Functional Assessment: Keys to Understanding Challenging Behaviour

1
Functional Assessment Keys to Understanding
Challenging Behaviour

• Kim Meyer, Ph.D.
• Director of Research in Behaviour Support
• Centre of Excellence for Behaviour Support
• Department of Community/University of Queensland

2
Functional Assessment (cont.)

• Applied Behaviour Analysis
• Antecedents
• Behaviours
• Consequences
• Setting events

3
Functional Assessment (cont.)

• Functional analysis
• Functional assessment
• What are they?
• Whats the difference?
• Experimental functional analysis

4
Functional Assessment (cont.)

• Behaviour is lawful (it makes sense!)
• Other influences
• A persons past experiences (history)
• Biology
• Intermittent Reinforcement
• Thinking and its effects

5
Functional Assessment (cont.)

• Myths about behaviour analysis
• Doesnt consider feelings (emotions)
• Cold and inhumane
• Doesnt consider thinking
• Punitive

6
Functional Assessment (cont.)

• Contributions of applied behaviour analysis
• Parenting programs
• Educational programs

7
Functional Assessment (cont.)

• Type of procedure determined by how frequency of
  behaviour changes
• Reinforcement increases behaviour
• Positive reinforcement (pleasure)
• Negative reinforcement (relief)
• Punishment decreases behaviour
• Positive punishment (add aversive)
• Negative punishment (remove preferred)

8
Functional Assessment (cont.)

• Purpose of a functional assessment
• Identify why a behaviour occurs
• Typical functions of behaviour
• Access to social interactions
• Escape/avoid something unpleasant
• Access a preferred item
• Automatic reinforcement?

9
Functional Assessment (cont.)

• Key components to a functional assessment
• Operational definition of the behaviour
• Identification of variables that are associated
  with the occurrence of the behaviour
• Identification of variables that are not
  associated with the occurrence
• Hypotheses about why the behaviour occurs

10
Functional Assessment (cont.)

• Starting the assessment process
• The Contextual Assessment Inventory (CAI)
• 93 item screening inventory
• Rate behaviours on a five-point scale (0 Never
  to 5 Always)
• Examines four domains
• Social/Cultural
• Negative Interactions
• Disappointments
• Daily routines
• Nature of tasks/activities
• Factors related to activities
• Daily routine
• Physical
• Uncomfortable environment
• Changes in the environment
• Biological
• Medication
• Illness
• Physiological states

11
Functional Assessment (cont.)

• Functional Assessment Interview (FAI)
• Describe the behaviours
• Topography (what does they look like)
• Frequency
• Duration
• Intensity
• Define ecological events that predict behaviour
• What are the effects of medications?
• Are there medical or physical conditions that
  affect the behaviour?
• How do sleeping patterns impact the behaviour?
• How does diet and food intake affect the
  behaviour?
• Are activities on the daily schedule predictable?
• Are there opportunities to make choices?
• How many other people are around the person?
• What are the staffing levels (numbers,
  interactions)?

12
Functional Assessment (cont.)

• FAI (cont.)
• Define immediate antecedents that predict when
  behaviour most and least likely to occur
• Times of the day
• Settings
• People
• Activities
• Any other things that we havent talked about
• The one thing that would make the behaviours
  occur
• The one thing where the problems never occur
• What would happen if
• The person were asked to something difficult?
• The person were interrupted when doing something
  she liked?
• The persons routine was unexpectedly changed?
• The person wanted something but couldnt get it?
• The person were left alone for a while and nobody
  paid attention?

13
Functional Assessment (cont.)

• FAI (cont.)
• Identify the consequences (outcomes) of the
  challenging behaviour
• Think of each behaviour listed and when it is
  most likely to occur
• What does the person get when the behaviour
  occurs?
• What does the person avoid when it occurs?

14
Functional Assessment (cont.)

• FAI (cont.)
• Consider the overall efficiency of the
  challenging behaviours. Efficiency is the
  combined result of how much physical effort is
  required, how often the behaviour must be
  performed, and how long the person must wait to
  get the reward.
• Rate each behaviour from low to high efficiency

15
Functional Assessment (cont.)

• FAI (cont.)
• What functional alternative behaviours does the
  person already know how to do?
• What socially appropriate behaviours can the
  person already perform to generate the same
  results?
• What are the primary ways the person communicates
  with other people? Are they used consistently?
• Speech
• Signs/gestures
• Communication boards
• Electronic devices

16
Functional Assessment (cont.)

• FAI (cont.)
• How does the person
• Request attention
• Request help
• Request preferred food/objects/activities
• Request breaks
• Show you something or some place
• Indicate physical pain
• Indicate confusion or unhappiness
• Protest or reject a situation or activity

17
Functional Assessment (cont.)

• FAI (cont.)
• With regard to communication
• List examples (if possible) for each of the
  following
• Does the person respond to spoken requests?
• Does the person respond to gestural requests?
• Is the person able to imitate if you provide a
  model?
• How does the person typically tell you yes or
  no when asked if he/she wants something?

18
Functional Assessment (cont.)

• FAI (cont.)
• What are things you should do and you should
  avoid doing in supporting this person?
• What things increase the likelihood that an
  activity or teaching session will go well?
• What should be avoided because they might
  interfere with or disrupt an activity?

19
Functional Assessment (cont.)

• FAI (cont.)
• What are the things the person likes?
• Food items
• Toys and objects
• Activities at home
• Activities/outings in the community
• Anything else?

20
Functional Assessment (cont.)

• FAI (cont.)
• What do you know about the history of the
  undesirable behaviours, the programs that have
  been attempted to decrease or eliminate them, and
  the effects of those programs?

21
Functional Assessment (cont.)

• Summarizing the FAI
• Develop summary statements for each major
  predictor and/or consequence

22
Functional Assessment (cont.)

• Direct observation
• Another source of information
• Confirms or voids possible hypotheses
• ABC cards
• General information (person, observer, date,
  time)
• General context
• (A) Interpersonal context
• (B) Behaviour problem
• (C) Social reaction
• Hypothesis (purpose or function of behaviour)