Behavioral Assessment: Initial Considerations

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Chapter 20

• Behavioral Assessment Initial Considerations

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Behavior Modification Program Phases

• Screening/Intake
• Presenting concerns
• Agency Policies
• Crisis screening
• Diagnosis (insurance)

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Behavior Modification Program Phases (cont.)

• Baseline Phase Assess behavior quantitatively
  (frequency, duration, etiology severity, quality,
  environmental controls).
• Treatment Phase Design a program using the
  tools weve learned thus far. Assess success,
  redesign if necessary and fade stimuli/reduce
  consequences to bring behavior under control of
  natural reinforcers.
• Follow-up Phase See if behavior maintains,
  adjust natural reinforcers or begin treatment
  again.

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Indirect Assessment Procedures

• Interviews with the Client and Significant Others
  (See Table 20-1)
• Rapport
• Non-judgmental
• Confidentiality
• Set target behaviors

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Indirect Assessment Procedures (cont.)

• Questionnaires
• Life History
• Survey
• Rating scales and checklists (CBCL, Conners,
  BASC, etc.)

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Indirect Assessment Procedures (cont.)

• Role Playing ( to assess behavior in office).
• Information from Consulting Professionals.
• Client Self-Monitoring ( not as good as trained
  observers).

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Direct Assessment Procedures

• More accurate but more time consuming and thus
  costly.
• Covert behaviors not observable.

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Experimental Assessment Procedures

• Experimental functional analysis See Chap 22

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DATA Why Bother?

• To Determine whether behavioral treatment is
  appropriate.
• Maybe the behavior isnt in your area of
  expertise.
• Maybe the behavior is not really a problem.
• Data can lead to treatment by discovering
  controlling environmental variables.

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DATA Why Bother? (cont)

• To see if Treatment is working.
• To prompt and/or reinforce the treatment
  providers.
• Counting behavior may impact its frequency apart
  from treatment effects. Reactivity is the effect
  of being watched (keeping track of weight
  loss/gain, exercise, etc. can be motivating).

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Chapter 21

• Direct Behavioral assessment What to Record and
  How

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Characteristics of Behavior to be Recorded

• Topography
• Amount
• Rate/frequency.
• Frequency graphs. Pg. 271
• Cumulative Graphs pg. 273
• (If comparing more than one behavior
  and/or rate changes are small)

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Characteristics of Behavior to be Recorded (cont.)

• Duration
• Intensity (may need instrumentation such as
  voice meter).
• Stimulus Control What in the environment PROMPTS
  the behavior?
• Latency between stimulus and response.
• Quality just an arbitrary rating along one of the
  previously listed quantitative dimensions.

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How to Record Behavior

• Continuous recording every instance
• Interval recording
• Partial interval recording maximum one instance
  within a specified time interval.
• Whole interval recording record only if the
  behavior persists throughout the entire interval.
• Time-Sampling Recording intervals are separated
  by longer periods of time to save time in
  sampling.

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Assessing Accuracy of Observations

• Response definition may be vague.
• Observational situation may be difficult to
  detect behavior.
• Observer may be poorly trained.
• Data Sheets/recording procedures may be poorly
  designed.

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Assessing Accuracy of Observations (cont.)

• Interobserver Reliability (IOR) 80-100
  acceptable
• Frequency recordings
• smaller number
• larger number X 100
• Interval recordings
• of intervals agreed
• intervals either observer recorded a
  behavior X 100

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Chapter 22

• Functional Assessment of the Causes of Problem
  Behavior

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What is Functional Analysis?

• Examination of the relationship between behavior
  and its antecedents and consequences
• Antecedents
• eliciting stimuli
• Consequences
• Positive or negative reinforcement

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Types of Assessment

• Questionnaire
• Completed by those familiar with client
• Reliability issues
• Observation
• Observe what is going on
• Form hypotheses about antecedents and
  consequences

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Types of Assessment

• Functional Analysis
• Systematic manipulation of environmental events
  to experimentally test their role in behavior
  maintenance
• Limitations
• Infrequent behaviors
• Not applicable in dangerous behaviors
• Expensive and time consuming

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Causes of Problem Behavior

• Attention From Others Social Positive
  Reinforcement
• Attention follows behavior
• Individual approaches attention giver prior to
  behavior
• Smiling prior to behavior
• Treatment
• Give attention at other times
• Reduce attention to behavior

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Causes of Problem Behavior

• Self Stimulation Internal Sensory Positive
  Reinforcement
• Continues doing the behavior because it offers a
  desired level of stimulation
• Behavior continues at steady rate
• Treatment
• Increase sensory stimulation
• Reduce stimulation level of behavior

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Causes of Problem Behavior

• Environmental Consequences External Sensory
  Positive Reinforcement
• Behavior maintained by reinforcing sights and
  sounds from the nonsocial external environment
• Behavior continues undiminished even though it
  appears to have no social consequences over
  numerous occasions
• Treatment
• Sensory reinforcement of a desirable alternate
  behavior

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Causes of Problem Behavior

• Escape From Demands Social Negative
  Reinforcement
• Escape from aversive stimuli
• Problem behavior as a way to escape various
  undesirable demands
• Behavior only happens when certain types of
  requests are made of the person
• Treatment
• Persist with requests (demands) until compliance
• Teach other responses
• Program where level of difficulty of requested
  behavior starts low and is gradually increased

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Causes of Problem Behavior

• Elicited Respondent
• Some behavior is elicited rather than controlled
  by consequences
• Behavior consistently occurs in a certain
  situation or in the presence of certain stimuli
• Behavior seems involuntary
• Treatment
• Establishing one or more responses that compete
  with problem behavior (counterconditioning)

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Causes of Problem Behavior

• Medical
• Problem emerges suddenly and does not seem to be
  related to any changes in the individuals
  environment
• Behavioral diagnostics
• Therapist diagnoses the problem after examining
  antecedents, consequences, and medical and
  nutritional variables as potential causes of
  problem behaviors
• Develop treatment plan based on diagnosis
• Physician should be consulted prior to treatment

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Guidelines for Conducting Functional Assessment

• Define the problem behavior
• Identify antecedents
• Identify consequences
• Consider health/medical/personal variables
• Form hypothesis based on information collected
• Collect data to determine if hypothesis is
  correct
• If possible, do a functional analysis by directly
  testing the hypothesis
• Design treatment program
• If treatment is successful, accept the causal
  analysis as confirmed.
• If treatment is not successful, redo the
  functional analysis

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Examples of FBA measures

• FAST
• FBA Inventory
• ABC chart
• See pg. 295 of text

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Chapter 23

• Doing Research in Behavior Modification

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Reversal-Replication (ABAB) Research Designs

• Baseline (A) is followed by treatment (B), return
  to baseline (A) condition, and then treatment
  again (B)
• Allows for replication of treatment effect
• Replication makes it clearer that treatment
  caused change in behavior

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Reversal-Replication (ABAB) Research Designs
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Reversal-Replication (ABAB) Research Designs
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Reversal-Replication (ABAB) Research Designs

• Considerations
• Do baseline until pattern is stable and
  predictable
• May be undesirable to do a reversal (dangerous
  behaviors)
• May be unable to do a reversal if natural
  reinforcers have already taken effect (behavioral
  trapping)
• How many reversals and replications are
  necessary?
• Less replications if large effects are observed
  and a lot of previous research exists in the area
• Limitations
• Withdrawal of treatment may not lead to return to
  baseline
• Withdrawal may be undesirable or unethical

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Multiple-Baseline Designs

• Conduct more than one AB design concurrently with
  treatments beginning at different times
• Useful when reversals cannot be introduced

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Multiple-Baseline Designs

• Across behaviors
• Baselining several similar behaviors within an
  individual
• Across subjects
• Applying the same treatment to the same behavior
  problems of two or more individuals
• Across situations
• Baselining one type of behavior for a single
  individual in more than one setting

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Multiple-Baseline Designs
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Changing-Criterion Designs

• Change over time the criterion for success and
  look for relationship between criteria changes
  and behavior change
• Can increase or decrease
• Frequency requirements
• Rate requirements
• Duration requirements
• Etc.

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Changing-Criterion Designs
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Multiple-Baseline Designs (cont.)

• Compare effects of two or more treatment
  conditions considerably more rapidly than in ABAB
  design
• Applied at alternating times within the same time
  period
• Also known as multielement design
• Does not require reversal
• Several treatments can be evaluated at the same
  time
• Disadvantage treatment effects interaction

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Data Analysis and Interpretation

• Data typically analyzed without control groups
  and statistical techniques used in other areas of
  psychology
• Behavior modifiers interested in understanding
  and improving the behavior of individuals, not
  groups

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Data Analysis and Interpretation

• No control groups or statistics, just visual
  inspection of data graphs to draw conclusions.
• Number of replications.
• Quantitative difference between baseline and
  treatment behavior.
• Latency of treatment effects.
• Number of overlaps baseline and treatment.
• Precision of treatment procedures.
• Reliability of response measures.
• Consistency of findings with existing data and
  theory.
• Practical impact of results.
• Consumer satisfaction.

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Data Analysis and Interpretation

• Social Validity
• Behavior modifiers need to socially validate
  their work on at least three levels (Wolf, 1978)
• Must examine the extent to which target behaviors
  identified for treatment programs are really the
  most important for client and society
• Must be concerned with the acceptability to the
  client of the particular procedures used
• Must ensure that the consumers are satisfied with
  the results

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Advantages of Within Subjects (Single-case, N of
1) Designs

• Repeated measurements vs. Data at single point in
  time
• Small number of subjects vs. Large number of
  subjects
• No resistance to control group participation from
  subjects
• No need for statistical assumptions of normal
  distribution of DV and random selection of
  subjects from population