Function-Based Intervention for Problem Behavior in Developmental Delay

Overseen By Stephanie Gerow, PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: University of Nevada, Las Vegas

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 15

9 Participants Needed

Trial Summary

What is the purpose of this trial?

The purpose of this study is to evaluate the effect of function-based assessment and intervention to reduce problem behavior in children with developmental disability or delay in the context of IDEA Part C services. The investigators will conduct a single-case study to evaluate the efficacy of the intervention.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the treatment Function-based assessment and intervention for problem behavior in developmental delay?

Research shows that functional assessment, which helps understand why problem behaviors occur, has improved the success of behavioral treatments in adults with mental retardation and autism. These assessments guide the development of effective interventions by focusing on skill development and reducing harmful behaviors. ^{1 2 3 4 5}

Is function-based intervention for problem behavior in developmental delay safe for humans?

The research does not specifically address safety concerns for function-based interventions, but it suggests that these interventions focus on improving behavior by teaching new skills and reducing the need for restrictive measures, which implies a focus on safety and well-being. ^{4 6 7 8 9}

How does the Function-based assessment and intervention treatment differ from other treatments for problem behavior in developmental delay?

This treatment is unique because it uses a functional assessment to understand the reasons behind problem behaviors and then creates personalized interventions to replace these behaviors with positive alternatives. Unlike other treatments, it focuses on teaching new skills and reducing the need for restrictive measures by reinforcing desired behaviors. ^{2 3 4 6 10}

Eligibility Criteria

This trial is for caregivers of children aged birth to 5 years old who have developmental disabilities or delays and exhibit problem behaviors. Caregivers will implement procedures with guidance from professionals, and the child must be reported to have problem behavior by the caregiver or a professional.

Inclusion Criteria

Caregivers (e.g., parent, grandparent) of eligible child participants will participate with their child as the implementer of all procedures

An early intervention professional will participate with each caregiver-child dyad to coach the caregiver, in addition to the researcher.

My child is between 0 to 5 years old.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline

Baseline sessions with no intervention to observe problem behavior

2-4 weeks

Intervention

Function-based intervention implemented by the caregiver to teach alternative skills and reduce problem behavior

15 weeks

15 sessions (in-person)

Follow-up

Participants are monitored for safety and effectiveness after intervention

4 weeks

Treatment Details

Interventions

• Function-based assessment and intervention

Trial Overview The study tests function-based assessment and intervention methods aimed at reducing problem behaviors in young children with developmental issues within IDEA Part C services. It's a single-case study assessing how effective these interventions are.

Participant Groups

Group I: Intervention Experimental Treatment 1 Intervention

Following baseline (i.e., no intervention/business as usual) sessions, children will receive the intervention, consisting of a function-based intervention. This intervention will be implemented by the caregiver. The intervention will consist of teaching the child an alternative, appropriate skill (usually communication) to replace the problem behavior. The caregiver will provide reinforcement for the appropriate skill and no reinforcement (i.e., extinction) following problem behavior. The caregiver will also learn and use general strategies for teaching social-emotional skills (e.g., setting appropriate rules) as part of the intervention.

Who Is Running the Clinical Trial?

University of Nevada, Las Vegas

Lead Sponsor

Trials

81

Recruited

14,700+

Institute of Education Sciences

Collaborator

Trials

10

Recruited

3,200+

Findings from Research

Functional assessment methods, such as direct observation and interviews, have greatly enhanced the effectiveness of behavioral treatments for problem behaviors in adults with mental retardation.

Functional analysis provides empirical evidence of behavioral functions in controlled settings, highlighting the importance of tailored assessment methods based on individual client needs and available resources.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Functional assessment of problem behaviors in adults with mental retardation. Paclawskyj, TR., Kurtz, PF., O'Connor, JT.[2011]

The study demonstrated that function-based treatments, implemented by teachers and home providers in real-life settings, effectively reduced severe problem behaviors in two children with autism, such as self-injury and aggression.

Following the intervention, the children showed significant improvements in functional communication skills and compliance with adult instructions, indicating that the treatments not only addressed problem behaviors but also enhanced essential life skills.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Generality of Interview-Informed Functional Analyses: Systematic Replications in School and Home. Santiago, JL., Hanley, GP., Moore, K., et al.[2018]

Understanding the function of problem behaviors in individuals with intellectual disabilities is crucial for developing effective intervention plans, as recent studies confirm that success in reducing these behaviors is closely linked to this understanding.

Training nonprofessionals to conduct functional behavioral assessments has shown promise, indicating that effective behavioral interventions can be implemented even in challenging school settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Functional behavioural assessment in people with intellectual disabilities. Tassé, MJ.[2015]

Functional assessment is crucial for understanding and addressing maladaptive behaviors, allowing for the development of treatments that promote positive, prosocial behaviors instead of relying on aversive methods.

Despite an increase in the use of functional assessment and skill training in treating aggression among individuals with developmental delays from 1979 to 1990, there was no corresponding decrease in the use of intrusive procedures, highlighting a need for better implementation of these methodologies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The relationship between functional assessment and treatment selection for aggressive behaviors. Hile, MG., Desrochers, MN.[2019]

A survey of 205 practitioners in Massachusetts revealed that while 67.8% believe functional analysis is the best tool for developing behavior plans, only 34.6% actually use it in practice.

Descriptive assessment was the most commonly used type of functional assessment among practitioners, indicating a gap between belief in the efficacy of functional analysis and its actual implementation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A statewide survey assessing practitioners' use and perceived utility of functional assessment. Roscoe, EM., Phillips, KM., Kelly, MA., et al.[2018]

The study found that reinforcing spontaneous requests in children with autism can effectively reduce severe problem behavior, as parents provided the same rewards for both requests and problem behavior.

By reinforcing requests alongside problem behavior, children showed a preference for making requests, leading to a decrease in problem behavior, highlighting the potential for function-based treatments in managing behaviors in children with developmental disabilities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Increased parent reinforcement of spontaneous requests in children with autism spectrum disorder: effects on problem behavior. Robertson, RE., Wehby, JH., King, SM.[2019]

A new methodology was developed to assess the impact of adverse side effects (ASE) from psychotropic medications on challenging behavior in individuals with intellectual and developmental disabilities (IDD), involving seven participants.

The study found that most participants showed differences in their response rates under conditions designed to evaluate ASEs, indicating that these side effects can significantly influence behavior and warrant further investigation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adverse Side Effects of Psychotropic Medication and Challenging Behavior: Pilot Work Assessing Impact. Valdovinos, MG., Schieber, E., McMahon, M., et al.[2020]

A professional development package successfully trained three Head Start teachers to conduct trial-based functional analyses (TBFAs) with fidelity, allowing for effective assessment of challenging behaviors in the classroom.

The study found that a function-based intervention, derived from the TBFA results, led to significantly greater reductions in challenging behavior and increases in appropriate communication compared to a non-function-based intervention for all three children involved.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluating the Accuracy of Results for Teacher Implemented Trial-Based Functional Analyses. Rispoli, M., Ninci, J., Burke, MD., et al.[2019]

Trial-based functional analysis can effectively assess challenging behaviors in children with autism spectrum disorder in real educational settings, overcoming limitations of traditional functional analysis methods.

Individualized function-based interventions designed from trial-based analyses led to significant reductions in problem behaviors and increased classroom engagement for the students involved in the study.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using trial-based functional analysis to design effective interventions for students diagnosed with autism spectrum disorder. Larkin, W., Hawkins, RO., Collins, T.[2019]

A trial-based functional analysis (FA) was successfully implemented by three teachers with three boys who have developmental and intellectual disabilities, leading to the identification of behavior functions.

Five function-based interventions derived from the trial-based FAs effectively reduced problem behaviors and increased alternative behaviors, demonstrating the efficacy of this approach in managing challenging behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Teacher-conducted trial-based functional analyses as the basis for intervention. Bloom, SE., Lambert, JM., Dayton, E., et al.[2019]

References

1. United States pubmed.ncbi.nlm.nih.gov

Functional assessment of problem behaviors in adults with mental retardation. [2011]

2. United States pubmed.ncbi.nlm.nih.gov

The Generality of Interview-Informed Functional Analyses: Systematic Replications in School and Home. [2018]

3. United States pubmed.ncbi.nlm.nih.gov

Functional behavioural assessment in people with intellectual disabilities. [2015]

4. United States pubmed.ncbi.nlm.nih.gov

The relationship between functional assessment and treatment selection for aggressive behaviors. [2019]

5. United States pubmed.ncbi.nlm.nih.gov

A statewide survey assessing practitioners' use and perceived utility of functional assessment. [2018]

6. United States pubmed.ncbi.nlm.nih.gov

Increased parent reinforcement of spontaneous requests in children with autism spectrum disorder: effects on problem behavior. [2019]

7. United States pubmed.ncbi.nlm.nih.gov

Adverse Side Effects of Psychotropic Medication and Challenging Behavior: Pilot Work Assessing Impact. [2020]

8. United States pubmed.ncbi.nlm.nih.gov

Evaluating the Accuracy of Results for Teacher Implemented Trial-Based Functional Analyses. [2019]

9. United States pubmed.ncbi.nlm.nih.gov

Using trial-based functional analysis to design effective interventions for students diagnosed with autism spectrum disorder. [2019]

10. United States pubmed.ncbi.nlm.nih.gov

Teacher-conducted trial-based functional analyses as the basis for intervention. [2019]