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Functional Analysis of Low-Rate Problem Behavior

Permanent Link: http://ufdc.ufl.edu/UFE0021329/00001

Material Information

Title: Functional Analysis of Low-Rate Problem Behavior
Physical Description: 1 online resource (44 p.)
Language: english
Creator: Rolider, Natalie Ursula
Publisher: University of Florida
Place of Publication: Gainesville, Fla.
Publication Date: 2007

Subjects

Subjects / Keywords: Psychology -- Dissertations, Academic -- UF
Genre: Psychology thesis, Ph.D.
bibliography   ( marcgt )
theses   ( marcgt )
government publication (state, provincial, terriorial, dependent)   ( marcgt )
born-digital   ( sobekcm )
Electronic Thesis or Dissertation

Notes

Abstract: When problem behavior occurs infrequently during assessment, identification of its maintaining variables (via functional analysis) may by difficult or impossible. A strategy for altering standard functional analysis conditions was evaluated after initial assessment results yielded undifferentiated, low-rate responding. Several variables that may influence behavior were identified and systematically manipulated during modified functional analysis sessions: noncontingent attention and tangible items were delivered to peer confederates during sessions while the participant was ignored (combined establishing operations), consequences were delivered for longer durations (enhanced reinforcer characteristics), participants were given access to attention and preferred tangibles during the escape interval of demand conditions (combined contingencies), and all visible cues related to observation were removed from the alone condition (covert observation). An additional manipulation involved increased exposure to contingencies associated with each session by conducting longer sessions. Functional analysis conditions were conducted until differentiated rates of responding were observed in one or more of the modified conditions. Seven individuals participated in the study. Results for 3 participants showed that the modified conditions produced differentiation (i.e., higher rates of problem behavior in one or both of the social-reinforcement conditions). One participant began to engage in high rates of self-injurious behavior during the covert alone condition. Results for the 3 remaining participants showed that increased exposure to standard functional analysis conditions produced higher rates of responding than standard-length sessions. The overall results suggested that this may be a viable model for the assessment of low-rate behavior.
General Note: In the series University of Florida Digital Collections.
General Note: Includes vita.
Bibliography: Includes bibliographical references.
Source of Description: Description based on online resource; title from PDF title page.
Source of Description: This bibliographic record is available under the Creative Commons CC0 public domain dedication. The University of Florida Libraries, as creator of this bibliographic record, has waived all rights to it worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law.
Statement of Responsibility: by Natalie Ursula Rolider.
Thesis: Thesis (Ph.D.)--University of Florida, 2007.
Local: Adviser: Iwata, Brian.

Record Information

Source Institution: UFRGP
Rights Management: Applicable rights reserved.
Classification: lcc - LD1780 2007
System ID: UFE0021329:00001

Permanent Link: http://ufdc.ufl.edu/UFE0021329/00001

Material Information

Title: Functional Analysis of Low-Rate Problem Behavior
Physical Description: 1 online resource (44 p.)
Language: english
Creator: Rolider, Natalie Ursula
Publisher: University of Florida
Place of Publication: Gainesville, Fla.
Publication Date: 2007

Subjects

Subjects / Keywords: Psychology -- Dissertations, Academic -- UF
Genre: Psychology thesis, Ph.D.
bibliography   ( marcgt )
theses   ( marcgt )
government publication (state, provincial, terriorial, dependent)   ( marcgt )
born-digital   ( sobekcm )
Electronic Thesis or Dissertation

Notes

Abstract: When problem behavior occurs infrequently during assessment, identification of its maintaining variables (via functional analysis) may by difficult or impossible. A strategy for altering standard functional analysis conditions was evaluated after initial assessment results yielded undifferentiated, low-rate responding. Several variables that may influence behavior were identified and systematically manipulated during modified functional analysis sessions: noncontingent attention and tangible items were delivered to peer confederates during sessions while the participant was ignored (combined establishing operations), consequences were delivered for longer durations (enhanced reinforcer characteristics), participants were given access to attention and preferred tangibles during the escape interval of demand conditions (combined contingencies), and all visible cues related to observation were removed from the alone condition (covert observation). An additional manipulation involved increased exposure to contingencies associated with each session by conducting longer sessions. Functional analysis conditions were conducted until differentiated rates of responding were observed in one or more of the modified conditions. Seven individuals participated in the study. Results for 3 participants showed that the modified conditions produced differentiation (i.e., higher rates of problem behavior in one or both of the social-reinforcement conditions). One participant began to engage in high rates of self-injurious behavior during the covert alone condition. Results for the 3 remaining participants showed that increased exposure to standard functional analysis conditions produced higher rates of responding than standard-length sessions. The overall results suggested that this may be a viable model for the assessment of low-rate behavior.
General Note: In the series University of Florida Digital Collections.
General Note: Includes vita.
Bibliography: Includes bibliographical references.
Source of Description: Description based on online resource; title from PDF title page.
Source of Description: This bibliographic record is available under the Creative Commons CC0 public domain dedication. The University of Florida Libraries, as creator of this bibliographic record, has waived all rights to it worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law.
Statement of Responsibility: by Natalie Ursula Rolider.
Thesis: Thesis (Ph.D.)--University of Florida, 2007.
Local: Adviser: Iwata, Brian.

Record Information

Source Institution: UFRGP
Rights Management: Applicable rights reserved.
Classification: lcc - LD1780 2007
System ID: UFE0021329:00001


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134a8ded3e1295b6f4bb08693bf899eb60b9d6e9







FUNCTIONAL ANALYSIS OF LOW-RATE PROBLEM BEHAVIOR


By

NATALIE U. ROLIDER













A DISSERTATION PRESENTED TO THE GRADUATE SCHOOL
OF THE UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT
OF THE REQUIREMENTS FOR THE DEGREE OF
DOCTOR OF PHILOSOPHY

UNIVERSITY OF FLORIDA

2007





































O 2007 Natalie U. Rolider



































To my parents, Amos and Ora









ACKNOWLEDGMENTS

I would like to thank all those who made this dissertation possible. Thanks to the graduate

and undergraduate students who helped in the development and implementation of this study,

especially Erin Camp, Jennifer Fritz, Jennifer Hammond, Brooke Jones, and Yanerys Leon.

Thanks to my family for their love, advice, and unwavering support from across the miles.

Thanks to my boyfriend, Gerard, for being my local family and providing constant

encouragement. Thanks to my committee members, Drs. Scott Miller, Stephen Smith, and

Timothy Vollmer for their cooperation and assistance. And finally, I extend a special thank you

to my advisor, Dr. Brian Iwata, for his guidance, patience, and encouragement. His high

standards have made this experience one of the most difficult and, at the same time, the most

fulfilling of all.












TABLE OF CONTENTS


page

ACKNOWLEDGMENT S ............. ......___ .............. 4....


LIST OF TABLES ............. ......___ ..............6....


LIST OF FIGURES ............. ......___ ..............7....


AB STRACT ............. .............. 8.....


1 INTRODUCTION ................. ................. 10..............


Response Class ................. ........... ................. 11....
Combined Establishing Operations.............. ............... 12
Reinforcer Characteristics ................. ................. 13.............
Combined Contingencies ................. ................. 14.............
Covert Behavior.............. ................ 15
Insufficient Exposure ................ ................. 16..............
Purpose ................ ................. 18..............

2 M ETHOD ................. ................. 19.............


Participants and Setting .............. .... ........... .......... ........... 1
Response Measurement and Interobserver Agreement ....._____ .......___ ............._ 19
Procedures .............. ....._ .............. 20....
Preference Assessment ............... ......_ ..............20....
Standard (Initial) Functional Analysis ................ ..............20. ..............
Modified Functional Analysis ................ ..............23. .......... ....
Standard Functional Analysis (30 min). ................ ..............26. .......... ...
Modified Functional Analysis (30 min) ................ ..............26. .......... ...


3 RE SULT S ............. ......___ .............. 29...


4 DI SCUS SSION ............. ......___ .............. 3 5...


LIST OF REFERENCES .............. ..............41.....


BIOGRAPHICAL SKETCH. ............._ ..............44.____.......










LIST OF TABLES

Table page

2-1 Participant characteristics. ........... ..... ._ ..............27...

2-2 Response topographies. ................ ................. 28......... ....










LIST OF FIGURES


Figure page

3-1 Levels of problem behavior during standard and modified functional analysis
conditions for Phyllis, Debbie, Terrance, and Jacob. ....._._._ .......___ ........._....32

3-2 Levels of problem behavior during standard and modified functional analysis
conditions for Tony, Glenn, and Becky. ......................... .......... ...........3

3-3 Cumulative frequency of target behaviors during the first 30-min session with
problem behavior ................. ..............34. ...............









Abstract of Dissertation Presented to the Graduate School
of the University of Florida in Partial Fulfillment of the
Requirements for the Degree of Doctor of Philosophy

FUNCTIONAL ANALYSIS OF LOW-RATE PROBLEM BEHAVIOR

By

Natalie U. Rolider

August 2007

Chair: Brian Iwata
Major: Psychology

When problem behavior occurs infrequently during assessment, identification of its

maintaining variables (via functional analysis) may by difficult or impossible. A strategy for

altering standard functional analysis conditions was evaluated after initial assessment results

yielded undifferentiated, low-rate responding. Several variables that may influence behavior

were identified and systematically manipulated during modified functional analysis sessions:

noncontingent attention and tangible items were delivered to peer confederates during sessions

while the participant was ignored (combined establishing operations), consequences were

delivered for longer durations (enhanced reinforcer characteristics), participants were given

access to attention and preferred tangibles during the escape interval of demand conditions

(combined contingencies), and all visible cues related to observation were removed from the

alone condition (covert observation). An additional manipulation involved increased exposure to

contingencies associated with each session by conducting longer sessions. Functional analysis

conditions were conducted until differentiated rates of responding were observed in one or more

of the modified conditions. Seven individuals participated in the study. Results for 3 participants

showed that the modified conditions produced differentiation (i.e., higher rates of problem

behavior in one or both of the social-reinforcement conditions). One participant began to engage









in high rates of self-injurious behavior during the covert alone condition. Results for the 3

remaining participants showed that increased exposure to standard functional analysis conditions

produced higher rates of responding than standard-length sessions. The overall results suggested

that this may be a viable model for the assessment of low-rate behavior.









CHAPTER 1
INTRODUCTION

The results of over 30 years of research on problem behavior such as aggression, property

destruction, and self-injury have shown that these behaviors are learned responses. That is,

variables responsible for the acquisition and maintenance of problem behavior are based on an

individual's history of interaction with the social and physical environment in the form of

reinforcement contingencies. Once these contingencies are identified, treatment can involve the

modification of relevant antecedents and consequences to effect reductions in problem behavior.

In the context of behavior disorders, functional analysis methodology involves the

identification of variables that influence the occurrence of problem behavior through the

experimental manipulation of suspected maintaining contingencies. In a controlled environment,

programmed antecedent and consequent events are varied to produce an empirical demonstration

that behavior will occur in the presence of one contingency but not in its absence. A

comprehensive model for concurrently assessing the sensitivity of problem behavior to positive,

negative, and automatic reinforcement was first described by Iwata, Dorsey, Slifer, Bauman, and

Richman (1982/1994). The utility of the procedures described by Iwata et al. has been

demonstrated in hundreds of published studies and is considered the standard behavioral

assessment methodology within the Hield of applied behavior analysis (Hanley, Iwata, &

McCord, 2003).

A basic assumption of functional analysis methodology is that under optimal conditions

of reinforcement, responding will occur at differential rates across conditions, thereby facilitating

a conclusion of behavioral function. However, results of several large-scale studies have shown

that differential functional analysis results are not always obtained. In their summary of 79

outpatient brief functional analyses, Derby et al., (1992) reported that 36.7% of individuals did









not display the target behavior during assessment. In a similar analysis conducted on a short-term

inpatient program, it was reported that 9% of 152 clients (14 individuals) did not display the

target behavior during the first 3 days of admission and were subsequently discharged from the

clinic (Asmus et al., 2004).

The assessment and treatment of problem behavior that occurs infrequently or at very low

rates poses a challenge for functional analysis methodologies (Iwata, 1994). When problem

behavior occurs infrequently or sporadically during assessment, its determinants may be difficult

to identify. Many factors can account for low-rate behavior during assessment, and a review of

the literature generated six potential determinants of infrequent responding. Each of these factors

is described below.

Response Class

In a response class hierarchy, different topographies of problem behavior that share a

common effect on the environment occur in an escalating sequence (Lalli, Mace, Wohn, &

Livezey, 1995). A particular topography of problem behavior may occur rarely if it is one of

several members of a response class and is the least likely to occur. During functional analysis,

the identification of maintaining variables for severe problem behavior may be limited if

reinforcement is concurrently provided for less severe problem behavior (Harding et al., 2001;

Richman, Wacker, Asmus, Casey, & Andelman, 1999), resulting in low or zero rates of severe

problem behavior. Magee and Ellis (2000) demonstrated this pattern of responding with 2

participants who exhibited multiple topographies of problem behavior. When the authors

provided consequences for multiple topographies of problem behavior in a functional analysis,

they observed a single topography consistently in one test condition for each participant. When

extinction was arranged for the most common response, a decrease in that response and

concomitant increases in other responses were observed. Extinction was sequentially applied to









the other responses, and similar effects were observed. Thus, when an individual displays more

than one topography of problem behavior, it may be necessary to provide consequences only for

the most severe topography (and to arrange extinction for more common, less severe

topographies) during functional analysis in order to increase the occurrence of an individual's

most severe problem behavior.

Combined Establishing Operations

Typical functional analysis conditions involve the presentation of a single establishing

operation (deprivation from attention) and the delivery of a corresponding consequence

(attention) contingent on problem behavior. However, some problem behavior maintained by a

given contingency may be occasioned only in the presence of more than one establishing

operation. Mace, Page, Ivancic, and O'Brien (1986) described a functional analysis condition

labeled "divided attention," in which the antecedent condition involved the therapist attending to

another person in the room in addition to ignoring the participant. In this case, two establishing

operations were present: the absence of attention and its delivery to someone else. The divided-

attention condition was included in a functional analysis for 2 participants who engaged in

aggression. Although both participants engaged in higher levels of aggression in other social-

reinforcement test conditions, responding was higher in the divided-attention condition than in

the play (control) condition, suggesting the utility of the combined establishing operation

arrangement. In a subsequent study, Fisher, Kuhn, and Thompson (1998) compared levels of

destructive behavior during standard-, divided-, and noncontingent-attention conditions with 1

participant and saw high levels of destructive behavior during the divided-attention condition,

and near-zero rates of behavior in the standard- and noncontingent-attenti on conditions. These

data suggest that low rates of problem behavior might be observed when it is occasioned by

idiosyncratic stimulus conditions. An alternative circumstance of multiple establishing










operations was suggested by Ringdahl, Winborn, Andelman, and Kitsukawa (2002), who found

that the presence of leisure items in the attention condition may suppress problem behavior

maintained by attention. Thus, for some individuals the absence of attention may occasion

problem behavior but only if alternative sources of reinforcement (e.g., toys) also are

unavailable.

Similarly, problem behavior maintained by social negative reinforcement might only

emerge when two or more establishing operations are concurrently present. For example, the

presence of task demands and sleep deprivation (O'Reilly, 1995) or task demands coupled with

an ear infection (O'Reilly, 1997) may occasion episodic problem behavior in some individuals.

When it may be unethical to induce some of these events, it may be possible to wait for the

occurrence of one establishing operation (a headache) before introducing the second establishing

operation (task demands) during functional analysis conditions, although this may result in long

delays between assessment sessions.

Reinforcer Characteristics

Some problem behavior may be maintained by an idiosyncratic quality of reinforcement,

or by unusual consequences. When these consequences or their associated establishing

operations are absent during a functional analysis, zero or low rates of problem behavior may be

observed. Several studies have examined the effects of access to forms of attention other than

verbal reprimands during a functional analysis (Fisher, Ninness, Piazza, & Owen-DeSchryver,

1996; Kodak, Northup, & Kelley, 2007; Piazza et al., 1999; Richman & Hagopian, 1999). For

example, after an initial functional analysis resulted in low and sporadic occurrences of problem

behavior for 2 participants, Richman and Hagopian conducted a second assessment that was

based on direct observations of the participants' interactions with their caregivers. The second

assessment consisted of comparing levels of problem behavior during a standard attention









condition (wherein brief reprimands were delivered contingent on problem behavior) to a

condition in which a different type of attention (physical attention in the form of being picked up

for one participant, and exaggerated high-pitched, dramatic statements about the problem

behavior for the second participant) was delivered contingent on problem behavior. Results

showed high and consistent levels of problem behavior in the modified-attention conditions,

suggesting that these participants' problem behaviors were maintained by particular types of

attention that were not included in their initial functional analysis.

It is possible that an increase in the magnitude of reinforcement (delivering more attention

or allowing a longer escape interval) may facilitate the emergence of higher rates of problem

behavior during a functional analysis, although no studies to date have specifically examined the

use of larger magnitudes of reinforcement to clarify ambiguous functional analyses. Conducting

an extended descriptive analysis (e.g., A-B-C data collection) might be necessary to identify

potential reinforcers for problem behavior maintained by unusual consequences (compliance

with the participant's mands [Bowman, Fisher, Thompson, & Piazza, 1997], access to self-

restraint materials [Vollmer & Vorndran, 1998]).

Combined Contingencies

Unlike multiple control, in which problem behavior is maintained by two separate

contingencies (aggression for either attention or escape), or control by multiple establishing

operations, in which behavior maintained by a given contingency occurs only in the presence of

more than one establishing operation, maintenance by combined contingencies occurs when

problem behavior results in access to two different consequences at the same time (aggression

during the demand condition produces both escape and access to positive reinforcement). In a

recent attempt to arrange both positive and negative reinforcement contingencies within

functional analysis conditions, Call, Wacker, Ringdahl, and Boelter (2005) exposed 1 participant









to a condition in which a therapist delivered a prompt at the beginning of the session to engage in

a task and then ignored the participant except to deliver attention contingent upon problem

behavior. A second participant was exposed to a condition in which a therapist prompted the

participant to engage in tasks while a preferred leisure item was present but unavailable. The

participant was given a 20-s break from work contingent on problem behavior, but access to the

tangible item remained restricted throughout the session. Thus, although potential establishing

operations for both negative reinforcement (a task demand situation) and positive reinforcement

(attention or preferred items) were presented, only one of the associated consequences was

delivered contingent on problem behavior (attention for the first participant; escape for the

second), representing an incomplete analysis of combined contingencies.

Although not conducted in the context of a functional analysis, a study by Zarcone, Fisher,

and Piazza (1996) showed that one participant's responding significantly increased when both

negative and positive reinforcement contingencies (20 s break from work with access to

preferred stimuli during the break) were in effect. These results suggest that the addition of an

assessment condition in which problem behavior results in access to both positive and negative

reinforcement simultaneously may occasion higher-rate responding in some individuals.

Covert Behavior

Covert problem behavior is behavior that occurs in the absence of social contingencies and

that actually is suppressed by the presence of others. Typical test conditions for automatic

reinforcement involve observing individuals while they are left "alone" in an austere

environment and recording occurrences of problem behavior. Depending on the facility and

resources available, observations are conducted from behind a partition or screen (Paisey &

Whitney, 1989), through an observation window (Rapp, Miltenberger, Galensky, Ellingson, &

Long, 1999), or via video monitoring (Long, Miltenberger, Ellingson, & Ott, 1999; Ringdahl et










al., 2002). The prevalence of covert behavior is unknown, mainly because many studies provide

anecdotal reports on the covert nature of problem behavior but do not provide an empirical

demonstration of such (Grace, Thompson, & Fisher, 1996; Maglieri, DeLeon, Rodriguez-Catter,

& Sevin, 2000). Studies by Paisey and Whitney and by Ringdahl et al. are exceptions. Paisey and

Whitney showed that an individual engaged in low levels of pica when an observer was in the

room (even though the observer never interacted with the individual) but in much higher levels

of pica when the observer was stationed in a closet. Ringdahl et al. showed that one individual's

stereotypy did not occur when an adult was present in the room but did occur when the adult was

absent. Thus, a functional analysis may result in low or zero rates of covert problem behavior

when some feature of the test condition for automatic reinforcement is discriminative for the

presence of others. It is possible that the assessment of covert behavior will necessitate

conducting functional analysis alone sessions in settings that minimize the individuals' ability to

discriminate the presence of observers.

Insufficient Exposure

Problem behavior may occur at low rates during functional analyses due to limited

exposure to either an establishing operation or a reinforcement contingency. An example of this

may be seen in the Derby et al. (1992) study that reported outcome data from a large number of

brief functional analyses, which consisted of one, 5- or 10-min session of each test and control

condition. The authors were unable to identify the function of problem behavior for 29 of 79 of

participants because they never observed it during the assessment. It is unclear whether these

findings were the direct result of insufficient exposure to assessment conditions, but subsequent

analyses of the effects of repeated exposure to assessment contingencies (Kahng & Iwata, 1999)

and of session duration (Wallace & Iwata, 1999) indicate that both may influence functional

analysis outcomes. Of particular interest were three cumulative records from the Wallace and









Iwata study showing little or no responding during the first 5 min of a 15-min session. Although

Wallace and Iwata did not examine session durations beyond 15 min, their data suggest that

continued exposure to establishing operations and/or contingencies may be required to occasion

some problem behavior.

A more extreme example of the effects of session duration was described by Kahng, Abt,

and Schonbachler (2001). After an initial functional analysis (with 10-min sessions) resulted in

zero instances of aggression, the authors extended the observation periods to 7 hours (9:00 AM -

4:00 PM) and conducted one functional analysis condition each day. The all-day assessment

produced differentiated results in that increasing rates of aggression were observed in one

condition (attention) only; however, this method may be limited in that lengthy sessions may be

difficult to implement or may require imposition of severe deprivation from social interaction

(e.g., during attention and ignore conditions).

Tarbox, Wallace, Tarbox, Landaburu, and Williams (2004) described an alternative

procedure that was evaluated with 3 participants whose initial functional analysis resulted in low

or zero rates of problem behavior. Functional analysis sessions were initiated when, during the

course of daily activities, an episode of problem behavior was observed. During these sessions,

moderate to high rates of problem behavior were observed in the attention and demand condition

for 2 participants, and in the attention condition only for the third participant, while rates of

problem behavior remained low during the control condition. Although this procedure involved a

simple scheduling manipulation, it was unclear how much time and effort were required to

conduct the low-rate assessment. That is, no information was provided on how much time passed

or what was required to observe the participants prior to initiating the functional analysis. In

addition, all 3 participants were exposed to relatively brief initial functional analyses (6 to 12, 5-










min sessions). It is possible that problem behavior eventually would have emerged had additional

or longer sessions been conducted.

Purpose

The purpose of this study was to evaluate a strategy for altering functional analysis

conditions when the results of an initial functional assessment yielded undifferentiated and low-

rate responding. The modified assessment conditions were designed to account for the

aforementioned determinants of low-rate behavior.









CHAPTER 2
IVETHOD

Participants and Setting

Seven individuals who attended either an adult vocational day program or a school for

students with developmental disabilities participated. All participants were referred for the

assessment and treatment of low frequency, high-intensity self-injurious behavior (SIB),

aggression, or property destruction. Participant information is listed in Table 2-1. Sessions were

conducted in therapy rooms at the day program or in a classroom at the school two to five times

per day, 2 to 4 days per week.

Response Measurement and Interobserver Agreement

Target behaviors were operationally defined on an individual basis and are listed in Table

2-2. Trained observers recorded the occurrence in 10-s intervals (Jacob) or frequency (all other

participants) of target and therapist behaviors using handheld or laptop computers. A second

observer simultaneously and independently collected data during an average 43.7% (range,

30.7%-59.4%) of sessions for each participant. In comparing observers' records, agreement

percentages for frequency data were calculated by first dividing session time into 10-s intervals.

The smaller number of recorded responses in each interval was divided by the larger number;

these fractions were averaged across the session and multiplied by 100% to yield the percentage

agreement between two observers. Agreement percentages for occurrence data were calculated

by dividing the number of intervals in which both observers scored the occurrence or

nonoccurrence of responses by the total number of intervals in the session and multiplying by

100%. Mean percentage agreement across participants was 99.3% (range, 75%-100%) for the

target behavior and 94.0% (range, 56.7%-100%) for therapist responses.









Procedures


Preference Assessment

Prior to the start of the study, a preference assessment was conducted to identify preferred

edible and leisure items for use in the functional analysis. Items were presented either in all

possible pairs (Fisher et al., 1992) or as a group (DeLeon & Iwata, 1996), and the participant was

prompted to "select one." At least seven stimuli were assessed, and the participant was allowed

brief access to all items prior to the assessment. The three highest-ranked items (i.e., the three

stimuli approached on the highest percentage of trials) were selected for use in subsequent

tangible, play, multiple Sr+, and Sr-/Sr+ conditions. Two moderate-to-low ranked items (i.e., the

two items ranked fifth and sixth from the top of the hierarchy) were selected for use in

subsequent attention conditions.

Standard (Initial) Functional Analysis

The initial functional analysis was conducted according to the procedures described by

Iwata et al. (1982/1994), with the inclusion of a tangible condition, as well as condition-

correlated stimuli (e.g., different therapists and settings, colored shirts; Conners et al., 2000) to

enhance discrimination between different functional analysis conditions. Each condition was run

at least six times, yielding approximately 30 sessions (Phyllis was an exception; her tangible and

ignore conditions were not included until the second and third series of the functional analysis,

respectively). Sessions were conducted in a room containing a table and chairs and relevant

session materials (when applicable) as described below. All sessions in this phase were 10 min in

length. The functional analysis conditions (alone or ignore, attention, tangible, demand, and

play) were alternated in a multi-element experimental design.

Alone. The participant was alone in a room equipped with a one-way observation window

through which data collectors observed the participant and recorded instances of the target









behavior. The participant did not have access to leisure items or social interaction. The purpose

of this condition was to test for maintenance by automatic reinforcement. That is, if behavior

persisted under conditions in which no social reinforcement contingencies were programmed and

in which stimuli that may occasion escape-maintained behavior were absent, then evidence for

behavior maintained by automatic reinforcement was provided. The alone condition was

conducted with the participants for whom SIB was the only target behavior (Debbie and Jacob),

and with Terrance, who was reported to engage in property destruction when unsupervised.

Ignore. The participant and a therapist were seated approximately 1 m from one another in

a room. The participant did not have access to leisure items, and the therapist did not interact

with the participant throughout the session. The purpose of this condition was similar to that of

the alone condition, except the presence of the therapist was necessary for the occurrence of

aggression. The ignore condition was conducted with the 3 participants who engaged in

aggression (Phyllis, Glenn, and Becky) and with Tony, who had a history of engaging in

property destruction (tearing paper and clothes) in his classroom. Note that paper materials were

present in all conditions of the functional analysis conducted with Tony.

Attention. The participant and a therapist were seated approximately 1 m apart in a room

that contained moderate-to-low preferred items from the preference assessment. The session

began after the therapist instructed the participant to play with the toys while the therapist had

work to do (i.e., was engaged with reading material). Contingent on each occurrence of the target

behavior, the therapist delivered a brief statement of concern or disapproval (e.g., "Don't do that,

you're going to hurt yourself'; "Don't throw things, you might break them") paired with brief

physical contact (e.g., hand on arm or shoulder) and then resumed reading. The therapist ignored

all other participant behaviors. The purpose of the attention condition was to test if the target









behavior was maintained by social positive reinforcement in the form of brief contingent

attention delivered by the therapist.

Tangible. The participant and a therapist were seated in a room that contained highly

preferred items from the preference assessment. The participant had free access to the preferred

items for 2 min prior to the session, after which the therapist told the participant it was time to

"put the toys away," removed the items, and began the session. The therapist delivered attention

whenever solicited by the participant; however, questions or comments pertaining to the items

were ignored. Contingent on each occurrence of the target behavior, the therapist delivered the

items to the participant for 30 s and then removed them again. The therapist ignored all other

participant behaviors. The purpose of this condition was to test if the target behavior was

maintained by social positive reinforcement specifically in the form of contingent access to

preferred items.

Demand. The participant and a therapist were seated at a table where instructional (e.g.,

academic, self-care, or domestic task) materials were present. The therapist presented

instructional trials using a graduated, three-prompt sequence. The therapist delivered a verbal

instruction initially and allowed the participant 5 s to initiate a response. If, after 5 s, the

participant did not initiate the appropriate response, the therapist repeated the instruction,

modeled the correct response, and waited an additional 5 s. If an incorrect or no response

occurred, the therapist delivered the instruction a third time and physically guided the participant

through the response, using the least amount of contact necessary to complete it. The therapist

delivered praise contingent upon independent completion of a correct response (i.e., following

the verbal or model prompt), and then initiated the next instructional trial. Contingent on each

occurrence of the target behavior during the prompting sequence, the therapist terminated the









instructional trial, removed the instructional materials, and turned away from the participant for

30 s. At the end of the 30 s break, the therapist re-initiated the instructional trial (unless the

participant was engaging in the target behavior, in which case the therapist waited until 3 s with

no instances of the target behavior occurred before re-initiating the instructional trial). The

purpose of the demand condition was to test whether the target behavior was maintained by

social negative reinforcement in the form of escape from or avoidance of demand situations.

Play. The participant and the therapist were seated in a room that contained highly

preferred items from the preference assessment. The participant had free access to the preferred

items, the therapist delivered attention (i.e., praise) and brief physical contact at least once every

30 s, and no instructional demands were presented. All occurrences of the target behavior were

ignored, and scheduled delivery of attention was delayed for 3 s following the occurrence of the

target behavior. The play condition served as a control for the above test conditions. That is, the

establishing operations (deprivation from attention or stimulation, or the presentation of

instructional trials) for social and automatic reinforcement, as well as the contingencies for

problem behavior, were eliminated or at least minimized in this condition.

Modified Functional Analysis

Participation in the modified functional analysis of the study required that the participant' s

standard functional analysis yield (a) zero or near-zero rates of responding across all conditions,

or (b) isolated occurrences not indicative of any particular function. Glenn met these criteria;

however, his aggression was of such high intensity that it was deemed unsafe to allow additional

individuals (i.e., peer confederates) to participate in Glenn's sessions. Thus, Glenn did not

participate in the modified functional analysis.

The test conditions of the functional analysis were modified to account for idiosyncratic

variables that may affect responding. Specifically, establishing operations and reinforcement









contingencies were combined, and reinforcer characteristics were enhanced. All sessions in this

phase were 10 minutes in length, and participants were exposed to at least three of the modified

functional analysis conditions described below. The modified functional analysis conditions

were alternated in a multi-element experimental design.

Multiple Sr+. The participant, therapist, and 1-3 peer confederates of the client were

seated in a room that contained highly preferred items from the preference assessment. The

participant had 3-5 min of pre-session exposure to attention from the therapist and confederates,

as well as access to the items. At the start of the session, the therapist told the participant it was

time for "the other kids to play," removed the items and delivered them to the confederates, and

directed verbal and physical attention only to the confederates. Contingent on each occurrence of

the target behavior, the therapist and confederates delivered 30 s of verbal and physical attention

and access to the preferred items. At the end of the 30-s reinforcement interval, attention and the

items were again removed and were delivered to the confederates. The therapist and confederates

ignored all non-target participant behaviors, and the therapist blocked the participant' s access to

the items. The purpose of the this condition was to test if the target behavior would be

occasioned by the unavailability of multiple positive reinforcers along with their delivery to

others (combined establishing operations), and maintained by social positive reinforcement in the

form of contingent access to various forms of attention and preferred items.

Sr-/Sr+. If the participant demonstrated high levels of compliance (i.e., 90% or above) in

the initial functional analysis, new task demands were identified via direct observation or

caregiver/teacher report. The participant and therapist were seated at a table where instructional

(e.g., academic, self-care, or domestic task) materials were present, and 1-3 peer confederates

were seated next to the participant and consumed the highly preferred items from the preference









assessment. The therapist presented instructional trials using the graduated, three-step prompt

sequence (or a modified sequence based on direct observation or anecdotal reports). Compliance

with instructional trials resulted in no programmed consequences, and the next instructional trial

was initiated. Contingent on each occurrence of the target behavior during the prompting

sequence, the therapist terminated the instructional trial and removed the instructional materials,

and the therapist and confederates delivered 45 s of verbal and physical attention and access to

the preferred items. At the end of the 45-s reinforcement interval, attention and the items were

again removed and were delivered to the confederates, and instructional trials resumed. The

purpose of the Sr-/Sr+ condition was to test if the target behavior was sensitive to the combined

antecedent events of work and the unavailability of positive reinforcement and was maintained

by social negative and positive reinforcement (combined contingencies in the form of escape

plus access to attention and preferred items during break).

Modified alone. The participant was alone in a room that had no windows and was

equipped with a hidden camera in lieu of an observation window. The participant did not have

access to leisure items or social interaction. The purpose of this condition was to test for

maintenance by automatic reinforcement in a setting that was less discriminative for the presence

of others (i.e., no visual cues). The modified alone condition was intended for participants whose

sole target behavior was SIB (Debbie and Jacob); however, Debbie's school could not

accommodate a room equipped with a hidden camera, and a standard alone condition was

conducted during her modified functional analysis.

Play. The play condition was conducted as described in the standard functional analysis

(above) .









Each condition of the modified functional analysis was conducted at least four times.

Participants were exposed to one or both of the subsequent phases of the study if their modified

functional analyses continued to yield (a) zero or near-zero rates of responding across all

conditions, or (b) isolated occurrences not indicative of any particular function.

Standard Functional Analysis (30 min)

Standard functional analysis conditions were conducted as described above; however, all

sessions were 30 min in length (Becky's standard functional analysis sessions consisted solely of

consecutive 30-min demand sessions; see below for details). An undifferentiated (i.e., low-rate)

pattern of responding as described above resulted in participation in the subsequent phase of the

study .

Modified Functional Analysis (30 min)

Modified functional analysis conditions were conducted as described above; however, all

sessions were 30 min in length. Becky was the only participant exposed to these procedures,

which were conducted immediately following her modified functional analysis (10 min

sessions). The order of phases was reversed for Becky because hers was the first functional

analysis that was conducted, and the most of efficient order of conditions was not established at

the time.





Table 2-1. Participant characteristics.

Participant Age Diagnosis

Phyllis 48 Moderate MR, seizure disorder


Debbie 16 Moderate-severe MR, autism


Target behaviors
Aggression (hair pulling)


SIB (face slapping, head banging,
hair pulling)

Property destruction (object/surface
banging, throwing items)

SIB (skin picking)


Property destruction (tearing or
throwing items)

SIB (face slapping, body hitting),
aggression (hitting)

Aggression (hitting, biting)


Terrance


Jacob


Tony


Glenn


Becky


MR, autism, seizure disorder


MR, Prader-Willi Syndrome


Profound MR, Angelman Syndrome


Moderate MR


Mild MR, Prader-Willi Syndrome










Table 2-2. Response topographies.

Behavior Definition

SIB


Body hitting


Face slapping


Hair pulling


Head banging


Skin picking


Aggression
Biting others


Hair pulling


Hitting others


Property destruction
Obj ect/surface banging


Tearing items


Throwing items


Contact between hand and chest from a distance of 6
inches or greater.

Contact between hand and face or head from a distance of
6 inches or greater.

Fingers intertwined in hair, grabbing or pulling hair.


Contact of head on a hard surface from a distance of 3
inches or greater.

Contact between fingernail and skin.



Closure of upper and lower teeth on any part of another
person's body.

Fingers intertwined in another person's hair, pulling on
hair.

Audible contact between participant' s hand and another
person.


Contact between participant' s hand or foot and wall or
obj ects from a distance of 6 inches or greater.
Tearing of paper or clothing for at least 1/2 inch.


Thrown items land 6 inches or more from their original
position.









CHAPTER 3
RESULTS

Figure 3-1 shows the results of the standard and modified functional analyses for Phyllis,

Debbie, Terrance, and Jacob. All participants engaged in zero or near-zero rates of problem

behavior across all conditions of the original (standard) functional analysis. When the functional

analysis conditions were modified, Phyllis's aggression, although occurring at low rates, was

observed during 5 of the 7 multiple Sr+ sessions. Thus, data indicated that her aggression was

maintained by social positive reinforcement in the form of access to both attention and preferred

activities in situations where those reinforcers were being delivered to others. During Debbie's

modified functional analysis, increased rates of SBE were observed in the Sr-/Sr+ condition, no

SIB was observed in the multiple Sr+ condition, and rare occurrences of SIB were observed in

the alone and play conditions. These results indicated that Debbie's SIB was occasioned by work

situations in which problem behavior produced access to attention and preferred items (Sr+)

during breaks from tasks (Sr-). During Terrance's modified functional analysis, increased rates

of property destruction were observed in the multiple Sr+ condition, with lower rates of property

destruction in the Sr-/Sr+ and play conditions. These results were verified during a subsequent

pairwise comparison, in which Terrance engaged in increasing rates of property destruction

during the multiple Sr+ condition and near-zero responses during the play condition, indicating

that his problem behavior was maintained by social positive reinforcement in the form of access

to both attention and preferred activities in situations when others are provided access to those

reinforcers. Finally, Jacob's SIB was observed only in the alone condition of the modified

functional analysis; no instances of SIB were observed during the multiple Sr+, Sr-/Sr+, or play

conditions. These results indicated that Jacob's SBE was maintained by automatic reinforcement,









and that a more covert setting than that typically used to conduct alone sessions occasioned

responding.

Figure 3-2 shows results obtained for Tony, Glenn, and Becky. Tony engaged in zero or

near-zero instances of property destruction during both the standard and modified functional

analyses. However, when standard functional analysis sessions were lengthened to 30 min, high

rates of property destruction were observed in the demand condition, whereas zero or rare

occurrences of property destruction were observed in all other conditions. These results indicated

that Tony's property destruction was maintained by social negative reinforcement in the form of

breaks from tasks. However, an increase in session length was required to clarify the function of

Tony's property destruction. Glenn did not engage in any occurrences of aggression or SIB

during the standard functional analysis when sessions were 10 min in length. Sessions that were

30 min in length, however, resulted in increased rates of aggression and SIB during the demand

condition, indicating that Glenn's problem behavior was maintained by social negative

reinforcement in the form of breaks from tasks. Becky engaged in aggression in 2 of 6 tangible

sessions during the standard functional analysis; however, these low and sporadic rates did not

seem indicative of a clear function. Becky's aggression did not increase during the modified

functional analysis when sessions were 10 min in length. Modified functional analysis sessions

that were 30 min in length, however, resulted in increased rates of aggression during the multiple

Sr+ and Sr-/Sr+ conditions. To clarify whether these increased rates of aggression resulted from

session modification versus increased session length (both of which occurred during this phase),

we conducted consecutive 30-min standard demand sessions. Results of this phase showed that

Becky's aggression maintained when her exposure to standard conditions was lengthened and










suggest that the apparent cause of Becky's initial functional analysis phases was lack of exposure

to functional analysis sessions.

Within-session patterns of responding were examined for the functional analyses that were

clarified following increased exposure to session contingencies. Figure 3-3 shows the cumulative

frequency of target behaviors during the first 30-min session in which problem behavior was

observed for Tony, Glenn, and Becky (sessions 60, 33, and 49, respectively). The arrow below

the x-axis points to where a 10-min session would have been terminated. These data show that

Tony and Glenn began to engage in their target behaviors only after the 10th min Of the session

(Tony at min 13, Glenn at min 27). Becky engaged in a few responses between minutes 7 and 10,

and then showed a steady rate of responding throughout the rest of the session. For all 3

participants, had the session been terminated after 10 min, little (Becky) or no (Tony and Glenn)

responding would have been observed.


































































Attention Dmn Ply Tangible Aoe


____1____1___1___1__1------1-1------- --- -- --


n


I I I I
10 20 30 40 50
SESSIONS


Figure 3-1. Levels of problem behavior during standard and modified functional analysis
conditions for Phyllis, Debbie, Terrance, and Jacob.


Standard FA


Modifed FA


0.


-


Mult. Sr+

Sr-/Sr+



o-A--o~"


10


Standard FA


Modifed FA
Sr-/Sr+





Mult. Sr+


10 20

Standard FA


40

Modifed FA


10 20 30


Standard FA


Play Attention Ignore Demand Tangibkt


Play Alone Tangible Attention Demand


40 50


Modifed FA




Mod,.Aon


Mult. Sr+ Sr- ~r+











Standard FA


Modifed FA


Standard FA (30 min)


Tony


10 20 30 40 50 60


Standard FA









[~~ noeAtninTnil eadPa


Standard FA (30 min)


Modifed FA Standard FA
(30 min) | (30 min)


10 20 30 40 50 60


SESSINS~T


Figure 3-2. Levels of problem behavior during standard and modified functional analysis
conditions for Tony, Glenn, and Becky.











Tony


MINUTES


Figure 3-3. Cumulative frequency of target behaviors during the first 30-min session with
problem behavior.









CHAPTER 4
DISCUSSION

Problem behavior occurs infrequently because the conditions that influence it are unusual,

and several possibilities that might account for such findings have been reported in isolated

studies. Through an analysis of unusual assessment findings, we identified several determinants

of low-rate responding and constructed functional analysis conditions that accommodated them.

The general model was evaluated with 7 individuals who engaged in low-rate, high-intensity

behavior and whose initial assessments resulted in very little or no responding. These "low-rate"

functional analyses accounted for approximately 12% of all functional analyses that were

conducted over an 18 month-period. Modified functional analysis conditions that involved

multiple establishing operations, enhanced reinforcer characteristics, and combined

contingencies clarified three assessments, and increased exposure to session contingencies

clarified three other assessments. A condition that involved an unobtrusive observation strategy

for covert behavior clarified the final participant' s assessment. These results provided a further

demonstration of the versatility of experimental approaches to behavioral assessment. When it is

suspected that unusual events or combinations of events influence behavior, that possibility may

be tested and verified directly.

Results of the initial functional analysis resembled those reported in several studies

showing that, in some cases, typical functional analysis conditions may not identify the

environmental determinants of problem behavior. One possibility that may account for such

results is that behavior is maintained by commonly observed reinforcing consequences such as

attention or escape but that these consequences are delivered infrequently. This account is

unlikely, however, because programmed consequences are delivered under dense schedules in

typical functional analyses.









Another possibility is that problem behavior occurs at zero or low rates due to a lack of

discrimination between the different test or control conditions (Conners et al., 2000). However,

a discrimination failure was unlikely in the present study given that stimulus controls (i.e.,

distinctive visual cues) specifically designed to minimize interaction effects were included in all

assessment conditions.

A third possibility is that occurrences of the target behavior may be infrequent if other

behaviors are members of the same response class and also are reinforced during assessment

(Harding et al., 2001). The effects of minimizing the number of response topographies in the

contingency class were not explicitly demonstrated in the present study. That is, contingencies

during the initial functional analysis were placed only on the target behaviors for which the

participants were referred, thereby obviating our ability to examine changes in responding due to

extinction of less-severe members of a response class during the modified conditions. However,

our participants were referred for the assessment and treatment of severe problem behaviors, and

even when contingencies during standard conditions were limited to those responses, target

behaviors were rarely or never observed.

Fourth, problem behavior may occur infrequently during assessment if the antecedent or

consequent events are insufficient to evoke or reinforce behavior, respectively. That is, the

antecedent events typically manipulated in a functional analysis (i.e., low levels of attention,

presentation of instructions) may constitute neutral events for some individuals. We attempted to

increase the potency of antecedent influences on behavior maintained by positive reinforcement

by arranging a condition wherein multiple positive reinforcers were unavailable but were

delivered to others; the delivery of these reinforcers for a longer period of time following

problem behavior strengthened the potency of consequent events. Although not evaluated in









isolation, the specific contribution of this manipulation may be seen in Phyllis' s and Terrance' s

data, which showed that their respective target behaviors increased noticeably only during the

multiple Sr+ condition of the modified functional analysis. Similarly, the negative reinforcement

contingency could have been strengthened by increasing the duration of the escape interval.

Rather than enhancing the duration of escape, however, we chose to enhance the quality of

escape by providing free access to attention and highly preferred leisure items during contingent

breaks from instruction, and the effects of this modification can be seen in Debbie' s data, which

showed an increase in responding only during the Sr+/Sr- condition of the modified functional

analysis.

In a functional analysis of covert problem behavior, the target response will occur

infrequently (or not at all) when assessment conditions are associated with stimuli that are

discriminative for the presence of others. This may include the test condition for automatic

reinforcement if some feature of the alone setting, such as the presence of an observer or even

just an observation window, permits an individual to detect the presence of observers. In Jacob's

modified functional analysis, the test condition for automatic reinforcement was conducted in a

setting that considerably minimized this possibility, and high rates of problem behavior were

observed in that condition only. Although not replicated with other participants, these results

suggest that sophisticated methods of unobtrusive observation may be necessary to verify the

covert nature of some behaviors.

Finally, limited exposure to session contingencies may account for low rates of problem

behavior during assessment. Our results showed that extending the duration of functional

analysis sessions to 30 min (in contrast to approximately 7 hours in the Kahng et al., 2001 study)

was sufficient to produce differential increases in problem behavior in three cases. Given that










increased exposure was found to be an important determinant of low-rate behavior, a question

that arises is whether simply continuing standard functional analysis sessions eventually would

have produced differential responding. In other words, an inherent feature of the modified

conditions was increased exposure to assessment. However, the standard functional analysis

conditions were continued for an extended run with little or no responding, so it is unlikely that

relatively quick changes observed under modified conditions were simply a function of running

more sessions. Increased session duration also involved additional exposure to functional

analysis contingencies; however, the within-session analysis of responding indicated that longer

sessions and not simply more sessions were necessary to strengthen the establishing operations

associated with the different conditions.

Some limitations of the present analysis should be noted. First, although we concluded

that Becky's low-rate responding in her initial assessment was due to lack of exposure to

functional analysis sessions, her modified analysis only included an evaluation of behavior under

30-min (standard) demand conditions. A more definitive conclusion regarding the determinants

of Becky's behavior may have been obtained had a full set of 30-min standard conditions been

conducted.

Second, the participation of peer confederates in functional analysis sessions may not be

appropriate when high-intensity aggression may occur during the assessment, as was the case

with Glenn. The decision to exclude peers from assessment sessions should be made by

considering whether their presence places them at risk for undue harm. If this is the case, it may

be possible to examine only the effects of increased exposure to standard conditions.

Alternatively, the possibility of including non-peer confederates may be explored. For example,

therapists trained in maintaining their own and others' safety when dealing with aggressive









clients may assume the role of confederates. Future studies may explore the effects of including

pseudo versus actual peers as confederates during modified functional analysis sessions.

The overall results of the present study raise questions about the general implementation of

functional analysis methodology. That is, one implication of these results is that functional

analysis procedures should include the modified conditions at the outset. Such a strategy does

not seem advisable for two reasons. First, results reported in a large number of studies indicate

that simple contingencies often account for problem behavior; therefore, the inclusion of

additional conditions during the initial assessment may further complicate the process

unnecessarily. Second, some of the modified conditions contained confounded variables whose

separate influences would later need to be identified. For example, if high levels of problem

behavior were observed in the both of the social reinforcement conditions (multiple Sr+ and Sr-

/Sr+), a subsequent test would be required to determine which of the two variables (positive or

negative reinforcement) was responsible for the observed effect. Thus, the modified conditions

described in the present study seem appropriate under special circumstances (i.e., following the

completion of a functional analysis that rules out typical influences and results in infrequent

responding).

Finally, our procedures did not account for all possible determinants of low-rate

responding. For example, our analysis did not include procedures for assessing combined

establishing operations such as the presence of an environmental event along with a biological

one (O'Reilly, 1995, 1997), which may require delaying the occurrence of one establishing

operation (e.g., presentation of task demands) until the second establishing operation (e.g., a

headache) is present. In addition, our analysis did not include situations that involved highly

specific consequences (e.g., attention delivered by a specific caregiver [Ringdahl & Sellers,










2002], escape from activities only when a particular alternative activity is made available, etc.),

which may be useful to explore if the present procedures do not produce an increase low-rate

behavior. Future research may be helpful in documenting these influences and demonstrating

how they may be operationalized for the purposes of assessment.










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BIOGRAPHICAL SKETCH

Natalie Rolider received her Bachelor of Arts in Psychology in 2002 from Emek Yezreel

College in Israel. After completing an introductory course in applied behavior analysis, she

began serving as a therapist for home-based early intervention programs for young children with

autism and assisting in conducting parent-training seminars. Those experiences led her to seek

further training in behavior analysis, and so she accepted the position offered to her by the

Psychology Department at the University of Florida (UF) to study under the supervision of Dr.

Brian Iwata. While at UF, Natalie had the opportunity to conduct clinical research with

individuals with developmental disabilities at various laboratory sites: an adult vocational

program, a residential program for individuals with Prader-Willi Syndrome, an outpatient clinic

for children diagnosed with autism, and a special education school. Following graduation,

Natalie intends to pursue an academic career in applied behavior analysis, with emphasis on the

identification and use of reinforcers to increase adaptive behavior and the assessment and

treatment of problem behavior.





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1 F U N C T I O N A L A N A L Y S I S O F L O W R A T E P R O B L E M B E H A V I O R B y N A T A L I E U R O L I D E R A D I S S E R T A T I O N P R E S E N T E D T O T H E G R A D U A T E S C H O O L O F T H E U N I V E R S I T Y O F F L O R I D A I N P A R T I A L F U L F I L L M E N T O F T H E R E Q U I R E M E N T S F O R T H E D E G R E E O F D O C T O R O F P H I L O S O P H Y U N I V E R S I T Y O F F L O R I D A 2007

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2 2007 N a t a l i e U R ol i de r

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3 T o m y pa r e nt s A m os a nd O r a

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4 A C K N O W L E D G M E N T S I w oul d l i ke t o t ha nk a l l t hos e w ho m a de t hi s d i s s e r t a t i on pos s i bl e T ha nks t o t he gr a dua t e a nd unde r gr a dua t e s t ude nt s w ho he l pe d i n t he de ve l opm e nt a nd i m pl e m e nt a t i on of t hi s s t udy, e s pe c i a l l y E r i n C a m p, J e nni f e r F r i t z J e nni f e r H a m m ond, B r ooke J one s a nd Y a ne r ys L e on. T ha nks t o m y f a m i l y f or t he i r l ove a dvi c e a nd un w a ve r i ng s uppor t f r om a c r os s t he m i l e s T ha nks t o m y boyf r i e nd G e r a r d f or be i ng m y l oc a l f a m i l y a nd pr ovi di ng c ons t a nt e nc our a ge m e nt T ha nks t o m y c om m i t t e e m e m be r s D r s S c ot t M i l l e r S t e phe n S m i t h a nd T i m ot hy V ol l m e r f or t he i r c oope r a t i on a nd a s s i s t a nc e A nd f i na l l y, I e xt e nd a s pe c i a l t ha nk you t o m y a dvi s or D r B r i a n I w a t a f or hi s gui da nc e p a t i e nc e a nd e nc our a ge m e nt H i s hi gh s t a nda r ds ha ve m a de t hi s e xpe r i e nc e one o f t he m o s t di f f i c ul t a nd, a t t he s a m e t i m e t he m os t f ul f i l l i ng of a l l

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5 T A B L E O F C O N T E N T S pa ge A C K N O W L E D G M E N T S . . . . . . . . . . . . . . . . . . . . . . . . . . 4 L I S T O F T A B L E S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 L I S T O F F I G U R E S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 A B S T R A C T . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 1 I N T R O D U C T I O N . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 R e s pons e C l a s s . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 C om bi ne d E s t a bl i s hi ng O pe r a t i ons . . . . . . . . . . . . . . . . . . . . . 12 R e i nf or c e r C ha r a c t e r i s t i c s . . . . . . . . . . . . . . . . . . . . . . . . 13 C om bi ne d C ont i nge nc i e s . . . . . . . . . . . . . . . . . . . . . . . . 14 C ove r t B e ha vi or . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 I ns uf f i c i e nt E xpos ur e . . . . . . . . . . . . . . . . . . . . . . . . . . 16 P ur pos e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 2 M E T H O D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 P a r t i c i pa nt s a nd S e t t i ng . . . . . . . . . . . . . . . . . . . . . . . . . 19 R e s pons e M e a s ur e m e nt a nd I nt e r obs e r ve r A gr e e m e nt . . . . . . . . . . . . . . 19 P r oc e dur e s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 P r e f e r e nc e A s s e s s m e nt . . . . . . . . . . . . . . . . . . . . . . . . 20 S t a nda r d ( I ni t i a l ) F unc t i ona l A na l ys i s . . . . . . . . . . . . . . . . . . 20 M odi f i e d F unc t i ona l A na l ys i s . . . . . . . . . . . . . . . . . . . . . 23 S t a nda r d F unc t i o na l A na l ys i s ( 30 m i n) . . . . . . . . . . . . . . . . . . 26 M odi f i e d F unc t i ona l A na l ys i s ( 30 m i n) . . . . . . . . . . . . . . . . . 26 3 R E S U L T S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 4 D I S C U S S I O N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 L I S T O F R E F E R E N C E S . . . . . . . . . . . . . . . . . . . . . . . . . . 41 B I O G R A P H I C A L S K E T C H . . . . . . . . . . . . . . . . . . . . . . . . . 44

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6 L I S T O F T A B L E S T a bl e pa ge 2 1 P a r t i c i pa nt c ha r a c t e r i s t i c s . . . . . . . . . . . . . . . . . . . . . . . . 27 2 2 R e s pons e t opogr a phi e s . . . . . . . . . . . . . . . . . . . . . . . . . 28

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7 L I S T O F F I G U R E S F i gur e pa ge 3 1 L e ve l s of pr obl e m be ha vi or du r i ng s t a nda r d a nd m odi f i e d f unc t i ona l a na l ys i s c ondi t i ons f or P hyl l i s D e bbi e T e r r a nc e a nd J a c ob. . . . . . . . . . . . . . 32 3 2 L e ve l s of pr obl e m be ha vi or du r i ng s t a nda r d a nd m odi f i e d f unc t i ona l a na l ys i s c ondi t i ons f or T ony, G l e nn, a nd B e c ky. . . . . . . . . . . . . . . . . . . 33 3 3 C um ul a t i ve f r e que nc y of t a r ge t be ha vi or s dur i ng t he f i r s t 30 m i n s e s s i on w i t h pr obl e m be ha vi or . . . . . . . . . . . . . . . . . . . . . . . . . . 34

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8 A bs t r a c t of D i s s e r t a t i on P r e s e nt e d t o t he G r a dua t e S c hool of t he U ni ve r s i t y of F l or i da i n P a r t i a l F u l f i l l m e nt o f t he R e qui r e m e nt s f or t he D e g r e e of D oc t o r of P hi l os o phy F U N C T I O N A L A N A L Y S I S O F L O W R A T E P R O B L E M B E H A V I O R B y N a t a l i e U R ol i de r A ugus t 2007 C ha i r : B r i a n I w a t a M a j or : P s yc hol ogy W he n pr obl e m be ha vi or oc c ur s i nf r e que nt l y dur i n g a s s e s s m e nt i de nt i f i c a t i on o f i t s m a i nt a i ni ng va r i a bl e s ( vi a f unc t i ona l a na l ys i s ) m a y by di f f i c ul t o r i m pos s i bl e A s t r a t e gy f or a l t e r i ng s t a nda r d f unc t i ona l a na l ys i s c ondi t i ons w a s e va l ua t e d a f t e r i ni t i a l a s s e s s m e nt r e s ul t s yi e l de d undi f f e r e nt i a t e d l ow r a t e r e s pondi ng. S e v e r a l va r i a bl e s t ha t m a y i nf l ue nc e be ha vi or w e r e i de nt i f i e d a nd s ys t e m a t i c a l l y m a ni pul a t e d dur i ng m odi f i e d f unc t i ona l a na l ys i s s e s s i ons : n onc ont i nge nt a t t e nt i on a nd t a ngi b l e i t e m s w e r e de l i ve r e d t o pe e r c onf e de r a t e s dur i ng s e s s i ons w hi l e t he pa r t i c i pa nt w a s i gnor e d ( c om bi ne d e s t a bl i s hi ng ope r a t i ons ) c ons e que nc e s w e r e de l i ve r e d f or l onge r d ur a t i ons ( e nha nc e d r e i n f or c e r c ha r a c t e r i s t i c s ) pa r t i c i pa nt s w e r e gi ve n a c c e s s t o a t t e nt i on a nd p r e f e r r e d t a ngi bl e s dur i ng t he e s c a pe i nt e r va l of de m a nd c ondi t i ons ( c om bi ne d c ont i nge nc i e s ) a nd a l l vi s i bl e c ue s r e l a t e d t o obs e r va t i on w e r e r e m ove d f r om t he a l one c ondi t i on ( c ove r t obs e r va t i on) A n a ddi t i ona l m a ni pul a t i on i nvo l ve d i nc r e a s e d e xpos ur e t o c ont i nge nc i e s a s s o c i a t e d w i t h e a c h s e s s i on by c onduc t i ng l onge r s e s s i ons F unc t i ona l a na l ys i s c ondi t i ons w e r e c onduc t e d unt i l d i f f e r e nt i a t e d r a t e s of r e s pondi ng w e r e obs e r ve d i n one or m or e of t he m odi f i e d c ondi t i ons S e ve n i nd i vi dua l s pa r t i c i pa t e d i n t he s t udy. R e s ul t s f or 3 pa r t i c i pa nt s s how e d t ha t t he m odi f i e d c ondi t i ons pr oduc e d d i f f e r e nt i a t i on ( i e hi ghe r r a t e s of pr obl e m be ha vi or i n one or bo t h of t he s oc i a l r e i n f or c e m e nt c ondi t i ons ) O ne pa r t i c i pa nt be ga n t o e nga ge

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9 i n hi gh r a t e s of s e l f i n j ur i ous be ha vi or dur i ng t he c ove r t a l one c ondi t i on R e s ul t s f or t he 3 r e m a i ni ng pa r t i c i pa nt s s how e d t ha t i nc r e a s e d e xpos ur e t o s t a nda r d f unc t i ona l a na l ys i s c ondi t i ons pr oduc e d hi ghe r r a t e s of r e s pondi ng t ha n s t a nda r d l e ng t h s e s s i ons T he ove r a l l r e s ul t s s ugge s t e d t ha t t hi s m a y be a vi a bl e m ode l f or t he a s s e s s m e nt of l ow r a t e be ha vi or

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10 C H A P T E R 1 I N T R O D U C T I O N T he r e s ul t s of ove r 30 ye a r s of r e s e a r c h on p r obl e m be ha vi or s uc h a s a ggr e s s i on, pr o pe r t y de s t r uc t i on, a nd s e l f i n j ur y ha ve s how n t ha t t he s e be ha vi or s a r e l e a r ne d r e s pons e s T ha t i s va r i a bl e s r e s pons i bl e f or t he a c qui s i t i on a nd m a i n t e na nc e of pr obl e m be ha vi o r a r e ba s e d on a n i ndi vi dua l s hi s t or y o f i nt e r a c t i on w i t h t he s oc i a l a nd phys i c a l e nvi r onm e nt i n t he f or m of r e i nf or c e m e nt c ont i nge nc i e s O nc e t he s e c ont i nge n c i e s a r e i de nt i f i e d, t r e a t m e nt c a n i nvol ve t he m odi f i c a t i on of r e l e va nt a nt e c e de nt s a nd c ons e que nc e s t o e f f e c t r e duc t i ons i n pr obl e m be ha vi or I n t he c ont e xt of be ha vi o r di s or de r s f unc t i ona l a na l ys i s m e t hodol ogy i nvol ve s t he i de nt i f i c a t i on of va r i a bl e s t ha t i n f l ue nc e t he oc c ur r e nc e of pr obl e m be ha vi or t h r ough t he e xpe r i m e nt a l m a ni pul a t i on o f s us pe c t e d m a i nt a i ni ng c ont i nge nc i e s I n a c ont r ol l e d e nvi r onm e nt pr ogr a m m e d a nt e c e de nt a nd c ons e que nt e ve nt s a r e va r i e d t o pr oduc e a n e m pi r i c a l de m ons t r a t i on t ha t be ha vi or w i l l oc c ur i n t he p r e s e nc e of one c on t i nge nc y but not i n i t s a bs e nc e A c om pr e he ns i ve m ode l f or c onc ur r e nt l y a s s e s s i ng t he s e ns i t i vi t y of pr ob l e m be ha vi or t o pos i t i ve ne ga t i ve a nd a ut om a t i c r e i nf or c e m e nt w a s f i r s t de s c r i be d by I w a t a D or s e y, S l i f e r B a um a n, a nd R i c hm a n ( 1982/ 1994) T he ut i l i t y of t he pr oc e dur e s de s c r i be d by I w a t a e t a l ha s be e n de m ons t r a t e d i n hundr e ds of publ i s he d s t udi e s a nd i s c ons i de r e d t he s t a nda r d be ha vi or a l a s s e s s m e nt m e t hodol ogy w i t hi n t he f i e l d of a ppl i e d be ha vi or a na l ys i s ( H a nl e y, I w a t a & M c C or d, 2003) A ba s i c a s s um pt i on of f unc t i ona l a na l ys i s m e t hodol ogy i s t ha t unde r opt i m a l c ondi t i ons of r e i nf o r c e m e nt r e s pondi ng w i l l oc c ur a t d i f f e r e n t i a l r a t e s a c r os s c ondi t i ons t he r e by f a c i l i t a t i ng a c onc l us i on of be ha vi or a l f unc t i on. H ow e ve r r e s ul t s of s e ve r a l l a r ge s c a l e s t udi e s ha ve s how n t ha t di f f e r e nt i a l f unc t i ona l a na l ys i s r e s ul t s a r e not a l w a ys ob t a i ne d. I n t he i r s um m a r y of 79 out pa t i e nt br i e f f unc t i ona l a na l ys e s D e r by e t a l ( 1992) r e por t e d t ha t 36 7% of i ndi vi dua l s di d

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11 not di s pl a y t he t a r ge t be ha vi or du r i ng a s s e s s m e nt I n a s i m i l a r a na l ys i s c onduc t e d on a s hor t t e r m i npa t i e nt pr ogr a m i t w a s r e por t e d t ha t 9 % of 152 c l i e nt s ( 14 i ndi vi dua l s ) di d not di s pl a y t he t a r ge t be ha vi or du r i ng t he f i r s t 3 da ys of a dm i s s i on a nd w e r e s ubs e que nt l y di s c ha r ge d f r om t he c l i ni c ( A s m us e t a l 2004 ) T he a s s e s s m e nt a nd t r e a t m e nt of pr obl e m be ha vi or t ha t oc c ur s i n f r e que nt l y o r a t ve r y l ow r a t e s pos e s a c ha l l e nge f or f unc t i ona l a na l ys i s m e t hodol ogi e s ( I w a t a 1994 ) W he n pr obl e m be ha vi or oc c ur s i nf r e que nt l y or s por a di c a l l y dur i n g a s s e s s m e nt i t s de t e r m i na nt s m a y be di f f i c ul t t o i de nt i f y M a ny f a c t or s c a n a c c ount f o r l ow r a t e be ha vi or dur i ng a s s e s s m e nt a nd a r e vi e w of t he l i t e r a t ur e ge ne r a t e d s i x pot e nt i a l de t e r m i na nt s of i nf r e que nt r e s pondi ng. E a c h o f t he s e f a c t or s i s de s c r i be d be l ow R e s p on s e C l as s I n a r e s pons e c l a s s hi e r a r c hy, di f f e r e nt t opogr a phi e s of pr obl e m be ha vi or t ha t s ha r e a c om m on e f f e c t on t he e nvi r on m e nt oc c ur i n a n e s c a l a t i ng s e que nc e ( L a l l i M a c e W ohn, & L i ve z e y, 1995) A pa r t i c ul a r t opogr a phy of p r obl e m be ha vi or m a y oc c ur r a r e l y i f i t i s one o f s e ve r a l m e m be r s of a r e s pons e c l a s s a nd i s t he l e a s t l i ke l y t o oc c ur D ur i ng f unc t i ona l a na l ys i s t he i de nt i f i c a t i on o f m a i nt a i ni ng va r i a bl e s f o r s e ve r e pr obl e m be ha vi or m a y be l i m i t e d i f r e i nf or c e m e nt i s c onc ur r e nt l y p r ovi de d f o r l e s s s e ve r e pr obl e m be ha vi or ( H a r d i ng e t a l 2001; R i c hm a n, W a c ke r A s m us C a s e y, & A nde l m a n, 1 999) r e s ul t i ng i n l ow or z e r o r a t e s of s e ve r e pr obl e m be ha vi or M a ge e a nd E l l i s ( 2000) de m ons t r a t e d t hi s pa t t e r n of r e s pondi ng w i t h 2 pa r t i c i pa nt s w ho e xhi bi t e d m ul t i pl e t opog r a phi e s of pr obl e m be ha vi or W he n t he a ut ho r s pr ovi de d c ons e que nc e s f or m ul t i pl e t opogr a phi e s o f pr obl e m be ha vi or i n a f unc t i ona l a na l ys i s t he y obs e r ve d a s i ngl e t opogr a phy c ons i s t e nt l y i n one t e s t c ondi t i on f o r e a c h pa r t i c i pa nt W he n e xt i nc t i on w a s a r r a nge d f o r t he m os t c om m on r e s pons e a de c r e a s e i n t ha t r e s pons e a nd c onc om i t a nt i nc r e a s e s i n ot he r r e s pons e s w e r e obs e r ve d. E x t i nc t i on w a s s e que nt i a l l y a ppl i e d t o

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12 t he ot he r r e s pons e s a nd s i m i l a r e f f e c t s w e r e obs e r ve d. T hus w he n a n i nd i vi dua l di s pl a ys m or e t ha n one t opogr a phy of p r obl e m be ha vi or i t m a y b e ne c e s s a r y t o pr ovi de c ons e que nc e s onl y f or t he m os t s e ve r e t opogr a phy ( a nd t o a r r a nge e xt i nc t i on f or m or e c om m on, l e s s s e ve r e t opogr a phi e s ) dur i ng f unc t i ona l a na l ys i s i n o r de r t o i nc r e a s e t he oc c ur r e nc e of a n i ndi vi dua l s m os t s e ve r e pr obl e m be ha vi or C om b i n e d E s t ab l i s h i n g O p e r at i on s T ypi c a l f unc t i ona l a na l ys i s c ondi t i ons i nvol ve t he pr e s e nt a t i on of a s i ngl e e s t a bl i s hi ng ope r a t i on ( de pr i va t i on f r om a t t e nt i on ) a nd t he de l i ve r y of a c or r e s pondi ng c ons e que nc e ( a t t e nt i on) c ont i nge nt on p r obl e m be ha vi or H ow e ve r s om e p r ob l e m be ha vi or m a i nt a i ne d by a gi ve n c ont i nge nc y m a y be oc c a s i one d onl y i n t he pr e s e nc e of m or e t ha n one e s t a bl i s hi ng ope r a t i on. M a c e P a ge I va nc i c a nd O B r i e n ( 1986 ) de s c r i be d a f unc t i ona l a na l ys i s c ondi t i on l a be l e d di vi de d a t t e nt i on, i n w hi c h t he a nt e c e de nt c ondi t i on i nvo l ve d t he t he r a pi s t a t t e ndi ng t o a not he r pe r s on i n t he r oom i n a ddi t i on t o i gnor i ng t he pa r t i c i pa nt I n t hi s c a s e t w o e s t a bl i s hi ng ope r a t i ons w e r e pr e s e nt : t he a bs e nc e of a t t e nt i on a nd i t s de l i ve r y t o s om e one e l s e T he di vi de d a t t e nt i on c ondi t i on w a s i nc l ude d i n a f unc t i ona l a n a l ys i s f or 2 pa r t i c i pa nt s w ho e nga ge d i n a ggr e s s i on. A l t hough bot h pa r t i c i pa nt s e nga ge d i n hi ghe r l e ve l s of a ggr e s s i on i n ot he r s oc i a l r e i nf or c e m e nt t e s t c ondi t i ons r e s pondi ng w a s hi gh e r i n t he di vi de d a t t e nt i on c ondi t i on t ha n i n t he pl a y ( c ont r o l ) c ondi t i on, s ugge s t i ng t he ut i l i t y of t he c om bi ne d e s t a bl i s hi ng ope r a t i on a r r a nge m e nt I n a s ubs e que nt s t udy, F i s he r K uhn a nd T hom ps on ( 1998 ) c om pa r e d l e ve l s of de s t r uc t i ve be ha vi or dur i ng s t a nda r d di vi de d a n d nonc o nt i nge nt a t t e nt i on c ondi t i ons w i t h 1 pa r t i c i pa nt a nd s a w hi gh l e ve l s of de s t r uc t i ve be ha vi or dur i ng t he di v i de d a t t e nt i on c ondi t i on, a nd ne a r z e r o r a t e s o f be ha vi or i n t he s t a nda r d a n d nonc ont i nge nt a t t e nt i on c ondi t i ons T he s e da t a s ugge s t t ha t l ow r a t e s of pr obl e m be ha vi or m i ght be obs e r ve d w he n i t i s oc c a s i one d by i di os ync r a t i c s t i m ul us c ondi t i ons A n a l t e r na t i ve c i r c um s t a nc e of m ul t i pl e e s t a bl i s hi ng

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13 ope r a t i ons w a s s ugge s t e d by R i ngda hl W i nbor n, A nde l m a n, a nd K i t s uka w a ( 2002) w ho f ound t ha t t he pr e s e nc e of l e i s ur e i t e m s i n t he a t t e nt i on c ondi t i on m a y s uppr e s s pr obl e m be ha vi or m a i nt a i ne d by a t t e nt i on. T hus f o r s om e i ndi v i dua l s t he a bs e nc e of a t t e nt i on m a y oc c a s i on pr obl e m be ha vi or but onl y i f a l t e r na t i ve s our c e s of r e i nf or c e m e nt ( e g t oys ) a l s o a r e un a va i l a bl e S i m i l a r l y, pr obl e m be ha vi or m a i nt a i ne d by s oc i a l ne ga t i ve r e i nf or c e m e nt m i ght onl y e m e r ge w he n t w o or m or e e s t a bl i s hi ng ope r a t i ons a r e c onc ur r e nt l y p r e s e nt F o r e xa m pl e t he pr e s e nc e of t a s k de m a nds a nd s l e e p de pr i va t i on ( O R e i l l y, 1995 ) or t a s k de m a nds c oupl e d w i t h a n e a r i nf e c t i on ( O R e i l l y, 1997) m a y oc c a s i on e pi s odi c pr obl e m be ha vi or i n s om e i ndi vi dua l s W he n i t m a y be une t hi c a l t o i nduc e s om e of t he s e e ve nt s i t m a y be pos s i bl e t o w a i t f or t he oc c ur r e nc e of one e s t a bl i s hi ng ope r a t i on ( a he a da c he ) be f or e i nt r oduc i ng t he s e c ond e s t a bl i s hi ng ope r a t i on ( t a s k de m a nds ) du r i ng f u nc t i ona l a na l ys i s c ondi t i ons a l t hough t h i s m a y r e s ul t i n l ong de l a ys be t w e e n a s s e s s m e nt s e s s i on s R e i n f or c e r C h ar ac t e r i s t i c s S om e pr obl e m be ha vi or m a y be m a i nt a i ne d by a n i di os ync r a t i c qua l i t y of r e i nf o r c e m e nt or by unus ua l c ons e que nc e s W he n t he s e c ons e que nc e s or t he i r a s s oc i a t e d e s t a bl i s hi ng ope r a t i ons a r e a bs e nt dur i ng a f unc t i ona l a na l ys i s z e r o or l ow r a t e s of pr obl e m be ha vi or m a y be obs e r ve d. S e ve r a l s t udi e s ha ve e x a m i ne d t he e f f e c t s of a c c e s s t o f or m s o f a t t e nt i on ot he r t ha n ve r ba l r e pr i m a nds du r i ng a f unc t i ona l a na l ys i s ( F i s he r N i nne s s P i a z z a & O w e n D e S c hr yve r 1996; K oda k, N o r t hup, & K e l l e y 2007; P i a z z a e t a l 1999 ; R i c hm a n & H a gopi a n, 1999 ) F or e xa m pl e a f t e r a n i ni t i a l f unc t i ona l a na l ys i s r e s ul t e d i n l ow a nd s por a di c oc c ur r e nc e s of pr obl e m be ha vi or f or 2 pa r t i c i pa nt s R i c hm a n a nd H a gopi a n c onduc t e d a s e c ond a s s e s s m e nt t ha t w a s ba s e d on di r e c t obs e r va t i ons of t he pa r t i c i pa nt s i nt e r a c t i ons w i t h t he i r c a r e gi v e r s T he s e c ond a s s e s s m e nt c ons i s t e d of c om pa r i ng l e ve l s o f pr ob l e m be ha vi or dur i ng a s t a nda r d a t t e nt i on

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14 c ondi t i on ( w he r e i n br i e f r e pr i m a nds w e r e de l i ve r e d c ont i nge nt on p r obl e m be ha vi or ) t o a c ondi t i on i n w hi c h a di f f e r e nt t ype of a t t e nt i on ( ph ys i c a l a t t e nt i on i n t he f or m of be i ng pi c ke d up f or one pa r t i c i pa nt a nd e xa gge r a t e d hi gh pi t c he d, dr a m a t i c s t a t e m e nt s a bout t he pr obl e m be ha vi or f or t he s e c ond pa r t i c i pa nt ) w a s de l i ve r e d c ont i nge nt on pr obl e m be ha vi or R e s ul t s s how e d hi gh a nd c ons i s t e nt l e ve l s of pr obl e m be ha vi or i n t he m odi f i e d a t t e nt i on c ondi t i ons s ugge s t i ng t ha t t he s e pa r t i c i pa nt s pr obl e m be ha vi or s w e r e m a i nt a i ne d by p a r t i c ul a r t ype s of a t t e nt i on t ha t w e r e no t i nc l ude d i n t he i r i ni t i a l f unc t i ona l a na l ys i s I t i s pos s i bl e t ha t a n i nc r e a s e i n t he m a gni t ude of r e i nf or c e m e nt ( de l i ve r i ng m or e a t t e nt i on or a l l ow i ng a l onge r e s c a pe i nt e r va l ) m a y f a c i l i t a t e t he e m e r ge nc e of hi ghe r r a t e s of pr obl e m be ha vi or dur i ng a f unc t i ona l a na l ys i s a l t hough no s t udi e s t o da t e ha ve s pe c i f i c a l l y e xa m i ne d t he us e of l a r ge r m a gni t ude s of r e i nf or c e m e nt t o c l a r i f y a m bi guous f unc t i ona l a na l ys e s C onduc t i ng a n e xt e nde d de s c r i pt i ve a na l ys i s ( e g. A B C da t a c ol l e c t i on) m i ght be ne c e s s a r y t o i de nt i f y pot e nt i a l r e i nf o r c e r s f or pr obl e m be ha vi or m a i nt a i ne d by unus ua l c ons e que nc e s ( c om pl i a nc e w i t h t he pa r t i c i pa nt s m a nds [ B ow m a n, F i s he r T h om ps on, & P i a z z a 1997] a c c e s s t o s e l f r e s t r a i nt m a t e r i a l s [ V ol l m e r & V o r ndr a n, 1998] ) C om b i n e d C on t i n ge n c i e s U nl i ke m ul t i pl e c ont r ol i n w hi c h pr obl e m be ha vi or i s m a i nt a i ne d by t w o s e pa r a t e c ont i nge nc i e s ( a ggr e s s i on f or e i t he r a t t e nt i on o r e s c a pe ) or c ont r ol by m ul t i pl e e s t a bl i s hi ng ope r a t i ons i n w hi c h be ha vi or m a i nt a i ne d by a gi v e n c ont i nge nc y oc c ur s onl y i n t he p r e s e nc e of m or e t ha n one e s t a bl i s hi ng ope r a t i on, m a i nt e na nc e by c om bi ne d c o nt i nge nc i e s oc c ur s w he n pr obl e m be ha vi or r e s ul t s i n a c c e s s t o t w o di f f e r e nt c ons e que nc e s a t t he s a m e t i m e ( a ggr e s s i on dur i ng t he de m a nd c ondi t i on p r oduc e s bot h e s c a pe a nd a c c e s s t o pos i t i ve r e i nf or c e m e nt ) I n a r e c e nt a t t e m pt t o a r r a nge bot h pos i t i ve a nd n e ga t i v e r e i nf or c e m e nt c ont i nge nc i e s w i t hi n f unc t i ona l a na l ys i s c ondi t i ons C a l l W a c ke r R i ng da hl a nd B oe l t e r ( 2005) e xpos e d 1 pa r t i c i pa nt

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15 t o a c ondi t i on i n w hi c h a t he r a pi s t de l i ve r e d a pr o m pt a t t he be gi nni ng of t he s e s s i on t o e nga ge i n a t a s k a nd t he n i gno r e d t he pa r t i c i pa nt e xc e pt t o de l i ve r a t t e nt i on c ont i nge nt upon p r obl e m be ha vi or A s e c ond pa r t i c i pa nt w a s e xpos e d t o a c ondi t i on i n w hi c h a t he r a pi s t p r om pt e d t he pa r t i c i pa nt t o e nga ge i n t a s ks w hi l e a p r e f e r r e d l e i s ur e i t e m w a s pr e s e nt but una va i l a bl e T he pa r t i c i pa nt w a s gi ve n a 20 s br e a k f r om w o r k c ont i nge nt on pr obl e m be ha vi or but a c c e s s t o t he t a ngi bl e i t e m r e m a i ne d r e s t r i c t e d t h r oughout t he s e s s i on. T hus a l t hough pot e nt i a l e s t a bl i s hi ng ope r a t i ons f or bo t h ne ga t i ve r e i nf or c e m e nt ( a t a s k de m a nd s i t ua t i on) a nd pos i t i ve r e i nf or c e m e nt ( a t t e nt i on or pr e f e r r e d i t e m s ) w e r e pr e s e nt e d, on l y one of t he a s s oc i a t e d c ons e que n c e s w a s de l i ve r e d c ont i nge nt on pr obl e m be ha vi o r ( a t t e nt i o n f or t he f i r s t pa r t i c i pa nt ; e s c a pe f or t he s e c ond) r e pr e s e nt i ng a n i nc om pl e t e a na l ys i s of c o m bi ne d c ont i nge nc i e s A l t hough not c onduc t e d i n t he c ont e xt of a f unc t i o na l a na l ys i s a s t udy by Z a r c one F i s he r a nd P i a z z a ( 1996) s how e d t ha t one pa r t i c i pa nt s r e s pondi ng s i gni f i c a nt l y i nc r e a s e d w he n bot h ne ga t i ve a nd pos i t i ve r e i nf o r c e m e nt c ont i nge nc i e s ( 20 s br e a k f r om w or k w i t h a c c e s s t o pr e f e r r e d s t i m ul i dur i ng t he b r e a k) w e r e i n e f f e c t T he s e r e s ul t s s ugge s t t ha t t he a ddi t i on o f a n a s s e s s m e nt c ondi t i on i n w hi c h pr obl e m be ha vi or r e s ul t s i n a c c e s s t o bot h pos i t i ve a nd ne ga t i ve r e i nf o r c e m e nt s i m ul t a ne ous l y m a y oc c a s i on hi ghe r r a t e r e s pondi ng i n s om e i ndi vi dua l s C ove r t B e h avi or C ove r t pr obl e m be ha vi or i s be ha vi or t ha t oc c ur s i n t he a bs e nc e of s oc i a l c ont i nge nc i e s a nd t ha t a c t ua l l y i s s uppr e s s e d by t he pr e s e nc e of ot he r s T ypi c a l t e s t c ondi t i ons f or a ut om a t i c r e i nf or c e m e nt i nvol ve obs e r vi ng i ndi vi dua l s w hi l e t he y a r e l e f t a l one i n a n a us t e r e e nvi r onm e nt a nd r e c or di ng oc c ur r e nc e s of pr obl e m be ha vi or D e pe ndi ng on t he f a c i l i t y a nd r e s our c e s a va i l a bl e obs e r va t i ons a r e c onduc t e d f r o m be h i nd a pa r t i t i on o r s c r e e n ( P a i s e y & W hi t ne y, 1989) t h r ough a n obs e r va t i on w i ndow ( R a pp, M i l t e nbe r ge r G a l e ns ky, E l l i ngs on, & L ong, 1999 ) or vi a vi de o m oni t or i ng ( L ong, M i l t e nbe r ge r E l l i ngs on, & O t t 1999 ; R i ngda hl e t

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16 a l 2002 ) T he pr e va l e nc e of c ove r t be ha vi or i s un know n, m a i nl y be c a us e m a ny s t udi e s pr ovi de a ne c dot a l r e por t s on t he c ove r t na t ur e of pr obl e m be ha vi or but do not p r ovi de a n e m p i r i c a l de m ons t r a t i on of s uc h ( G r a c e T hom ps on, & F i s he r 1996; M a gl i e r i D e L e on, R odr i gue z C a t t e r & S e vi n, 2000) S t ud i e s by P a i s e y a nd W hi t ne y a nd by R i ngda hl e t a l a r e e xc e pt i ons P a i s e y a nd W hi t ne y s how e d t ha t a n i ndi vi dua l e nga ge d i n l ow l e ve l s of pi c a w he n a n obs e r ve r w a s i n t he r oom ( e ve n t hough t he obs e r ve r ne ve r i nt e r a c t e d w i t h t he i ndi vi dua l ) but i n m uc h hi ghe r l e ve l s of pi c a w he n t he obs e r ve r w a s s t a t i one d i n a c l os e t R i ngda hl e t a l s how e d t ha t one i ndi v i dua l s s t e r e ot ypy di d not oc c ur w he n a n a dul t w a s pr e s e nt i n t he r oom but di d oc c ur w he n t he a dul t w a s a bs e nt T hus a f unc t i ona l a na l ys i s m a y r e s ul t i n l o w or z e r o r a t e s of c ove r t p r obl e m be ha vi or w he n s om e f e a t ur e of t he t e s t c ondi t i on f o r a ut om a t i c r e i nf or c e m e nt i s di s c r i m i na t i ve f or t he pr e s e nc e of ot he r s I t i s pos s i bl e t ha t t he a s s e s s m e n t of c ove r t be ha vi or w i l l ne c e s s i t a t e c onduc t i ng f unc t i ona l a na l ys i s a l one s e s s i ons i n s e t t i ngs t ha t m i ni m i z e t he i ndi vi dua l s a bi l i t y t o di s c r i m i na t e t he pr e s e nc e of obs e r ve r s I n s u f f i c i e n t E xp os u r e P r obl e m be ha vi or m a y oc c ur a t l ow r a t e s dur i ng f u nc t i ona l a na l ys e s due t o l i m i t e d e xpos ur e t o e i t he r a n e s t a bl i s hi ng ope r a t i on or a r e i nf or c e m e nt c ont i nge nc y. A n e xa m pl e o f t hi s m a y be s e e n i n t he D e r by e t a l ( 1992) s t udy t ha t r e por t e d out c om e da t a f r om a l a r ge nu m be r o f br i e f f unc t i ona l a na l ys e s w hi c h c ons i s t e d of one 5 or 10 m i n s e s s i on of e a c h t e s t a nd c ont r ol c on di t i on. T he a ut hor s w e r e una bl e t o i de nt i f y t he f unc t i on of pr obl e m be ha vi or f or 29 of 79 o f pa r t i c i pa nt s be c a us e t he y ne ve r obs e r ve d i t du r i ng t he a s s e s s m e nt I t i s unc l e a r w he t he r t he s e f i ndi ngs w e r e t he d i r e c t r e s ul t of i ns uf f i c i e nt e xpos ur e t o a s s e s s m e nt c ondi t i ons but s ubs e que nt a na l ys e s of t he e f f e c t s of r e pe a t e d e xpos ur e t o a s s e s s m e nt c ont i nge nc i e s ( K a hng & I w a t a 1999 ) a nd of s e s s i on dur a t i on ( W a l l a c e & I w a t a 1999) i n di c a t e t ha t bot h m a y i nf l ue nc e f unc t i ona l a na l ys i s out c om e s O f pa r t i c ul a r i nt e r e s t w e r e t h r e e c um ul a t i ve r e c or ds f r om t he W a l l a c e a nd

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17 I w a t a s t udy s how i ng l i t t l e or no r e s pondi ng du r i ng t he f i r s t 5 m i n of a 15 m i n s e s s i on. A l t hough W a l l a c e a nd I w a t a di d not e xa m i ne s e s s i on dur a t i ons be yond 15 m i n t he i r da t a s ugge s t t ha t c ont i nue d e xp os ur e t o e s t a bl i s hi ng ope r a t i ons a nd/ or c ont i nge nc i e s m a y be r e qui r e d t o oc c a s i on s om e pr obl e m be ha vi or A m or e e xt r e m e e xa m pl e of t he e f f e c t s of s e s s i on dur a t i on w a s de s c r i be d by K a hng, A bt a nd S c honba c hl e r ( 2001) A f t e r a n i ni t i a l f unc t i ona l a na l ys i s ( w i t h 10 m i n s e s s i ons ) r e s ul t e d i n z e r o i ns t a nc e s of a ggr e s s i on, t he a ut hor s e xt e nde d t he obs e r va t i on pe r i ods t o 7 hou r s ( 9: 00 A M 4: 00 P M ) a nd c onduc t e d one f unc t i ona l a na l ys i s c ondi t i on e a c h da y. T he a l l da y a s s e s s m e nt pr oduc e d di f f e r e nt i a t e d r e s ul t s i n t ha t i nc r e a s i ng r a t e s of a ggr e s s i on w e r e obs e r ve d i n one c ondi t i on ( a t t e nt i on) onl y; how e ve r t hi s m e t hod m a y be l i m i t e d i n t ha t l e ngt hy s e s s i ons m a y be di f f i c ul t t o i m pl e m e nt or m a y r e qui r e i m pos i t i on o f s e ve r e de pr i va t i on f r om s oc i a l i nt e r a c t i on ( e g. du r i ng a t t e nt i on a nd i gno r e c ondi t i ons ) T a r box, W a l l a c e T a r box, L a nda bur u a nd W i l l i a m s ( 2004) de s c r i be d a n a l t e r na t i ve pr oc e dur e t ha t w a s e va l ua t e d w i t h 3 pa r t i c i pa nt s w hos e i ni t i a l f unc t i ona l a na l ys i s r e s ul t e d i n l ow or z e r o r a t e s of p r obl e m be ha vi or F unc t i ona l a na l ys i s s e s s i ons w e r e i ni t i a t e d w he n, dur i ng t he c our s e of da i l y a c t i vi t i e s a n e pi s ode of pr obl e m be ha vi or w a s obs e r ve d. D ur i ng t he s e s e s s i ons m ode r a t e t o hi gh r a t e s of pr obl e m be ha vi or w e r e o bs e r ve d i n t he a t t e nt i on a nd de m a nd c ondi t i on f or 2 pa r t i c i pa nt s a nd i n t he a t t e nt i on c ondi t i on on l y f or t he t hi r d pa r t i c i pa nt w hi l e r a t e s of pr obl e m be ha vi or r e m a i ne d l ow dur i ng t he c ont r ol c ondi t i on. A l t hough t hi s pr oc e dur e i nvol ve d a s i m pl e s c he dul i ng m a ni pul a t i on, i t w a s unc l e a r ho w m uc h t i m e a nd e f f o r t w e r e r e qui r e d t o c onduc t t he l ow r a t e a s s e s s m e nt T ha t i s no i nf or m a t i on w a s pr ovi de d on how m uc h t i m e pa s s e d or w ha t w a s r e qui r e d t o obs e r ve t he pa r t i c i pa nt s p r i or t o i ni t i a t i ng t he f unc t i ona l a na l ys i s I n a ddi t i on, a l l 3 pa r t i c i pa nt s w e r e e xpos e d t o r e l a t i ve l y br i e f i ni t i a l f unc t i ona l a na l ys e s ( 6 t o 12 5

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18 m i n s e s s i ons ) I t i s pos s i bl e t ha t p r obl e m be ha vi or e ve nt ua l l y w oul d ha ve e m e r ge d ha d a ddi t i ona l or l onge r s e s s i ons be e n c onduc t e d. P u r p os e T he pur pos e of t hi s s t udy w a s t o e va l ua t e a s t r a t e g y f or a l t e r i ng f unc t i ona l a na l ys i s c ondi t i ons w he n t he r e s ul t s of a n i ni t i a l f unc t i ona l a s s e s s m e nt yi e l de d undi f f e r e nt i a t e d a nd l ow r a t e r e s pondi ng. T he m odi f i e d a s s e s s m e nt c ondi t i ons w e r e de s i gne d t o a c c ount f o r t he a f or e m e nt i one d de t e r m i na nt s of l ow r a t e be ha vi or

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19 C H A P T E R 2 M E T H O D P ar t i c i p an t s a n d S e t t i n g S e ve n i ndi vi dua l s w ho a t t e nde d e i t he r a n a dul t voc a t i ona l da y pr og r a m or a s c hool f o r s t ude nt s w i t h de ve l opm e nt a l di s a bi l i t i e s pa r t i c i pa t e d. A l l pa r t i c i pa nt s w e r e r e f e r r e d f or t he a s s e s s m e nt a nd t r e a t m e nt of l ow f r e que nc y, hi gh i nt e ns i t y s e l f i nj ur i ous be ha vi or ( S I B ) a ggr e s s i on, or pr ope r t y de s t r uc t i on P a r t i c i pa nt i nf or m a t i on i s l i s t e d i n T a bl e 2 1 S e s s i ons w e r e c onduc t e d i n t he r a py r oom s a t t he da y pr og r a m or i n a c l a s s r oom a t t he s c hool t w o t o f i ve t i m e s pe r da y, 2 t o 4 da ys pe r w e e k. R e s p on s e M e as u r e m e n t an d I n t e r ob s e r ve r A gr e e m e n t T a r ge t be ha vi or s w e r e ope r a t i ona l l y de f i ne d on a n i ndi vi dua l ba s i s a nd a r e l i s t e d i n T a bl e 2 2. T r a i ne d obs e r ve r s r e c or de d t he oc c ur r e nc e i n 10 s i nt e r va l s ( J a c ob) o r f r e que nc y ( a l l ot he r pa r t i c i pa nt s ) of t a r ge t a nd t he r a pi s t be ha vi or s us i n g ha ndhe l d or l a pt op c om put e r s A s e c ond obs e r ve r s i m ul t a ne ous l y a nd i nde pe nde nt l y c ol l e c t e d da t a dur i ng a n a ve r a ge 43. 7 % ( r a nge 30. 7% 59 4% ) of s e s s i ons f or e a c h pa r t i c i pa nt I n c om pa r i ng obs e r ve r s r e c or ds a gr e e m e nt pe r c e nt a ge s f or f r e que nc y da t a w e r e c a l c ul a t e d by f i r s t di vi di ng s e s s i on t i m e i nt o 10 s i nt e r va l s T he s m a l l e r num be r of r e c or de d r e s pons e s i n e a c h i nt e r va l w a s di vi de d by t he l a r ge r num be r ; t he s e f r a c t i ons w e r e a ve r a ge d a c r os s t he s e s s i on a nd m ul t i pl i e d by 100% t o y i e l d t he pe r c e nt a ge a gr e e m e nt be t w e e n t w o obs e r ve r s A gr e e m e nt pe r c e nt a ge s f or oc c ur r e nc e da t a w e r e c a l c ul a t e d by di vi di ng t he num be r of i nt e r va l s i n w hi c h bot h obs e r ve r s s c or e d t he oc c ur r e nc e or nonoc c ur r e nc e of r e s pons e s by t he t ot a l num be r of i nt e r va l s i n t he s e s s i on a nd m ul t i pl yi ng by 100% M e a n pe r c e nt a ge a gr e e m e nt a c r os s pa r t i c i p a nt s w a s 99. 3% ( r a nge 75 % 100 % ) f or t he t a r ge t be ha vi or a nd 94. 0% ( r a nge 56 7% 100% ) f or t he r a pi s t r e s pons e s

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20 P r oc e d u r e s P r e f e r e n c e A s s e s s m e n t P r i or t o t he s t a r t of t he s t udy, a p r e f e r e nc e a s s e s s m e nt w a s c onduc t e d t o i de nt i f y pr e f e r r e d e di bl e a nd l e i s ur e i t e m s f o r us e i n t he f unc t i ona l a n a l ys i s I t e m s w e r e pr e s e nt e d e i t he r i n a l l pos s i bl e pa i r s ( F i s he r e t a l 1992) or a s a gr oup ( D e L e on & I w a t a 1996 ) a nd t he pa r t i c i pa nt w a s pr om pt e d t o s e l e c t one A t l e a s t s e ve n s t i m ul i w e r e a s s e s s e d, a nd t he pa r t i c i pa nt w a s a l l ow e d br i e f a c c e s s t o a l l i t e m s p r i or t o t he a s s e s s m e nt T h e t hr e e hi ghe s t r a nke d i t e m s ( i e t he t h r e e s t i m ul i a ppr oa c he d on t he hi ghe s t pe r c e nt a ge of t r i a l s ) w e r e s e l e c t e d f or us e i n s ubs e que nt t a ngi bl e pl a y, m ul t i pl e S r + a nd S r / S r + c ondi t i on s T w o m ode r a t e t o l ow r a nke d i t e m s ( i e t he t w o i t e m s r a nke d f i f t h a nd s i xt h f r om t he t op of t h e hi e r a r c hy) w e r e s e l e c t e d f or us e i n s u bs e que nt a t t e nt i on c ondi t i ons S t an d ar d ( I n i t i al ) F u n c t i on a l A n al ys i s T he i ni t i a l f unc t i ona l a na l ys i s w a s c onduc t e d a c c or di ng t o t he pr oc e dur e s de s c r i be d by I w a t a e t a l ( 1982/ 1994 ) w i t h t he i nc l us i on of a t a ngi bl e c ondi t i on, a s w e l l a s c ondi t i on c or r e l a t e d s t i m ul i ( e g. d i f f e r e nt t he r a pi s t s a nd s e t t i ngs c ol or e d s hi r t s ; C onne r s e t a l 2000 ) t o e nha nc e di s c r i m i na t i on be t w e e n di f f e r e nt f unc t i on a l a na l ys i s c ondi t i ons E a c h c ondi t i on w a s r un a t l e a s t s i x t i m e s yi e l di ng a ppr oxi m a t e l y 30 s e s s i ons ( P hyl l i s w a s a n e xc e pt i on; he r t a ngi bl e a nd i gnor e c ondi t i ons w e r e not i nc l ude d unt i l t he s e c ond a nd t hi r d s e r i e s of t he f unc t i ona l a na l ys i s r e s pe c t i ve l y) S e s s i ons w e r e c onduc t e d i n a r oom c ont a i ni ng a t a bl e a nd c ha i r s a nd r e l e va nt s e s s i on m a t e r i a l s ( w he n a ppl i c a b l e ) a s de s c r i be d b e l ow A l l s e s s i ons i n t hi s pha s e w e r e 10 m i n i n l e ngt h. T he f unc t i ona l a na l ys i s c ondi t i ons ( a l one o r i gnor e a t t e nt i on t a ngi bl e de m a nd, a nd pl a y) w e r e a l t e r na t e d i n a m ul t i e l e m e nt e xpe r i m e nt a l de s i gn. A l on e T he pa r t i c i pa nt w a s a l one i n a r oom e qui pp e d w i t h a one w a y obs e r va t i on w i ndow t hr ough w hi c h da t a c ol l e c t or s obs e r ve d t he pa r t i c i pa nt a nd r e c or de d i ns t a nc e s of t he t a r ge t

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21 be ha vi or T he pa r t i c i pa nt di d not ha ve a c c e s s t o l e i s ur e i t e m s or s oc i a l i nt e r a c t i on. T he pu r pos e of t hi s c ondi t i on w a s t o t e s t f or m a i nt e na nc e by a ut om a t i c r e i nf or c e m e nt T ha t i s i f be ha vi or pe r s i s t e d unde r c ondi t i ons i n w hi c h no s oc i a l r e i n f or c e m e nt c ont i nge nc i e s w e r e pr ogr a m m e d a nd i n w hi c h s t i m ul i t ha t m a y oc c a s i on e s c a pe m a i nt a i ne d be ha vi or w e r e a bs e nt t he n e vi de nc e f o r be ha vi or m a i nt a i ne d by a ut om a t i c r e i n f or c e m e nt w a s pr ovi de d. T he a l one c ondi t i on w a s c onduc t e d w i t h t he pa r t i c i pa nt s f or w hom S I B w a s t he onl y t a r ge t be ha vi or ( D e bbi e a nd J a c ob) a nd w i t h T e r r a nc e w ho w a s r e por t e d t o e nga ge i n pr ope r t y de s t r u c t i on w he n uns upe r vi s e d. I gn or e T he pa r t i c i pa nt a nd a t he r a pi s t w e r e s e a t e d a ppr oxi m a t e l y 1 m f r om one a not he r i n a r oom T he pa r t i c i pa nt di d not ha ve a c c e s s t o l e i s ur e i t e m s a nd t he t he r a pi s t d i d not i nt e r a c t w i t h t he pa r t i c i pa nt t hr oughout t he s e s s i on T he pu r pos e of t hi s c ondi t i on w a s s i m i l a r t o t ha t of t he a l one c ondi t i on, e xc e pt t he p r e s e nc e of t he t he r a pi s t w a s ne c e s s a r y f or t he oc c ur r e nc e of a ggr e s s i on. T he i gnor e c ondi t i on w a s c onduc t e d w i t h t he 3 pa r t i c i pa nt s w ho e nga ge d i n a ggr e s s i on ( P hyl l i s G l e nn, a nd B e c ky) a nd w i t h T ony, w ho ha d a hi s t or y of e nga gi ng i n pr ope r t y de s t r uc t i on ( t e a r i ng pa pe r a nd c l ot he s ) i n hi s c l a s s r oom N ot e t ha t pa pe r m a t e r i a l s w e r e pr e s e nt i n a l l c ondi t i ons of t he f unc t i ona l a na l ys i s c onduc t e d w i t h T ony A t t e n t i on T he pa r t i c i pa nt a nd a t he r a pi s t w e r e s e a t e d a ppr oxi m a t e l y 1 m a pa r t i n a r oom t ha t c ont a i ne d m ode r a t e t o l ow pr e f e r r e d i t e m s f r o m t he pr e f e r e nc e a s s e s s m e nt T he s e s s i on be ga n a f t e r t he t he r a pi s t i ns t r uc t e d t he pa r t i c i pa nt t o pl a y w i t h t he t oys w hi l e t he t he r a pi s t ha d w or k t o do ( i e w a s e nga ge d w i t h r e a di ng m a t e r i a l ) C ont i nge nt on e a c h oc c ur r e nc e of t he t a r ge t be ha vi or t he t he r a pi s t de l i ve r e d a br i e f s t a t e m e nt of c onc e r n or di s a ppr ova l ( e g. D on t do t ha t you r e goi ng t o hu r t you r s e l f ; D on t t hr ow t h i ng s you m i ght br e a k t he m ) pa i r e d w i t h b r i e f phys i c a l c ont a c t ( e g. ha nd on a r m or s houl de r ) a n d t he n r e s um e d r e a di ng T he t he r a pi s t i gno r e d a l l ot he r pa r t i c i pa nt be ha vi or s T he pu r pos e of t he a t t e nt i on c ondi t i on w a s t o t e s t i f t he t a r ge t

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22 be ha vi or w a s m a i nt a i ne d by s oc i a l pos i t i ve r e i nf or c e m e nt i n t he f or m of b r i e f c ont i nge nt a t t e nt i on de l i ve r e d by t he t he r a pi s t T an gi b l e T he pa r t i c i pa nt a nd a t he r a pi s t w e r e s e a t e d i n a r oom t ha t c ont a i ne d hi ghl y pr e f e r r e d i t e m s f r om t he p r e f e r e nc e a s s e s s m e nt T he pa r t i c i pa nt ha d f r e e a c c e s s t o t he pr e f e r r e d i t e m s f or 2 m i n pr i or t o t he s e s s i on, a f t e r w hi c h t he t he r a pi s t t ol d t he pa r t i c i pa nt i t w a s t i m e t o put t he t oys a w a y, r e m ove d t he i t e m s a nd be ga n t he s e s s i on. T he t he r a pi s t de l i ve r e d a t t e nt i on w he ne ve r s ol i c i t e d by t he pa r t i c i pa nt ; how e ve r qu e s t i ons or c om m e nt s pe r t a i ni ng t o t he i t e m s w e r e i gnor e d. C ont i nge nt on e a c h oc c ur r e nc e of t h e t a r ge t be ha vi or t he t he r a pi s t de l i ve r e d t he i t e m s t o t he pa r t i c i pa nt f o r 30 s a nd t he n r e m ove d t he m a ga i n. T he t he r a pi s t i gno r e d a l l ot he r pa r t i c i pa nt be ha vi or s T he pu r pos e of t hi s c ondi t i o n w a s t o t e s t i f t he t a r ge t be ha vi or w a s m a i nt a i ne d by s oc i a l pos i t i ve r e i n f or c e m e nt s pe c i f i c a l l y i n t he f or m of c ont i nge nt a c c e s s t o pr e f e r r e d i t e m s D e m an d T he pa r t i c i pa nt a nd a t he r a pi s t w e r e s e a t e d a t a t a bl e w he r e i ns t r uc t i ona l ( e g a c a de m i c s e l f c a r e o r dom e s t i c t a s k) m a t e r i a l s w e r e pr e s e nt T he t he r a pi s t p r e s e nt e d i ns t r uc t i ona l t r i a l s us i ng a gr a dua t e d, t hr e e pr om p t s e que nc e T he t he r a pi s t de l i ve r e d a ve r ba l i ns t r uc t i on i ni t i a l l y a nd a l l o w e d t he pa r t i c i pa nt 5 s t o i ni t i a t e a r e s pons e I f a f t e r 5 s t he pa r t i c i pa nt di d not i ni t i a t e t he a ppr op r i a t e r e s pons e t he t he r a pi s t r e pe a t e d t he i ns t r uc t i on, m ode l e d t he c or r e c t r e s pons e a nd w a i t e d a n a ddi t i ona l 5 s I f a n i nc or r e c t or no r e s pons e oc c ur r e d, t he t he r a pi s t de l i ve r e d t he i ns t r uc t i on a t hi r d t i m e a nd phys i c a l l y gui de d t he pa r t i c i pa nt t hr ough t he r e s pons e us i ng t he l e a s t a m ount of c o nt a c t ne c e s s a r y t o c om pl e t e i t T he t he r a pi s t de l i ve r e d pr a i s e c ont i nge nt upon i nde pe nde nt c om pl e t i on of a c or r e c t r e s pons e ( i e f ol l ow i ng t he ve r ba l or m ode l p r om pt ) a nd t he n i ni t i a t e d t he ne xt i ns t r uc t i ona l t r i a l C ont i nge nt on e a c h oc c ur r e nc e of t he t a r ge t be ha vi or dur i ng t he p r om p t i ng s e que nc e t he t he r a pi s t t e r m i na t e d t he

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2 3 i ns t r uc t i ona l t r i a l r e m ove d t he i ns t r uc t i ona l m a t e r i a l s a nd t ur ne d a w a y f r om t he pa r t i c i pa nt f o r 30 s A t t he e nd o f t he 30 s br e a k t he t he r a pi s t r e i ni t i a t e d t he i ns t r uc t i ona l t r i a l ( unl e s s t he pa r t i c i pa nt w a s e nga gi ng i n t he t a r ge t be ha vi or i n w hi c h c a s e t he t he r a pi s t w a i t e d unt i l 3 s w i t h no i ns t a nc e s of t he t a r ge t be ha vi or oc c ur r e d be f or e r e i ni t i a t i n g t he i ns t r uc t i ona l t r i a l ) T he pur pos e of t he de m a nd c ondi t i on w a s t o t e s t w he t h e r t he t a r ge t be ha vi or w a s m a i nt a i ne d by s oc i a l ne ga t i ve r e i nf or c e m e nt i n t he f or m of e s c a pe f r om or a voi da nc e o f de m a nd s i t ua t i ons P l ay. T he pa r t i c i pa nt a nd t he t he r a pi s t w e r e s e a t e d i n a r oom t ha t c ont a i ne d hi ghl y pr e f e r r e d i t e m s f r om t he p r e f e r e nc e a s s e s s m e nt T he pa r t i c i pa nt ha d f r e e a c c e s s t o t he pr e f e r r e d i t e m s t he t he r a pi s t de l i ve r e d a t t e nt i on ( i e pr a i s e ) a nd br i e f phys i c a l c ont a c t a t l e a s t onc e e ve r y 30 s a nd no i ns t r uc t i ona l de m a nds w e r e pr e s e nt e d. A l l oc c ur r e nc e s of t he t a r ge t be ha vi or w e r e i gnor e d, a nd s c he dul e d de l i ve r y of a t t e nt i on w a s d e l a ye d f or 3 s f ol l ow i ng t he oc c ur r e nc e of t he t a r ge t be ha vi or T he pl a y c ondi t i on s e r ve d a s a c on t r ol f o r t he a bove t e s t c ondi t i ons T ha t i s t he e s t a bl i s hi ng ope r a t i ons ( de pr i va t i on f r om a t t e nt i on or s t i m ul a t i on o r t he pr e s e nt a t i on of i ns t r uc t i ona l t r i a l s ) f or s oc i a l a nd a ut om a t i c r e i nf or c e m e nt a s w e l l a s t he c ont i nge nc i e s f o r pr obl e m be ha vi or w e r e e l i m i na t e d or a t l e a s t m i ni m i z e d i n t hi s c ondi t i on M od i f i e d F u n c t i on a l A n al ys i s P a r t i c i pa t i on i n t he m odi f i e d f unc t i ona l a na l ys i s of t he s t udy r e qui r e d t ha t t he pa r t i c i pa nt s s t a nda r d f unc t i ona l a na l ys i s yi e l d ( a ) z e r o o r ne a r z e r o r a t e s of r e s pondi ng a c r os s a l l c ondi t i ons or ( b ) i s ol a t e d oc c ur r e nc e s not i ndi c a t i ve of a ny pa r t i c ul a r f unc t i on. G l e nn m e t t he s e c r i t e r i a ; how e ve r hi s a ggr e s s i on w a s of s uc h hi gh i nt e ns i t y t ha t i t w a s de e m e d uns a f e t o a l l ow a d di t i ona l i ndi vi dua l s ( i e pe e r c onf e de r a t e s ) t o pa r t i c i pa t e i n G l e nn s s e s s i ons T hus G l e nn di d not pa r t i c i pa t e i n t he m odi f i e d f unc t i ona l a na l ys i s T he t e s t c ondi t i ons of t he f unc t i ona l a na l ys i s w e r e m odi f i e d t o a c c ount f or i di os ync r a t i c va r i a bl e s t ha t m a y a f f e c t r e s pondi ng. S pe c i f i c a l l y, e s t a bl i s hi ng ope r a t i ons a nd r e i nf or c e m e nt

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24 c ont i nge nc i e s w e r e c om bi ne d, a nd r e i nf or c e r c ha r a c t e r i s t i c s w e r e e nha nc e d. A l l s e s s i ons i n t hi s pha s e w e r e 10 m i nut e s i n l e ngt h a nd pa r t i c i pa nt s w e r e e xpos e d t o a t l e a s t t hr e e of t he m odi f i e d f unc t i ona l a na l ys i s c ondi t i ons de s c r i be d be l ow T h e m odi f i e d f unc t i ona l a na l ys i s c ondi t i ons w e r e a l t e r na t e d i n a m ul t i e l e m e nt e xpe r i m e nt a l de s i gn. M u l t i p l e S r + T he pa r t i c i pa nt t he r a pi s t a nd 1 3 p e e r c onf e de r a t e s of t he c l i e nt w e r e s e a t e d i n a r oom t ha t c ont a i ne d hi ghl y pr e f e r r e d i t e m s f r om t he pr e f e r e nc e a s s e s s m e nt T he pa r t i c i pa nt ha d 3 5 m i n of p r e s e s s i on e xpos ur e t o a t t e nt i on f r om t he t he r a pi s t a nd c onf e de r a t e s a s w e l l a s a c c e s s t o t he i t e m s A t t he s t a r t of t he s e s s i on, t he t he r a p i s t t ol d t he pa r t i c i pa nt i t w a s t i m e f or t he ot he r ki ds t o pl a y, r e m ove d t he i t e m s a nd de l i ve r e d t he m t o t he c on f e de r a t e s a nd di r e c t e d ve r ba l a nd phys i c a l a t t e nt i on onl y t o t he c onf e de r a t e s C ont i nge nt on e a c h oc c ur r e nc e of t he t a r ge t be ha vi or t he t he r a pi s t a nd c onf e de r a t e s de l i ve r e d 30 s of ve r ba l a nd phys i c a l a t t e nt i on a nd a c c e s s t o t he pr e f e r r e d i t e m s A t t he e nd o f t he 30 s r e i n f or c e m e nt i nt e r va l a t t e nt i on a nd t he i t e m s w e r e a ga i n r e m ove d a nd w e r e de l i ve r e d t o t h e c onf e de r a t e s T he t he r a pi s t a nd c o nf e de r a t e s i gnor e d a l l non t a r ge t pa r t i c i pa nt be ha vi or s a nd t h e t he r a pi s t bl oc ke d t he pa r t i c i pa nt s a c c e s s t o t he i t e m s T he pur pos e of t he t hi s c ondi t i on w a s t o t e s t i f t he t a r ge t be ha vi or w oul d be oc c a s i one d by t he una va i l a bi l i t y of m ul t i pl e pos i t i ve r e i nf or c e r s a l ong w i t h t he i r de l i ve r y t o ot he r s ( c om bi ne d e s t a bl i s hi ng ope r a t i ons ) a nd m a i nt a i ne d by s oc i a l pos i t i ve r e i n f or c e m e nt i n t he f or m o f c ont i nge nt a c c e s s t o va r i ous f or m s o f a t t e n t i on a nd pr e f e r r e d i t e m s S r / S r + I f t he pa r t i c i pa nt de m ons t r a t e d hi gh l e ve l s of c om pl i a nc e ( i e 90 % or a bove ) i n t he i ni t i a l f unc t i ona l a na l ys i s ne w t a s k de m a nds w e r e i de nt i f i e d vi a di r e c t obs e r va t i on or c a r e gi ve r / t e a c he r r e por t T he pa r t i c i pa nt a nd t he r a pi s t w e r e s e a t e d a t a t a bl e w he r e i ns t r uc t i ona l ( e g. a c a de m i c s e l f c a r e o r dom e s t i c t a s k) m a t e r i a l s w e r e pr e s e nt a nd 1 3 pe e r c onf e de r a t e s w e r e s e a t e d ne xt t o t he pa r t i c i pa nt a nd c ons um e d t he hi ghl y pr e f e r r e d i t e m s f r om t he p r e f e r e nc e

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25 a s s e s s m e nt T he t he r a pi s t pr e s e nt e d i ns t r uc t i ona l t r i a l s us i ng t he gr a dua t e d, t hr e e s t e p pr om p t s e que nc e ( or a m odi f i e d s e que nc e ba s e d on di r e c t obs e r va t i on or a ne c dot a l r e po r t s ) C om pl i a nc e w i t h i ns t r uc t i ona l t r i a l s r e s ul t e d i n no pr og r a m m e d c ons e que nc e s a nd t he ne xt i ns t r uc t i ona l t r i a l w a s i ni t i a t e d. C ont i nge nt on e a c h oc c ur r e nc e of t h e t a r ge t be ha vi or dur i ng t he pr om pt i ng s e que nc e t he t he r a pi s t t e r m i na t e d t he i ns t r uc t i ona l t r i a l a nd r e m ove d t he i ns t r uc t i ona l m a t e r i a l s a nd t he t he r a pi s t a nd c on f e de r a t e s de l i ve r e d 45 s o f ve r ba l a nd phys i c a l a t t e nt i on a nd a c c e s s t o t he pr e f e r r e d i t e m s A t t he e nd of t he 45 s r e i nf or c e m e nt i nt e r va l a t t e nt i on a nd t he i t e m s w e r e a ga i n r e m ove d a nd w e r e de l i ve r e d t o t he c onf e de r a t e s a nd i ns t r uc t i ona l t r i a l s r e s um e d. T he pur pos e of t he S r / S r + c ondi t i on w a s t o t e s t i f t he t a r ge t be ha vi or w a s s e ns i t i ve t o t he c om bi ne d a nt e c e de nt e ve nt s of w or k a nd t he una va i l a bi l i t y of pos i t i ve r e i nf o r c e m e nt a nd w a s m a i nt a i ne d by s oc i a l ne ga t i ve a nd pos i t i ve r e i n f or c e m e nt ( c om bi ne d c ont i nge nc i e s i n t he f or m of e s c a pe pl us a c c e s s t o a t t e nt i on a nd pr e f e r r e d i t e m s dur i ng br e a k) M od i f i e d al on e T he pa r t i c i pa nt w a s a l one i n a r o om t ha t ha d no w i ndow s a nd w a s e qui ppe d w i t h a hi dde n c a m e r a i n l i e u of a n obs e r v a t i on w i ndow T he pa r t i c i pa nt di d not ha ve a c c e s s t o l e i s ur e i t e m s or s oc i a l i nt e r a c t i on. T he pu r pos e of t hi s c ondi t i on w a s t o t e s t f or m a i nt e na nc e by a ut om a t i c r e i nf o r c e m e nt i n a s e t t i ng t ha t w a s l e s s di s c r i m i na t i ve f o r t he p r e s e nc e of ot he r s ( i e no vi s ua l c ue s ) T he m od i f i e d a l one c ondi t i on w a s i nt e nde d f or pa r t i c i pa nt s w hos e s ol e t a r ge t be ha vi or w a s S I B ( D e bbi e a nd J a c ob) ; how e ve r D e bbi e s s c hool c oul d not a c c om m oda t e a r oom e qui ppe d w i t h a h i dde n c a m e r a a nd a s t a nda r d a l one c ondi t i on w a s c onduc t e d dur i ng he r m odi f i e d f unc t i ona l a na l ys i s P l ay T he pl a y c ondi t i on w a s c onduc t e d a s de s c r i b e d i n t he s t a nda r d f unc t i ona l a na l ys i s ( a bove )

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26 E a c h c ondi t i on o f t he m odi f i e d f unc t i ona l a na l ys i s w a s c onduc t e d a t l e a s t f our t i m e s P a r t i c i pa nt s w e r e e xpos e d t o one o r bot h of t he s ub s e que nt pha s e s of t he s t udy i f t he i r m od i f i e d f unc t i ona l a na l ys e s c ont i nue d t o yi e l d ( a ) z e r o or n e a r z e r o r a t e s of r e s pondi ng a c r os s a l l c ondi t i ons or ( b) i s ol a t e d oc c ur r e nc e s not i ndi c a t i ve of a ny pa r t i c ul a r f unc t i on. S t an d ar d F u n c t i on al A n al ys i s ( 30 m i n ) S t a nda r d f unc t i ona l a na l ys i s c ondi t i ons w e r e c onduc t e d a s de s c r i be d a bove ; how e ve r a l l s e s s i ons w e r e 30 m i n i n l e ngt h ( B e c ky s s t a nda r d f unc t i ona l a na l ys i s s e s s i ons c ons i s t e d s ol e l y of c ons e c ut i ve 30 m i n de m a nd s e s s i ons ; s e e be l ow f or de t a i l s ) A n undi f f e r e nt i a t e d ( i e l ow r a t e ) pa t t e r n of r e s pondi ng a s de s c r i be d a bove r e s ul t e d i n pa r t i c i pa t i on i n t he s ubs e que nt pha s e of t he s t udy. M od i f i e d F u n c t i on a l A n al ys i s ( 30 m i n ) M odi f i e d f unc t i ona l a na l ys i s c ondi t i ons w e r e c ond uc t e d a s de s c r i be d a bove ; how e ve r a l l s e s s i ons w e r e 30 m i n i n l e ngt h. B e c ky w a s t he onl y pa r t i c i pa nt e xpos e d t o t he s e pr oc e dur e s w hi c h w e r e c onduc t e d i m m e di a t e l y f ol l ow i ng he r m odi f i e d f unc t i ona l a na l ys i s ( 10 m i n s e s s i ons ) T he o r de r o f pha s e s w a s r e ve r s e d f or B e c ky be c a us e he r s w a s t he f i r s t f unc t i ona l a na l ys i s t ha t w a s c onduc t e d, a nd t he m os t o f e f f i c i e nt or de r o f c ondi t i ons w a s no t e s t a bl i s he d a t t he t i m e

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27 T a bl e 2 1 P a r t i c i pa nt c ha r a c t e r i s t i c s P a r t i c i pa nt A ge D i a gnos i s T a r ge t be ha vi or s P hyl l i s 48 M ode r a t e M R s e i z ur e di s or de r A ggr e s s i on ( ha i r pul l i ng ) D e bbi e 16 M ode r a t e s e ve r e M R a ut i s m S I B ( f a c e s l a ppi ng, he a d ba ngi ng, ha i r pul l i ng) T e r r a nc e 12 M R a ut i s m s e i z ur e di s or de r P r ope r t y de s t r uc t i on ( obj e c t / s ur f a c e ba ngi ng, t hr ow i ng i t e m s ) J a c ob 20 M R P r a de r W i l l i S yndr o m e S I B ( s ki n pi c ki ng ) T ony 21 P r of ound M R A nge l m a n S yndr o m e P r ope r t y de s t r uc t i on ( t e a r i ng or t hr ow i ng i t e m s ) G l e nn 32 M ode r a t e M R S I B ( f a c e s l a ppi ng, body h i t t i ng) a ggr e s s i on ( hi t t i ng) B e c ky 23 M i l d M R P r a de r W i l l i S ynd r om e A ggr e s s i on ( hi t t i ng, bi t i ng)

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28 T a bl e 2 2 R e s pons e t opogr a phi e s B e ha vi or D e f i ni t i on S I B B ody hi t t i ng C ont a c t be t w e e n ha n d a nd c he s t f r om a di s t a nc e of 6 i nc he s or gr e a t e r F a c e s l a ppi ng C ont a c t be t w e e n ha nd a nd f a c e or he a d f r om a d i s t a nc e of 6 i nc he s or g r e a t e r H a i r pul l i ng F i nge r s i nt e r t w i ne d i n ha i r g r a bbi ng or pul l i ng ha i r H e a d ba ngi ng C ont a c t of he a d on a ha r d s ur f a c e f r om a di s t a nc e of 3 i nc he s or gr e a t e r S ki n pi c ki ng C ont a c t be t w e e n f i nge r na i l a nd s ki n A ggr e s s i on B i t i ng ot he r s C l os ur e of uppe r a nd l ow e r t e e t h on a ny pa r t o f a n ot he r pe r s on s body. H a i r pul l i ng F i nge r s i nt e r t w i ne d i n a not he r pe r s on s ha i r pul l i n g on ha i r H i t t i ng ot he r s A udi bl e c ont a c t be t w e e n pa r t i c i pa nt s ha nd a nd a n ot he r pe r s on. P r ope r t y de s t r uc t i on O bj e c t / s ur f a c e ba ngi ng C ont a c t be t w e e n pa r t i c i pa nt s ha nd or f oot a nd w a l l or obj e c t s f r om a d i s t a nc e of 6 i nc he s or g r e a t e r T e a r i ng i t e m s T e a r i ng of pa pe r o r c l ot hi ng f o r a t l e a s t 1/ 2 i nc h. T hr ow i ng i t e m s T hr ow n i t e m s l a nd 6 i nc he s o r m or e f r o m t he i r or i gi na l pos i t i on.

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29 C H A P T E R 3 R E S U L T S F i gur e 3 1 s how s t he r e s ul t s of t he s t a nda r d a nd m odi f i e d f unc t i ona l a na l ys e s f or P hyl l i s D e bbi e T e r r a nc e a nd J a c ob. A l l pa r t i c i pa nt s e nga ge d i n z e r o o r ne a r z e r o r a t e s o f pr ob l e m be ha vi or a c r os s a l l c ondi t i ons of t he o r i gi na l ( s t a nda r d) f unc t i ona l a na l ys i s W he n t he f unc t i ona l a na l ys i s c ondi t i ons w e r e m odi f i e d, P hyl l i s s a ggr e s s i on, a l t hough oc c ur r i ng a t l ow r a t e s w a s obs e r ve d dur i ng 5 of t he 7 m u l t i pl e S r + s e s s i ons T hus da t a i ndi c a t e d t ha t he r a ggr e s s i on w a s m a i nt a i ne d by s oc i a l po s i t i ve r e i n f or c e m e nt i n t he f or m o f a c c e s s t o bot h a t t e nt i on a nd pr e f e r r e d a c t i vi t i e s i n s i t ua t i ons w he r e t hos e r e i nf o r c e r s w e r e be i ng de l i ve r e d t o ot he r s D ur i ng D e bbi e s m odi f i e d f unc t i ona l a na l ys i s i nc r e a s e d r a t e s of S I B w e r e obs e r ve d i n t he S r / S r + c o ndi t i on, no S I B w a s obs e r ve d i n t he m ul t i pl e S r + c ondi t i on a nd r a r e oc c ur r e nc e s of S I B w e r e obs e r ve d i n t he a l one a nd pl a y c ondi t i ons T he s e r e s ul t s i ndi c a t e d t ha t D e bbi e s S I B w a s oc c a s i one d by w or k s i t ua t i ons i n w hi c h pr obl e m be ha vi or p r oduc e d a c c e s s t o a t t e nt i on a nd pr e f e r r e d i t e m s ( S r + ) dur i ng br e a ks f r om t a s ks ( S r ) D ur i ng T e r r a nc e s m odi f i e d f unc t i ona l a na l ys i s i nc r e a s e d r a t e s of pr ope r t y de s t r uc t i on w e r e obs e r ve d i n t he m ul t i pl e S r + c ondi t i on w i t h l ow e r r a t e s of pr ope r t y de s t r uc t i on i n t he S r / S r + a nd pl a y c ondi t i ons T he s e r e s ul t s w e r e ve r i f i e d du r i ng a s ubs e que nt pa i r w i s e c om pa r i s on, i n w hi c h T e r r a nc e e nga ge d i n i nc r e a s i ng r a t e s of pr ope r t y de s t r uc t i on dur i ng t he m ul t i pl e S r + c ondi t i on a nd ne a r z e r o r e s pons e s dur i ng t he pl a y c ondi t i on, i ndi c a t i ng t ha t hi s pr obl e m be ha vi or w a s m a i nt a i ne d by s oc i a l pos i t i ve r e i nf o r c e m e nt i n t he f o r m o f a c c e s s t o bot h a t t e nt i on a nd pr e f e r r e d a c t i vi t i e s i n s i t ua t i o ns w he n ot he r s a r e pr ov i de d a c c e s s t o t hos e r e i nf or c e r s F i na l l y, J a c ob s S I B w a s obs e r ve d onl y i n t he a l one c ondi t i on o f t he m odi f i e d f unc t i ona l a na l ys i s ; n o i ns t a nc e s of S I B w e r e obs e r ve d dur i ng t he m ul t i pl e S r + S r / S r + o r pl a y c ondi t i ons T he s e r e s ul t s i ndi c a t e d t ha t J a c ob s S I B w a s m a i nt a i ne d by a ut om a t i c r e i nf or c e m e nt

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30 a nd t ha t a m o r e c ove r t s e t t i ng t ha n t ha t t ypi c a l l y us e d t o c onduc t a l one s e s s i ons oc c a s i one d r e s pondi ng. F i gur e 3 2 s how s r e s ul t s obt a i ne d f or T ony G l e nn a nd B e c ky. T ony e nga ge d i n z e r o or ne a r z e r o i ns t a nc e s of pr ope r t y de s t r uc t i on du r i ng bot h t he s t a nda r d a nd m odi f i e d f unc t i ona l a na l ys e s H ow e ve r w he n s t a nda r d f unc t i ona l a na l ys i s s e s s i ons w e r e l e ngt he ne d t o 30 m i n hi gh r a t e s of pr ope r t y de s t r uc t i on w e r e obs e r ve d i n t he de m a nd c ondi t i on, w he r e a s z e r o or r a r e oc c ur r e nc e s of pr ope r t y de s t r uc t i on w e r e obs e r ve d i n a l l ot he r c ondi t i ons T he s e r e s ul t s i ndi c a t e d t ha t T ony s p r ope r t y de s t r uc t i on w a s m a i nt a i ne d b y s oc i a l ne ga t i ve r e i nf o r c e m e nt i n t he f or m of br e a ks f r om t a s ks H ow e ve r a n i nc r e a s e i n s e s s i on l e ngt h w a s r e qui r e d t o c l a r i f y t he f unc t i on of T ony s pr ope r t y de s t r uc t i on. G l e nn di d not e nga ge i n a ny oc c ur r e nc e s of a ggr e s s i on or S I B dur i ng t he s t a nda r d f unc t i ona l a na l ys i s w he n s e s s i ons w e r e 10 m i n i n l e ngt h S e s s i ons t ha t w e r e 30 m i n i n l e ngt h, how e ve r r e s ul t e d i n i nc r e a s e d r a t e s of a ggr e s s i on a nd S I B dur i ng t he de m a nd c ondi t i on, i n di c a t i ng t ha t G l e nn s pr obl e m be ha vi o r w a s m a i nt a i ne d by s oc i a l ne ga t i ve r e i nf or c e m e nt i n t he f or m o f b r e a ks f r om t a s ks B e c ky e nga ge d i n a ggr e s s i on i n 2 of 6 t a ngi bl e s e s s i ons dur i ng t he s t a nda r d f unc t i ona l a na l ys i s ; h ow e ve r t he s e l ow a nd s por a di c r a t e s di d no t s e e m i ndi c a t i ve of a c l e a r f unc t i on B e c ky s a ggr e s s i on di d not i nc r e a s e dur i ng t he m odi f i e d f unc t i ona l a na l ys i s w he n s e s s i ons w e r e 10 m i n i n l e ngt h. M odi f i e d f unc t i ona l a na l ys i s s e s s i ons t ha t w e r e 30 m i n i n l e ngt h, how e ve r r e s ul t e d i n i n c r e a s e d r a t e s of a ggr e s s i on dur i ng t he m ul t i pl e S r + a nd S r / S r + c ondi t i ons T o c l a r i f y w he t he r t he s e i nc r e a s e d r a t e s of a ggr e s s i on r e s ul t e d f r om s e s s i on m odi f i c a t i on ve r s us i nc r e a s e d s e s s i on l e ngt h ( bot h o f w hi c h oc c ur r e d du r i ng t h i s pha s e ) w e c onduc t e d c ons e c ut i v e 30 m i n s t a nda r d de m a n d s e s s i ons R e s ul t s of t hi s pha s e s how e d t ha t B e c ky s a ggr e s s i on m a i nt a i ne d w he n he r e xpos ur e t o s t a nda r d c ondi t i ons w a s l e ngt he ne d a nd

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31 s ugge s t t ha t t he a ppa r e nt c a us e of B e c ky s i ni t i a l f unc t i ona l a na l ys i s pha s e s w a s l a c k of e xpos ur e t o f unc t i ona l a na l ys i s s e s s i ons W i t hi n s e s s i on pa t t e r ns of r e s pondi ng w e r e e xa m i ne d f or t he f unc t i ona l a na l ys e s t ha t w e r e c l a r i f i e d f ol l ow i ng i nc r e a s e d e xpos ur e t o s e s s i on c ont i nge nc i e s F i gur e 3 3 s how s t he c um ul a t i ve f r e que nc y of t a r ge t be ha vi or s du r i ng t he f i r s t 30 m i n s e s s i on i n w hi c h pr obl e m be ha vi or w a s obs e r ve d f or T ony, G l e nn, a nd B e c ky ( s e s s i ons 60, 33, a nd 49, r e s pe c t i ve l y) T he a r r ow be l ow t he x a xi s poi nt s t o w he r e a 10 m i n s e s s i on w oul d ha ve be e n t e r m i na t e d. T he s e da t a s how t ha t T ony a nd G l e nn be ga n t o e nga ge i n t he i r t a r ge t be ha vi or s onl y a f t e r t he 10 t h m i n of t he s e s s i on ( T ony a t m i n 13 G l e nn a t m i n 27) B e c ky e nga ge d i n a f e w r e s pons e s be t w e e n m i nut e s 7 a nd 10 a nd t he n s how e d a s t e a dy r a t e o f r e s pondi ng t h r ou ghout t he r e s t o f t he s e s s i on F or a l l 3 pa r t i c i pa nt s ha d t he s e s s i on be e n t e r m i na t e d a f t e r 10 m i n, l i t t l e ( B e c ky) or no ( T ony a nd G l e nn) r e s pondi ng w oul d ha ve be e n obs e r ve d.

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32 10 20 30 40 50 0 0.5 1 Standard FA Modifed FA Ignore Attention Tangible Demand Play Mult. Sr+ Phyllis Sr-/Sr+ 10 20 30 40 50 60 0 1 2 Standard FA Modifed FA Alone Attention Tangible Demand Play Sr-/Sr+ Debbie Mult. Sr+ 10 20 30 40 50 60 0 4 8 12 16 Standard FA Modifed FA Alone Attention Tangible Demand Play Sr-/Sr+ Terrance Mult. Sr+ 10 20 30 40 50 0 20 40 60 80 100 Standard FA Modifed FA Alone Attention Tangible Demand Play Jacob Sr-/Sr+ Mod. Alone Mult. Sr+ SESSIONS F i gur e 3 1 L e ve l s of pr obl e m be ha vi or du r i ng s t a nda r d a nd m odi f i e d f unc t i ona l a na l ys i s c ondi t i ons f or P hyl l i s D e bbi e T e r r a nc e a nd J a c ob.

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33 10 20 30 40 50 60 70 0 2 4 6 8 Standard FA Modifed FA Ignore Attention Tangible Demand Play Tony Sr-/Sr+ Standard FA (30 min) Mult. Sr+ 10 20 30 40 50 0 1 2 Standard FA Standard FA (30 min) Ignore Attention Tangible Demand Play Glenn 10 20 30 40 50 60 70 0 1 2 Standard FA Modifed FA Ignore Attention Tangible Demand Play Becky Sr-/Sr+ Modifed FA (30 min) Standard FA (30 min) Mult. Sr+ SESSIONS F i gur e 3 2 L e ve l s of pr obl e m be ha vi or du r i ng s t a nda r d a nd m odi f i e d f unc t i ona l a na l ys i s c ondi t i ons f or T ony, G l e nn, a nd B e c ky.

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34 10 20 30 0 10 20 30 40 50 60 70 Becky Tony Glenn MINUTES F i gur e 3 3 C um ul a t i ve f r e que nc y of t a r ge t be ha vi or s dur i ng t he f i r s t 30 m i n s e s s i on w i t h pr obl e m be ha vi or

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35 C H A P T E R 4 D I S C U S S I O N P r obl e m be ha vi or oc c ur s i nf r e que nt l y be c a us e t he c ondi t i ons t ha t i nf l ue nc e i t a r e unus ua l a nd s e ve r a l pos s i bi l i t i e s t ha t m i ght a c c ount f or s uc h f i ndi ngs ha ve be e n r e por t e d i n i s ol a t e d s t udi e s T hr ough a n a na l ys i s of unus ua l a s s e s s m e n t f i ndi ngs w e i de nt i f i e d s e ve r a l de t e r m i na nt s of l ow r a t e r e s pondi ng a nd c ons t r uc t e d f unc t i ona l a na l ys i s c ondi t i ons t ha t a c c om m oda t e d t he m T he ge ne r a l m ode l w a s e va l ua t e d w i t h 7 i ndi vi dua l s w ho e nga ge d i n l ow r a t e h i gh i nt e ns i t y be ha vi or a nd w hos e i ni t i a l a s s e s s m e nt s r e s ul t e d i n ve r y l i t t l e or no r e s pondi ng. T he s e l ow r a t e f unc t i ona l a na l ys e s a c c ount e d f or a ppr oxi m a t e l y 1 2% of a l l f unc t i ona l a na l ys e s t ha t w e r e c onduc t e d ove r a n 18 m ont h pe r i od M odi f i e d f un c t i ona l a na l ys i s c ondi t i ons t ha t i nvol ve d m ul t i pl e e s t a bl i s hi ng ope r a t i ons e nha nc e d r e i n f or c e r c ha r a c t e r i s t i c s a nd c om bi ne d c ont i nge nc i e s c l a r i f i e d t hr e e a s s e s s m e nt s a nd i nc r e a s e d e xpos ur e t o s e s s i on c ont i nge nc i e s c l a r i f i e d t hr e e ot he r a s s e s s m e nt s A c ondi t i on t ha t i nvol ve d a n unobt r us i ve obs e r va t i o n s t r a t e gy f or c ove r t be ha vi or c l a r i f i e d t he f i na l pa r t i c i pa nt s a s s e s s m e nt T he s e r e s ul t s pr ovi de d a f u r t he r de m ons t r a t i on of t he ve r s a t i l i t y o f e xpe r i m e nt a l a p pr oa c he s t o be ha vi or a l a s s e s s m e nt W he n i t i s s us pe c t e d t ha t unus ua l e ve nt s or c om bi na t i ons of e ve nt s i nf l ue nc e be ha vi or t ha t pos s i bi l i t y m a y be t e s t e d a nd ve r i f i e d di r e c t l y. R e s ul t s of t he i ni t i a l f unc t i ona l a na l ys i s r e s e m bl e d t hos e r e por t e d i n s e ve r a l s t udi e s s how i ng t ha t i n s om e c a s e s t ypi c a l f unc t i ona l a na l ys i s c ondi t i ons m a y not i de nt i f y t he e nvi r onm e nt a l de t e r m i na nt s of pr obl e m be ha vi or O ne pos s i bi l i t y t ha t m a y a c c ount f or s uc h r e s ul t s i s t ha t be ha vi or i s m a i nt a i ne d by c om m on l y obs e r ve d r e i nf o r c i ng c ons e que nc e s s uc h a s a t t e nt i on or e s c a pe but t ha t t he s e c ons e que nc e s a r e de l i ve r e d i nf r e que nt l y. T hi s a c c ount i s unl i ke l y, how e ve r be c a us e pr ogr a m m e d c ons e que nc e s a r e de l i ve r e d unde r de ns e s c he dul e s i n t ypi c a l f unc t i ona l a na l ys e s

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36 A not he r pos s i bi l i t y i s t ha t pr obl e m be ha vi o r oc c ur s a t z e r o or l ow r a t e s due t o a l a c k of di s c r i m i na t i on be t w e e n t h e di f f e r e nt t e s t or c ont r ol c ondi t i ons ( C onne r s e t a l 2000) H ow e ve r a di s c r i m i na t i on f a i l u r e w a s unl i ke l y i n t he pr e s e nt s t udy gi ve n t ha t s t i m ul us c ont r ol s ( i e di s t i nc t i ve vi s ua l c ue s ) s pe c i f i c a l l y de s i gne d t o m i ni m i z e i nt e r a c t i on e f f e c t s w e r e i nc l ude d i n a l l a s s e s s m e nt c ondi t i ons A t hi r d pos s i bi l i t y i s t ha t oc c ur r e nc e s of t he t a r ge t be ha vi or m a y be i n f r e que nt i f ot he r be ha vi or s a r e m e m be r s of t he s a m e r e s pons e c l a s s a nd a l s o a r e r e i nf o r c e d dur i ng a s s e s s m e nt ( H a r di ng e t a l 2001) T he e f f e c t s of m i ni m i z i ng t he num be r of r e s pons e t opogr a phi e s i n t he c ont i nge nc y c l a s s w e r e not e xpl i c i t l y de m ons t r a t e d i n t he pr e s e nt s t udy. T ha t i s c ont i nge nc i e s dur i ng t he i ni t i a l f unc t i ona l a na l ys i s w e r e pl a c e d o nl y on t he t a r ge t be ha vi or s f or w hi c h t he pa r t i c i pa nt s w e r e r e f e r r e d, t he r e by obvi a t i ng our a bi l i t y t o e xa m i ne c ha nge s i n r e s pondi ng due t o e xt i nc t i on of l e s s s e ve r e m e m be r s of a r e s pons e c l a s s dur i ng t he m odi f i e d c ondi t i ons H ow e ve r our pa r t i c i pa nt s w e r e r e f e r r e d f o r t he a s s e s s m e nt a nd t r e a t m e nt o f s e ve r e p r obl e m be ha vi or s a nd e ve n w he n c ont i nge nc i e s dur i ng s t a nda r d c ondi t i o ns w e r e l i m i t e d t o t hos e r e s pons e s t a r ge t be ha vi or s w e r e r a r e l y o r ne ve r obs e r ve d. F our t h, pr obl e m be ha vi or m a y oc c ur i n f r e que nt l y dur i ng a s s e s s m e nt i f t he a nt e c e de nt or c ons e que nt e ve n t s a r e i ns uf f i c i e nt t o e voke o r r e i nf or c e be ha vi or r e s pe c t i ve l y. T ha t i s t he a nt e c e de nt e ve nt s t ypi c a l l y m a ni pul a t e d i n a f unc t i ona l a na l ys i s ( i e l ow l e ve l s of a t t e nt i on pr e s e nt a t i on of i ns t r uc t i ons ) m a y c ons t i t ut e ne ut r a l e ve nt s f or s om e i ndi vi dua l s W e a t t e m pt e d t o i nc r e a s e t he pot e nc y of a nt e c e de nt i n f l ue nc e s on b e ha vi or m a i nt a i ne d by pos i t i ve r e i nf o r c e m e nt by a r r a ngi ng a c ondi t i on w he r e i n m ul t i pl e pos i t i ve r e i nf or c e r s w e r e una va i l a bl e but w e r e de l i ve r e d t o ot he r s ; t he de l i ve r y of t he s e r e i nf or c e r s f or a l onge r pe r i od of t i m e f ol l ow i ng pr obl e m be ha vi or s t r e ngt he ne d t he pot e nc y o f c on s e que nt e ve nt s A l t hough not e va l ua t e d i n

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37 i s ol a t i on, t he s pe c i f i c c ont r i but i on o f t hi s m a ni pul a t i on m a y be s e e n i n P hyl l i s s a nd T e r r a nc e s da t a w hi c h s how e d t ha t t he i r r e s pe c t i ve t a r ge t be h a vi or s i nc r e a s e d not i c e a bl y onl y dur i ng t he m ul t i pl e S r + c ondi t i on o f t he m odi f i e d f unc t i ona l a na l ys i s S i m i l a r l y, t he ne ga t i ve r e i nf or c e m e nt c ont i nge nc y c oul d ha ve be e n s t r e ngt he ne d by i nc r e a s i ng t he dur a t i on of t he e s c a pe i nt e r va l R a t he r t ha n e nha nc i ng t he du r a t i on of e s c a pe how e ve r w e c hos e t o e nha nc e t he qua l i t y o f e s c a pe by pr ovi di ng f r e e a c c e s s t o a t t e nt i on a nd hi ghl y pr e f e r r e d l e i s ur e i t e m s du r i ng c ont i nge nt br e a ks f r om i ns t r uc t i on a nd t he e f f e c t s of t h i s m od i f i c a t i on c a n b e s e e n i n D e bbi e s da t a w hi c h s how e d a n i nc r e a s e i n r e s pondi ng onl y du r i ng t he S r + / S r c ondi t i on of t he m odi f i e d f unc t i ona l a na l ys i s I n a f unc t i ona l a na l ys i s of c ove r t pr obl e m be ha vi or t he t a r ge t r e s pons e w i l l oc c ur i nf r e que nt l y ( or not a t a l l ) w he n a s s e s s m e nt c ondi t i ons a r e a s s oc i a t e d w i t h s t i m ul i t ha t a r e di s c r i m i na t i ve f or t he pr e s e nc e of ot he r s T hi s m a y i nc l ude t he t e s t c ondi t i on f o r a ut om a t i c r e i nf or c e m e nt i f s om e f e a t ur e of t he a l one s e t t i ng, s uc h a s t he pr e s e nc e of a n obs e r ve r o r e ve n j us t a n obs e r va t i on w i ndow pe r m i t s a n i ndi vi dua l t o de t e c t t he p r e s e nc e of obs e r ve r s I n J a c ob s m odi f i e d f unc t i ona l a na l ys i s t he t e s t c ondi t i on f o r a ut om a t i c r e i nf or c e m e nt w a s c onduc t e d i n a s e t t i ng t ha t c ons i de r a bl y m i ni m i z e d t hi s pos s i bi l i t y, a nd hi gh r a t e s of p r obl e m be ha vi or w e r e obs e r ve d i n t ha t c ondi t i on onl y. A l t hough not r e pl i c a t e d w i t h ot he r pa r t i c i pa nt s t he s e r e s ul t s s ugge s t t ha t s ophi s t i c a t e d m e t hods of unobt r us i ve obs e r va t i on m a y be ne c e s s a r y t o ve r i f y t he c ove r t na t ur e o f s om e be ha vi or s F i na l l y, l i m i t e d e xpos ur e t o s e s s i on c ont i nge nc i e s m a y a c c ount f or l ow r a t e s of p r obl e m be ha vi or dur i ng a s s e s s m e nt O ur r e s ul t s s how e d t ha t e xt e ndi ng t he du r a t i on of f unc t i ona l a na l ys i s s e s s i ons t o 30 m i n ( i n c ont r a s t t o a ppr oxi m a t e l y 7 hour s i n t he K a hng e t a l 2001 s t udy) w a s s uf f i c i e nt t o pr oduc e di f f e r e nt i a l i nc r e a s e s i n p r obl e m be ha vi or i n t h r e e c a s e s G i ve n t ha t

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38 i nc r e a s e d e xpos ur e w a s f ound t o be a n i m por t a nt d e t e r m i na nt of l ow r a t e be ha vi or a que s t i on t ha t a r i s e s i s w he t he r s i m pl y c ont i nui ng s t a nda r d f unc t i ona l a na l ys i s s e s s i ons e ve nt ua l l y w oul d ha ve pr oduc e d di f f e r e nt i a l r e s pondi ng. I n ot he r w or ds a n i nhe r e nt f e a t ur e of t he m odi f i e d c ondi t i ons w a s i nc r e a s e d e xpos ur e t o a s s e s s m e nt H ow e ve r t he s t a nda r d f unc t i ona l a na l ys i s c ondi t i ons w e r e c ont i nue d f o r a n e xt e n de d r un w i t h l i t t l e o r no r e s pondi ng, s o i t i s unl i ke l y t ha t r e l a t i ve l y qui c k c ha nge s obs e r ve d unde r m o di f i e d c ondi t i ons w e r e s i m pl y a f unc t i on of r unni ng m or e s e s s i ons I nc r e a s e d s e s s i on dur a t i on a l s o i nv ol ve d a ddi t i ona l e xpos ur e t o f unc t i ona l a na l ys i s c o nt i nge nc i e s ; how e ve r t he w i t hi n s e s s i on a na l ys i s of r e s pondi ng i ndi c a t e d t ha t l onge r s e s s i ons a nd not s i m pl y m or e s e s s i ons w e r e ne c e s s a r y t o s t r e ngt he n t he e s t a bl i s hi ng ope r a t i ons a s s oc i a t e d w i t h t he di f f e r e nt c ondi t i ons S om e l i m i t a t i ons o f t he pr e s e nt a na l ys i s s houl d be not e d. F i r s t a l t hough w e c onc l ude d t ha t B e c ky s l ow r a t e r e s pondi ng i n he r i ni t i a l a s s e s s m e nt w a s due t o l a c k of e xpos ur e t o f unc t i ona l a na l ys i s s e s s i on s he r m odi f i e d a na l ys i s onl y i nc l ude d a n e va l ua t i on of be ha vi o r unde r 30 m i n ( s t a n da r d) de m a nd c ondi t i ons A m o r e de f i ni t i ve c onc l us i on r e ga r di ng t he de t e r m i na nt s of B e c ky s be ha vi or m a y ha ve be e n obt a i ne d ha d a f ul l s e t of 30 m i n s t a nda r d c ondi t i ons be e n c onduc t e d. S e c ond, t he pa r t i c i pa t i on of pe e r c on f e de r a t e s i n f u nc t i ona l a na l ys i s s e s s i ons m a y not be a ppr opr i a t e w he n hi gh i nt e ns i t y a ggr e s s i on m a y oc c ur dur i ng t he a s s e s s m e nt a s w a s t he c a s e w i t h G l e nn. T he de c i s i on t o e xc l ude pe e r s f r om a s s e s s m e nt s e s s i ons s houl d be m a de by c ons i de r i ng w he t he r t he i r pr e s e nc e pl a c e s t he m a t r i s k f or u ndue ha r m I f t hi s i s t he c a s e i t m a y be pos s i bl e t o e xa m i ne onl y t he e f f e c t s of i nc r e a s e d e xpos ur e t o s t a nda r d c ondi t i ons A l t e r na t i ve l y, t he pos s i bi l i t y of i nc l udi ng non pe e r c onf e de r a t e s m a y be e xpl or e d F o r e xa m pl e t he r a pi s t s t r a i ne d i n m a i nt a i ni ng t he i r ow n a nd ot h e r s s a f e t y w he n de a l i ng w i t h a ggr e s s i ve

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39 c l i e nt s m a y a s s um e t he r ol e of c onf e de r a t e s F u t ur e s t udi e s m a y e xpl or e t he e f f e c t s of i nc l udi ng ps e udo ve r s us a c t ua l pe e r s a s c onf e de r a t e s dur i ng m odi f i e d f unc t i ona l a na l ys i s s e s s i on s T he ove r a l l r e s ul t s of t he pr e s e nt s t udy r a i s e que s t i ons a bout t he ge ne r a l i m pl e m e nt a t i on of f unc t i ona l a na l ys i s m e t hodol ogy. T ha t i s one i m pl i c a t i on of t he s e r e s ul t s i s t ha t f unc t i ona l a na l ys i s pr oc e dur e s s houl d i nc l ude t he m odi f i e d c ondi t i ons a t t he out s e t S uc h a s t r a t e gy doe s not s e e m a dvi s a bl e f or t w o r e a s ons F i r s t r e s ul t s r e por t e d i n a l a r ge num be r of s t udi e s i ndi c a t e t ha t s i m pl e c ont i nge nc i e s of t e n a c c ount f or p r obl e m be ha vi or ; t he r e f or e t he i nc l us i on of a ddi t i ona l c ondi t i ons dur i ng t he i ni t i a l a s s e s s m e nt m a y f ur t he r c om pl i c a t e t he pr oc e s s unne c e s s a r i l y. S e c ond, s om e of t he m odi f i e d c ondi t i ons c ont a i ne d c onf ounde d va r i a bl e s w hos e s e pa r a t e i nf l ue nc e s w oul d l a t e r ne e d t o be i de nt i f i e d. F o r e xa m pl e i f hi gh l e ve l s o f pr obl e m be ha vi or w e r e obs e r ve d i n t he bot h of t he s oc i a l r e i nf or c e m e nt c ondi t i ons ( m ul t i pl e S r + a nd S r / S r + ) a s ubs e que nt t e s t w oul d be r e qui r e d t o de t e r m i ne w hi c h of t he t w o va r i a bl e s ( pos i t i ve o r ne ga t i ve r e i nf or c e m e nt ) w a s r e s pons i bl e f or t he ob s e r ve d e f f e c t T hus t he m odi f i e d c ondi t i ons de s c r i be d i n t he pr e s e nt s t udy s e e m a ppr op r i a t e un de r s pe c i a l c i r c um s t a nc e s ( i e f ol l ow i ng t he c om pl e t i on of a f unc t i ona l a na l ys i s t ha t r ul e s out t ypi c a l i nf l ue nc e s a nd r e s ul t s i n i n f r e que nt r e s pondi ng) F i na l l y, ou r p r oc e dur e s di d not a c c ount f or a l l pos s i bl e d e t e r m i na nt s of l ow r a t e r e s pondi ng. F or e xa m pl e our a na l ys i s di d not i nc l ude pr oc e dur e s f or a s s e s s i ng c om bi ne d e s t a bl i s hi ng ope r a t i ons s uc h a s t he pr e s e nc e of a n e nvi r onm e nt a l e ve nt a l ong w i t h a bi o l ogi c a l one ( O R e i l l y, 1995, 1997) w hi c h m a y r e qui r e de l a yi ng t he oc c ur r e nc e of one e s t a bl i s hi ng ope r a t i on ( e g pr e s e nt a t i on of t a s k de m a nds ) unt i l t he s e c ond e s t a bl i s hi ng ope r a t i on ( e g. a he a da c he ) i s pr e s e nt I n a ddi t i on, our a na l ys i s di d not i nc l ude s i t ua t i ons t ha t i nvo l ve d hi ghl y s pe c i f i c c ons e que nc e s ( e g. a t t e nt i on de l i ve r e d by a s pe c i f i c c a r e gi ve r [ R i ngda hl & S e l l e r s

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40 2002] e s c a pe f r om a c t i vi t i e s onl y w he n a pa r t i c ul a r a l t e r na t i ve a c t i vi t y i s m a de a va i l a bl e e t c ) w hi c h m a y be us e f ul t o e xpl or e i f t he pr e s e nt pr oc e dur e s do not p r oduc e a n i nc r e a s e l ow r a t e be ha vi or F ut u r e r e s e a r c h m a y be he l pf ul i n doc um e nt i ng t he s e i nf l ue nc e s a nd de m ons t r a t i ng how t he y m a y be ope r a t i ona l i z e d f o r t he pur pos e s of a s s e s s m e nt

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41 L I S T O F R E F E R E N C E S A s m us J M R i ngda hl J E S e l l e r s J A C a l l N A A nde l m a n M S & W a c ke r D P ( 2004) U s e of a s hor t t e r m i npa t i e nt m ode l t o e va l ua t e a be r r a nt be ha vi or : O ut c om e da t a s um m a r i e s f r om 1996 t o 2001 J our nal of A pp l i e d B e hav i or A nal y s i s 37 283 304 B ow m a n, L G F i s he r W W T hom ps on, R H & P i a z z a C C ( 1997) O n t he r e l a t i on of m a nds a nd t he f unc t i on of de s t r uc t i ve be ha vi or J o ur nal of A ppl i e d B e hav i or A nal y s i s 30 251 265. C a l l N A W a c ke r D P R i ngda hl J E & B oe l t e r E W ( 2005 ) C om bi ne d a nt e c e de nt va r i a bl e s a s m ot i va t i ng ope r a t i ons w i t hi n f unc t i on a l a na l ys i s J our nal of A pp l i e d B e hav i or A nal y s i s 38 385 389. C onne r s J I w a t a B A K a hng S H a nl e y, G P W or s de l l A S & T hom p s on, R H ( 2000) D i f f e r e nt i a l r e s pondi ng i n t he pr e s e nc e a nd a bs e nc e of di s c r i m i na t i ve s t i m ul i du r i ng m ul t i e l e m e nt f unc t i ona l a na l ys e s J our nal of A ppl i e d B e hav i or A nal y s i s 33 299 308. D e L e on, I G & I w a t a B A ( 1996 ) E va l ua t i on o f a m ul t i pl e s t i m ul us pr e s e nt a t i on f o r m a t f or a s s e s s i ng r e i nf or c e r pr e f e r e nc e s J our nal of A ppl i e d B e hav i or A nal y s i s 29 519 533. D e r by, K M W a c ke r D P S a s s o, G S t e e ge M N or t hup, J C i gr a nd, K e t a l ( 1992) B r i e f f unc t i ona l a s s e s s m e nt t e c hni que s t o e va l ua t e a be r r a nt be ha vi or i n a n out pa t i e nt s e t t i ng: A s um m a r y of 79 c a s e s J our nal of A ppl i e d B e hav i or A nal y s i s 25 713 721 F i s he r W W K uhn D E & T hom ps on, R H ( 1 998) E s t a bl i s hi ng di s c r i m i na t i ve c ont r o l of r e s pondi ng us i ng f unc t i ona l a nd a l t e r na t i ve r e i nf or c e r s dur i ng f unc t i ona l c om m uni c a t i on t r a i ni ng. J our nal of A ppl i e d B e hav i or A nal y s i s 31 543 560. F i s he r W W N i nne s s H A C P i a z z a C C & O w e n D e S c hr yve r J S ( 1996 ) O n t he r e i nf or c i ng e f f e c t s of t he c ont e nt o f ve r ba l a t t e nt i o n. J our n al of A ppl i e d B e hav i or A nal y s i s 29 235 238 F i s he r W P i a z z a C C B ow m a n, L G H a gopi a n, L P O w e ns J C & S l e vi n, I ( 1992) A c om pa r i s on of t w o a ppr oa c he s f or i de nt i f yi ng r e i nf or c e r s f or pe r s ons w i t h s e ve r e a nd pr of ound di s a bi l i t i e s J our na l of A ppl i e d B e hav i or A nal y s i s 25 491 498. G r a c e N C T hom ps on, R & F i s he r W W ( 199 6) T he t r e a t m e nt of c ove r t s e l f i nj ur y t hr ough c ont i nge nc i e s on r e s pons e pr oduc t s J our nal of A p pl i e d B e hav i or A nal y s i s 29 239 242. H a nl e y, G P I w a t a B A & M c C or d, B E ( 200 3) F unc t i ona l a na l ys i s of p r obl e m be ha vi or : A r e vi e w J our nal of A ppl i e d B e hav i or A nal y s i s 36 147 186. H a r di ng, J W W a c ke r D P B e r g W K B a r r e t t o, A W i nbor n, L & G a r dne r A ( 2001) A na l ys i s of r e s pons e c l a s s hi e r a r c hi e s w i t h a t t e nt i on m a i nt a i ne d pr obl e m be ha vi or s J our nal of A ppl i e d B e hav i or A nal y s i s 34 61 64.

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42 I w a t a B A ( 1994) F unc t i ona l a na l ys i s m e t hodol ogy: S om e c l os i ng c om m e nt s J our nal of A ppl i e d B e hav i or A nal y s i s 27, 413 418 I w a t a B A D or s e y, M F S l i f e r K J B a um a n, K E & R i c hm a n, G S ( 1994 ) T ow a r d a f unc t i ona l a na l ys i s of s e l f i nj u r y. J our nal of A ppl i e d B e hav i or A nal y s i s 27 197 209. ( R e pr i nt e d f r o m A na l y s i s and I nt e r v e nt i on i n D e v e l opm e nt al D i s abi l i t i e s 2 3 20 1982 ) K a hng, S A bt K A & S c honba c hl e r H E ( 200 1) A s s e s s m e nt a nd t r e a t m e nt of l ow r a t e hi gh i nt e ns i t y pr obl e m be ha vi or J our nal of A ppl i e d B e hav i or A nal y s i s 34 225 228. K a hng, S & I w a t a B A ( 1999) C or r e s ponde nc e be t w e e n out c om e s of b r i e f a nd e xt e nde d f unc t i ona l a n a l ys e s J our nal of A ppl i e d B e hav i or A nal y s i s 32 149 159. K oda k, T N or t hup J & K e l l e y, M E ( 2007) A n e va l ua t i on of t he t ype s of a t t e nt i on t ha t m a i nt a i n pr obl e m be ha vi o r J our nal of A ppl i e d B e hav i or A nal y s i s 40 167 171. L a l l i J S M a c e F C W ohn T & L i ve z y, K ( 1 995) I de nt i f i c a t i on a nd m odi f i c a t i on of a r e s pons e c l a s s hi e r a r c hy. J our nal of A ppl i e d B e ha v i or A nal y s i s 28 551 559. L ong, E S M i l t e nbe r ge r R G E l l i ngs on, S A & O t t S M ( 1999) A ugm e nt i ng s i m pl i f i e d ha bi t r e ve r s a l i n t he t r e a t m e nt of o r a l di gi t ha bi t s e xhi bi t e d by i ndi v i dua l s w i t h m e nt a l r e t a r da t i on. J our nal o f A ppl i e d B e hav i or A nal y s i s 32 353 365 M a c e F C P a ge T J I va nc i c M T & O 'B r i e n S ( 1986) A na l ys i s of e nvi r onm e nt a l de t e r m i na nt s of a ggr e s s i on a nd di s r upt i on i n m e nt a l l y r e t a r de d c hi l d r e n. A ppl i e d R e s e ar c h i n M e nt al R e t ar dat i on, 7 203 221 M a ge e S K & E l l i s J ( 2000 ) E xt i nc t i on e f f e c t s dur i ng t he a s s e s s m e nt of m ul t i pl e pr obl e m be ha vi or s J our nal of A ppl i e d B e hav i or A nal y s i s 3 3 313 316 M a gl i e r i K A D e L e on I G R odr i gue z C a t t e r V & S e vi n B M ( 2000) T r e a t m e nt o f c ove r t f ood s t e a l i ng i n a n i nd i vi dua l w i t h P r a de r W i l l i s yndr om e J our nal of A ppl i e d B e hav i or A nal y s i s 33 615 618 O 'R e i l l y, M F ( 1995) F unc t i ona l a na l ys i s a nd t r e a t m e nt of e s c a pe m a i nt a i ne d a ggr e s s i on c or r e l a t e d w i t h s l e e p de pr i va t i on J our nal o f A pp l i e d B e hav i or A nal y s i s 28 225 226. O 'R e i l l y, M F ( 1997) F unc t i ona l a na l ys i s of e pi s odi c s e l f i nj ur y c or r e l a t e d w i t h r e c ur r e nt ot i t i s m e di a J our nal of A ppl i e d B e h av i or A nal y s i s 30 165 167. P a i s e y, T J H & W hi t ne y, R B ( 1989) A l ong t e r m c a s e s t udy of a na l ys i s r e s pons e s uppr e s s i on, a nd t r e a t m e nt m a i nt e na nc e i nvol vi ng l i f e t hr e a t e ni ng pi c a B e hav i or al R e s i de nt i al T r e at m e nt 4 191 211 P i a z z a C C B ow m a n L G C ont r uc c i S A D e l i a M D A de l i ni s J D & G oh, H ( 1999) A n e va l ua t i on of t he pr ope r t i e s of a t t e nt i on a s r e i n f or c e m e nt f o r de s t r uc t i ve a nd a ppr opr i a t e be ha vi or J our nal of A ppl i e d B e hav i or A nal y s i s 32, 437 449.

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43 R a pp, J T M i l t e nbe r ge r R G G a l e ns ky, T L E l l i ngs on, S A & L ong E S ( 1999) A f unc t i ona l a na l ys i s of ha i r pul l i ng J our nal of A ppl i e d B e hav i or A nal y s i s 32 329 337. R i c hm a n, D M & H a gopi a n, L P ( 1999) O n t he e f f e c t s of qua l i t y" of a t t e nt i on i n t he f unc t i ona l a na l ys i s of de s t r uc t i ve be ha vi or R e s e ar c h i n D e v e l opm e nt al D i s abi l i t i e s 20 51 62. R i c hm a n, D M W a c ke r D P A s m us J M C a s e y, S D & A nde l m a n, M ( 1999) F u r t he r a na l ys i s of pr obl e m be ha vi or i n r e s pons e c l a s s hi e r a r c hi e s J our nal of A ppl i e d B e hav i or A nal y s i s 32, 269 283. R i ngda hl J E A nde l m a n, M S K i t s uka w a K W i nbor n, L C B a r r e t t o A & W a c ke r D P ( 2002) E va l ua t i on a nd t r e a t m e nt of c ove r t s t e r e ot y py. B e hav i or al I nt e r v e nt i ons 17 43 49. R i ngda hl J E & S e l l e r s J A ( 200 0) T he e f f e c t s of di f f e r e nt a dul t s a s t he r a pi s t s dur i ng f unc t i ona l a na l ys e s J our nal of A ppl i e d B e hav i or A nal y s i s 33, 247 250. R i ngda hl J E W i nbo r n, L C A nde l m a n, M S & K i t s uka w a K ( 2002) T he e f f e c t s of nonc ont i nge nt l y a va i l a bl e a l t e r na t i ve s t i m ul i on f u nc t i ona l a na l ys i s out c om e s J our nal of A ppl i e d B e hav i or A nal y s i s 35 407 410 T a r box, J W a l l a c e M D T a r box, R S F L a nda bur u, H J & W i l l i a m s W L ( 2004) F unc t i ona l a na l ys i s a nd t r e a t m e nt o f l ow r a t e pr ob l e m be ha vi or i n i ndi vi du a l s w i t h de ve l opm e nt a l di s a bi l i t i e s B e hav i or al I nt e r v e nt i o ns 19, 73 90. V ol l m e r T R & V or ndr a n C M ( 1998) A s s e s s m e nt of s e l f i nj ur i ous be ha vi or m a i nt a i ne d by a c c e s s t o s e l f r e s t r a i nt m a t e r i a l s J our nal of A ppl i e d B e hav i or A nal y s i s 31 647 650. W a l l a c e M D & I w a t a B A ( 1999) E f f e c t s of s e s s i on dur a t i on on f unc t i ona l a na l ys i s out c om e s J our nal of A pp l i e d B e hav i or A nal y s i s 3 2 175 183 Z a r c one J R F i s he r W W & P i a z z a C C ( 19 96) A na l ys i s of f r e e t i m e c ont i nge nc i e s a s pos i t i ve ve r s us ne ga t i ve r e i nf or c e m e nt J our nal of A ppl i e d B e hav i or A nal y s i s 29, 247 250.

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44 B I O G R A P H I C A L S K E T C H N a t a l i e R ol i de r r e c e i ve d he r B a c he l or of A r t s i n P s yc hol ogy i n 2002 f r om E m e k Y e z r e e l C ol l e ge i n I s r a e l A f t e r c om pl e t i ng a n i nt r oduc t or y c our s e i n a ppl i e d be ha vi or a na l ys i s s he be ga n s e r vi ng a s a t he r a pi s t f o r hom e ba s e d e a r l y i nt e r ve nt i on pr og r a m s f or young c hi l d r e n w i t h a ut i s m a nd a s s i s t i ng i n c onduc t i ng pa r e nt t r a i ni ng s e m i na r s T hos e e xpe r i e nc e s l e d he r t o s e e k f ur t he r t r a i ni ng i n be ha vi or a na l ys i s a nd s o s he a c c e pt e d t he pos i t i on of f e r e d t o he r by t he P s yc hol ogy D e pa r t m e nt a t t he U ni ve r s i t y of F l o r i d a ( U F ) t o s t udy unde r t he s upe r vi s i on of D r B r i a n I w a t a W hi l e a t U F N a t a l i e ha d t he oppo r t u ni t y t o c onduc t c l i ni c a l r e s e a r c h w i t h i ndi vi dua l s w i t h de ve l opm e nt a l di s a bi l i t i e s a t va r i o us l a bor a t or y s i t e s : a n a dul t voc a t i ona l pr ogr a m a r e s i de nt i a l p r ogr a m f or i ndi vi dua l s w i t h P r a de r W i l l i S ynd r om e a n out pa t i e nt c l i ni c f or c hi l d r e n di a gnos e d w i t h a ut i s m a nd a s pe c i a l e duc a t i on s c hool F ol l ow i ng gr a dua t i on N a t a l i e i nt e nds t o pur s ue a n a c a de m i c c a r e e r i n a p pl i e d be ha vi or a na l ys i s w i t h e m pha s i s on t he i de nt i f i c a t i on a nd us e of r e i n f or c e r s t o i nc r e a s e a da pt i ve be ha vi or a nd t he a s s e s s m e nt a nd t r e a t m e nt of pr obl e m be ha vi o r