acknowledging essentials, inferences, and all that you are ... · acknowledging essentials,...
TRANSCRIPT
Gregory P. Hanley. Ph.D., BCBA-D
Acknowledging essentials, inferences, and all that you are willing to not know when
functionally analyzing behavior
BABATOctober, 2016
For more information and free materials, go to:
www.practicalfunctionalassessment.com
Be wary of
incontrovertible truths.
“All models are wrong;
some are useful.”
Box & Draper, 1987, p. 424
Functional assessment
process to determine the variables influencing problem
behavior
Some Assumptions
Problem behavior is an operant
Certain situations potentiate certain consequences
Goal of a Functional Assessment
Identify the consequences that maintain problem behavior
Identify the situations that evoke the behavior
In order to treat problem behavior
Functional Assessment Process
Functional AnalysisObserve while manipulating
Indirect Assessment Interview
Descriptive AssessmentObserve
Defining features of the
Standard Functional AnalysisMultiple test conditions
Uniform test conditions
Isolated test contingencies
Reinforce dangerous behavior only
Toy-play control condition
Pro
ble
m B
eh
avio
rP
er
Min
ute
Sessions
Example of a
standard functional analysis
How do we know this is the standard functional analysis?
(Jessel, Hanley, Ghaemmaghami, 2016)
1965-2000 (Hanley et al., 2003)
64% SFAs1 out 3 with modifications
2001-2012 (Beavers et al., 2014)
85% SFAs1 out of 7 with modifications
Multiple test conditions
Uniform test conditions
Isolated test contingencies
Reinforce dangerous behavior only
Toy-play control condition
Is the Standard Functional Analysis Effective?
Does it lead to a differentiated analysis?
Literature reviews:
Hanley et al. (2003): approx. 94%
Beavers et al. (2014): approx. 92%
Case series:
Hagopian et al. (2014): 47%
Slaton et al. (2016): 44%
Is the Standard Functional Analysis Effective?
Does it leads to larger treatment effect sizes?
Campbell (2003)
Higher PZD when Rx was based on “EFA”
But, these larger effects were almost exclusively obtained when researchers implemented the treatments in controlledsettings under rich schedules of reinforcement
Is the Standard Functional Analysis Effective?
Not one study showing practical outcome in relevant context (e.g., school, home, community) with only a function-based treatment
when a standard functional analysis was used
Is the Standard Functional Analysis Effective?
Not one study showing the social acceptability
of the process
when a standard functional analysis was used
Is the Standard Functional Analysis Effective?
Not one study showing a socially-validated effect on problem behavior
when a standard functional analysis was used
Apparent solution to ineffectiveness:
Excessive elaboration
Elaboration of the standard functional analysis (SFA)
Prior to a SFA
Formal Descriptive assessments
Preference assessments
Demand Assessments
Manuals outlining extensive team-based processes Following a failed SFA
Slight and systematic deviations from the SFA core procedures
Following a failed SFA-based treatment
Stimulus avoidance assessments
More preference assessment and reinforcer assessments
Despite the Excessive Elaboration of the Standard Functional Analysis…
Not one study showing…
…a practical outcome in a relevant context
…the social acceptability of the process
…a socially-validated effect on problem behavior
“Since all models are wrong, the scientist cannot obtain a ‘correct’ one by excessive elaboration.
Just as the ability to devise simple but evocative models is the signature of the great scientist so overelaboration is often the mark of mediocrity.”
George Box, 1976, p. 792
Research to practice gap Possible reason:
Because the outcomes are mediocre even when the process is elaborate
Functional analysis has been around for approx. 50 years (e.g., Lovaas et al., 1965; Sailor et al., 1968)
Standard functional analyses have been around 34 years (Iwata et al., 1982)
Over 300 studies containing over 500 standard functional analyses have been published (Jessel et al., 2016)
Yet, 55 to 65% of practitioners recently surveyed reported never conducting a functional analysis (Oliver et al., 2016; Roscoe et al., 2015)
Interview-informed
Synthesized Contingency
Analysis
IISCA
Standard
Functional
Analysis
Multiple test conditions
Uniform test conditions
Isolated test contingencies
Reinforce dangerous behavior
Toy-play control condition
Interview-Informed
Synthesized Contingency
Analysis
Single-test condition
Individualized test conditions
Synthesized contingencies
Reinforce precursors to and
dangerous behavior
Test-matched control
Sessions
1 2 3 4 5 6
0
1
2
3
4
Escape/Tangible/Attention
Zeke
Pro
ble
m B
ehav
ior
per
min
An IISCA
1. An open-ended interview is always part of the process
Primary goals are to identify:
a) co-occurring topographies of problem behavior
b) events/interactions that appear to routinely evoke problem behavior
c) interactions that follow problem behavior and are reported to stop it
Interviews allow for discoveries
which can then be verified (or not) in the IISCA
Some Important Aspects of the IISCA
2. We synthesize multiple contingencies into one test condition
which contingencies and the specific materials and interactions are informed by the interview
Some Important Aspects of our Approach
Why might problem behavior occur?Single contingencies:1. Attention or toys (social-positive reinforcement)
2. Escape/avoidance (social-negative reinforcement)
3. Sensory/non-social (automatic reinforcement)
Combinatorial contingencies:
1. Attention and Toys
2. Escape to toys
3. Escape to toys and attention
4. Escape to automatic reinforcement
5. Compliance with mands
6. Escape to access to rituals, preferred conversations
7. Etc…..
Case Example (Bob, 8 yo, dx: Autism)Therapist: Sandy JinSetting: Clinic
Inextricable synthesis
Hypothesis:
Bob engages in meltdowns and aggression in order to obtain:
“His way” in the form of escape from adult instructions and access to preferred ways of interacting with electronics or academic materials
Pro
ble
m B
ehav
ior
per
Min
Sessions
0
1
2
3
4
5
6
1 2 3 4 5
0
2
4
6
8
10
12
14
Escape /
Tangible
Escape /
Tangible
Bob(Ipad context)
Bob(Math context)
Elective synthesis
(with initial verification)
Hypotheses:
Gail engages in meltdowns and aggression in order to obtain:
preferred (tangible) items and maternal attention
0
1
2
3
4
Tangible /
Attention
Analyst
Mother
Analyst
Mother
Analyst
Gail
Pro
ble
m B
ehav
ior
per
Min
0
1
2
3
4
Tangible
Sessions
2 4 6 8 10 12 14
0
1
2
3
4
Test
Control
Meltdowns
Col 46 Attention
Case Example (Gail, 3 yo, dx: PDD-NOS)Therapist: Nicholas VanselowSetting: Clinic
Why synthesize?
1. Seems to emulate the ecology better
Why synthesize?
1. Seems to emulate the ecology better
2. Isolated contingencies sometimes do not control behavior whereas synthesized contingencies do.
• Call et al., 2005
• Dolezal & Kurtz, 2010
• Hanley et al., 2014
• Ghaemmaghami et al., 2016
• Mueller et al., 2005
• Slaton et al., 2016
• Slaton et al., 2016
www.practicalfunctionalassessment.com
0
2
4
6
8Test
Control
Food,attention
Addison
Attention
Tangible (food)
Control
0
2
4
6
8
10
Escape totangibles,attention
Jay
Control
Attention
Tangible
Escape
0
2
4Escape tocompliance withrequests
Franklin
Escape
Requests
Control
2 4 6 8
0
1
2
3
4Escape tocompliancewith requests
Ned
2 4 6 8 10 12
Control
EscapeRequests
IISCA Decoupled IISCASynthesized Isolated SynthesizedType of
contingency
Pro
ble
m b
ehav
ior
per
min
Sessions
Slaton et al., 2016
Why synthesize?
1. Seems to emulate the ecology better
2. Isolated contingencies sometimes do not control behavior whereas synthesized contingencies do.
3. Doing so leads to effective action—meaningful treatment effects
– Hanley et al., 2014, Santiago et al., 2016; Ghaemmaghami et al., 2016
Some reasonable questions:
Have IISCAs been replicated?
(I.e., Do they have generality?)
Yes.
From Jessel, Hanley, and
Ghaemmaghami (JABA, 2016)
0
4
8
12Will
TestControl
Wayne Allen Kat (Cxt 1)Sam
0
2
4
6Jack (Cxt 1) Keo
Kristy Jim
Roxy
0
2
4
6Alex (Cxt 2) Chris
Jeff Zeke Kat (Cxt 2)
0
1
2
3
4 Mike Mitch
Gary Jian Earl
0.5
1.0
1.5
2.0
0
Paul Dan
Alex (Cxt 1) Beck
Sid
2 6 10
0.5
1.0
1.5
2.0
0
Lee
2 4 6
Steve
1 3 5
Jesse
1 3 5
Carson
1 3 5
Jack (Cxt 2)
Sessions
Pro
ble
m b
ehav
ior
per
min
Sessions
Pro
ble
m b
ehav
ior
per
min
ute
From Rajaraman et al. (2016)
Has the process been socially validated?
Yes.
Social Acceptability Questionnaire Results
Ratings
Questions Gail Dale Bob Mean
1. Acceptability of assessment procedures
7 7 7 7
2. Acceptability of treatment packages
7 7 7 7
3. Satisfaction with improvement in problem behavior 7 7 6 6.7
4. Helpfulness of consultation 7 7 7 7
Note. 7=highly acceptable, highly satisfied, or very helpful
1=not acceptable, not satisfied, or not helpful
from Hanley et al., JABA, 2014
Has the process been socially validated?
Yes.
from Santiago et al., JADD, 2016
Have socially validated treatments been developed from the IISCA?
Have socially validated effects been achieved from the IISCA?
Social Acceptability Questionnaire Results
Ratings
Questions Gail Dale Bob Mean
1. Acceptability of assessment procedures
7 7 7 7
2. Acceptability of treatment packages
7 7 7 7
3. Satisfaction with improvement in problem behavior 7 7 6 6.7
4. Helpfulness of consultation 7 7 7 7
Note. 7=highly acceptable, highly satisfied, or very helpful
1=not acceptable, not satisfied, or not helpful
from Hanley et al., JABA, 2014
Socially validated treatments and outcomes.
Yes.
Socially validated treatments and outcomes.
Yes.
from Santiago et al., JADD, 2016
0
1
2
3
4
0
1
2
3
4
Com
ple
x F
CR
per
min
0
1
2
3
4
Rein
forcem
ent (%
)
0
20
40
60
80
100
Pro
ble
m B
ehav
ior
per
min
0
1
2
3
4
Sessions
5 10 15 20 25 30 35 40 45 50 55 60 65
Res
ponse
to
Inst
ruct
ions
(%)
0
20
40
60
80
100
Treatment Extension
1 2
Compliance
Noncomp.
Levels3
BL FCT + EXT Denial and Delay Tolerance Training
Simple FCR Complex FCR
Zeke
Sim
ple
FC
R
per
min
Tole
rance
Res
ponse
per
min
Response Chaining
from Santiago et al., JADD, 2016
Treatment:
Unpredictable and intermittent reinforcement of
communication, toleration, and compliance
Implemented by relevant caregivers in relevant contexts who impose relevant and historically challenging routines
Let’s compare.Standard
Functional Analysis IISCA
Number of differentiated analyses 500+ x 34
Social validation of assessment process x
Social validation of derived Rx x
Social validation of outcome x
Towards a more efficient analysis
0 200 400 6000 200 400 600
IISCA
Latency-based
Brief
Trial-based
Other
Standard
Single-testIISCA
N = 115
N = 456
N = 21
N = 64
N = 6
N = 34
N = 8
Analysis duration (min)
Func
tiona
l an
alysi
s fo
rmat
Min Max
Jessel et al., 2016
Let’s compare.Standard
Functional AnalysisIISCA
Number of differentiated analyses 500+ x 34
Social validation of assessment process x
Social validation of derived Rx x
Social validation of outcome x
Efficiency x (average: 245 min) (average: 25 min)
Levels of Analytic Control
Strong Test condition: Consistently elevated rates Control condition: Zero or near-zero rates
Moderate Test condition: Some zeros or near-zero ratesControl condition: Zero or near-zero rates
Weak Test Condition: Variable but higher ratesControl condition: Lower but non-zero rates
Pro
ble
m B
ehav
ior
per
Min
Sessions
1 2 3 4 5 6
0
1
2
3
4
Test
Control
Pro
ble
m B
ehav
ior
per
Min
Sessions
1 2 3 4 5 6 7 8 9 10
0
1
2
3
4
Test
Control
Pro
ble
m B
ehav
ior
per
Min
Sessions
1 2 3 4 5 6 7 8 9 10
0
1
2
3
4
Test
Control
Interpretation and Implications of Varying Levels of Analytic Control
Strong experimental control
Interpretation: Have access to all reinforcers and EOs
Implication: Can turn off problem behavior with reinforcement; should achieve meaningful outcome with only function-based Rx
Pro
ble
m B
ehav
ior
per
Min
Sessions
1 2 3 4 5 6
0
1
2
3
4
Test
Control
Interpretation and Implications of Varying Levels of Analytic Control
Weak experimental control
Interpretation: All reinforcers for problem behavior are not identified
Implication: Variable responding will persist throughout skill development, probably necessitating punishment or arbitrary reward system
Pro
ble
m B
ehav
ior
per
Min
Sessions
1 2 3 4 5 6 7 8 9 10
0
1
2
3
4
Test
Control
The necessity of punishment when function-based treatments are made more practical is commonly reported:Fisher et al., 2003, Hagopian et al.,1998, Hanley et al., 2005, Wacker et al., 1990
Towards a more controlled analysis
0 25 50 75 100
IISCA
Latency-based
Brief
Trial-based
Other
Standard
Single-testIISCA
N = 21
N = 64
N = 6
N = 34
N = 8
no weak moderate strong
N = 115
N = 456
Percentage of applications with
control
Functio
nal
anal
ysi
s fo
rmat
Let’s compare.Standard
Functional Analysis IISCA
Number of differentiated analyses 500+ x 34
Social validation of assessment process x
Social validation of derived Rx x
Social validation of outcome x
Efficiency x (average: 245 min) (average: 25 min)
% of analyses with strong control x (26%) (92%)
But these conclusions are from literature reviews.
Within-subject comparison is best next step.
From Fisher et al., 2016Differentiation SFA: 4 of 5IISCA: 4 of 5
Escape to Tangibles & Attention
Escape / Tangible
Disagreement
Many believe that a standard functional analysis is a goldstandard.
I think: Oh my.
Oh my science.
Main assertion
When there are different outcomes between two analyses, the one that has been around longer does not necessarily trump the findings of the other.
The truth can be found in
effective action.
- Treatment effects
- Speed of process
- Acceptability/adoptability of practice
Slaton, J., Hanley, G., & Raftery, K. (2016)
IISCA vs. Standard Analysis
0
1
2TestControl
Escape to tangiblesand attention
Tangible
Ignore/Alone
PlayEscape
Attention
0
1
2
3Escape to tangiblesand attention
1 2 3 4 5
0
1
2
3Escape totangibles
5 10 15
0
2
4 Escape totangiblesand attention
Diego
Mason
Riley
Pro
ble
m b
ehav
ior
per
min
Sessions
IISCA Standard IISCA
IISCA vs. Standard Analysis
0
1
2
Escape topredictableschedule
Control
Test
EscapePlay
AttentionTangible
Alone
1 2 3 4 5
0
1
2Escape to tangibles,stereotypy, andattention
5 10 15 20 25
0
2
4
6
8
1 2 3 4 5
0
1
2
3Escape to tangiblesand attention
5 10 15
Pro
ble
m b
ehav
ior
per
min
Kyle
Jonah
IISCA Standard
Sessions
IISCA vs. Standard AnalysisIgnore/Alone
EscapeTangible
Play
Attention
0
2
4 Escape totangiblesand attention
0
2
4 Escape totangiblesand attention
0
2
4Escape to rituals
2 4 6
0
1Escape to tangibles
5 10 15 20
Pro
ble
m b
ehav
ior
per
min
Sessions
IISCA Standard
Dylan
Emily
Chloe
Jeff
0
2
4
ControlTest
Escape totangibles
Treatment Comparison Results
0
1
2
3
4
5
FCR
BL FCT + EXT
Escape totangibles,attention
Problembehavior
BL FCT + EXT
Escape
5 10
0
1
Escape totangibles
BL FCT + EXT
5 10
Attention
BL FCT + EXT
IISCA- based treatment Standard-based treatment
Pro
ble
m b
ehav
ior
per
min
Sessions
Emily
Jeff
Treatment Comparison Results
5 10 15 20 25
0
2
4
6
Escape torituals
BL FCT + EXT
5 10 15 20 25
Escape
BL FCT + EXT
0
1
2
3Escape totangibles
Escape
Tangibles
IISCA- based treatment Standard-based treatment
Pro
ble
m b
ehav
ior
per
min
Sessions
Chloe
Dylan
Let’s compare.Standard
Functional Analysis IISCA
Number of differentiated analyses 500+ x 34
Social validation of assessment process x
Social validation of derived Rx x
Social validation of outcome x
Efficiency x (average: 245 min) (average: 25 min)
% of analyses with strong control x (26%) (92%)
Within-S comparison: % differentiated x (57%) (93%)
Within-S comparison: % initial Rx success x (50%) (100%)
Let’s compare.Standard
Functional Analysis IISCA
Number of differentiated analyses 500+ x 34
Social validation of assessment process x
Social validation of derived Rx x
Social validation of outcome x
Efficiency x (average: 245 min) (average: 25 min)
% of analyses with strong control x (26%) (92%)
Within-S comparison: % differentiated x (57%) (93%)
Within-S comparison: % initial Rx success x (50%) (100%)
The supposed problem(s) with the IISCAImprecision
Do not know the specific operant class to which any particular topography of problem behavior belongs.
Do not know whether some part(s) of the synthesized contingency are irrelevant
Do not know whether behavior is maintained by pos or neg sr
Sometimes cannot neatly describe or compartmentalize the controlling variables
Consider the effective action without knowing these things
Imprecision is not Unique to the IISCAInterpretive ambiguity from an IISCA
Partly synthesized contingencies populate SFAs
Interpretive ambiguity from an SFA
The supposed precision of a SFA is but an illusion
Antecedent PB Consequence Interpretation
No Attention / No tangible No Attention / Tangible Might be evoked by low attn. or lack of tangible, or both and maintained by attn. or tang or both
Attention / No tangible Attention / Tangible Might be maintained by tangible or attention or both
Antecedent PB Consequence Interpretation
No Attention / No tangible Attention / Tangible Behavior may be controlled by one, the other, or both
“All models are wrong; the practical question is how
wrong do they have to be to not be useful.”
Box & Draper, 1987, p. 424
Recognize the Historical Significance
of the Standard Functional Analysis• Moved us from behavior modification to behavior analysis
– Taught us our professional humility
• Inspired us to transcend description and prediction to control
– Allowed us to be scientific practitioners
• Showed us how to create stable and controlled baselines
• Allowed us to discover and enhance treatments
Multiple test conditions
Uniform test conditions
Isolated test contingencies
Reinforce dangerous behavior only
Toy-play control condition
To achieve the humane promise of a function-based treatment and a socially valid outcome
From a functional analysis:
What can I safely infer?
What must I know?
What do I not need to know?
That which I can safely infer via my functional analysis:
Response class membership
Problem Behaviors reported to co-occur
(in order of concern)
1. SIB
2. Aggression
3. Disruptive Behavior
4. Disruptive vocalizations
5. Whining/complaining
This analysis shows all forms of problem behavior are evoked and maintained by same synthesized contingency.
This happens every time we conduct this sort of analysis.(Warner et al., 2016)
This happens every time anybody else conduct this sort of analysis (Smith and Churchill, 2002, Borrero & Borrero, 2008, Herscovitch et al., 2009)
That which I can safely infer via my functional analysis:
Response class membership
If parents or teachers report that other topographies of problem behavior precede or co-occur with the primary topography of problem behavior, they are likely to be maintained by the same reinforcers.
I will infer response class membership and use their response to intervention (RTI) as verification
That which I must know via my functional analysis:
That I can reliably turn problem behavior off with the presentation of the reinforcer(s)
That I can reliably turn problem behavior on with the presentation of the evocative event
(And that the reinforcers and evocative events were identified by other people relevant to the behaver)
That which I do not need to know via my functional analysis:
The single operant function of each problem behavior
Whether problem behavior is maintained by positive or negative reinforcement
Whether some element of a synthesized contingency is a “true” contingency or merely a “false positive”
That which I do not need to know via my functional analysis:
The single operant function of each problem behavior
Whether problem behavior is maintained by positive or negative reinforcement
Whether some element of a synthesized contingency is a “true” contingency or merely a “false positive”
Whether I can neatly compartmentalize the operation in the analysis into a tidy generic class of reinforcement
(e.g., social positive, social negative, attn, tang, esc, etc.)
My gold standardGeneral and socially validated behavior change
by relevant people in relevant contextsBaer, Wolf, & Risley, 1968
I achieve it by being able to turn on and off problem behavior in an analysis informed by caregivers.
For more information go to:
www.practicalfunctionalassessment.com
Many thanks to my Practical Functional Assessment Research and Practice group:
Nick Vanselow, Sandy Jin, Laura Hanratty, Joana Santiago,
Mahshid Ghaemmaghami, Joshua Jessel, Jessica Slaton,
Robin Landa, Christy Warner, Shannon Ward, Tanya Mouzakes
Adithyan Rajaraman, Ellen Gage, Holly Gover, & Kelsey Ruppel
Enjoy your weekend.
Work to be done
1. Teaching people how to discover relevant reinforcement contingencies via open-ended interviews
2. Teaching people how to design analyses from results of interviews
3. Determining a more systematic process for progressing from inconclusive to strongly differentiated analyses
4. Determining whether a valid treatment outcome can be obtained despite a sometimes unreliable process
5. Determining the probability of a socially valid outcome for heterogeneous groups of children who engage in severe problem behavior (i.e., RCT of the IISCA & skill-based treatment process)