The Four Term Contingency and Tier 3 Functional Behavior Intervention: Avoiding Common Pitfalls and Encouraging Successful Outcomes

Transcription

1 The Four Term Contingency and Tier 3 Functional Behavior Intervention: Avoiding Common Pitfalls and Encouraging Successful Outcomes Kevin Kuhn, 2014 ASPP Conference Kahoot.it Code: The Four Term Contingency 1. The ABCs of ABA a. b. c. 2. The 3 Term Contingency cannot account for all behavior what's missing? a. Stimuli that momentarily change the value of a particular reinforcer and evoke or abate behaviors as a result i. Operations Establish and Evoke ii. Operations Abolish and Abate 3. Unconditioned Motivating Operations: a. and Food, water, sleep, activity, oxygen, and sex b. Temperature too hot or too cold c. Aversive or painful stimulation 4. Conditioned Motivating Operations a. CMO S ( ) Pairing of a neutral stimulus with a UMO resulting in the formerly neutral stimulus evoking behavior to a greater degree than would be appropriate given the actual degree of the UMO b. CMO T ( ) Occur when one environmental stimulus momentarily alters the reinforcing effectiveness of another stimulus c. CMO R ( ) Any stimulus that has systematically preceded the onset of any avoidable worsening condition and momentarily increases the value of as a reinforcer. Evaluating Function 1. Indirect Assessment a. Includes things like rating scales and interviews (FAST, MAS, QABF) b. Low when considered on an item by item basis i. FAST inter rater reliability overall 71.5% (item by item) (Iwata et al., 2013) ii. Other rating scales typically lower c. Validity compared to Functional Analysis (FA; Iwata et al., 2013): i. 63.8% agreement overall 1

2 ii. 70.8% agreement if two raters identify same function iii. Improves slightly if FAST is used as a structured interview with ABA specialist as interviewer d. Generally indirect assessments overestimate attention and underestimate escape as functions 2. Direct Observation a. ABC recording As with indirect assessments, direct observation overestimates attention and underestimates escape as function of behavior 3. Functional Analysis (FA) a. Iwata & Dozier (2008) identify variations of full FA that show promise for applied settings: i. Brief FA abbreviated session count and duration ii. Single Function test and control for only one function iii. Precursor FA FA of correlated behaviors iv. Latency FA session terminates after first response and latency is measured rather than number of responses v. FA assessment is embedded in ongoing activities b. Bloom et al. (2013) Teacher Conducted Trial Based FA i. Conditions a presented in paired sequences of ii. Responses are measured across trials rather than sessions iii. Trials are typically a maximum of 2 minutes each, for a total of 4 minutes for each paired sequence; trials per condition iv. Trials terminate contingent upon problem behavior v. Trials are embedded in the ongoing activities as opportunities arise vi. Benefits: 1. Less time than traditional FA 2. Completed in natural setting 3. Decreased frequency of problem behavior during FA trials 4. 80% correspondence with traditional FA results and improving as process is refined Functional Behavior Intervention 1. Many effective behavioral interventions exist, but they all basically boil down to 3 behavioral principles (Iwata, 2013): a. MO meet the functional need prior to problem behavior, essentially 2

3 initiating an Operation through Noncontingent Reinforcement (NCR) b. Discontinuing reinforcement of a previously reinforced behavior so that the target behavior no longer produces reinforcement (Cooper et al., 2007) c. Reinforcing only those responses within a response class that meet a specific criterion along some dimension of behavior (Cooper et al., 2007) 2. Function: Social Positive Reinforcement (SR+) a. MO b. Maintaining Reinforcer i. Extinction ii. Other 3. Function: Social Negative Reinforcement (SR ) a. MO i ii iv. See Carbone et al. (2010) for more strategies b. Maintaining Reinforcer i. Extinction 4. Function: Automatic Positive Reinforcement (AR+) a. MO b. Maintaining Reinforcer i. Extinction ii. Other i_ 5. Function: Automatic Negative Reinforcement (AR ) a. MO 3

4 b. Maintaining Reinforcer i. Extinction Troubleshooting Tier 3 Interventions 1. Three considerations at the tier 3 level: a. Treatment b. Function/Intervention (FIC) c. (CV) 2. See Witt, VanDerHeyden, & Gilbertson (2004) for their troubleshooting process a. Includes Behavior Intervention Troubleshooter (BIT) b. Broader focus (Tiers 1, 2, and 3) c. Suggests a 4 step linear troubleshooting process d. Does NOT address FIC and CV components as two separate issues 3. Treatment Integrity a. Promoting Treatment Integrity i. Ensure adequate support, instruction, and modeling for the teacher ii. Direct instruction for including modeling and rehearsal with feedback (Sterling Turner & Watson, 2002) iii. See Test Driving Interventions article by Dart et al. (2012) for interesting data on promoting intervention integrity and increasing successful outcomes b. Assessing Treatment Integrity i. Self report of implementation is unreliable ii. built into intervention is the easiest way to monitor integrity iii. Best case mix permanent product with administrative or consultant observations and performance feedback c. Repairing Treatment Integrity i. Performance feedback is most meaningful and effective when a representation of data is used 4. Function/Intervention Correspondence (FIC) a. If treatment integrity is sound, consider possible mismatch between function of behavior and intervention selection b. Use additional measures (indirect assessment, direct observation) to develop a better functional hypothesis 4

5 c. Optimally, use FA procedures to gain the most valid estimate of function d. Avoid functional reducing problem behavior alone is not sufficient; appropriate, functionally equivalent replacement behaviors must be acquired and reinforced e. Direct functional reinforcement is better than generalized conditioned reinforcement when possible 5. Competing Variables a. Motivating Operations Consequences we can offer as reinforcement may be more or less effective at any particular time, and can fluctuate often i. If you say nothing reinforces this kid you probably need to consider MO ii. Vary reinforcement when possible iii. It is only reinforcing if it increases the future likelihood of the behavior, so we must always be tracking and analyzing the data iv. Verify motivation in each situation when possible offer choice, monitor response to S D b. Discriminative Stimulus i. Reinforcement is more effective when present ii. Visual cues act as reminders when reinforcement cannot be immediately present iii. Be aware of how people and settings have been paired with reinforcement or punishment ( He never acts that way with me ) iv. Stimulus can be achieved by ensuring that reinforcement is delivered by multiple people in multiple settings c. Unprogrammed Consequences Naturally occurring changes in the environment immediately following a behavior that are not part of the intervention design d. Assessing Competing Variables: i. FIC is assessed through Analysis ii. Competing variables are discovered through Analysis Access the presentation slides and handouts at: research/presentations 5

6 References Alberto, P., & Troutman, A. C. (1999). Applied behavior analysis for teachers. Upper Saddle River, NJ: Merrill. *Bloom, S. E., Lambert, J. M., Dayton, E., & Samaha, A. L. (2013). Teacher conducted trial based functional analyses as the basis for intervention. Journal of Applied Behavior Analysis, 46(1), *Carbone, V. J., Morgenstern, B., Zecchin Tirri, G., & Kolberg, L. (2010). The role of the reflexive conditioned motivating operation (CMO R) during discrete trial instruction of children with autism. Focus on Autism and Other Developmental Disabilities, 25(2), Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied behavior analysis (2nd Edition). Upper Saddle River, NJ: Pearson Education, Inc. *Dart, E. H., Cook, C. R., Collins, T. A., Gresham, F. M., & Chenier, J. S. (2012). Test driving interventions to increase treatment integrity and student outcomes. School Psychology Review, 41(4), Iwata, B. A., (July 29, 2013). Problem behavior: Issues in assessment, treatment, and prevention. National Autism Conference, Penn State University. Iwata, B. A., Deleon, I. G., & Roscoe, E. M. (2013). Reliability And validity of the functional analysis screening tool. Journal of Applied Behavior Analysis, 46(1), Iwata, B. A. & Dozier, C. L. (2008). Clinical application of functional analysis methodology. Behavior Analysis in Practice, 1(1), 3 9. Iwata, B. A., & Worsdell, A. S. (2005). Implications of functional analysis methodology for the design of intervention programs. Exceptionality, 13(1), Martens, B. K. & Kelly, S. Q. (1993). A behavioral analysis of effective teaching. School Psychology Quarterly, 8, Michael, J. (November 18, 2005). Motivating Operations. Maryland Association for Behavior Analysis. Sterling Turner, H. E. & Watson, T. S. (2002). An analog investigation of the relationship between treatment acceptability and treatment. Journal of Behavioral Education, 11, *Witt, J. C., VanDerHeyden, A. M., & Gilbertson, D (2004). Troubleshooting behavioral interventions: A systematic process for finding and eliminating problems. School Psychology Review, 33(3), * Recommended follow up reading 6