Functional Analysis and Treatment of Aberrant Behavior

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Functional Analysis and Treatment of Aberrant
Behavior

• WAYNE W. FISHER
• Munroe-Meyer Institute and
• University of Nebraska Medical Center

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Structural vs. Functional Diagnosis

• Structural Approach
• How often a particular set of symptoms or
  responses cluster or covary.
• Functional Approach
• Whether and which environmental variables
  influence the response.

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Functional Analysis

• Identifies the environmental contexts in which
  aberrant behavior is likely and unlikely.
• Identifies the consequences that reinforce and
  maintain the behavior.
• Used to prescribe effective treatments.

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Functional Analysis Quiz

• What is the most common parental or teacher
  reaction to problem behavior?

Answer Verbal disapproval
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Functional Analysis Quiz

• What is the most commonly used behavior
  modification procedure?

Answer Time out
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Functional Analysis Quiz

• How are verbal disapproval and time out likely to
  affect problem behavior?

Answer It depends.
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Functional Analysis Quiz

• Social attention in the form of verbal
  disapproval significantly worsens self-injury in
  about one-fourth of cases.

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Functional Analysis Quiz

• Time out significantly worsens self-injury in
  about one-third of cases.

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Common Functions of SIB

• Social Positive Reinforcement (Attention,
  Tangible items)
• Social Negative Reinforcement (Escape)
• Automatic Reinforcement (e.g., Sensory
  Stimulation)

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Differentiating Analysis v. Assessment

• Broadly defined, functional analysis and behavior
  analysis are one and the same.
• The analysis of a behavior ... requires a
  believable demonstration of the events that can
  be responsible for the occurrence or
  non-occurrence of that behavior.
• Baer, Wolf, Risley, 1968

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Functional Assessment is Broader than Functional
Analysis

• Indirect Assessments
• Direct Observation Assessments
• Functional Analyses

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Essential Features of Functional Analysis
Conditions

• Unique discriminative stimuli that signal the
  available of a specific reinforcer
• Establishing operation (EO) that increases
  motivation for the specific reinforcer
• An EO is an environmental condition that
  momentarily increases the effectiveness of a
  reinforcer and that evokes responses that have
  produced that reinforcer in the past.
• Contingency between the target behavior and the
  specific reinforcer

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Identifying the Essential Features of Functional
Analysis Conditions

• See if you can identify the discriminative
  stimulus, the establishing operation, and the
  reinforcement contingency in each of the
  following functional analysis conditions.

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Attention Condition

• Adult is busy reading. Child is expected to play
  quietly with toys.
• Adult attention shifts to child following SIB
  (e.g., Please dont hit yourself).
• Determines whether adult attention functions as
  reinforcement for SIB.

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Essential Features of the Attention Condition

• Discriminative Stimulus Adult is seated in a
  chair reading a book.
• EO Attention is unavailable.
• Contingency SIB produces attention.

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Tangible Condition

• Adult takes preferred toys or leisure materials
  from the child and returns them following SIB.
• Determines whether access to preferred items
  functions as reinforcement for SIB.

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Essential Features of the Tangible Condition

• Discriminative Stimulus Adult takes and holds
  the preferred tangible item at the start of the
  session.
• EO Tangible item is unavailable in the absence
  of SIB.
• Contingency SIB produces the tangible item.

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Demand Condition

• Child is prompted to complete non-preferred tasks
  by an adult.
• The task is removed and the child is given a
  short break following SIB.
• Determines whether termination of non-preferred
  activities functions as reinforcement for SIB.

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Essential Features of the Demand Condition

• Discriminative Stimulus Instructional materials
  and demands are presented.
• EO Nonpreferred demands are presented.
• Contingency SIB results in temporary removal of
  the demands.

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Alone Condition

• Child is placed in a room alone without toys or
  materials.
• Indirectly assesses whether SIB may be maintained
  by automatic reinforcement (e.g., sensory
  stimulation).

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Essential Features of the Alone Condition

• Discriminative Stimulus Absence of another
  individual or materials.
• EO Alternative sources of stimulation are
  unavailable.
• Contingency SIB produces self-stimulation.

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Toy Play Condition

• Child and adult play together with preferred toys
  or leisure items.
• Adult delivers praise about once every 30 seconds
  for the absence of SIB.
• Designed to be an analogue of an enriched
  environment, which serves as a control condition.

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Essential Features of the Toy Play Condition

• Discriminative Stimulus Adult and toys are near
  the individual.
• EO (or AO) Attention and tangible items (toys)
  are freely available and no demands are
  presented.
• Contingency SIB produces no consequence.

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3
Attention
Per Minute
Aggressive Responses
2
Ignore
1
Demand
Tangible
Play
0
1
3
5
7
9
11
13
15
17
19
21
23
25
27
29
31
33
35
37
39
Sessions
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FCT
FCT
Baseline
Baseline
Extinction
Extinction
8
Destructive
Behavior
6
4
Response per Minute
Kirk
Communication
2
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
Session
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Functional Analysis of Covert Drug Ingestion

• Three Operant Hypotheses Generated After
  Caregiver Interview and Chart Review
• Attention/Excitement From Medical Procedures
• Attention From Mother
• Escape From Work Activities

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Functional Analysis of Covert Drug Ingestion
(cont.)

• Sessions Conducted in a Classroom and an
  Adjoining Medication Room Baited With Placebos in
  a Pillbox.
• Patient was Left Unsupervised in the Classroom
  With a Schoolwork Assignment.

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Functional Analysis of Covert Drug Ingestion
(cont.)

• In the Pillbox Were Four Pill Bottles Containing
  Placebos.
• Each Pill Bottle had a Uniquely Colored Label.
• Consuming Pills From Each Pill Bottle Produced a
  Specific Consequence.

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Functional Analysis of Covert Drug Ingestion
(cont.)

• Red Medical Attention
• Orange Attention From Mother
• Blue Rest Period (Escape)
• Yellow Control (Ignore)

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Escape From Work
15
Parent Attention
PILLS INGESTED PER MINUTE
10
Control
5
Medical Attention
LYLE
0
1
5
10
15
SESSIONS
FUNCTIONAL ANALYSIS
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Treatment of Escape-Maintained Drug Ingestion

• Lyle Earned Preferred, Nonwork Activities for
  Completing Scheduled Activities and Turning in
  Pills.
• He was Required to Complete His Least Preferred
  Work Activity (Shoe Polishing) if He Ingested
  Pills.

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Baseline
Treatment
Baseline
Treatment
20
15
10
PILLS INGESTED PER MINUTE
5
LYLE
0
10
20
30
40
50
60
70
80
SESSIONS
TREATMENT ANALYSIS
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Treatment Extension of Escape-Maintained Drug
Ingestion

• Lyle was Gradually Exposed to Different Settings
  where He was Observed and Supervised Less.
• Detection Methods Were Faded From Direct
  Observation to Pill Bottles With Residue and Then
  to Weekly Tox Screens.

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Modifying Functional Analyses to Identify
Idiosyncratic Social and Automatic Functions

• Wayne W. Fisher, Rachel H. Thompson, David E.
  Kuhn, Cathleen C. Piazza, Greg P. Hanley

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Previous Models

• Iwata et al. (1982/1994)
• Multielement Analog Assessment
• Mace Lalli (1991)
• Linking Descriptive Assessments and Experimental
  Analyses

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Previous Models (cont.)

• Wacker et al. (1991)
• Brief Analog Assessments
• Vollmer et al. (1993)
  Iwata et al. (1994)
• Reversal and Pairwise Designs

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Previous Models (cont.)

• Vollmer et al. (1995)
• Model That Provided Decision Rules for Moving
  from Brief to Multielement, to Extended Alone, to
  Reversal Designs
• Current Model
• No Brief Assessment
• DAs for Identifying Idiosyncratic Functions
• Methods for Identifying Specific Automatic
  Functions

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Conduct Standard Functional Analysis
If High Rates in Alone, Analyze Automatic Sources
of SR or SR-
If High Rates in Most Conditions, Conduct
Extended Alone, Reversals or Pairwise Analyses
If Social Function is Clear, Proceed to Treatment
If Low or Variable Rates, Conduct Descriptive
Assessment
Generate and Test Hypotheses About Idiosyncratic
Functions
If Responding Decreases, Conduct Reversals or
Pairwise Analyses
If Responding Persists, Analyze Automatic Sources
of SR or SR-
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Conduct Standard Functional Analysis
If High Rates in Alone, Analyze Automatic Sources
of SR or SR-
If High Rates in Most Conditions, Conduct
Extended Alone, Reversals or Pairwise Analyses
If Social Function is Clear, Proceed to Treatment
If Low or Variable Rates, Conduct Descriptive
Assessment
Generate and Test Hypotheses About Idiosyncratic
Functions
If Responding Decreases, Conduct Reversals or
Pairwise Analyses
If Responding Persists, Analyze Automatic Sources
of SR or SR-
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3
Attention
Per Minute
Destructive Responses
2
Ignore
1
Demand
Play
Tangible
0
1
3
5
7
9
11
13
15
17
19
21
23
25
27
29
31
33
35
37
39
Sessions
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FCT
FCT
Baseline
Baseline
Extinction
Extinction
8
Destructive
Behavior
6
4
Response per Minute
Communication
2
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
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Session
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Conduct Standard Functional Analysis
If High Rates in Alone, Analyze Automatic Sources
of SR or SR-
If High Rates in Most Conditions, Conduct
Extended Alone, Reversals or Pairwise Analyses
If Social Function is Clear, Proceed to Treatment
If Low or Variable Rates, Conduct Descriptive
Assessment
Generate and Test Hypotheses About Idiosyncratic
Functions
If Responding Decreases, Conduct Reversals or
Pairwise Analyses
If Responding Persists, Analyze Automatic Sources
of SR or SR-
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3
2
Alone
BUTT PICA PER MINUTE
1
Social Attention
Toy Play
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
SESSIONS
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3
Herbal
2
BUTT PICA PER MINUTE
Tobacco
1
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
SESSIONS
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100
90
80
70
60
PERCENTAGE OF TRIALS CONSUMED
50
40
30
20
10
0
Herbal Butts
Tobacco
Tobacco Butts
Herbs
Paper
STIMULI
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NCF
NCF v. NCF Interrupt
NCF Interrupt
BL
3.0
2.0
NCF
BUTT PICA PER MINUTE
1.0
NCF Interrupt
0.0
11
16
21
29
34
37
42
47
52
55
60
65
1
6
SESSIONS
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Conduct Standard Functional Analysis
If High Rates in Alone, Analyze Automatic Sources
of SR or SR-
If High Rates in Most Conditions, Conduct
Extended Alone
If Social Function is Clear, Proceed to Treatment
If Low or Variable Rates, Conduct Descriptive
Assessment
Generate and Test Hypotheses About Idiosyncratic
Functions
If Responding Decreases, Conduct Reversals or
Pairwise Analyses
If Responding Persists, Analyze Automatic Sources
of SR or SR-
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25.5
20
16
Demand
12
DESTRUCTIVE RESPONSES PER MINUTE
8
Tangible
4
Attention
Play
0
1
5
9
13
17
21
25
29
33
37
41
45
49
53
57
61
65
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SESSIONS
Functional Analysis
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Attention vs. Play
Tangible vs. Play
Demand vs. Play
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Attention
Demand
12
DESTRUCTIVE RESPONSES PER MINUTE
8
Tangible
4
Play
0
72
74
76
78
80
82
84
86
88
90
94
98
92
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SESSIONS
Functional Analysis (Pairwise)
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Conduct Standard Functional Analysis
If High Rates in Alone, Analyze Automatic Sources
of SR or SR-
If High Rates in Most Conditions, Conduct
Extended Alone, Reversals or Pairwise Analyses
If Social Function is Clear, Proceed to Treatment
If Low or Variable Rates, Conduct Descriptive
Assessment
Generate and Test Hypotheses About Idiosyncratic
Functions
If Responding Decreases, Conduct Reversals or
Pairwise Analyses
If Responding Persists, Analyze Automatic Sources
of SR or SR-
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Descriptive Assessment Methods

• Staff and Parent Interviews
• Collect ABC Data
• Sulzer-Azaroff Mayer, 1977
• Selected Naturalist Observations
• Probe Sessions
• Hypothesis Development

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Case Example Idiosyncratic Social Function

• Hypothesis I Respondent Behavior Elicited by
  Transitions or Changes in Routine
• Hypothesis II Escape from or Avoidance of
  Transitions or Changes in Routine
• Hypothesis III Escape from Nonpreferred Tasks

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100
90
M
Sarah
H
80
70
H
60
Engagement
M
Chosen
PERCENTAGE OF TRIALS CONSUMED
50
40
30
20
L
L
10
0
Schoolwork
Dust
Pick Up Trash
Make Bed
Fold Clothes
Set Table
Wash Windows
Vacuum
TASKS
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2
Transition From Moderate Preference Task
Transition From High Preference Task
Transition From Low Preference Task
Sarah
High to Low
Moderate to Low
DESTRUCTIVE RESPONSES PER MINUTE
1
Low to Moderate
High to Moderate
Moderate to High
Low to High
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
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SESSIONS
Task Transition Assessment
60
BL
DRAEXT(ESC)
4
100
90
VACUUM
80
Destructive Responses
3
70
60
2
50
40
30
1
20
Compliance
10
0
0
DESTRUCTIVE RESPONSES PER MINUTE
PERCENT DURATION COMPLIANCE
4
100
Sarah
90
WINDOWS
80
3
70
60
2
50
40
30
1
20
10
0
0
1
3
5
7
9
11
13
15
17
19
21
23
25
27
29
31
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Treatment Evaluation
SESSIONS
(Transitions to Low Preference)
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Summary of 29 Cases

• Clear Function Identified During Standard
  Functional Analysis
• Social SR N 16 (55.2)
• Automatic SR N 2 (6.9)
• Total N 18 (62.1)

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Summary of 29 Cases (cont.)

• Function Clarified Through Additional Analyses
• Idiosyncratic
• Social SR N 7 (24.1)
• Pervasive
• Automatic SR N 4 (13.8)
• Total N 11 (37.9)

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