Comparison of Function-Based, Nonfunction-Based, and Combined Treatments for Escape-Maintained Aggression in a Child With Attention Deficit Hyperactivity Disorder: A Case Study

Abstract

In applied behavior analysis, the use of function-based treatments to reduce problem behavior is well-supported. However, in some cases, function-based treatments alone may not be as effective as nonfunction-based treatments or function-based treatments with additional, nonfunction-based components. In this case study, we compared the delivery of preferred edible items (a nonfunction-based treatment), a break from a task (a function-based treatment), and an enhanced break, which consisted of a break plus access to a preferred tangible item (combination of a nonfunction-based and function-based treatment), to treat escape-maintained aggression exhibited by a young child with attention deficit hyperactivity disorder. Across all three treatments, reinforcement (i.e., edible, break, or enhanced break) was delivered contingent upon compliance with instructions and problem behavior resulted in escape. The nonfunction-based treatment and the combination treatment reduced aggression to zero levels; the function-based treatment did not. Finally, we allowed the participant to choose which of the three treatments he preferred to experience; he selected the combination treatment most often.

Clinical Safety and Treatment of Severe Aggression: Behavioral-Pharmacological Intervention Evaluation in a Young Adult With Autism Spectrum Disorder

“…Clinicians and students should be keenly aware of assessing the many variables that evoke and maintain aggression and other destructive behavior (Matson et al, 2008; Wilder et al, 2019). For individuals like Dwayne who are unable to self-report, assessment is predicated on taking a detailed history from available documents, conducting direct observations, inquiring with care providers, and recording behavior data that can be correlated with environmental conditions (Zangrillo et al, 2021).…”

Functional Communication Training and Most-To-Least Prompting as Treatments for Problem Behavior

“…Behaviors with this function are evoked by an aversive demand and maintained by escape from that demand (i.e., a reflexive conditioned establishing operation; Carbone et al, 2010; Michael & Miguel, 2020). One evidence-based treatment for escape-maintained problem behavior is functional communication training (FCT; Chezan et al, 2018; Wilder et al, 2019). When using FCT for escape-maintained problem behavior, the therapist presents a (aversive, by definition) demand, prompts a request for a brief break (or sometimes help), and contingently provides a brief (e.g., 30-s) break (Gerow et al, 2020).…”