A Functional Approach to the Assessment and Treatment of Challenging Behavior: A Description with Video Examples
By John Lee, Patrick Romani, David Wacker, Scott Lindgren and Todd Kopelman for the exclusive use by the authors and the website https://travisithompson.net/
The image at the end of this sentence is a clickable link that will take you to a video example of play conducted as part of an FA and will appear when a video example is available.
Anchor and image with link to “Play” video were in my version here. (Please look in the folder “TT_NewsLetter\Video_Examples\index.files\html5video” for the videos in .mov and .mp4 formats that should be compatible with your software. There are also videos in .m4v and .webm formats there too.)
The first step of the FA is typically to create a situation in which there is no reason for the child to use challenging behavior for any of the purposes listed above. This situation is typically called a free play or control condition, and was shown to you in the previous video clip. In this condition applied behavior analysts try to provide the optimal type and amount of attention, unrestricted access to toys and activities, and removal of demands, non-preferred items and non-preferred activities. If we do not see any challenging behavior in this condition, we have a control condition that shows that challenging behavior may be functional; challenging behavior may function to change the environment. These results are also used to compare against other test conditions of the FA. If challenging behavior occurs much more often in a test condition than during free play, we have identified a specific environmental function. Test conditions often involve the parent: (a) ignoring the child (and then attending only when challenging behavior occurs), (b) restricting access to preferred toys (and presenting the toy only when challenging behavior occurs), and (c) presenting demands (but removing the demand only when challenging behavior occurs). Each of these conditions tests the role of a specific function. Does challenging behavior increase if it produces attention, preferred items, or breaks from demands? If challenging behavior occurs in any of the test conditions, and stops when that condition stops or during free play, then we have identified a function.
Once the FA shows that challenging behavior is functional for a person, applied behavior analysts then employ treatment based on the identified function. FCT is the most common reinforcement-based treatment and was first described by Dr. Edward Carr and Dr. Mark Durand in 1985. FCT is an intervention that attempts to replace challenging behavior with a more appropriate communicative behavior that serves the same function. The goal of this approach is to teach and reinforce an appropriate communicative response(s) (e.g. “play please”) that can be used in place of the challenging behavior. We try to make the communicative response as easy to use and as effective as the challenging behavior because we want the children to use their communication to make requests to control their environment rather than to use their challenging behavior. Many research teams, including our team at Iowa, have experienced a great deal of success with these procedures and high acceptability ratings by parents
In the following video example you will see the parent conducting an example of FCT that was based on the results of the FA. This is early in treatment and the child is required to do a brief amount of work before returning to play. John (first author) is coaching the family via telehealth and is shown in the upper right-hand corner. It is his voice that you hear coaching mom.
Beavers, G. A., Iwata, B.A., & Lerman, D.C. (2013). Thirty years of research on the functional analysis of problem behavior. Journal of Applied Behavior Analysis, 46 (1), 1-21. doi: 10.1002/jaba.30
Carr, E.G. & Durand, V.M. Reducing behavior problems through functional communication training. Journal of Applied Behavior Analysis, 18 (2), 111-126. doi: 10.1901/jaba.1985.18-111
Harding, J.W., Wacker, D.P., Berg, W.K., Lee, J.F., & Dolezal, D. (2009). Conducting functional communication training in home settings: A case study and recommendations for practitioners. Behavior Analysis in Practice, 2 (1), 21-33.
Iwata, B.A., Dorsey, M.F., Slifer, K.J., Bauman, K.E., & Richman, G.S. (1982). Toward a functional analysis of self-injury. Analysis & Intervention in Developmental Disabilities, 2 (1), 3-20. doi: 10.1016/0270-4684(82)9003-9
Wacker, D.P., Lee, J.F., Padilla-Dalmau, Y.C., Kopelman, T.G., Lindgren, S.D., Kuhle, J., Pelzel, K.E., & Waldron, D.B. (2013). Conducting functional analyses of problem behavior via telehealth. Journal of Applied Behavior Analysis, 46 (1), 31-46
Wacker, D.P., Lee, J.F., Padilla-Dalmau, Y.C., Kopelman, T.G., Lindgren, S.D., Kuhle J., Pelzel, K.E., Dyson, S., Schieltz, K.M., & Waldron, D.B. (2013). Conducting functional communication training via telehealth to reduce the problem behavior of young children with autism.Journal of Developmental and Physical Disabilities, 25 (1), 35-48. doi: 10.1007/s10882-012-9314-0