Functional Analysis Screening for Problem Behavior Maintatined by Automatic Reinforcement

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Functional Analysis Screening for Problem Behavior Maintatined by Automatic Reinforcement
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Querim, Ange Christine
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Doctorate ( Ph.D.)
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University of Florida
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Psychology
Committee Chair:
Iwata, Brian
Committee Members:
Farrar, Michael J
Vollmer, Timothy R
Conroy, Maureen A

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analysis -- functional -- multielement -- stereotypy
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Abstract:
In a typical functional analysis, an individual is exposed to a series of test conditions representing different sources of reinforcement for problem behavior. One common finding in previous research is that behavior maintained by social reinforcement typically extinguishes in the ?alone? (or ignore) condition, whereas behavior maintained by automatic reinforcement continues to occur. Thus, initial exposure to only the alone condition may represent an efficient screening procedure when maintenance by automatic reinforcement is suspected. We conducted a series of 5-min alone sessions with individuals who exhibited varied forms of problem behavior and verified initial predictions of maintenance versus extinction in a subsequent functional analysis.
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Includes vita.
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by Ange Christine Querim.
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Thesis (Ph.D.)--University of Florida, 2012.
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Adviser: Iwata, Brian.
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1 FUNCTIONAL ANALYSIS SCREENI NG FOR PROBLEM BEHAVIOR MAINTAI NED BY AUTOMATIC REINFORCEMENT By ANGIE C. QUERIM A DISSERTATION PRESENTED TO THE GRADUATE SCHOOL OF THE UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT OF THE REQUI REMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY UNIVERSITY OF FLORIDA 2012

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2 2012 Angie C. Querim

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3 To my parents, David and Corinne Querim To my love, Daniel C. DeRosa

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4 ACKNOWLEDGEMENTS I would like to express appreciation to the many in dividuals who made thi s dissertation possible : T o the graduate and undergraduate students who helped in the implementation of this study. T o Eileen M. Roscoe, Kevin J. Schlichenmeyer Javier Virus Ortega, Kylee E. H url -t his project would not have been p ossible without you. To my family and friends for their continued love, support, and patience throughout this process. S pecial t hanks to my committee members, Drs. Maureen Conroy, Jeffrey Farrar, and Timothy Vollmer, for their time and assistance. And f inally, I would like to thank my advisor, Dr. Brian Iwata, for his guidance and critical feedback.

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5 TABLE OF CONTENTS page ACKNO WLEDGEMENTS ................................ ................................ ................................ ............. 4 LIST OF TABLES ................................ ................................ ................................ ........................... 6 LIST OF FIGURES ................................ ................................ ................................ ......................... 7 ABSTRACT ................................ ................................ ................................ ................................ ..... 8 CHAPTER 1 INTRODUCTION ................................ ................................ ................................ .................... 9 2 METHOD ................................ ................................ ................................ ............................... 12 Subjects and Settings ................................ ................................ ................................ .............. 12 Response Measurement and Interobserver Agreement ................................ .......................... 12 Preference Assessment ................................ ................................ ................................ ........... 13 Experimental Design ................................ ................................ ................................ .............. 13 Assessment Conditions ................................ ................................ ................................ ........... 14 Alone/No Interaction. ................................ ................................ ................................ ...... 14 Attention. ................................ ................................ ................................ ......................... 14 Play. ................................ ................................ ................................ ................................ 14 Demand. ................................ ................................ ................................ ........................... 15 3 RESULTS ................................ ................................ ................................ ............................... 19 4 DISSCUSSION ................................ ................................ ................................ ....................... 30 LIST OF REFERENCES ................................ ................................ ................................ ............... 34 BIOGRAPHICAL SKETCH ................................ ................................ ................................ ......... 36

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6 LIST OF TABLES Table page 2 1 Subject characteristics. ................................ ................................ ................................ ....... 17 2 2 Possible outcomes. ................................ ................................ ................................ ............. 18 3 1 Summary of results. ................................ ................................ ................................ ........... 29

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7 LIS T OF FIGURES Figure page 3 1 Percent of intervals with stereotypy across the screening assessment and functional analysis conditions. ................................ ................................ ................................ ............ 23 3 2 Percent of intervals with stereotypy across the screening assessment and functional analysis conditions. ................................ ................................ ................................ ............ 24 3 3 S elf injury across the screening assessment and funct ional analysis conditions for four subject s. ................................ ................................ ................................ ..................... 25 3 4 Responses per minute of property destruction across the screening assessment and functional analysis conditions. ................................ ................................ ........................... 26 3 5 A ggression across the screening assessment and functional analysis conditions for four subjects ................................ ................................ ................................ ....................... 27 3 6 S elf injury and stereotypy across the screening assessment and functional analysis conditions for two subjects ................................ ................................ ............................... 28

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8 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 F UNCTIONAL ANALYSIS SCREE NING FOR PROBLEM BEHAVIOR MAINTA INED BY AUTOMATIC REINFORCEMENT By Angie C. Querim Augus t 2012 Chair: Brian Iwata Major : Psychology In a typical functional analysis of problem behavior an individual is exposed to a series of test conditions representing different potential sources of reinforcement. One common finding in previous research is that behavior maintained by social reinforcement typically extinguishes in no intera ction ) condition, whereas behavior maintained by automatic reinforcement continues to occur. Thus, initial exposure to only the alone condition may represent an efficient screening procedure when maintenance by automatic reinforcement is suspected. We co nducted a series of 5 min alone sessions in 30 cases for individuals who exhibited varied forms of problem behavior and verified initial predictions of maintenance versus extinction in a subsequent functional analysis. R esults of the functional analyses i ndicated that the problem behavior of 22 individuals was maintained by automatic reinforcement, of which 21 were predicted by results of the screening procedure, whereas the problem behavior of 8 individuals was maintained by social reinforcement, of which 7 were predicted by results of the screening procedure. Thus, results of the screening accurately predicted the function of problem behavior (social vs. automatic reinforcement) in 28 out of 30 cases.

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9 CHAPTER 1 INTRODUCTION Functional analysis (FA) metho dology is an experimental approach to assessment that identifies environmental determinants of problem behavior. In a typical FA (Iwata, Dorsey, Slifer, Bauman, & Richman, 1982/1994), an individual is exposed repeatedly to a series of conditions in which antecedent and consequent events are manipulated to determine which events are responsible for behavioral maintenance. The utility of the FA as a basis for intervention has been demonstrated in hundreds of studies; as a result, it is considered the standa rd throughout the field (Hanley, Iwata, & McCord, 2003). Much of the research in the FA literature has consisted of systematic replication and extension across client population, problem b ehavior, and setting. Other research has focused on methodologica l refinement or adaptation to accommodate unusual client histories or limiting conditions of assessment. These modifications have included variation s in both the content and arrangement of assessment conditions, and the present study focuses on the latter One limitation to assessment in settings such as outpatient clinics is the amount of time available for conducting observations, and a model developed specifically for use in time limited situations is the brief functional analysis ( BFA ) As described by Northup et al. (1991), the BFA consist ed of single exposures to 5 min assessment conditions, with the addition of one replication (the condition in which behavior occurred most frequently) and a treatment probe if time permit ted In an analysis of data from 79 cases in which the BFA was used, Derby et al. (1992) reported that the BFA yielded interpretable results in 47% of the cases. Kahng and Iwata (1999) subsequently compared outcomes from brief and more typical (repeated measures) FAs for 50 cases a nd found correspondence in 66% of the cases. Thus, although the BFA may represent the only option for

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10 experimental assessment under some conditions, the greatly reduced number and duration of sessions yield limited samples of behavior. Vollmer, Marcus, Ringdahl, and Roane (1995) proposed a progressive or hi erarchical model of assessment in which lengthier components were added as needed. Twenty subjects progressed through four phases of as sessment, which were terminated following any stage in which the function of problem behavior was identified. In phase one, eight to twelve sessions of a typical FA were conducted in a multielement design, and data were examined as within session patt erns of responding. In p hase two, FA sessions continued and data wer e examined as overall session means. In phase three, additional sessions only from the alone (or no interaction) condition were conducted. In the final phase, all assessment conditions again were conducted but were alternated in a reversal design. Using this strategy, Vollmer et al. identified the function of problem behavior in 17 of the 20 cases. Six subjects completed the assessment following phase 1, four additional subjects in phase 2, five in phase 3, and two in phase 4. It should be noted, howev er, that the assessment was not especially brief in nature because even phase 1 entailed eight to twelve, 10 min sessions, the typical duration for many FAs. Roscoe, Iwata, and Zhou (201 2 ) described an alternative assessment model for a specific applicat ion. Assuming that the target behavior in their study, hand mouthing, was most likely to be maintained by automatic reinforcement, they arranged FA conditions in a 2:1 ratio of no interaction versus attention and demand sessions and eliminated the play co ndition entirely. This resulted in an FA consisting mostly of no interaction sessions interspersed with attention and demand probes. If results were clear after 14 sessions, the functional analysis was terminated; if not, further manipulations were condu cted. Forty six of 64 subjects (72%) required only the

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11 initial assessment phase, suggesting that exposure to only the alone or no interaction sessions may have been sufficient for a large number of individuals The purpose of this study is to evaluate the utility of brief exposure to alone or no interaction sessions as a screening procedure for problem behavior maintained by automatic reinforcement. If problem behavior maintains during this brief assessment, it may be possible to skip all other condit ions and proceed directly to intervention. By contrast, if problem behavior does not maintain, further assessment would be warranted. In the present study, we conducted the initial screening and subsequent FA for all subjects to determine (a) if high rat es of problem behavior during screening sessions were predictive of the outcome of an FA and (b) whether behavior maintained by automatic reinforcement revealed a more consistent pattern of responding during screening sessions relative to behavior having o ther (social) functions. Because several studies have demonstrated that stereotypy is likely to be maintained by automatic reinforcement ( Piazza, Adelinis, Hanley, Goh, & Delia, 2000; Rapp, Miltenberger, Galensky, Ellingson, & Long, 1999; Vollmer, Marcus, & LeBlanc, 1994 ) stereotypy was the topography examined most often for this study. We included other topographies of problem behavior (agg ression, self injury, etc.) as well because these topographies have been shown to be maintained more often by social reinforcement (Vollmer, Borrero, Lalli & Daniel, 1999; Iwata et al., 1994) The inclusion of multiple topographies of problem behavior increased the likelihood that we would be able to verify predictions (extinction or maintenance) from the screening da ta.

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12 CHAPTER 2 METHOD Subjects and S ettings Twenty seven i ndividuals (30 cases) referred for assessment of problem behavior (stereotypy, self injury, aggression, or property destruction) participated. Table 2 1 shows demographic information for all subjec ts. The study was conducted at three sites: two school programs and a residential program, all serving students with intellectual disabilities and/or autism. All sessions were conducted in small room s containing a desk, two chairs and other materials as needed. Screening ses sions were 5 min in duration, FA sessions were 10 min in duration, and both were conducted three to five times per day, one to five days per week. Response Measurement and Interobserver Agreement The primary dependent measure was th e occurrence of problem behavior, which was defined on an individual basis. Trained observers record ed frequency data on Personal Digital Assistants ( PDAs ) which were converted to rate measures (responses per min) or the percentage of 10 s intervals duri ng which responding occurred. A rate measure was used for those behaviors that had a discrete beginning and end (e.g., aggression was recorded every time the An inte rval measure was used for those behaviors whose duration was variable (e.g., subject pulls Observers also recorded therapist behaviors (initiation of social interaction or removal of instructions) to assess procedural consistency. A se cond observer simultaneously but independently collected data for at least 25% of all sessions. Reliability was calculated by first dividing session time into consecutive 10 s intervals. Percent agreement for frequency measures was calculated by dividing the smaller number of responses by the larger number of responses in each interval, summing these fractions across the session, dividing by the total number of intervals, and multiplying by 100. Percent agreement for interval measures was calculated by

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13 d ividing the number of agreement intervals by the total number of intervals in a session and multiplying by 100. The mean reliability percentage for problem behavior across all subjects was 94.5% ( range 69.0 % to 100.0 % ) Reliability results for other m easures are available from the author upon request. Preference Assessment A paired stimulus preference assessment (Fisher et al., 1992) was conducted to identify preferred items to be included in the FA. Nine leisure items were assessed, and each item was paired with every other item twice. At the beginning of each trial, the experimenter presented two items and prompted the subje Approach to an item was scored when the subject touched one of the two items. The subject was given 10 s access to the selected item while the unselected item was removed. After 10 s the selected item was removed and the next pair was presented. Attempts to a pproach both items were blocked and the items were re presented. A hierarchy of preference was det ermined by calculating the percentage of trials during which each item was approached. Items chosen frequently were designated as highly preferred (HP), and items chosen in the middle of the hierarchy were designate d as moderately preferred (MP). The two HP items were used in the play condition, and the two MP items were used in the attention condition. Experimental Design A series of alone or no interaction sessions was conducted prior to beginning the FA. Each session was 5 min in duration and was con ducted in a single block with 2 min breaks between sessions. Next, a standard FA (Iwata et al., 1982/1994) was conducted in a multielement design that included alone or no interaction, attention, play, and demand conditions in a fixed sequence.

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14 Assessmen t Conditions Alone/No I nteraction The purpose of this condition was to determine whether problem behavior maintained in the absence of any social interaction; if so, it was most likely maintained by automatic reinforcement. The subject was in a room th at did not contain any leisure items. In the alone condition, the experimenter was not in the room. The no interaction condition was conducted if the target behavior was aggression. An experimenter was present during the no interaction condition, but th e experimenter did not interact with the subject at any time and did not deliver any consequences for the occurrence of problem behavior. Attention. The purpose of this condition was to determine whether problem behavior was maintained by social positive consequences in the form of attention. The subject was in a room with free access to two moderately preferred leisure items. At the beginning of the session, the experimenter stated that he or she had work to do, turned away from the subject, and engaged in a solitary activity (e.g., read a magazine). If the subject engaged in problem behavior, the experimenter delivered 3 5 s of verbal and physical attention. The experimenter ignored all non target behavior. Play. This condition served as the control condition to which problem behavior in the test conditions was compared. The individual had access to highly preferred leisure items. The experimenter delivered 3 5 s of verbal and physical attention at least every 30 s and whenever the subject initiated social interaction with the experimenter. All instances of problem behavior were ignored.

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15 Demand. The purpose of this condition was to determine whether problem behavior was maintained by social negative consequences in the form of escape from task dem ands. The experimenter continuously presented academic tasks and used a three prompt sequence (vocal instruction, model prompt, physical prompt) to prompt the subject to complete the task. The experimenter terminated the trial (ceased instructions, remov ed all materials, and turned away from the subject) for 30 s contingent on problem behavior. The experimenter deliver ed brief praise (3 5 s) Data Interpretation A t least three and usually eight Board Certified Behav ior Analysts examined separate graphs of screening and functional analysis data and came to a consensus regarding ( a) the prediction made by the screening assessment, ( b) the functional analysis outcome, and (c ) the extent to which the predictions made in the screening assessment corresponded to the functional analysis outcome ( Table 2 2) If behavior maintained for 3 or more sessions during the scr eening assessment, behavior was predicted to be maintained by automatic reinforcement. If data showed a clea r downward trend ending in a zero or near zero rate of behavior, behavior was predicted to be maintained by social reinforcement. The play condition of the functional analysis served as the control condition against which the test conditions (alone, atten tion, demand) were compared If problem behavior maintained during the screening and also was either highest in the alone or no interaction condition relative to the play condition or high in all conditions of the subsequent functional analysis, problem b ehavior was determined to be maintained by automatic reinforcement (hit). Similarly, if behavior in the screening assessment was observed to decrease or occur at zero levels across 3 or more sessions, behavior was predicted to be maintained by

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16 social rein forcement. If problem behavior during the subsequent functional analysis was highest in the attention or demand condition, behavior was determined to be maintained by either attention or escape from demands (also a hit). Two types of error could have occ urred. If the screening assessment predicted behavior maintained by automatic reinforcement but was observed to occur at the highest levels in either the attention or demand condition ( or at high levels in both conditions ) behavior was determined to be ma intained by social reinforcement (false alarm). Finally, i f behavior did not maintain during the screening (automatic reinforcement prediction) but occurred at its highest in the alone condition or in all conditions of the subsequent functional analysis i s behavior was determined to be maintained by automatic reinforcement (miss).

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17 Table 2 1. Subject characteristics. Subject Age Diagnosis Topography Michele 13 Autism Spectrum Disorder (ASD) STPY: Hand wave Bri 19 ASD STPY: Finger play Dan 11 ASD S TPY: Vocal Karl 13 ASD STPY: Vocal Cor 36 Spastic Quadriplegia, Idiopathic Developmental Delay STPY: Hand/object in mouth Niki 47 Cerebral Atrophy, Microcephalic, Deaf, Blind, Severe Developmental Delay STPY: Finger play Eric 30 Left Hemiparesis, Seizu re Disorder, Mental Retardation, Severe Developmental Delay, Right Retinal Detachment STPY: Hand in mouth Winn 13 ASD STPY: Hand wave Natalie 14 ASD STPY: Vocal Dave 12 ASD STPY: Finger tap, spin Jake 14 ASD STPY: Hand wave Nate 14 ASD STPY: Hand wave Sonya 14 ASD STPY: Hand wave Holly 16 Intellectual Disability (ID), speech and language impaired STPY: Rub lips Ron 23 ID, speech and language (S/L) impaired, physical impairment STPY: Head twirl Mark 10 Orthopedically impaired, S/L impaired STPY: Lip rub Neil 20 ASD, language impaired STPY: hand wring Jude 12 ASD, language impaired STPY: Finger curl Sal 16 ASD SIB: Fist to head Dana 14 ASD SIB: Self pinch Kim 14 ID, language impaired SIB: Hand bite Linda 9 Cerebral Palsy, Hydrocephalus, Cortical Blindness, Severe Developmental Delay, Infantile Seizure Disorder SIB: Hand/arm to head Ed 36 Mental Retardation, Spastic Deplegia, Seizure Disorder, Developmental Delay with Autistic Features SIB: Finger to throat Eve 17 ID, speech and language impaire d PD: Rip/tear paper, throw materials Queen 13 Other health impaired, S/L impaired AGG: Hit, kick, hair pull, bite, throw objects at person; SIB: Hand to Pablo 23 ID, S/L impaired greater); PD: R ip/tear paper, throw materials

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18 Table 2 2. Possible outcomes from the Screening Assessment and the Functional Analysis Functional Analysis (FA) Screening Assessment (SA) Automatic Reinforcement Social Reinforcement Automatic Reinforcement S A Main tains FA High alone or no interaction HIT S A Maintains FA High attention or demand FALSE ALARM Social Reinforcement S A Decreases or zero FA High alone or no interaction MISS S A Decreases or zero FA High att ention or demand HIT

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19 CHAPTER 3 RESULTS Figure 3 1 shows the percent intervals in which 10 subjects (Jude, Winn, Natalie, Karl, Jake, Dan, Cor, Niki, Eric, and Ron) engaged in stereotypy during the screening assessment and standard FA. All subject s stereotypy maintained during their screening assessments, suggesting that behavior was maintained by automatic reinfo rcement. During the subsequent FAs all subjects engaged in stereotypy in all conditions. This outcome confirmed the prediction made b y the screening assessment. That is, stereotypy was maintained by automatic reinforcement. Figure 3 2 shows the percent intervals in which 8 subjects (Holly, Ed, Sal, Nate, Dave, Bri, Mark, and Sonia) engaged in stereotypy. ma intained during the screening assessment (Holly, Ed, Sal, Nate, Dave, Bri, and Mark) and occurred at its highest levels dur ing either the alone condition ( Holly Dave, and Bri) or during all conditions ( Ed, Sal, Nate, and Mark) of the FA The screening re sults for these seven subjects also predicted that stereotypy was mainta ined by automatic reinforcement, which was confirmed by the subsequent FA. One subject, Sonia, engaged in stereotypy that decreased markedly during the screening assessment, which sug gested that her behavior was maintained by social reinforcement Results of her FA confirmed this prediction because her highest level of stereotypy was observed in the demand condition. Figure 3 3 shows data for subjects who engaged in self injurious beh avior (SIB) Pablo maintained in the screening assessment, suggesting that it was maintained by automatic reinforcement. During the subsequent FA, their SIB maintained in all conditions, confirming the prediction made by the sc reening assessment. Kim did not engage in any SIB during the screening assessment, suggesting that her SIB was maintained by social

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20 reinforcement She subsequently engaged in the highest levels of SIB during the demand condition of her FA, which confirme d the prediction made by the screening assessment. Figure 3 4 shows data for 2 subjects who engaged in property destruction (Pablo and Eve). Pablo did not engage in any property destruction during the screening assessment, and engaged in property destruc tion exclusively in the demand condition during his FA. Thus, the prediction from his screening (maintenance by social reinforcement) was confirmed by his FA (maintenance by escape). high levels of re sponding during the screening assessment and during all conditions of her FA, with high est levels during the alone condition. Thus, her screening assessment accurately predicted that property destruction was maintained by automatic reinforcement. Figure 3 5 shows data for 4 subjects who engaged in aggression (Brad, Pablo, Kim, and Queen). All subjects had zero or near zero levels of aggression during the screening assessment, suggesting maintenance by social reinforcement. During the subsequent FAs, Brad and Pablo engaged in the highest levels of aggression during the attention condition whereas Kim and Queen engaged in the highest levels of aggression during the demand condition, confirming that their aggression was maintained by social reinforcement (a ttention for Brad and Pablo, escape for Kim and Queen). Figure 3 6 shows data for the only two subjects whose screening results were inconsistent with those obtained in the subsequent FA. assessment. During her FA, however, Queen engaged in the highest levels of SIB during the alone condition. These data exemplify a miss in that the prediction based on her screening data (social reinforcement) was not borne out by her FA data (automatic reinforcement). Michele s stereotypy occurred at high levels during her screening assessment. Her FA data showed

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21 decreasing trends in all conditions initially but gradual emergence in only the attention condition. These data exemplify a false alarm. That is, her screening asses sment incorrectly predicted that behavior was maintained by automatic reinforcement, whereas her FA indicated that behavior was maintained by social reinforcement (attention). Table 3 1 shows a summary of the results. Overall, the screening assessment acc urately predicted that behavior was maintained by either automatic or social reinforcement in 28 of 30 cases. A total of 19 subjects engaged in stereotypy. For 18 of these 19 subjects, results of the screening assessment accurately predicted the function o f problem behavior (17 automatic reinforcement and 1 social reinforcement). Only one error (a false alarm) occurred: T he screening assessment predicted that stereotypy was maintained by automatic reinforcement, whereas the FA identified attention as the maintaining reinforcer Fi ve subjects engaged in SIB T he screening assessment accurately predicted that SIB was maintained by automatic reinforcement for three of these subjects and that SIB was maintained by social reinforcement for a fourth su bject, whose FA identified escape from demands as the source of reinforcement ) screening assessment produce d an error (a miss): it predicted that SIB was maintained by social reinforcement, whereas results of the FA showed th at SIB was maintained by automatic reinforcement. T wo subjects engaged in property destruction -one maintained by automatic reinforcement and the other by social reinforcement and the screening assessment accurately predicted both of the FA outcomes. Fi nally, t he screening assessment accurately predicted that the aggression exhibited by four of f our subjects was maintained by social reinforcement Specifically,

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22 aggression either never occurred or decreased to zero during the scree ning sessions, and the subsequent FAs indicated that two of the four engaged in aggression maintained by attention, and that the other two engaged in aggression maintained by escape.

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23 Figure 3 1. Percent of intervals with stereotypy across the screening ass essment and functional analysis conditions.

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24 Figure 3 2. Percent of intervals with stereotypy across the screening assessment and functional analysis conditions.

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25 Figure 3 3. Responses per minute or percent of intervals of self injury across the scr eening assessment and functional analysis conditions.

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26 Figure 3 4. Responses per minute of property destruction across the screening assessment and functional analysis conditions.

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27 Figure 3 5. Res p onses per minute or p ercent of i ntervals with aggression across the screening assessment and functional analysis conditions.

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28 Figure 3 6. Responses per minute of self injury across screening assessment and functional analysis conditions for Queen. Percent of intervals with ster eotypy across the screening assessment and functional analysis conditions for Michele.

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29 Table 3 1. Summary of results. Topography #Ss SA FA Result STPY (n=19) 17 Auto Auto Hit 1 Social Escape Hit 1 Auto Attention False Alarm SIB (n=5) 3 Auto Auto Hi t 1 Social Escape Hit 1 Social Auto Miss PD (n=2) 1 Auto Auto Hit 1 Social Escape Hit AGG (n=4) 2 Social Attention Hit 2 Social Escape Hit

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30 CHAPTER 4 DISSCUSSION S ubjects with varied problem behaviors, but predominantly stereotypy, completed a brief screening assessment (SA) consisting of exposure to a single abbreviated test co ndition, followed by a typical functional analysis (FA) Results of the screening assessment accurately predicted the function of problem behavior (automatic or social reinforcement ) in 28 out of 30 cases. In all but one case in which results of the FA indicated that problem behavior was maintained by automatic reinforcement (21 out of 22), the screening assessment provided an accurate predict ion Given these results, the SA may be most useful for behavior suspected to be maintained by automatic reinforcemen t (e.g., stereotypy and some self injurious behavior or property destruction). Because the SA was developed primarily for problem behavior maintained by automatic reinforcement, the extent to which the SA improve d efficiency in these cases is an important consideration. Screening efficiency for behavior maintained by automatic reinforcement was calculated by dividing the total duration of the SA for each subject w hose behavior was determined to be maintained by automatic reinforcement by both assessments (hit) A total of 21 subjects engaged in problem behavior maintained by automatic reinforcement. The mean duration of each assessment was 21.5 min and 170 min for the SA and FA, respectively. The SA was completed in 12.6% of the time it would have taken to complete the full FA. The screening assessment was not only quick but also easy to implement because the experiment er either was not present or did not deliver any consequences during the sessions. The screening assessment predicted that problem behavior was socially maintained for all four subjects who engaged in aggression. Given these results, the screening may not be very

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31 helpful when applied to aggression because it will not identify which social contingency positive or negative reinforcement maintains behavior In spite of the high degree of correspondence between results of the screening and FA procedures, it is important to emphasize that the screening procedure is not a replacement for a full FA of problem behavior. D ata in this study indicated that predictions based on the screening resulted in a 93.3% correspondence with outcomes of a functional analysis, or in a 7% loss of precision which seems significant when conducting clinical research Our data were based on a relatively large sample 30 subjects; even so, the generality of our results is unknown. We estimated the extent to which rates of problem b ehavior in the alone or no interaction condition predicted behavioral function in a larger sample by examining complete sets of functional analysis data published in the Journal of A pplied Behavior Analysis. We selected all articles in which: (a) a full F A was conducted, (b) an alone or no interaction condition was included in the FA, and (c) data were presented in the article In 108 out of 115 published data sets, problem behavior occurred at high rates in the alone / no interaction condition and was main tained by automatic reinforcement; in 2 22 out of 222 data sets, problem behavior occurred at low rates in the alone/no interaction condition and was maintained by social reinforcement. Thus, in 3 30 out of 337 data sets high or low rates of problem behavi or during the alone / no interaction condition were predictive of behavioral function, for an overall correspondence of 9 7.9 %, a 2% loss in accuracy The 7 data sets that did no t show complete correspondence consisted of cases in which problem behavior occu rring at high rates in the alone/no interaction condition was maintained by automatic reinforcement but also by social reinforcement (multiple control). Maintenance by automatic and social reinforcement would be missed in our screening procedure because i t did not contain any test for social reinforcement.

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32 Nevertheless results from this assessment are highly promising and suggest that the screening procedure may be an accurate and practical approximation to a complete FA in clinical situations when : (a) t he target behavior consists of stereotypy, (b) preliminary evidence suggests that problem behavior may be maintained by automatic reinforcement, and (c) a full FA cannot be conducted due to time limitations. Finally, although our primary interest was the assessment of behavior maintained by automatic reinforcement, patterns of responding observed during the screening suggested that it also may be helpful as an initial test for problem behavior maintained by social reinforcement. For example trends observe d during the screening may suggest that one source of social reinforce ment is more likely than another. T wo of the three subjects who engaged in attention maintained problem behavior as identified by the FA exhibited either low or decreasing rates of prob lem behavior during the screening which would be expected when problem behavior maintained by attention is exposed to extinction Thus, a decreasing trend during screening might be followed by a single function test in which the attention and control con ditions are alternated to confirm attention maintained problem behavior. Similarly, subjects whose behavior was maintained by escape from demands as identified by the FA did not engage in any problem behavior during the screening which also might be expe cted because either the absence of a therapist (or no interactions initiated by a therapist) eliminate s the motivational basis (establishing operation) for escape If this pattern of problem behavior is observed during screening, it might be followed by a s ingle function test for escape maintained problem behavior. Thus, even for cases in which problem behavior is maintained by social reinforcement, number of subseque nt test conditions.

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33 Future research might consider the extent to which anecdotal reports facilitate selection of experimental assessment strategies For example, verbal reports given by caregivers might suggest that problem behavior either is or is not likely to occur in social contexts; when accurate, this information may be helpful more complete assessment.

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34 LIST OF REFERENCES Derby, K.M., Wacker, D.P., Sasso, G., Steege, M., Northup, J., Ci grand, K., & Asmus, J. (1992). Brief functional assessment techniques to evaluate aberrant behavior in an outpatient setting: A summary of 79 cases. Journal of Applied Behavior Analysis, 25 713 721. Fisher, W., Piazza, C.C., Bowman, L.G., Hagopian, L.P., Owens, J.C., & Slevin, I (1992). A comparison of two approaches for identifying reinforcers for persons with severe and profound disabilities. Journal of Applied Behavior Analysis, 25 491 498. Hanley, G.P., Iwata, B.A., & McCord, B.E. (2003). Functiona l analysis of problem behavior: A review. Journal of Applied Behavior Analysis, 36 147 185. Iwata, B.A., Dorsey, M.F., Slifer, K.J., Bauman, K.E., & Richman, G.S. (1982/1994). Toward a functional analysis of self injury. Journal of Applied Behavior Anal ysis, 27 197 209. (Reprinted from Analysis and Interventions in Developmental Disabilities, 2, 3 20, 1982). Iwata, B.A., & Dozier, C.L. (2008). Clinical application of functional analysis methodology. Behavior Analysis in Practice, 1 3 9. Iwata, B.A., Du ncan, B.A., Zarcone, J.R., Lerman, D.C., & Shore, B.A. (1994). A sequential, test control methodology for conducting functional analyses of self injurious behavior. Behavior Modification, 18 289 306. Iwata, B.A., & Worsdell, A.S (2005). Implications of fu nctional analysis methodology for the design of intervention programs. Exceptionality, 13 25 34. Kahng, S. & Iwata, B.A. (1999). Correspondence between outcomes of brief and extended functional analyses. Journal of Applied Behavior Analysis, 32 149 159. Lovaas, O.I., Newsom, C.D., & Hickman, C. (1987). Self stimulatory behavior and perceptual reinforcement. Journal of Applied Behavior Analysis, 20 45 68. Northup, J., Wacker, D., Sasso, G., Steege, M., Cigrand, K., Cook, J., & DeRaad, A. (1991). A brief f unctional analysis of aggressive and alternative behavior in an outclinic setting. Journal of Applied Behavior Analysis, 24 509 522. Piazza, C.C., Adelinis, J.D., Hanley, G.P., Goh, H.L., & Delia, M.D. (2000). An evaluation of the effects of matched stim uli on behaviors maintained by automatic reinforcement. Journal of Applied Behavior Analysis, 33 13 27. Rapp, J.T., Miltenberger, R.G., Galensky, T.L., Ellingson, S.A., & Long, E.S. (1999). A functional analysis of hair pulling. Journal of Applied Behavio r Analysis, 32 329 337. Roscoe, E.M., Iwata, B.A., & Zhou, L. (201 2 ). Assessment and treatment of chronic hand mouthing. Manuscript under review.

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35 Smith, R.G. & Churchill, R.M. (2002). Identification of environmental determinants of behavior disorders thro ugh functional analysis of precursor behaviors. Journal of Applied Behavior Analysis, 35 125 136. Vollmer, T.R., Marcus, B.A., & LeBlanc, L. (1994). Treatment of self injury and hand mouthing following inconclusive functional analyses. Journal of Applied Behavior Analysis, 27 331 344. Vollmer, T.R., Marcus, B.A., Ringdahl, J.E., & Roane, H.S. (1995). Progressing from brief assessments to extended experimental analyses in the evaluation of aberrant behavior. Journal of Applied Behavior Analysis, 28 561 57 6. Vollmer, T.R., Borrero, J.C., Lalli, J.S., & Daniel, D. (1999). Evaluating self control and impulsivity in children with severe behavior disorders. Journal of Applied Behavior Analysis, 32 451 466

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36 BIOGRAPHICAL SKETCH Angie Querim graduated from the U niversity of Rhode Island with a B.A. in psychology in 2003. Her clinical experience as a behavior therapist at Perspectives Corp. in North Kingston, Rhode Island, piqued her interest in that field. After graduation, she began working as a behavior therapi st at the New England Center for Children in South bor ough Massachusetts to gain additional clinical experience. Her clinical work motivated her to expand her education and clinical experiences in applied behavior analysis. As she began to pursue her gradu ate degree, she gained advanced clinical experience at B.E.A.C.O.N Services, INC. After graduating with ucting parent training with caregivers of children in the state foster care system. This new experience inspired Angie to further her graduate studies and she began her PhD at the University of Florida. Since beginning her career in behavior analysis, Ang ie has had the opportunity to work with various populations in clinical a nd research settings, and she has greatly enjoyed these experiences. Following graduation, Angie intends to pursue a career in applied behavior analysis, with the terminal goal of teaching and conducting research.