Caregiver- and staff-conducted functional analysis outcomes: A summary of 52 cases

Abstract

In the present study, caregivers were trained as therapists to conduct functional analyses (FAs) after staff-conducted FAs were inconclusive with 52 participants. Caregiver-conducted FAs identified at least 1 function for problem behavior when staff-conducted FAs were undifferentiated. When results of the staff-conducted FAs were questionable, subsequent caregiver-conducted FAs resulted in an exact match with staff-conducted FA in about 68% of cases but identified new functions in about 30% of cases. Function-based treatments based on caregiver-conducted FAs were effective in reducing problem behavior by an average of 96% relative to baseline. Results suggest that when staff-conducted FA outcomes yield inconclusive findings, using caregivers to conduct FAs is likely to produce differentiated results and ultimately result in the development of effective treatments.

The consecutive controlled case series: Design, data‐analytics, and reporting methods supporting the study of generality

“…A number of other studies which share features of what we define as a CCCS study have examined the outcomes of functional behavioral assessment procedures, including the analog FA conducted with inpatients (Hagopian et al, ), with outpatients (Kurtz et al, ), and with students (Mueller et al, ); and the interview‐informed synthesized contingency analysis (IISCA; Greer et al, 2019; Jessel et al, ; Slaton et al, ) . These methods have also been used to examine the outcomes associated with treatment procedures including FCT (Greer et al, ; Hagopian et al, ; Rooker et al, ) and NCR (Phillips et al, ).…”

“…In light of the implications of case inclusion methods with respect to the generality of findings, it is important that authors of CCCS studies make explicit statements indicating whether every consecutive case exposed to the procedure is included in reporting the outcomes. The inclusion criteria may be focused on the application of a specific clinical procedure (e.g., assessment or treatment procedure; Derby et al, ) or sequence of procedures (e.g., FCT schedule thinning; Greer et al, ), a shared clinical target (e.g., SIB; Iwata, Pace et al, 1994), or shared clinical condition (e.g., Fragile‐X syndrome; Kurtz et al, ). Including this information is necessary to provide a more accurate account of the obtained outcomes for the sample and informs statements about its generality to others.…”

“…An informal and noncomprehensive review of studies that have elements of the CCCS suggests that many are retrospective studies. Some have examined the general efficacy of clinical procedures (e.g., FA; Iwata, Pace et al, 1994; IISCA; Jessel et al, ; FCT; Rooker et al, ; NCR; Phillips et al, ), the generality of procedures to specific clinical populations (e.g., Fragile X syndrome; Kurtz et al, ), or the epidemiology and phenomenology of SIB (Iwata, Pace et al, 1994 and Hagopian et al, , respectively). These studies summarize outcomes obtained in the course of delivering standard clinical care and the assessment or intervention selection is based on the clinician's judgment about the needs of the client or student.…”

Functional analysis and treatment of problem behavior exhibited by children with fragile X syndrome

“…This study represents a consecutive case-series in that all participants who met the inclusion criteria were included regardless of outcome. The consecutive case-series design was employed to minimize selection bias that might favor a particular outcome (e.g., Kurtz, Fodstad, Huete, & Hagopian, 2013;Rooker et al, 2013).…”

Noncontingent reinforcement for the treatment of severe problem behavior: An analysis of 27 consecutive applications

“…Because a single‐case experimental design is used in each case, these studies have high internal validity and have stronger external validity relative to studies describing fewer cases. Consecutive controlled case‐series studies of late have examined functional communication training (Rooker et al, ), schedule thinning during functional communication training (Greer, Fisher, Saini, Owen, & Jones, ), and functional analysis and treatment implemented by caregivers (Kurtz, Fodstad, Huete, & Hagopian, ). The current study employed a consecutive controlled case‐series design to extend the literature on NCR.…”