Interobserver agreement (IOA) is important for research and practice, and supports the consistency of behavioral data (Kahng et al., 2011). Although general parameters for how much IOA is needed have been suggested (Bailey & Burch, 2018), it is unknown if the total number of sessions with IOA might impact the IOA coefficient. In this study, IOA was reanalyzed using functional analysis data at various cutoffs. Obtained IOA from these analyses was then compared to the original IOA. Overall, results suggested that, at least when using highly trained observers in a structured clinical setting, there were no significant differences in IOA across cutoffs. However, IOA was sensitive to overall rate of responding in the functional analysis. These data are encouraging, particularly for practitioners, because they provide preliminary support that the amount of sessions with IOA may not be as important as the consistency of the data.
Pica is a life threating form of challenging behavior displayed by individuals with intellectual and developmental disabilities. In most cases, pica is maintained by automatic reinforcement. Common interventions for pica use some combination of response blocking, response interruption and redirection (RIRD), differential reinforcement of alternative behavior (DRA), and noncontingent reinforcement with competing stimuli. However, there is need for additional research regarding DRA procedures that emphasize skills acquisition by teaching alternative behaviors that modify the established behavioral chain of pica responses that occur in the presence of non-edible stimuli. There is also a need to examine the generality of recent advances in competing stimulus assessment (CSA) methodologies-namely, the augmented-CSA (A-CSA)-to pica. Thus, the purpose of the present investigation was to systematically replicate and extend previous research for the assessment and treatment of pica in an individual with IDD. First, we conducted a functional analysis to identify environmental variables associated with pica. Next, taught Patrick a differential response (i.e., discard pica items in trash receptacle) to earn reinforcers in conjunction with a RIRD procedure. Finally, we conducted an A-CSA for pica. Overall, low rates of pica were maintained over time with a combination of these procedures, and treatment was generalized across settings and people.
Cox et al. (2021) recently outlined a number of analytic methods (i.e., procedures for estimating effect size, conditional rates, and nonparametric partial correlation tests) that may help quantify the relative contributions of psychotropic medication and behavioral interventions on problem behavior among individuals with intellectual and developmental disorders. The purpose of the current study was to examine the generality of these methods by applying these procedures in a novel clinical context (i.e., a hospital-based inpatient unit for severe problem behavior). We extended the procedures described by Cox to include a larger sample size, cases with more frequent, severe and treatment-resistant problem behavior, cases with both medication decreases and increases, and cases with at least one similar class of psychotropic medication in common (i.e., atypical antipsychotics). This work remains a proof of concept, but we replicated a number of the preliminary findings from Cox et al. Implications for future research and medication monitoring practices are discussed.
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