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Functional Behavior Assessment for Challenging Behavior in Individuals with Autism

Ameera S. Bawazeer1, Mariam A. Alhammadi1 and Michelle P. Kelly1*
  • 1 Emirates College for Advanced Education, United Arab Emirates

Autism Spectrum Disorder (hereafter, autism) is a lifelong developmental disorder characterized by impaired communication and social interaction skills and a lack of flexibility in interests and behaviors (American Psychiatric Association, 2013). According to the Centers for Disease Control and Prevention (CDC; 2018) approximately 1 in every 59 children has been diagnosed with autism. Despite the fact that autism is on the rise, there is paucity in the literature examining this disorder and its treatment in the Middle East and specifically the Gulf Cooperation Council (GCC; Kelly et al., 2016). While exhibiting challenging behaviors is not a diagnostic criterion for autism, research shows that challenging behaviors are more common in individuals with autism than in typically developing individuals. In fact, Matson, Wilkins and Macken (2008) reported that 94.3% of children on the autism spectrum have been reported to display some form of challenging behavior. Functional Behavior Assessment (FBA) is a process of assessment designed to obtain information about the relationship between a person’s behavior and the environment and the purpose a specific behavior serves for a person (Scott & Cooper, 2017). FBA is the central idea of applied behavior analysis (ABA; Carr, 1994) and identifies the type and source of reinforcing variables for challenging behavior. FBA is the basis upon which improvements can be made on the effectiveness and efficiency of a clinical intervention designed to decrease the occurrence of those behaviors (Day, Horner, & O’Neill, 1994). Even if multiple reinforcers maintain a behavior or if the behavior serves different functions under different stimulus conditions, reliable functional assessment and successful intervention can be observed. The three types of FBA methods are indirect assessment (interviews, checklists, rating scales and questionnaires), descriptive assessment (ABC continuous recording, ABC narrative recording and scatterplots) and functional analysis (Cooper, Heron, & Heward, 2014). Functional analysis is the most widely researched approach to functional assessment (Horner, 1994). Functional analysis involves direct observation and measurement of challenging behavior under test and control conditions in which some environmental variable is manipulated (Hanley, Iwata, & McCord, 2003). The key reinforcement contingencies include social positive reinforcement (attention, access to tangibles or activities), social negative reinforcement (escape or avoid a demand) and automatic (or sensory) reinforcement. Therefore, the four main conditions in a functional analysis include (i) attention, (ii) demand, (iii) alone and (iv) control/play (Iwata, Dorsey, Slifer, Bauman, & Richman, 1994). Critically reviewing this methodology, it is clear that a pivotal advantage of functional analysis is that the function of challenging behavior can be “matched to specific treatment recommendations that focus on disrupting the response-reinforcer relationship associated with aberrant behavior” (Richman, Wacker, Asmus, Casey, & Andelman, 1999; p.269). This enables practitioners to develop treatments based on the principle of reinforcement, while relying less on punishment procedures. Conversely, the limitations of functional analysis include: the process may temporarily strengthen the target challenging behavior to unacceptable levels; the process may result in the behavior acquiring new functions; difficult for non-experts to understand the process; the process is not suitable for all types of challenging behavior, particular those that occur infrequently; and the process requires time, effort and professional expertise (Cooper et al, 2014). Are FBA methods currently used in the GCC? Kelly et al. (2016) report that due to a severe deficit in local professionals trained in ABA, the provision of ABA services, which would include the use of FBA, is significantly restricted within all GCC states. The United Arab Emirates (UAE) has the greatest proportion of board certified behavior analysts in the region (Behavior Analyst Certification Board, 2019). Given that behavior analysts are ethically obligated to first conduct a functional assessment before developing a behavior-reduction program (Behavior Analyst Certification Board, 2014), it can be postulated that FBAs are conducted more frequently in the UAE than in the rest of the GCC. In countries without a high proportion of board certified behavior analysts, it is less likely that appropriate FBAs are employed due to a lack of trained experts and limited awareness about the importance of assessments of function.

References

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: Author. Behavior Analyst Certification Board. (2014). Professional and ethical compliance code for behavior analysts. Littleton, CO: Author. Behavior Analyst Certification Board. (2019). Find/contact a BACB certificant. Retrieved from: https://www.bacb.com/find-a-certificant/ Carr, E.G. (1994). Emerging themes in the functional analysis of problem behavior. Journal of Applied Behavior Analysis, 27(2), 393-399. Centers for Disease Control and Prevention (2018). Data & Statistics on Autism Spectrum Disorder. Retrieved from: https://www.cdc.gov/ncbddd/autism/data.html Cooper, J.O., Heron, T.E. & Heward, W.L. (2014). Applied Behavior Analysis. (2nd Ed.). Essex, Great Britain: Pearson Education Limited. Day, H.M., Horner, R.H., & O’Neill, R.E. (1994). Multiple functions of problem behaviors: assessment and intervention. Journal of Applied Behavior Analysis, 27(2), 279-289. Hanley, G.P., Iwata, B.A., & McCord, B.E. (2003). Functional analysis of problem behavior: A review. Journal of Applied Behavior Analysis, 36, 147-185. Horner, R.H. (1994). Functional assessment: Contributions and future directions. Journal of Applied Behavior Analysis, 27(2), 401-404. Iwata, B.A., Dorsey, M.F., Slifer, K.J., Bauman, K.E., & Richman, G.S. (1994). Toward a functional analysis of self-injury. Journal of Applied Behavior Analysis, 27(2),197-209. (Reprinted from Analysis and Intervention in Developmental Disabilities, 2, 3-20, 1982). Kelly, M. P., Alireza, I., Busch, H. E., Northrop, S., Al-Attrash, M., Ainsleigh, S., & Bhuptani, N. (2016). An overview of autism and applied behavior analysis in the Gulf Cooperation Council in the Middle East. Review Journal of Autism and Developmental Disorders, 3(2), 154-164. Matson, J.L., Wilkins, J., & Macken, J. (2008). The relationship of challenging behaviors to severity and symptoms of autism spectrum disorders. Journal of Mental Health Research in Intellectual Disabilities, 2(1), 29-44. Richman, D.M., Wacker, D.P., Asmus, J.M., Casey, S.D. & Andelman, M. (1999). Further analysis of problem behavior in response class hierarchies. Journal of Applied Behavior Analysis, 32, 269-283. Scott, T. M., & Cooper, J. T. (2017). Functional behavior assessment and function-based intervention planning: Considering the simple logic of the process. Beyond Behavior, 26(3), 101-104.

Keywords: Autis Spectrum Disorder; ASD, Functional Behavior Assessment (FBA), functions of behavior, UAE, challenging behavior

Conference: 4th International Conference on Educational Neuroscience, Abu Dhabi, United Arab Emirates, 10 Mar - 11 Mar, 2019.

Presentation Type: Poster Presentation

Topic: Educational Neuroscience

Citation: Bawazeer AS, Alhammadi MA and Kelly MP (2019). Functional Behavior Assessment for Challenging Behavior in Individuals with Autism. Conference Abstract: 4th International Conference on Educational Neuroscience. doi: 10.3389/conf.fnhum.2019.229.00027

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Received: 04 Mar 2019; Published Online: 27 Sep 2019.

* Correspondence: Dr. Michelle P Kelly, Emirates College for Advanced Education, Abu Dhabi, United Arab Emirates, michellepatriciakelly@gmail.com