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Why Must Behavior Intervention Plans Be Based on Functional Assessments?

G. Roy Mayer

California State University, Los Angeles

Since the passage of Assembly Bill 2586 (Hughes Bill), and its implementing regulations, which became effective on May 20, 1993, school psychologists are being called on more frequently to do functional assessments. According to the Positive Behavior Intervention Regulations (PBIRs), “whenever the systematic use of behavioral interventions in response to a serious behavior problem is proposed, a functional analysis assessment must be conducted by, or under the supervision of a person who has documented training in behavior analysis with an emphasis on positive behavioral intervention” (CA. Title 5 Ed. Code, Sec. 3052-b). In addition, the regulations stipulate that the behavioral intervention plans shall be based upon the results of the functional assessment.

The Value of Functional

California is not alone in recognizing the validity and merit of functional assessments. For example, a National Institute of Health panel has recommended that treatment of severe behavior disorders be based on the results of pretreatment functional assessments (National Institute of Health, 1989).

This recent emphasis on functional assessments appears to be due to two major reasons. First, functional assessments can improve the effectiveness and efficiency of treatment (Horner, 1994). For example, teachers can be assisted not to use isolation or timeout with a student who is misbehaving to escape from an assignment. Similarly, they can be assisted to avoid scolding a student who is misbehaving in order to gain attention. These examples show that “interventions relevant to behavioral function are more likely to be effective than those that are arbitrarily chosen” (Iwata et al., 1994, p. 237). Information from a functional assessment, then, can be used by school psychologists to help teachers avoid the misuse of behavior management procedures to enhance the intervention’s effectiveness.

Secondly, until the more recent emphasis on functional assessments, punishment approaches were considered to be the most effective means of reducing severe behavior problems (Carr, Taylor, Carlson, & Robinson, 1991; Cataldo, 1991). A major problem with using punishment approaches, however, is that they foster aggression (e.g., violence, assaults, vandalism), escape (e.g., tardiness, truancies, and dropouts), low self-concepts, and negative attitudes toward self and school (Azrin, Hake, Holz, & Huchinson, 1965; Berkowitz, 1983; Mayer & Sulzer-Azaroff, 1991). They also tend to be dehumanizing. Thankfully, more recent research (Iwata et al., 1994) has shown that reinforcement approaches to behavior reduction that match behavioral function are just as effective as punishment approaches when used on self-injurious behavior of individuals with disabilities. Thus, functional assessments have become particularly relevant in responding effectively to the national trend of replacing punishment with reinforcement approaches in changing behavior. For example, the PBIRs made it illegal to use any intervention with special education students that: (a) causes physical pain; (b) releases noxious, toxic or other wise unpleasant sprays, mist, or substances near the student’s face; (c) denies adequate sleep, food, water, shelter, bedding, physical comfort, or access to bathroom facilities; (d) subjects a student to verbal abuse, ridicule or humiliation, or excessive emotional trauma; (e) uses locked seclusion; and, (f) uses any intervention that deprives the student of one or more of his or her senses (Mayer & Mayer, 1995).

Functional Assessment Defined

What is a functional assessment? A functional assessment is defined (Neef & Iwata, 1994) as “an attempt to identify the environmental determinants of specific responses that currently exist in an individual’s repertoire” (p. 211). It helps the school psychologist and other educators determine: What factors in the environment influence the behavior? Why is the behavior occurring at this time in this situation? What does the behavior result in for the student? What is the communicative intent of the behavior--what is the student requesting or protesting through the display of the behavior? Or, what is the behavior’s purpose?

Collection of Functional Assessment Information

Functional assessment data must be gathered from three sources: (1) interviews with significant others (e.g., parents, current and previous teachers, and others who know the student well) and the student (if at an adequate developmental level), (2) review of records and other assessment reports, and (3) direct observation. And according to the PBIRs, the following information must be obtained from these three sources: (a) baseline and treatment data on the targeted behavior, (b) information on the immediate antecedent events associated with the targeted inappropriate behavior, (c) information on the consequences to the targeted behavior to determine its function, (d) previously used interventions, (e) ecological factors, and (f) any possible health and medical factors which may influence the student’s behavior.

Three Basic Components of a Functional Assessment

Functional assessments include three basic components. These three components form what is often referred to as a contingency, or ABC analysis, where the “A” stands for the antecedents, the “B” for the behavior(s), and the “C” for the consequences (Goodwin, 1969; Sulzer-Azaroff & Mayer, 1991; 1994a).

Behaviors (B). First, the problem and positive replacement behaviors must be operationally defined to facilitate communication among all involved parties, and so that the behaviors’ severity can be measured. For example, if Mike engages in self-injurious behavior (SIB) during math, it might be operationalized as hitting his face with his fists. The positive replacement behavior might be completing his math without hitting. If the problem behavior was frequently leaving his seat, the positive replacement behavior might be working on his assignment while in his seat.

Antecedents (A). Next, antecedent events, including ecological, health and medical factors, are identified that predict the occurrence and nonoccurrence of the problem behavior. This also is done for the positive replacement behavior if it has occurred. For example, an antecedent event for SIB might be several instructions followed by several student errors (Munk & Repp, 1994). Antecedent events for working on the assignment without SIB might be academic materials that are adjusted to the student’s level and that program for frequent success.

To obtain information that might help to predict the occurrence and nonoccurrence of the identified behaviors, answers to questions such as those in Table 1 can be helpful:

Table 1

Gathering Information to Predict the Occurrence and Nonoccurrence of the Identified Behaviors

QUESTIONS INFORMATION COLLECTED
What are the differing circumstances under which problem and replacement behaviors occur? .
What are the circumstances under which the problem behavior does NOT occur? .
Does the behavior (problem and/or replacement) occur at certain times of the day (e.g., individual transitions poorly, has difficulty in non-structured activities)? .
Does the behavior occur only in the presence of certain people? .
Does the behavior occur prior to or collateral with any other behavior (e.g., doing an assignment)? .
Could the problem behavior be related to a social or an academic skill deficit? .
Does the problem behavior occur during certain seasons of the year? .
Does the problem behavior occur after eating certain food? .
Does the behavior occur after certain events in prior situa-tions (e.g., in home, on the way to school, during recess)? .
Consequences (C). As the antecedents are being identified, it is helpful to determine what interventions have been used previously, and what possible functions, or purposes, do the problem and positive replacement behaviors serve. Four major functions have been identified. These include escape (Does the student attempt to escape or avoid an activity or person?); attention seeking (Does the student engage in the behavior to obtain attention?); access to materials, activities, or food (Does the behavior result in getting the student what he wants?); and sensory stimulation (Is the behavior self-reinforcing?). One task of the functional assessment is to help determine which function, or combination of functions, are maintaining the problem behavior. Another task of the functional assessment is to determine what specific activities, food items, forms of attention and other reinforcers are maintaining the behavior. Once identified, these reinforcers can often be rearranged to support acceptable replacement behaviors.

Sometimes the problem behavior serves multiple functions. For example, three individuals with varying handicapping conditions and ages were found to engage in self-injury or aggression that resulted in escape from difficult tasks in one condition, and to engage in the same problem behavior to obtain access to preferred items in another condition (Day, Horner, & O’Neill, 1994).

To further complicate matters, the function or reinforcer for a behavior can change over time. In other words, the problem behavior may occur initially to achieve escape from a difficult task. An intervention is set up that successfully reduces the behavior, but later the behavior starts increasing in occurrence again, even though the “effective” program is still in consistent operation. Upon conducting an additional functional assessment it is found that the problem behavior is now being used to obtain access to preferred items. Thus, as Lerman, Iwata, Smith Zarcone, and Vollmer (1994) point out: “When relapse occurs following successful treatment to reduce problem behavior, it is often attributed to inconsistent implementation of maintenance programs. Although less likely, another potential cause for relapse is a change in the behavior’s maintaining contingency over time” (p. 357). Thus, when relapse is noted, and the agreed to intervention is being implemented consistently, a current functional assessment should be conducted to determine if new treatment components are needed.

Functional assessments, then, should not be viewed as one-time events. In fact, it’s helpful to continue the assessment throughout the intervention in order to better understand changes in the behavior and to fine-tune the intervention. For additional information on conducting functional assessments, a manual is available (O,Neill, Horner, Albin, Storey, & Sprague, 1990). In addition, Wright et al. (1994) have written a booklet containing forms and illustrations for implementing the PBIRs in California, Durand (1993) has written a chapter on functional assessment, and the approach is integrated in the books by Sulzer-Azaroff and Mayer (1991; 1994a, 1994b, 1994c).

Matching Behavior’s Function With Intervention

It is clear that interventions that match the function(s) of aberrant behaviors are much more likely to be effective than those chosen arbitrarily. Thus, the four major functions that behavior serve and the interventions relevant to each function are now addressed.

Escape/Avoidance

Currently, two types of escape have been identified. The most common involves task avoidance. For example, SIB and aggression often function to avoid or to remove demands, requests, or other aversive situations or activities (Iwata et al., 1994). Various activities acquire aversive properties by being paired with failure or punishment. Even the “failure to provide frequent reinforcement for appropriate performance during training may create a situation in which instruction per se amounts to aversive stimulation” (Iwata et al., 1994, p. 236). Thus, a student might respond to an instruction to do a difficult or non-reinforcing assignment by engaging in an aberrant behavior in order to escape having to do the assignment.

The second type of escape involves social avoidance. Some individuals with disabilities engage in aberrant behavior when they receive attention from others. Apparently, attention from others has been paired with, or is associated with, punishment for them. They will engage in aberrant behavior in order to get the person to leave them alone. When escape/avoidance from tasks is determined to be the behavior’s function, some appropriate strategies can include (Iwata et al., 1994) (1) increasing reinforcement for compliance (a differential reinforcement procedure of alternative behaviors--DRA), (2) initially removing or reducing the task demands followed by gradually increasing demands during training, (3) teaching students how to seek help when faced with difficult tasks, (4) providing differential reinforcement for the absence of the behavior (DRO), and (5) teaching alternative, acceptable ways of escaping, such as short work breaks. When social avoidance is determined to be the behavior’s function, the student would not be taught the alternative behavior of requesting assistance, as in task avoidance, for obvious reasons. One intervention strategy might be to pair social attention with other strong reinforcers, such as food, to help recondition social attention. Increased reinforcement for compliance (DRA) and for the absence of the aberrant behavior (DRO) also could be provided.

Avoid using procedures such as extinction and timeout with problem behaviors that are maintained by escape. The nonreinforcement conditions of timeout and extinction cannot be achieved; thus these procedures would be ineffective. Attempting to use them also would probably make the problem behavior worse, because the individuals would learn that if they engaged in the problem behavior they would be able to achieve escape--the behavior’s function or reinforcer. This would result in reinforcing, or teaching, the very behavior targeted for reduction. For example, if Jim threw objects, engaged in SIB, or became aggressive when given attention or requested to do a difficult or aversive task, placing him in isolation would provide him with (negative) reinforcement in that he would get out of doing, or escape from, the aversive task or the attention. Similarly, if he were no longer responded to as a result of his problem behavior, he also would escape the aversive demands or the attention. Thus, all reinforcement from the problem behavior would not be withheld, as is required to make extinction effective.

Attention-Seeking

Sometimes when a student engages in an aberrant behavior in response to an instructional demand, the function of the behavior might be to obtain additional attention rather than to avoid the task. Thus, it is important not to assume that certain behaviors (e.g., noncompliance) serve a certain function (e.g., escape). Careful, thorough functional assessments need to be conducted to determine the behavior’s function.

When the function of the behavior has been determined to be obtaining attention from others, a variety of possible interventions might be used effectively. Commonly used strategies have included: (1) Provide more frequent attention to decrease the need to misbehave in order to obtain the attention. (2) Place the inappropriate behavior on extinction. (3) Teach alternative acceptable behaviors, by using strategies such as DRA, DRO and modeling, that will provide the sought after attention (e.g., functional communication training). Timeout also has been used effectively on inappropriate attention seeking behaviors. However, its use should be a last resort because it is an aversive procedure.

Avoid using verbal reprimands and interrupting or redirecting the student’s behavior because these strategies sometimes make the problem behavior even worse. These strategies provide attention for the problem behavior and thus need to be avoided.

Access to Materials, Activities, or Food

When the function of problem behavior has been determined to be obtaining access to materials, activities, or food, several strategies have been used successfully to reduce the problem behavior. One has been to deny access to the material, activity, or food for the problem behavior (i.e., implement extinction), while teaching and reinforcing alternative acceptable behaviors to achieve access. Another strategy has been to provide more frequent access to the material, activity, or food, but not contingent on the problem behavior. Response cost and timeout also have been used effectively (Sulzer-Azaroff & Mayer, 1991, 1994a), but their use should be a minimized because they are aversive procedures.

Sensory Stimulation

Sensory stimulation can take various forms (e.g., waving hands in front of eyes when sitting in front of a light, rhythmic rocking, mouthing or biting hand, rubbing nose or ears lightly, masturbating, poking eyes, and scratching). Problem behaviors that produce automatic reinforcement usually occur when the individual is alone, perhaps to remove boredom. Thus, some strategies that have worked to reduce problem behaviors that are maintained by such sensory stimulation have involved (1) frequent or continuous access to alternative sources of stimulation, (2) response interruption and redirection, and, (3) the use of differential reinforcement strategies, such as DRO and DRA.

Avoid using withholding attention from the behavior, or placing the individual in timeout. Withholding attention from the behavior is not an application of extinction because it is impossible to withhold the self-reinforcement: The individual is likely to continue the self-reinforcement activity. Similarly, if placed in timeout, the individual is most likely to continue the self-stimulatory behavior during timeout. Thus, the nonreinforcing environment necessary for timeout to be effective is not achievable.

Table 2 presents the four functions and summarizes some potentially useful and harmful interventions for each function.

TABLE 2:

MATCHING INTERVENTION TO BEHAVIORAL FUNCTION

FUNCTION OF BEHAVIOR POTENTIAL INTERVENTIONS
ESCAPE/AVOIDANCE For Task Avoidance:
Reinforce for Compliance
Teach How to Seek Help
Teach Acceptable Alternatives to Escape
Reinforce for Absence of Problem
Initially Remove/Reduce Task Demands and Then Gradually Introduce/Increase Demands
For Social Avoidance:
Pair Social Attention with Strong Reinforcers
Reinforce for Compliance
Reinforce for Absence of Problem
Avoid
Extinction (Ignoring)
Timeout
ATTENTION SEEKING
Increase Attention for Appropriate Behaviors
Use Extinction on Problem Behavior
Teach Acceptable Alternatives for Attention
(Functional Communication Training)
Use Timeout as Last Resort
Avoid
Verbal Reprimands
Response Interruption/Redirection
ACCESS (To Material, Activity, or Food)
Deny Access (Extinction)
Teach Acceptable Alternatives to Obtain Access
Provide Frequent Non-Contingent Access
Use Response Cost or Timeout as Last Resort
Avoid
Access to Material, Activity, or Food Following Problem Behavior
SENSORY STIMULATION AND PAIN RELIEF
Increase Access to Alternative Sources of Stimulation
Interrupt/Redirect Behavior
Use Differential Reinforcement Strategies
Avoid
Withholding Attention
Timeout

Concluding Comments

Treatment approaches based on behavioral function are becoming widely recognized, accepted, and in some cases (e.g., the PBIRs) mandated. The reason for this greater emphasis is that functional assessments can result in major reductions in the misuse of behavioral procedures, and in significant reductions in the use of punishment by parents and educators. Functional assessments, then, focus on what changes can be made in the school and/or home that can create an environment more conducive for student learning, rather than on what can be done to students to stop their “problem” behavior.

When conducting a functional assessment, always remember that antecedent conditions must be carefully considered along with the consequences. Within each major functional category there can be many variants that need to be identified for effective treatment planning. For example, under social avoidance, it might be discovered that self-injury occurs following the attention of specific adults, and not others. Or, within task avoidance, aggression might be more likely when a youngster is given a long task rather than a short one (e.g., see Dunlap, Kern-Dunlap, Clarke, & Robbins, 1991). Sometimes a change in such antecedent conditions alone can substantially reduce the occurrence of the problem behavior. Thus, both antecedent and consequential factors must be analyzed in the functional assessment to obtain a clear picture of what might be the most effective intervention to employ.

A variety of effective interventions are possible, and depending on the situation, some are better than others. Also, the suggested interventions are only examples and are not meant to be comprehensive. Other interventions might be more appropriate in various contexts. Nor should it be assumed that the “best” intervention should always be recommended. The recommended intervention must be contextually appropriate. For as Horner (1994) has so eloquently stated:

The goal is not to find the one true intervention, but to find an intervention that is effective and will be implemented by the people in the setting. An intervention is contextually appropriate if it fits with the skills, schedules, resources, and values of the people who must implement the plan. (p. 403)

Therefore, it is usually best for the school psychologist to involve teachers and parents in the intervention selection process. By doing so, the selected interventions are much more likely to be based on the skills of the teachers and parents, and they will feel greater ownership and commitment to the program: important factors if the intervention is to be implemented.

References

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