Use of synthesized analysis and informed treatment to promote school reintegration

Abstract

Funding information High and Complex Needs UnitSevere problem behavior within a school can result in exclusion from education. A practitioner providing school-based services must plan an effective treatment, while mitigating safety risks to the child and others. In this study, we sought to replicate the interview-informed synthesized contingency analysis and treatment procedures developed by Hanley and colleagues in a school setting for a 12-year-old boy with autism and severe problem behavior. However, due to a severe burst in behavior, we increased treatment intensity and introduced procedures across increasing academic demand contexts to promote safety. During a treatment extension, procedures were implemented by teacher aides, across the entire school day. Treatment resulted in meaningful reductions in problem behavior, sustained improvements in compliance, and the student was fully integrated into the regular classroom. In addition, improvements in functional communication and tolerance persisted across contexts and the intervention received high social validity scores from those involved. KEYWORDSInterview-informed synthesized contingency analysis, public school, severe problem behavior, functional communication training, social validity

Assessing the generality and durability of interview‐informed functional analyses and treatment

“…Caregivers agreed that the target behaviors were important, the treatment was appropriate, and the effects acceptable. This study adds to the growing literature base (Hanley et al, 2014;Herman et al, 2018;Jessel et al, 2018;Santiago et al, 2016;Strand & Eldevik, 2017;Taylor et al, 2018) showing that socially meaningful reductions in problem behavior may be achieved when interviewinformed and synthesized reinforcers are used to strengthen the skills of communication, toleration, and contextually appropriate behavior. My child learned to accept being told "no" or "wait" from an adult.…”

“…The purpose of this was to evaluate the effectiveness of the process when implemented by nonexperts and when implemented in relevant settings. Santiago et al observed significant reductions in problem behavior and improvements in communication, caregivers were satisfied with the assessment and treatment process, and the process required slighltly less time than the clinic model described in Hanley et al More recently, Strand and Eldevik (2017), Herman, Healy, and Lydon (2018), and Taylor, Phillips, and Gertzog (2018) also replicated and extended Hanley et al in more ecologically valid environments (homes and schools) and observed marked reductions in problem behavior and increases in communication, toleration, and contextually appropriate behavior.…”

“…Although the results of the assessment and treatment model employed by Hanley et al () are promising and there have been numerous replications of the assessment process and initial stages of treatment (e.g., Ghaemmaghami, Hanley, & Jessel, ; Ghaemmaghami, Hanley, Jessel, & Landa, ; Ghaemmaghami, Hanley, Jin, & Vanselow, ; Jessel et al, ; Slaton, Hanley, & Raftery, ), there are fewer replications of the entire assessment and treatment process with evaluations of the social validity of the outcomes (Herman et al, ; Jessel et al, ; Santiago et al, ; Strand & Eldevik, ; Taylor et al, ), and there are limited data on the maintenance of effects. In addition, only three replications were published by authors who did not train with Dr. Hanley at the Life Skills Clinic at Western New England University (Herman et al, ; Strand & Eldevik, ; Taylor et al, ). Replications from different researchers are critical for understanding the utility, generality, and limits of the procedures.…”

Toward accurate inferences of response class membership

“…The validity of conclusions from synthesized reinforcement contingencies with an open‐contingency class is also supported by recent treatment effectiveness studies. Beaulieu, Clausen, Williams, and Herscovitch (), Rose and Beaulieu (), Hanley et al (), Herman, Healy, and Lydon (), Jessel et al (), Taylor, Phillips, and Gerzog (), Santiago, Hanley, Moore, and Jin (), and Strand and Eldevik (2017) all described socially validated outcomes of function‐based treatments designed from single‐test analyses that arranged interview‐informed synthesized reinforcement for open‐contingency classes. Treatments from these studies included practical schedules of reinforcement and were implemented by caregivers in relevant contexts by the close of each study.…”

An evaluation of the single‐session interview‐informed synthesized contingency analysis

“…A final limitation is that social validation of the treatment effects was not evaluated with the caregiver of one participant, and the long term and general effects of the process were not examined for all three participants (see Taylor, Phillips, & Gertzog ; Herman et al, ; or Santiago et al, for some examples of longer term and more general effects of full‐session IISCAs). Demonstrating a large reduction of problem behavior and acquisition of important skills like functional communication, delay toleration, and compliance in short sessions (5 to 20 min) within single subject designs is an important means for developing intervention technology; this methodological process demonstrating the efficacy of functional assessment based intervention (Ghaemmaghami, Hanley, & Jessel, ) has a strong precedent in this journal.…”