problem behaviors occurred most often during group lessons on the carpet and individual work at his desk. Carson's teachers and paraprofessionals could not identify a clear pattern of consequences for his behavior because they had tried so many different strategies without success. Following the interview, the behavior analyst used a structured data form to begin collecting ABC data during those times reported as most problematic by the teachers. The ABC assessment showed that escape from demands or access to one-on-one attention could be maintaining Carson's disruptive behavior. Testing Hypotheses At this point, the behavior analyst needed to test her hypotheses, but she had several reservations about conducting a traditional FA in the classroom setting. She was concerned about the time that a traditional FA would take as well the teacher's ability to implement it with a high degree of fidelity while also teaching. For these reasons, the behavior analyst decided to conduct a trial-based functional analysis (TBFA) on disruptive behavior, with the teacher implementing the conditions. Four conditions were conducted: attention test, attention control, escape test, and escape control. During the attention test condition, teacher attention was diverted unless Carson engaged in disruption. If he engaged in disruption, the teacher provided attention for 10 seconds and ended the trial. During the attention control condition, attention was delivered every 5 seconds for 60 seconds, with no programmed consequences for disruptive behavior. During the escape test condition, the teacher worked one-on-one with Carson, repeatedly prompting him to complete his work. If he engaged in disruption, the teacher walked away and removed task demands for 10 seconds. During the escape control condition, the teacher provided a 1-min break with no attention or task demands and no programmed consequences for disruption. Each condition was implemented 8 times (trials) for 1 min during regular instruction throughout the school day. The percentage of trials with disruption in each condition was then calculated and graphed. The results (see Figure 27.6) showed that disruption occurred most often in the attention Attention Escape Figure 27.6 Results from the trial-based functional analysis for Carson. The graph shows the percentage of trials, for both the control and the test conditions, in which disruptive behavior occurred. Carson's case example contributed by Rebecca Eldrige and Nathan VanderWeele. 696 Part 10 • Functional Assessment test condition, and thus supported the hypothesis that attention was maintaining disruptive behavior. In addition, the escape test condition evoked no problem behavior, which suggested that escape from demands was not a reinforcing variable for disruptive behavior. Developing an Intervention Based on the results of the trial-based functional analysis, a multicomponent treatment plan was developed that included discontinuing attention when Carson engaged in disruptive behavior, teaching him to raise his hand to gain attention, and providing contingent breaks with teacher attention for sitting quietly at his desk for increasing amounts of time. Thus, problem behavior was placed on extinction, and more appropriate behaviors (hand raising and sitting quietly engaged in his work) produced teacher attention. Elija—Latency-based Functional Analysis Gathering Information, Interpreting Information, and Forming Hypotheses Elija was a 9-year-old boy diagnosed with autism spectrum disorder. He engaged in elopement and noncompliance and was referred to a behavior analyst for a functional analysis. The behavior analyst began with a Functional Assessment Interview (O'Neill et al., 1997) with Elija's mother. Elija's mother reported that he typically engaged in elopement in the community as well as in the home; he would run out of the home or store and into the street when he wanted something he couldn't have (while in the community) or when he was denied access to his toys (at home). Consequently, his mother did not take him out much, which limited the number of activities Elija could engage in throughout the day. His mother kept all the doors locked in the house. Next, the behavior analyst conducted some direct observation of Elija's behavior at home using remote technology. Elija's mother was observed working with him under a variety of naturally occurring conditions. The behavior analyst took data on elopement attempts as well as the immediate antecedents and consequences. Attempts to elope were blocked to keep Elija safe. During the ABC assessment, the behavior analyst observed elopement attempts when Elija was asked to complete academic tasks. Additionally, when he eloped, Elija's mother provided extensive attention in an attempt to get him to sit back down at the table and do his work. Based on the ABC observations, the behavior analyst hypothesized that Elija's elopement was maintained by escape from task demands as well as access to tangible items, and attention. Testing Hypotheses The functional analysis was conducted at the center where Elija received services. The behavior analyst decided to conduct a latency-based functional analysis. She chose this assessment given the dangerous nature of the problem behavior. That is, she wanted to minimize the number of occurrences of elopement, and staff had to intervene when elopement did occur. The behavior analyst immediately reinforced elopement, which prevented Elija from eloping too far from the setting. Elopement was defined as any instance of Elija moving more than 3 feet away from the instructional setting and/or from an adult without permission. In addition to conducting the latency FA, the behavior analyst also ensured that additional therapists were assigned to all exits in the building to prevent Elija from going out of the building. The FA consisted of the following conditions: tangible, play (control), attention, and demand. The behavior analyst started a stopwatch when the condition began and let it run until elopement occurred. When elopement occurred, the behavior analyst stopped the stopwatch and recorded the time that had elapsed. This was the latency to elopement. The results of the FA are shown in Figure 27.7. The graph depicts that elopement was maintained by escape from demands and access to attention, because Elija's latency to elopement was shortest during the escape and attention conditions. Developing an Intervention It can be challenging when elopement or any other dangerous problem behavior serves an attention function, because the problem behavior cannot be placed on extinction (i.e., ignored) safely. The problem behavior will likely always result in at least some attention. Such was the case for Elija. As a result, the behavior analyst designed an intervention based on concurrently available reinforcement contingencies. When Elija was presented with a task demand, he was asked to make a choice from among three concurrently available options, which were signaled by three different colors (green, yellow, and red). Green was associated with Elija completing the assigned task demand. If he appropriately completed the task, he was given a high-quality break for 60 seconds. During his break, he received attention from his mother, as well as preferred toys. If he asked for a break from the w Figure 27.7 The latency to elopement for each o condition in the FA for Elija. Note that elopement o never occurred in the Play/Control condition; thus, & the data points are plotted at 300 s, which represents J the entire session duration (5 min). The latency ™ was shortest during the attention and demand conditions, indicating escape and attention functions. Elija's case example contributed by Denice Rios and Nicole Holiins. i—i—i—i—i—i—i—i—i—i—i—i—i—i—i—i—i—i—i—i—i—i—i—i 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 Sessions Chapter 27 • Functional Behavior Assessment 697 task (the yellow option), he was given a task break. However, the break lasted only 30 seconds, he had access to less preferred toys, and his mother stayed with him for only a few seconds. If he engaged in elopement (the red option), he escaped the task for 10 seconds, no toys were available, and his mother neutrally blocked his egress from the room. Over time, the duration of the task demand to earn the high-quality break increased until Elija reliably engaged in the task demand rather than eloping. Will—Evaluating Precursor Behavior Gathering Information, Interpreting Information, and Forming Hypotheses Will was 14 years old with a primary diagnosis of autism. He was quite large for his age and displayed high levels of physical aggression, verbal outbursts, and urinating on people. As a result of the severity and frequency of his problem behaviors, his size, a lack of informed treatment, and limited resources, Will was sent to a high-security juvenile detention center, where he was exposed to individuals without diagnosed disabilities who had committed violent, serious, and/or gang-related crimes. The county serving Will recognized that the juvenile detention center was not an appropriate placement for him but had no other placement options. As a last resort, the service coordinator on the case sought a behavior analytic consultation. Upon getting involved with the case, the behavior analyst realized that everyone working with Will was skeptical that anything would help. The behavior analyst conducted an FBA interview with individuals who had worked with Will in the detention center. Because the center was a lock-down facility, the staff could not give much information about how Will performed in a variety of conditions. The interview yielded little useful information. Also, observations of natural routines were limited due to the nature of the placement. As a result, no formal descriptive assessments were completed. The behavior analyst proposed a functional analysis, but one of Will's caseworkers was concerned hat once Will got upset, he would engage in aggression for hours. 5he was also concerned that Will's behaviors were so severe that Mowing them to occur even once could be dangerous. Based on a review of Will's records and the limited ^formation available, it was hypothesized that Will's aggres-ive behaviors were maintained by escape from demands or by ttention. In addition, it was determined that verbal outbursts ascribing the aggressive behavior he was about to engage in (e.g., "I'm going to piss on you!") reliably preceded Will's aggression. As a result of all these factors, it was decided that the functional analysis would be conducted on Will's verbal outbursts rather than on his aggression. Testing Hypotheses The functional analysis consisted of four conditions: tangible, free play, escape, and attention. In each of these conditions, occurrences of verbal outbursts were recorded using a 10-sec partial interval measurement system and plotted as the percentage of intervals with problem behavior (see Figure 27.8). Will displayed high levels of verbal outbursts during the tangible condition. The behavior analyst noted that Will's verbal outbursts could be interrupted if the therapist provided attention or task demands (i.e., the attention and demand conditions that followed the tangible condition) that redirected Will's behavior to some form of independent work. Developing an Intervention Based on the results of the functional analysis, the behavior analyst recommended that Will receive training in effectively and appropriately asking for tangible items. In addition, it was recommended that the training focus on teaching Will to tolerate delays in getting access to those tangible items. In his typical environment (e.g., school and home setting), gaining immediate access to tangible items was not always going to be feasible, so tolerating delays would be imperative for Will's success. Thus, a structured treatment that involved providing access to tangible items following appropriate requests, but not verbal outbursts, was recommended. After Will reliably requested items in an appropriate way, the behavior analyst slowly built in delays to the preferred item and asked Will to work on an independent task while waiting. Following appropriate waiting, Will received access to the preferred item. After observing the process. Will's caseworker—albeit initially resistant—considered that Will could live in a less restrictive environment. Chris—Evaluating ABC Data Gathering Information, Interpreting Information, and Forming Hypotheses Chris was a 37-year-old man diagnosed with intellectual disabilities who lived in a group home. He had a limited vocal verbal repertoire and he used a wheelchair for mobility. Chris displayed Figure 27.8 Results of Will's functional analysis of precursor behavior (verbal outbursts). Will's case example contributed by Cody Morris, Denice Rios, and Lloyd Peterson. 698 Part 10 • Functional Assessment frequent screaming toward caregivers and peers across many locations, including his home, various day programs, and outings. Interviews with staff members indicated that the screaming occurred throughout the day, but most frequently at his day programs. The staff hypothesized that the screaming occurred when Chris observed other roommates getting attention from staff. The behavior analyst also noticed that when staff members moved Chris's wheelchair, they often did so by walking up behind him and moving his wheelchair without saying anything to Chris about what was going to happen. This seemed to startle Chris, and the behavior analyst wondered if his screaming might also be maintained by avoidance of being removed from a specific area in the day program. Structured ABC observations (similar to that in Figure 27.3) and narrative recordings (providing descriptors of each event) were conducted across various times in Chris's home and day programs. Both inappropriate vocalizations (screaming) and appropriate vocalizations were tracked. After data were collected, each antecedent and consequence entry was coded into categories, such as attention, presentation or removal of a demand, being relocated, and alone. Each occurrence of appropriate and inappropriate vocalization was then analyzed to determine what category of antecedent immediately pre. ceded it and what category of consequence followed it. The percentage of both appropriate and inappropriate vocalizations preceded or followed by each category of variables was then graphed and analyzed using methods described in Chapter 6 The results are shown in Figure 27.9. Based on the ABC observations and graphed ABC data it was hypothesized that Chris's screaming served an attention function. The graphed data clearly showed that the most common antecedent variable that preceded both appropriate and inappropriate vocalizations was Chris being alone. However, Chris rarely received attention following appropriate attempts to interact with staff. In contrast, he reliably received staff attention following screaming. In fact, Chris was about twice as likely to receive attention for inappropriate vocalizations as for appropriate ones. Moreover, the narrative aspect of the ABC recording (see Table 27.3) indicated that staff members reliably ignored Chris while he scrolled through a wide variety of appropriate vocalizations (e.g., "hi," "how are you") that escalated to grunting and eventually screaming. Typically, it wasn't until Chris began screaming that he received high-quality attention from staff. ■ Inappropriate Vocalizations Antecedents 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% n I □ Appropriate Vocalizations Consequences J £□_la_ ^ ^ . rt*#ve ^ ^ Conditions ^e Figure 27.9 Results of Chris's ABC assessment. The left-hand panel shows the percentage of appropriate and inappropriate vocalizations that were preceded by the antecedent variables of one-on-one attention, access to edibles/tangibles, having someone move his wheelchair (relocated), having a demand placed on him, or being left alone. The right-hand panel shows the percentage of appropriate and inappropriate vocalizations that were followed by the consequence variables of one-on-one attention, access to edibles/tangibles, having access to a new area, having a demand removed, or being left alone. Case example contributed by Cody Morris and Becky Kolb, Chapter 27 • Functional Behavior Assessment 699 TABLE 27.3 Results of ABC Narrative Assessment for Chris's Appropriate and Inappropriate Behavior Antecedent Behavior Consequence Chris alone Said "hi you" Ignored by staff Chris alone Said "a ba" while pointing to a book Ignored by staff Chris alone Screamed Approached and told "Please stop screaming" and asked "What's wrong, Chris?" Chris transitioned to a new activity (sorting) Screamed Staff asked Chris why he was upset—"Chris, what do you need?" Chris transitioned to a different room (because of an event occurring) Said "are you my boy" to staff while walking Ignored by staff Developing an Intervention Because the ABC analysis identified a very apparent issue with staff interaction with Chris, it was not clear that a functional analysis was necessary. The behavior analyst wanted to first try having staff attend to appropriate behavior that Chris was already displaying. The intervention consisted of reversing staffs differential reinforcement of the inappropriate vocalizations. This was done by having staff reinforce the appropriate vocalizations (i.e., responding to the appropriate bids for attention) while placing screaming on extinction. In addition, because Chris engaged in high levels of appropriate vocalizations already, he was taught to tolerate a delay to reinforcement. Staff members were asked to acknowledge his requests and to provide reinforcement (attention) immediately, whenever possible. However, staff members were also taught to work directly with Chris to teach him to "wait" when necessary by slowly increasing delays to attention following their acknowledgement f his request. Finally, because Chris's vocalizations were somewhat difficult to understand and limited in variety, interventions expand and improve the quality of Chris's mand repertoire ere introduced. rian—Multiple Functions of Problem Behavior thering Information rian was 13 years old and diagnosed with pervasive developmental delay, oppositional defiant disorder, and attention-deficit hyperactivity disorder. He had moderate delays in cognitive id adaptive skills. Brian displayed several problem behav-fs, including aggression, property destruction, and tantrums, an's aggression had resulted in several of his teachers having ises, and his property destruction and tantrums frequently isrupted the daily activities of the classroom. A Functional Assessment Interview (O'Neill et al., 1997) conducted with Brian's teacher, Ms. Baker, who reported Brian s problem behavior occurred most frequently when he asked to perform a task that required any kind of physical ;1 (e.g., shredding papers) and occurred least during leisure •ties. However, Ms. Baker reported that Brian often engaged Problem behavior when he was asked to leave a preferred _ 'ty- She noted that Brian used complex speech (sentences), !gn he often used verbal threats, curse words, and/or ,SI0n- Property destruction, and tantrums to communicate l*ants and needs. Because Brian had a spoken repertoire, a Student-Assisted Functional Assessment Interview (Kern et al., 1995) was also conducted. In this interview, Brian reported that he found his math work loo difficult but that writing and using a calculator were too easy. He reported that he sometimes received help from his teachers when he asked for it, that sometimes teachers and staff noticed when he was doing a good job, and that he sometimes received rewards for doing good work. Brian indicated that his work periods were always too long, especially those that consisted of shredding papers. Brian reported that he had the fewest problems in school when he was allowed to answer the phone (his classroom job), when he was completing math problems, and when he was playing with his Gameboy. He stated that he had the most problems at school when he was outside playing with the other students because they often teased him, called him names, and cursed at him. An ABC assessment was conducted on two separate occasions. The results of the ABC assessment are shown in Table 27.4. Interpreting Information and Formulating Hypotheses Based on the interviews and ABC assessments, the function of Brian's problem behavior was unclear. It was hypothesized that some of Brian's problem behaviors were maintained by access to adult attention and preferred items. This hypothesis was a result of the ABC assessment, which indicated that many of Brian's problem behaviors occurred when adult attention was low or when access to preferred items was restricted. Brian's problem behavior often resulted in access to adult attention or preferred activities. It was also hypothesized that Brian's problem behavior was maintained by escape because his teacher reported that Brian frequently engaged in problem behavior in the presence of task demands and because Brian reported that some of his work was too hard and work periods lasted too long. Thus, a functional analysis was conducted to test these hypotheses. Testing Hypotheses The functional analysis consisted of the same conditions as described previously, with two exceptions. First, an alone condition was not conducted because there was no reason to believe that Brian's problem behavior served an automatic function. Second, a contingent tangible condition was added because there was reason to believe Brian engaged in problem behavior to gain access to preferred tangibles and activities. 700 Part 10 • Functional Assessment TABLE 27.4 Results of ABC Assessments for Brian's Aggression, Property Destruction, and Tantrums Antecedent Behavior Consequence Adult attention diverted to another student; denied access to Nintendo by teacher (i.e., told no when he asked if he could play it) Teacher attending to another student Yelled at teacher, "That's not fair! Why do you hate me? I" Told to "calm down' Hit sofa, attempted to leave classroom Given choice of activity and verbal Teacher attention diverted to another student Yelled "Stop!" at another student Story time, teacher attending to other students Story time, teacher listening to other students Laughed loudly Interrupted other students while they were talking: "Hey, it's my turn. I know what happens next!" warning to stay in classroom Reprimand from teacher: "Don't worry, Brian. I will take care of it." Reprimand from teacher: "Stop it!" Reprimand from teacher: "You need to listen." This condition was just like the play condition (i.e., Brian had access to adult attention and preferred toys at the beginning of the session), except that intermittently throughout the session, he was told it was time to give his toy to the teacher and to play with something else (which was less desirable). If Brian complied with the request to give the toy to the teacher, he was given a less preferred toy. If he engaged in problem behavior, he was allowed to continue playing with his preferred toys for a brief period. The results of the functional analysis are shown in Figure 27.10. Notice that problem behavior never occurred in the play condition when continuous attention and preferred items were available and no demands were placed on Brian. However, it occurred at high rates in all three of the test conditions (contingent attention, escape, and tangible). These results indicated that Brian's problem behavior was maintained by escape, attention, and access to preferred items. Developing an Intervention Based on the results of the functional analysis, a multicom-ponent intervention was implemented. The intervention components changed at different points in time, depending on the context. For example, when Brian was engaged in a work task, it was recommended that he be given frequent opportunities to request breaks. In addition, the time-out intervention that the teacher had been using was discontinued in the work context. During leisure times, when Brian had previously been expected to play alone, the classroom schedule was rearranged so that Brian could play and interact with peers. Brian was also taught to request toys appropriately while playing with peers. In addition, several interventions aimed at increasing teacher attention for appropriate behavior were implemented. Brian was taught how to request teacher attention appropriately, and teachers began to respond to these requests rather than ignoring them, as they had been doing. In addition, a self-monitoring plan was established, in which Brian was taught to monitor his own behavior and to match his self-recordings to the recordings of his teachers. Accurate self-recording resulted in teacher praise and access to preferred activities with the teacher. Brian's teachers also implemented their own plan to increase attention and praise every 5 minutes as long as Brian was not engaged in problem behavior during independent work. Lorraine—Multiple Topographies That Serve Multiple Functions Lorraine was 32 years old and functioned in the moderate range of intellectual disability. She had a diagnosis of Down syndrome and bipolar disorder with psychotic symptoms, for which Zoloft I I I I I I I i I I I I I 2 4 6 8 10 12 14 16 18 20 22 24 Sessions Figure 27.10 Results of Brian's functional analysis. Inappropriate behavior consists of aggression, property destruction, and tantrums. Based on Brian's functional analysis conducted by Renee Van Norman and Amanda Flaute. 100- o S 80^ 60- & c 3 o- 20- 0- Chapter 27 • Functional Behavior Assessment 701 (sertraline) and Risperdal (risperidone) were prescribed. She also took Tegretol (carbamazepine) for seizure control. Her verbal skills were low and her articulation was poor. She communicated through some signs, a simple communication device, gestures, and some words. Lorraine had resided in a group home for 9 years and attended a sheltered workshop during the day. Lorraine displayed noncompliance, aggression, and self-injurious behavior (SIB) in both settings, but the FBA focused on her problem behavior in the group home, where it was more severe and frequent. Noncompliance consisted of Lorraine putting her head down on the table, pulling away from people, or leaving the room when requests were made of her; aggression consisted of kicking others, throwing objects at others, biting others, and squeezing others' arms very hard; SIB consisted of biting her arm, pulling her hair, or pinching her skin. Gathering Information Interviews were conducted with Lorraine, her parents, and workshop and group home staff. Lorraine's parents noted that some of her behavior problems had increased when changes in her medication had been made. Workshop staff noted that Lorraine was more likely to have problem behavior at work if many people were around her. Workshop staff had also noted that noncompliance had increased shortly after a dosage change in medication 2 months previously. The group home staff members noted that they were most concerned about Lorraine's leaving the group home when she was asked to perform daily chores. Lorraine would often leave the group home and not return until the police had picked her up. Many neighbors had complained because Lorraine would sit on their porches for hours until the police came and removed her. An ABC assessment was conducted at the workshop and group home to determine whether environmental variables iffered across the two settings (e.g., the manner in which tasks vere presented, the overall level of attention). At the workshop, Lorraine was engaged in a jewelry assembly task (one she reportedly enjoyed), and she worked well for 2j hours. She appeared to work better when others paid attention to her and often became off task when she was ignored; however, no problem behavior was observed at work. At the group home, aggression was observed when staff ignored Lorraine. No other problem behavior occurred. No demands were placed on Lor-iine in the group home during the ABC observation. Group home staff rarely placed any demands on Lorraine in an attempt avoid her problem behavior. 'nterpreting Information and Formulating Hypotheses j^me of Lorraine's problem behaviors seemed to be related to a sage change in her medication. Because Lorraine's physician ^ ged her medication to be at therapeutic levels, a decision remade t0 analyze the environmental events related to her »B em Denavior. Observations of problem behavior during the minimaSSeSSmem Were limited because workshop staff placed H0^ma' demarids on Lorraine to avoid problem behaviors. ever, Lorraine's noncompliance reportedly occurred when "lands were placed on her. Therefore, it was hypothesized that these problem behaviors were maintained by escape from task demands. Aggression occurred during the ABC assessment when Lorraine was ignored. Although SIB was not observed during the ABC assessment, group home staff reported that Lorraine often engaged in SIB during the same situations that evoked aggression. Therefore, it was hypothesized that both aggression and SIB were maintained by attention. Testing Hypotheses The functional analysis consisted of free play, contingent attention, and contingent escape conditions (see Figure 27.11). Because the problem behaviors may have served different functions, each problem behavior was coded and graphed separately. Noncompliance occurred most frequently during the contingent escape condition and rarely occurred during the free play or contingent attention condition. SIB occurred most frequently during the contingent attention condition and rarely occurred during the free play or contingent escape condition. These data suggested that noncompliance served an escape function and SIB served an attention function. As is often the case for low-frequency, high-intensity behaviors, it was difficult to form hypotheses about the function of aggression because the behavior occurred rarely in any of the FBA conditions. Developing an Intervention Different interventions were developed for the problem behaviors because results of the FBA suggested that the behaviors served different functions. To address noncompliance, Lorraine was taught to request breaks from difficult tasks. Tasks were broken down into very small steps. Lorraine was presented with only one step of a task at a time. Each time a task request was made, Lorraine was reminded that she could request a break (either by saying "Break, please" or by touching a break card). If she requested a break, the task materials were removed for a brief period. Then they were presented again. Also, if Lorraine engaged in noncompliance, she was not allowed to escape the task. Instead, she was prompted through one step of the task, and then another step of the task was presented. Initially, Lorraine was allowed to completely escape the task if she appropriately requested a break each time the task was presented. Over time, however, she was required to complete increasing amounts of work before a break was allowed. Intervention for aggression consisted of teaching Lorraine appropriate ways to gain attention (e.g., tapping someone on the arm and saying, "Excuse me") and teaching group home staff to regularly attend to Lorraine when she made such requests. In addition, because her articulation was so poor, a picture communication book was created to assist Lorraine in having conversations with others. This communication book could be used to clarify words that staff could not understand. Finally, staff members were encouraged to ignore Lorraine's SIB when it did occur. In the past, staff had approached Lorraine and stopped her from engaging in SIB when it occurred. The functional analysis demonstrated that this intervention may have increased the occurrence of SIB, so this practice was discontinued. 702 Part 10 • Functional Assessment SUMMARY Functions of Behavior 1. Many problem behaviors are learned and maintained by positive, negative, and/or automatic reinforcement. In this respect, problem behavior can be said to have a "function" (e.g., to "get" something or to "get out of something). 2. The topography, or form, of a behavior often reveals little useful information about the conditions that account for it. Identifying the conditions that account for a behavior (its function) suggests what conditions need to be altered to change the behavior. Assessment of the function of a behavior can therefore yield useful information with respect to intervention strategies that are likely to be effective. Role of Functional Behavior Assessment in Intervention and Prevention 3. FBA can lead to effective interventions in at least three ways: (a) It can identify antecedent variables that can be altered to prevent problem behavior, (b) it can identify reinforcement contingencies that can be altered so that problem behavior no longer receives reinforcement, and (c) it can help identify reinforcers for alternative replacement behaviors. 4. FBA can decrease reliance on default technologies (increasingly intrusive, coercive, and punishment-based interventions) and contribute to more effective interventions. When FBAs are conducted, reinforcement-based interventions are more likely to be implemented than are interventions that include a punishment component. Overview of FBA Methods 5. FBA methods can be classified into three types: (a) functional (experimental) analysis, (b) descriptive assessment, and (c) indirect assessment. The methods can be arranged on a continuum with respect to considerations such as ease of use and the type and precision of information they yield. 6. Functional analysis involves systematically manipulating environmental events thought to maintain problem behavior within an experimental design. The primary advantage of functional analysis is its ability to yield a clear demonstration of the variable or variables that relate to the occurrence of a problem behavior. However, this assessment method requires a certain amount of expertise to implement and interpret. Several variations of functional analysis procedures have been developed to adapt to a variety of situations and contexts, including brief functional analysis, conducting functional analyses in natural settings, trial-based functional analysis, synthesized functional analysis, latency-based functional analysis, and analyzing precursor behaviors. Chapter 27 • Functional Behavior Assessment 703 7. Descriptive assessment involves observation of the problem behavior in relation to events that are not arranged in a systematic manner and includes ABC recording (both continuous and narrative) and scatterplot recording. The primary advantages to these assessment methodologies are that they are easier to do than functional analyses and they represent contingencies that occur within the individual's natural routine. Caution must be exercised when interpreting information from descriptive assessments, however, because it can be very difficult to parse the contingencies via them. 8. Indirect functional assessment methods use structured interviews, checklists, rating scales, or questionnaires to obtain information from persons who are familiar with the individual exhibiting the problem behavior (e.g., teachers, parents, caregivers, and/or the individual himself or herself) to identify possible conditions or events in the natural environment that correlate with the problem behavior. Again, these forms of FBA are easy to conduct, but they are limited in their accuracy. As such, they are probably best reserved for hypothesis formulation. Further assessment of these hypotheses is almost always necessary. Conducting a Functional Behavior Assessment 9. Given the strengths and limitations of the different FBA procedures, FBA can best be viewed as a four-step process: • First, gather information via indirect and descriptive assessment. • Second, interpret information from indirect and descriptive assessment and formulate hypotheses about the purpose of problem behavior. • Third, test hypotheses using functional analysis. • Fourth, develop intervention options based on the function of problem behavior. 10. When teaching an alternative behavior as a replacement for problem behavior, the replacement behavior should be functionally equivalent to the problem behavior (i.e., the replacement behavior should produce the same reinforcers that previously maintained the problem behavior). KEY TERMS conditional probability contingency reversal descriptive functional behavior assessment functional analysis functional behavior assessment (FBA) functionally equivalent indirect functional assessment MULTIPLE-CHOICE QUESTIONS 1. Devonia hits her head with a closed fist when her one-on-one teaching assistant leaves her side to interact with another student. Usually, when Devonia does this, her teaching assistant returns to her side, asks her to stop hitting herself, and soothes her. She rarely engages in head hitting when her assistant works directly with her. What is the most likely function of Devonia's problem behavior? a. Escape b. Attention C Automatic reinforcement d. Tangible e. Escape and/or tangible Hint: ,See "Functions of Behavior") Charles spits on his teacher when he prompts him to complete atoothbrushing task. For obvious-reasons, this behavior really grosses out the teacher, who refuses to work with him when he behaves like this. When Charles spits on him, the teacher walks away and allows Charles to leave the toothbrushing task and go to the computer to calm down. As long as he is playing on the computer, he rarely spits on his teacher. What is the most likely function of Charles' behavior? a. Escape b. Automatic reinforcement c. Tangible d. Escape and/or tangible e. Escape and/or attention Hint: (See "Functions of Behavior.") 3. On a practical level, FBA is important for prevention of and intervention for problem behavior because: a. When the cause-and-effect relation between environmental effects and behavior can be determined, that relation can be altered to improve behavior. b. It meets the federal guidelines for best practices in treating problem behavior. c. It will tell a teacher exactly what to do for intervention. d. None of these Hint: (See "Role of Functional Behavior Assessment in Intervention and Prevention") 704 Part 10 • Functional Assessment 4. Devonia's one-on-one assistant (see Question 1) decides that he will no longer leave Devonia's side to interact with other children as an intervention for her problem behavior. This is an example of what form of intervention? a. Altering antecedent variables b. Altering consequent variables c. Teaching alternative behaviors d. All of these Hint: (See "Role of Functional Behavior Assessment in Intervention and Prevention") 5. There are at least three forms of FBA. They are: a. Functional analysis, standardized assessment, and descriptive assessment b. Indirect assessment, descriptive assessment, and behavioral observation c. Functional analysis, descriptive assessment, and indirect assessment d. Behavioral observation, standardized assessment, and curriculum-based assessment Hint: (See "Overview of FBA Methods") 6. Which methods of FBA allow you to confirm hypotheses regarding the function of problem behavior? a. Functional analysis b. Descriptive assessment c. Indirect assessment d. All of these Hint: (See "Overview of FBA Methods") 7. Which of the following describes a descriptive functional behavior assessment? a. An analog analysis in which consequences representing those in the natural routine are systematically arranged. b. Direct observation of behavior made under naturally occurring conditions c. Structured checklists that caregivers fill out to identify events that correlate with problem behavior d. Behavior rating scales that caregivers fill out to identify events that correlate with problem behavior Hint: (See "Descriptive Functional Behavior Assessment") 8. A limitation of descriptive assessment is: a. It may be misleading in that it can identify environmental variables that occur in close proximity to the problem behavior but that are not causally related to the problem behavior. b. It may not be a very reliable measure of problem behavior and environmental events. c. It is extremely difficult and time-consuming to perform. d. The first two answer choices are correct. Hint: (See "Descriptive Functional Behavior Assessment") 9. Ms. Frieder, who teaches fifth grade at Franklin Elementary School, decides to conduct a descriptive FBA for Amelia. Amelia has been refusing to do her school work lately and has been ripping up her worksheets on a daily basis. Ms. Frieder creates a form on which she will mark specific antecedents and consequences that precede and follow Amelia's work refusals. For antecedents, she will mark one of the following: Math work given, reading work given, spelling work given, error correction given, work that requires writing given. For consequences, she will mark one of the following: verbal reprimand, another worksheet (same worksheet) provided, another worksheet (different worksheet) provided, time out, ignore. She will record these environmental events, whether or not a problem behavior occurs. What kind of descriptive assessment is Ms. Frieder conducting? a. Scatterplot recording b. ABC continuous recording c. ABC narrative recording d. Conditional probability recording Hint: (See "Descriptive Functional Behavior Assessment") 10. Mr. Peterson has been struggling with Arnold, a boy with severe disabilities who hums and rocks back and forth intermittently throughout the day. Mr. Peterson wants to see if these behaviors are associated with any specific activities during the school day so that he can then more closely analyze what occurs during those time periods. Which descriptive assessment method would be the best choice for what he wants to accomplish? a. Scatterplot recording b. ABC continuous recording c. ABC narrative recording d. Functional analysis Hint: (See "Descriptive Functional Behavior Assessment") 11. Ms. Carmichael is conducting an FBA for Jamal, a boy in her class who runs away from activities and teachers. Ms. Carmichael began by interviewing her teaching assistants and by participating in the conversation with them to define the target behavior and to determine what antecedents and consequences she would watch for during her ABC assessment. Ms. Carmichael completes her ABC assessment and finds that running away from tasks and materials occurs most frequently when difficult tasks are presented and that the most common consequence for this behavior is a teacher chasing after him and returning him to the classroom. Sometimes he is required to return to the task and sometimes he is allowed to do a different activity when he comes back to the classroom. What can be concluded from this descriptive assessment? a. The problem behavior most likely occurs to get attention from teachers b. The problem behavior most likely occurs to escape from nonpreferred tasks. c. The problem behavior most likely occurs to get access to more preferred activities. d. The function of the problem behavior remains unclear. Hint: (See "Conducting a Functional Behavior Assessment") Chapter 27 • Functional Behavior Assessment 705 12. After you complete a descriptive assessment, you should write hypothesis statements that reflect your interpretation of the data. Which of the following is a hypothesis statement that contains all of the important elements? a. Gain peer attention: When Valerie is playing alone on the playground, she bear hugs her peers. b. Gain peer attention: Valerie bear hugs her peers, which is followed by attention in the form of teasing from her peers. c. When Valerie is playing alone on the playground, she bear hugs her peers, which is followed by attention in the form of teasing from her peers. d. Gain peer attention: When Valerie is playing alone on the playground, she bear hugs her peers, which is followed by attention in the form of teasing from her peers. Hint: (See "Conducting a Functional Behavior Assessment") 13. The primary reason for conducting a functional analysis is: a. To test hypotheses generated via indirect and descriptive assessments. b. To generate hypotheses that can be further evaluated via indirect and descriptive assessments. c. To observe problem behavior within the naturally occurring routine. d. To identify any temporal patterns in problem behavior. Hint: (See "Overview of FBA Methods") 14. Characteristics of functional analysis include: a. They are conducted within naturally occurring routines. b. They are conducted within analog conditions that represent naturally occurring routines. c. They utilize interviews and rating scales rather than direct observation of problem behavior. They are conducted in clinical settings only. Hint: (See "Functional (Experimental) Analysis") 15. In addition to a control condition, a functional analysis typically consists of what test conditions? a- Contingent attention b. Contingent escape c Alone d. All of these Hint: (See "Functional (Experimental) Analysis") ■ Mr. Moon is conducting a functional analysis with In. who kicks his teachers frequently. Mr. Moon is •mplementing a contingent escape condition. He prompts j to engage in a difficult task. Ira kicks Mr. Moon in the How should Mr. Moon resppnd if he is to implement contingent escape condition correctly? He should continue prompting Ira to do the task, but he should provide a mild reprimand, such as, "Ira, don't ck me. That hurts. Come on. it's time to work." b. He should remove the task materials and turn away from Ira for a short period of time. c. He should ignore Ira's kicking and continue with the task. d. He should provide Ira with a more preferred activity for a short period of time. Hint: (See "Table 27.1, page 682") 17. Look at the following graph from a functional analysis of Elsa's tantrums. What would you conclude is the function of Elsa's tantrums? 100 -, 90 - £ 80 - : c 70- £ 3 60- "B 50- 2 Inte 40 - 'S 30- & 20 - c ill 10- Q. " '1 - Atone Contingent Escape Contingent Attention Conttoi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Sessions a. Escape b. Attention c. Both escape and attention d. The pattern of behavior is undifferentiated; therefore the analysis is inconclusive. Hint: (See "Overview of FBA Methods") 18. Look at the following graph from a functional analysis of Walter's skin picking. What would you conclude is the function of Walter's skin picking? 7 f 6-I u I 5 IS 3 2 1 0 • Alone -u~ Contingent Escape Contingent Attention Control 2 3 4 S 7 8 9 10 11 12 13 14 15 16 Sessions a. Escape b. Attention c. Automatic d. The pattern of behavior is undifferentiated; therefore the analysis is inconclusive. Hint: (See "Overview of FBA Methods") 706 Part 10 ■ Functional Assessment ESSAY-TYPE QUESTIONS 1. Provide an example of a problem behavior that is maintained by social positive reinforcement, social negative reinforcement, and automatic reinforcement. In your answer, state what happens prior to the problem behavior, what the problem behavior is, and what follows the problem behavior. Hint: (See "Functions of Behavior") 2. Discuss three different ways in which the results of a functional behavior assessment can be used to formulate interventions that prevent future occurrences of problem behavior. Hint: (See "Role of Functional Behavior Assessment in Intervention and Prevention") 3. Explain the three types of functional behavior assessment. Discuss them in the order in which they might best be implemented and explain this sequence. Your explanation of the sequence should include the strengths and limitations of each type. Hint: (See "Overview of FBA Methods and Case Examples") 4. Compare and contrast descriptive and indirect assessments. What is the primary variable that sets these two forms of gathering descriptive information apart? Hint: (See "Overview of FBA Methods: Descriptive Functional Behavior Assessment and Indirect Functional Behavior Assessment") 5. Give an example of a descriptive assessment and state what specific information this assessment would yield. Hint: (See "Overview of FBA Methods: Descriptive Functional Behavior Assessment") 6. Assume you are a behavioral consultant for a local developmental disabilities agency. You have been asked to consult on young adult, Melissa, who is 22 years old and frequently disrobes while at work. You conduct indirect and descriptive assessments with her staff and learn the following: Melissa rarely disrobes when she is in the break room having a snack and interacting with her co-workers and staff. She disrobes most frequently when she is working on her assigned job task. It doesn't seem to matter what task she is working on. You conduct an ABC assessment and note that she works well when a staff member comes by to check her work, and this seems to continue for a few minutes after the staff member leaves. About 4 minutes after the staff member leaves, however, the clothes start coming off. Melissa is happy to put her clothes back on when directed to by a staff member. Because of these behaviors, Melissa's work station has been moved to behind a curtain in the work room. Much to the staffs chagrin, Melissa's disrobing has actually been worsening since they did this. What is your working hypothesis for Melissa's problem behavior? Write your hypothesis in the form recommended by the text, and provide a rationale for your hypothesis. Hint: (See "Conducting a Functional Behavior Assessment: Gathering Information and Interpreting Information and Forming Hypotheses") 7. Explain the difference between a functional analysis and other forms of functional behavior assessment (e.g.. descriptive and indirect assessments). Specifically, why is it that a functional analysis allows you to test hypotheses, while other forms of functional behavior assessment are used for hypothesis formulation? Hint: (See "Overview of FBA Methods: Basic Procedure") 8. Describe the conditions that might be implemented in a functional analysts, as well as how and why each condition is implemented. Hint: (See "Overview of FBA Methods: Basic Procedure" and "Conducting a Functional Behavior Assessment: Testing Hypotheses") 9. Assume that in your role as a consultant, you decide to conduct a functional analysis of Melissa's disrobing (see Question 6). Assume that your functional analysis indicates her disrobing is maintained by both attention from others and escape from task demands. Assume that the functional analysis also confirmed your hypothesis that she rarely engages in problem behavior when she has attention and no task demands. Draw a graph that would illustrate this function appropriately. Hint: (See "Case Examples Illustrating the FBA Process")