Case Studies in
Functional Assessment
and Behavior
Intervention Planning
Jane I. Carlson, Ph.D., B.C.B.A.
The May Institute
www.mayinstitute.org
Jake
 2 1/2 years old
 Diagnosis: Autism
 Language: No functional speech,
babbling with some approximations of
words from songs and videos
 Problem Behavior: Tantrums, crying, selfinjury (head banging)
Functional Assessment Tools
 Interview
 A-B-C Data Collection
 Direct Observation
Interview
 Jake’s mother said, “He’s very hard to
please. I have to give him what he wants
or he’ll make a big scene.”
 Jake’s teacher said, “He really has a hard
time if he can’t get a toy, either because
another student has it or because he can’t
get it himself. He also has problems if I
take something away from him.”
Sample A-B-C Data
Antecedent
Behavior
Consequences
Jake came into the
playroom and another
child had the alphabet
blocks
Jake threw himself on
the floor and started
screaming.
I told Adam to share the
blocks and gave half of
them to Jake. He
stopped tantrumming
and played quietly with
the blocks.
Jake was in the
classroom and wanted
the penguin game. He
couldn’t reach it.
Jake started crying and
I told Jake that he
then fell to the floor and
needed to ask for help. I
banged his head 3 times. got him the game and he
played by himself for
about 15 minutes.
Hypothesis
 Function:
 Tangible-seeking
 Contexts:
 Unable to
independently access
desired item.
 Desired item
unavailable.
 Desired item taken
away.
Intervention
 Pivotal Response Teaching
Graph
 See transparency (verbal responding,
problem behavior)
Outcomes
 Jake quickly learned about 50 words for
preferred items.
 Jake learned to request spontaneously
within a relatively short period of time.
 Jake’s age and the relatively short history
of problem behavior precluded the need
for multicomponent intervention.
 Jake was able to remain in an integrated
preschool.
Alexandra
 11 years old
 Diagnosis: PDD-NOS, Bi-polar Disorder
 Language: Receptive and expressive
language one SD below average.
 Problem Behavior: Aggression, stripping,
destroying property, running out of
classroom, screaming, scratching self.
Functional Assessment Tools
 A-B-C Data Collection
 Everyday data collection
 Interview with teachers
Sample A-B-C Data
Antecedent
Behavior
Consequence
I had just finished working
with A. and gave her a
worksheet to do
independently.
Alex screamed, “F--- you,
I’m not doing any work.”
She threw herself to the
ground and started kicking
the wall. She tantrummed
for around 90 minutes.
I had a staff take all the
other kids out of the
classroom. I stayed with
Alex and maintained her
safety until she finally
calmed down.
We had just finished gym
class and were about to go
back upstairs. Alex started
running around the gym and
I tried to stop her.
Alex flopped to the floor and
took her clothes off. When
anyone approached her,
she would kick and hit. She
scratched her legs until she
was bleeding and was
extremely aggressive when
we tried to apply first aid.
Alex finally calmed down
after about 2 hours. She
got dressed and walked
back up to the classroom to
have lunch.
Analysis of Everyday Data
 See graph on transparency (rating scale).
Sample Interview Data
 Alex’s teacher said, “Nothing we’ve tried
with her works. When she’s manic, she’s
out of control and tantrums until she calms
herself down. Two or three staff often
have to stay with her for 2 hours or more
until she’s calm.”
Experimental FA
 Had to be stopped because the problem
behavior was so severe that she was
injuring staff and herself.
 Not enough data collected to develop
hypothesis.
Hypothesis
 Function: Attention-seeking
 Context: Teacher moves from instructing
Alex to working with another student,
moving from 1-1 attention to a group
activity.
 Setting Event: Manic episodes related to
bi-polar disorder
Short-term Prevention
 One-to-one staffing during school day.
 Neutralizing routine for manic episodes.
 Noncontingent preferred activity with 1-1
staff every hour.
Alex- Short-term Prevention
250
Base line
Short-term Prevention Strategies
200
1
2
150
3
4
100
5
6
50
25
15
5
ay
D
D
ay
1
0
Long-term Intervention
 Teach appropriate requests for attention
 Build tolerance for delay of reinforcement
 Social Skills Training
 Team approach to medication management.
Alex- Percent of Ops. FCT
100
Baseline
FCT
90
80
70
60
Line 1
50
40
30
20
10
25
23
21
19
17
15
13
11
9
7
5
3
1
0
Alex- Frequency of Problem Behavior
by Mood Rating
180
160
140
120
100
3-D Column 1
80
3-D Column 2
3-D Column 3
60
40
20
0
1
2
3
4
5
Outcomes
 Overall reduction in the rate of problem




behavior.
Decreased time per day spent engaged in
problem behavior.
Reduction in problem behavior related to manic
episodes.
Increased use of Functional communication
Increased participation in group activities.
Tom
 16 years old.
 Diagnosis: Autism
 Language skills: severe echolalia, appropriate
responding to social questions with prompting,
2-3 word utterances to request preferred items.
 Problem behavior: Severe aggression (hitting,
grabbing, biting), low frequency, high intensity,
episodes require physical holding procedures.
Functional Assessment Tools
 Interview with father and staff.
 A-B-C data collection
Sample Interview
 Father said, “He’s really autistic. He gets
something in his head and can’t let go of it.
That’s when he gets really aggressive.”
 Teacher said, “If he starts asking for
something that he can’t have that day,
watch out. There’s going to be trouble.”
Sample A-B-C Data
Antecedent
Behavior
Consequence
T. Was on the
computer when it was
time to go to the gym.
T. Started screaming
and then grabbed me
and tried to bite my
arm.
We had to implement
a seated team control
for about 10 minutes
until he was calm.
T. Came in this
morning asking for a
Jetson’s video. I told
him we don’t have that
at school.
T. Got very tense and
started screaming,
crying, and hitting
himself. When I tried
to stop him, he bit me
3 times.
We had to hold him on
the floor for about 15
minutes. He finally
calmed down
completely after about
30 minutes.
Hypothesis
 Function: Tangible-seeking
 Context: Asking for something that is
unavailable, moving from a highly
preferred to a nonpreferred activity.
 Setting event: unknown at this time.
Short-term prevention
 When an item is unavailable, offer him the
choice of two other highly preferred items,
activities.
 Use a “Now and Next” schedule for
transitions.
 No computer for now.
Tom- Episodes per Month
7
Intervention
Baseline
6
5
Episodes
4
Physical Holds
3
2
1
0
1
2
3
4
5
6
7
8
9
10
11 12
13 14
Long-Term Intervention
 Teach appropriate requesting to continue an
activity.
 Teach appropriate requesting for tangibles.
 Teach tolerance for delay of reinforcement.
 Teach relaxation strategies.
Outcomes
 Overall reduction in physical holding
procedures during episodes.
 Reduction in the frequency of problem
behavior.
 Increased ability to make alternate choices
when preferred item is unavailable.
Jack
 Age: 32 years
 Diagnosis: Autism, Mental Retardation
 Language ability: Nonverbal, can point to
pictures to request preferred edibles, uses
pointing and leading inconsistently.
 Problem Behavior: aggression (toward
staff and other residents, hitting, pushing),
self-injury (hitting and biting self).
Functional Assessment Tools
 A-B-C data collection
 Experimental Functional Analysis
Sample A-B-C Data
Antecedent
Behavior
Consequence
Jack seemed really
tired today. He was
sitting on the couch in
the living room when
D. came in and sat
next to him.
Jack hit D. 3 times,
then D. got up and
Jack hit and bit
himself about 20
times.
I sent Jack to his room
and told him he
couldn’t come back in
the living room until he
could be nice to his
housemates.
Jack had just gotten
up and was finishing
up his breakfast in the
kitchen. I told him to
empty the dishwasher.
Jack hit me and tipped
over the table. He
then started hitting
himself and biting
himself.
I told Jack to go to his
room and wait until it
was time to go to day
program.
Jack- Average Frequency of Problem Behavior
70
60
50
40
3-D Column 1
30
3-D Column 2
3-D Column 3
20
10
0
Low
Sleep
Sleep (6+
Hours)
Jack- Functional Analysis of Problem Behavior
25
20
15
Escape
Attention
Tangible
10
Free Time
5
0
Day1
Day2
Day3
Day4
Day5
Day6
Hypothesis
 Function: Escape (demands, social
avoidance)
 Context: Task demands (especially house
chores), person coming into his space
when he is agitated, presence of D.
 Setting Events: Noise and commotion,
fatigue
Short-term Prevention
 Scheduling Changes: limit contact with D.,




schedule AM and PM routines for calm.
Modification in van procedure.
Change AM and PM routines to
accommodate preferences.
Reduce task demands.
TV in bedroom.
Jack-Reversal Design
Presence of D. in Group Home
120
Baseline
"D" on Holiday
Baseline
"D" on Holiday
100
80
Line 1
60
40
20
0
1
2
3
4
5
6
7
8
9 10 11 12 13 14 15 16 17 18
Long-term Intervention
 Teach appropriate “break” response.
 Teach appropriate requesting of personal
space.
 Teach coping strategies (using
headphones to minimize noise)
 Choice procedure for house chores with
self-monitoring component.
Jack- Frequency of Problem Behavior
90
INTERVENTION
BL
80
70
60
Problem Behavior
50
Communication
40
30
20
10
0
1
5
9
13 17 21 25 29 33 37 41 45 49
Outcomes
 Discovered lack of sleep was related to D.
Moved D. to different house.
 Decrease in problem behavior.
 Increase in time on task.
 Ability to complete schedule of house
chores using self-monitoring.
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Case Studies in Functional Assessment and Behavior