A Practical Guide to Functional Assessment and Treatment for Severe Problem Behavior

1st Edition - October 29, 2024
Imprint: Academic Press
Editors: Joshua Jessel, Peter Sturmey
Language: English
Paperback ISBN:
9 7 8 - 0 - 4 4 3 - 2 1 7 6 9 - 2
eBook ISBN:
9 7 8 - 0 - 4 4 3 - 2 1 7 6 8 - 5

A Practical Guide to Functional Assessment and Treatment for Severe Problem Behavior discusses how to utilize functional assessment and function-based treatment for patients… Read more

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A Practical Guide to Functional Assessment and Treatment for Severe Problem Behavior discusses how to utilize functional assessment and function-based treatment for patients with severe problem behaviors. The book begins by defining problem behavior, contrasting functional and structural definitions, and clearly reviewing the term “severe”. The second section, Functional Assessment of Problem Behavior, reviews three different assessments in detail, providing sample questionnaires, methods for interviewing and brief bonus videos. The third section, Function-Based Treatments, outlines three main treatment options, including comprehensive and trauma-informed strategies and outline information on collecting, graphing, and analyzing treatment data.

The final section, Promoting Sustainability and Compassionate Care will review strategies to implement these assessments and treatments in a culturally relevant and compassionate way.

A Practical Guide to Functional Assessment and Treatment for Severe Problem Behavior
Cover image
Title page
Table of Contents
Copyright
Contributors
Preface
Reference
Section A: Introduction to behavioral assessment and intervention
Chapter 1 Problem behavior: Overview and contemporary issues
Abstract
Keywords
1 Overview
1.1 Topographies of problem behavior
2 Contemporary issues
3 Chapter summary
References
Chapter 2 Blueprints of behavior: Unraveling the threads of problem behavior within applied behavior analysis
Abstract
Keywords
1 Consequences
2 Antecedents
3 Historical overview of functional analysis
4 Application and overview of functional assessment
5 Functional assessment process and purpose
6 Comparison of function-based vs non-function-based interventions
7 Ethical considerations
8 Conclusion
References
Chapter 3 Prevention and behavioral hygiene procedures
Abstract
Keywords
Conflict of interest
1 Skill-building programs
1.1 Preschool Life Skills: Building skills via a class wide or response-to-intervention model
1.2 The Balance Program: Building skills in a one-to-one format
2 Avoiding problem behavior
2.1 Universal Protocols: An adjunct to other programming
2.2 Strategies
2.3 Personalization
3 Conclusion
References
Section B: Functional assessment of problem behavior
Chapter 4 Indirect assessments: Reliability, validity, and treatment utility
Abstract
Keywords
1 Indirect assessments
2 Questionnaires and rating scales
2.1 Questions about Behavioral Function
2.2 Motivation Assessment Scale
2.3 Functional Analysis Screening Tool
2.4 Problem Behavior Questionnaire
2.5 Comparison of questionnaires and rating scales
3 Interviews
3.1 Open-ended functional assessment interview
3.2 Sleep Assessment and Treatment Tool
4 Case example
5 Conclusion
References
Chapter 5 Descriptive assessments: Observation of behavior and the environment
Abstract
Keywords
1 Descriptive assessments: Observation of behavior and the accompanying contingencies
1.1 Importance of functional assessment
1.2 Rapport building
1.3 Informed consent and assent
1.4 Cultural and linguistic diversity
1.5 Providing choices and preference assessments
2 Descriptive assessment
2.1 Antecedent-behavior-consequence (ABC) recording
2.2 The scatterplot
2.3 Data analysis methods
2.4 Semi-structured assessments
3 Conclusion
References
Chapter 6 Functional analysis: Methodological variations and conceptual considerations
Abstract
Keywords
1 From behavior modification to functional analysis
2 Five core components of the standard functional analysis
3 Functional analysis as part of a comprehensive assessment
4 Functional analysis variations
4.1 Brief functional analysis
4.2 Latency-based functional analysis
4.3 Trial-based functional analysis
4.4 Precursor functional analysis
4.5 Single test condition functional analyses
4.6 Functional analysis based on individual characteristic: The problem with the statement “The function is ..”
4.7 Practical functional assessment
4.8 Adaptations of the IISCA
5 Safety concerns and other recommendations during functional analysis
6 Conclusion
References
Chapter 7 Practical considerations and clinical contributions of different functional assessment methods
Abstract
Keywords
1 Types of functional assessments
1.1 Indirect assessments
1.2 Descriptive assessments
1.3 Experimental functional analyses
2 Functional assessment processes
2.1 Indirect assessments or descriptive assessments alone
2.2 Indirect and descriptive assessments together
2.3 Experimental functional analyses alone
2.4 Indirect assessments, descriptive assessments, and experimental FAs together
2.5 Other considerations
3 Conclusions
References
Section C: Function-based treatments
Chapter 8 Foundational treatment components of function-based interventions
Abstract
Keywords
1 Antecedent-based interventions
1.1 Noncontingent reinforcement
1.2 Choice-making
2 Consequence-based interventions
2.1 Extinction
2.2 Differential reinforcement
2.3 Applications of differential reinforcement interventions
2.4 Reinforcement-schedule thinning approaches
3 Collecting, graphing, and analyzing treatment data
4 Conclusion
References
Chapter 9 Contemporary intervention approaches when addressing dangerous behavior
Abstract
Keywords
1 The conventional approach
2 A shift in commitments
3 A contemporary process for addressing dangerous behavior
3.1 Skill-based treatment
4 Progress toward effectiveness
5 Promoting choice and assent
6 Indices of happiness
7 Social validity and acceptability
8 Conclusion
References
Chapter 10 Addressing severe problem behavior without clear socially mediated functions
Abstract
Keywords
1 Conceptual issues related to automatically reinforced behavior
2 Topography of automatically reinforced problem behavior as an aspect of assessment
3 Modifications of functional assessment methodology for automatically reinforced problem behavior
4 Treatment of automatically reinforced problem behavior
4.1 Matched antecedent stimulation
4.2 Unmatched antecedent stimulation
4.3 Schedule thinning and noncontingent reinforcement
4.4 Response prevention
4.5 Consequent interventions targeting problem behavior
4.6 Interventions targeting appropriate behavior
4.7 Punishment-based interventions
5 Functional analysis, pattern analysis, and treatment of problem behavior
6 Compassionate and trauma-informed care
7 Conclusions
References
Chapter 11 ABA meets psychopharmacology: The interaction of two methodologies
Abstract
Keywords
1 Introduction to behavioral pharmacology
1.1 Mechanisms of psychotropic medications
1.2 Mechanism of antipsychotics
1.3 Mechanism of antidepressants
1.4 Mechanism of stimulants
1.5 Mechanism of anticonvulsants
1.6 Mechanism of benzodiazepines
1.7 Mechanism of naltrexone
2 Independent and interactive effects of psychotropic medication and severe problem behavior
2.1 Independent and interactive effects of antipsychotics
2.2 Independent and interactive effects of antidepressants
2.3 Independent and interactive effects of stimulants
2.4 Independent and interactive effects of mood stabilizers
2.5 Independent and interactive effects of benzodiazepines
2.6 Independent and interactive effects of naltrexone
2.7 Independent and interactive effects of polypharmacy
3 Concluding thoughts
References
Section D: Promoting sustainability and compassionate care
Chapter 12 Application considerations for compassionate, culturally responsive, and trauma-informed behavioral practices
Abstract
Keywords
1 Consideration 1: Use a posture of cultural humility
2 Consideration 2: Practice counter-modification tactics to disrupt your biases
2.1 Tactics to disrupt prejudice
2.2 Microaffirmations
2.3 Social validity assessments
2.4 Disrupting microaggressions
2.5 Implementation support
2.6 Abstain-from-controlling skills
3 Consideration 3: Using a collaborative service delivery model
3.1 Learn about your clients’ cultures and incorporate cultural adaptions
3.2 Social validity
3.3 Assent and informed consent
4 Consideration 4: Teaching replacement skills related to challenging behavior
5 Consideration 5: Enriching the environment
5.1 Design an environment with abundant safety signals
5.2 Incorporate choice
5.3 Reserve physical management for emergency procedures
6 Summary
References
Chapter 13 Preparation for the training of professionals and caregivers in behavioral programs
Abstract
Keywords
1 Introduction
2 Teaching essential procedural skills
2.1 What to teach
2.2 How to teach essential procedural skills
3 Teaching clinical decision making
3.1 How to teach clinical decision making
4 Evaluating and optimizing the effects of training
4.1 Evaluating the effects of BST
4.2 Optimizing the effectiveness of BST
5 Cultural responsiveness and the training model
6 Practical considerations
6.1 Training modality
6.2 Social validity
7 Large-scale training efforts to improve performance over time and across organizations
7.1 Pyramidal training
8 Conclusion
References
Chapter 14 Implementation considerations: Soft skills, hard skills, and the ethics of restraint
Abstract
Keywords
1 Resistance and barriers to implementation
2 The consultant role and skill set
3 Treatment integrity
4 Ethical considerations
5 Conclusion and future considerations
References
Index

Joshua Jessel

Dr. Joshua Jessel completed his master’s degree at the University of Maryland, Baltimore County where he worked with individuals who exhibited severe problem behavior on the neurobehavioral inpatient unit of the Kennedy Krieger Institute. He went on to earn his doctoral degree at Western New England University with his primary research focusing on the assessment and treatment of problem behavior with autistic children. Dr. Jessel continued to extend this line of research as a postdoctoral fellow at a clinic in Texas where he oversaw nearly 100 children admitted to an outpatient program. Dr. Jessel has currently authored over 50 research articles and chapters and continues his scholarship as an assistant professor at Queens College in New York City.

Affiliations and expertise

The Graduate Center and Department of Psychology, Queens College, City University of New York, New York, NY, United States and Department of Applied Disabilities Studies, Brock University, St. Catharines, Ontario, Canada

Peter Sturmey

I have worked with children and adults with developmental disabilities for over 30 years as a volunteer; camp counselor; researcher; clinical psychologist in the British National Health Service; Chief Psychologist in developmental centers in Texas; consultant for many community services; and consultant to the states of Louisiana and Wyoming. I have been involved in professional training in Britain, Louisiana State University and now Queens College. It has always struck me that children and adults with developmental disabilities would have a better life, be happier, more autonomous and valued by other people if their staff and family members got a little help to do few simple things –interact positively and often, use contingent reinforcement accurately, teach a few simple skills and be more sensitive to preferences. I also believe that if these happened consistently, staff and family members would feel more competent.

Affiliations and expertise

Life Sciences

Physical Sciences & Engineering

Social Sciences & Humanities

Health