Brief functional anlaysis and treatment of elopement in preschoolers with autism

Abstract

As a result of the impact of functional analysis methodologies in identifying maintaining variables of problem behavior, considerable research has been devoted to tailoring the methodologies to be practical for an outpatient setting. The purpose of this study was (a) to use brief functional analysis (BFA) methodologies to empirically demonstrate the function of elopement exhibited by two preschoolers diagnosed with autism and (b) to develop function-based interventions derived from the results of the BFA. In phase one, a BFA consisting of 5-min sessions with multiple repetitions of each condition was conducted with each participant. In phase two, the efficacy of function-based interventions was assessed using a pairwise design. Both participants' rates of elopement were differentially lower during the implementation of the function-based intervention relative to baseline. Collectively, these results demonstrated that brief functional methodologies could be applied successfully to the assessment and treatment of elopement. Moreover, the application of BFA and the ensuing treatment in an outpatient setting extend the existing research on functional analysis.

Systematic Review of Functional Analysis and Treatment of Elopement (2000–2015)

“…Only 25% of subjects' elopement was maintained by escape from demands, and 10% was maintained by automatic reinforcement. Regardless of function, when a treatment was implemented, FCT was the most common intervention (Davis et al, 2013;Falcomata et al, 2010;Gibson et al, 2010;Lehardy et al, 2013;Perrin et al, 2008;Stevenson et al, 2015;Tarbox et al, 2003), followed by NCR (Kodak et al, 2004;Lang et al, 2010;Perrin et al, 2008;Tarbox et al, 2003) and DRO (Call et al, 2011). None of the articles in the current review reported interventions for elopement maintained by automatic reinforcement.…”

“…Scorers disagreed on the type of FA in one article (Perrin, Perrin, Hill, & DiNovi, 2008). Authors of the article stated they used a "brief FA" (one scorer accordingly scored "brief FA"); however, their FA procedures were "multi-element" according to the definition utilized in this review (the other scorer accordingly scored "multi-element FA").…”

“…Further, FCT was always combined with another intervention, such as response blocking (Lehardy et al, 2013;Stevenson et al, 2015;Tarbox et al, 2003), extinction (Davis et al, 2013;Falcomata et al, 2010;Perrin et al, 2008), or response cost (Gibson et al, 2010). The next most commonly used intervention was NCR (Kodak et al, 2004;Lang et al, 2010;Perrin et al, 2008;Tarbox et al, 2003), which was also often combined with another intervention, such as response blocking (Lang et al, 2010), extinction (Lang et al, 2010), or timeout (Kodak et al, 2004;Tarbox et al, 2003), although in one case it was implemented in isolation (Perrin et al, 2008). Finally, DRO was the least frequently implemented and in only one study (Call et al, 2011) on a comparison of DRO alone versus in combination with response blocking.…”

“…One study (Lehardy et al, 2013) entailed the therapist repositioning to where the subject eloped and one (Perrin et al, 2008) used FT prompts for the subject to remain in or move to a specific location throughout the session.…”

“…Across the 12 studies, 27 FAs were conducted, the majority of which were conducted in either one classroom (Davis et al, 2013;Gibson, Pennington, Stenhoff, & Hopper, 2010;Lang et al, 2008;Lang et al, 2010;Neidert, Iwata, Dempsey, & Thomason-Sassi, 2013) or one clinic room (Lang et al, 2008;Lehardy, Lerman, Evans, O'Connor, & LeSage, 2013;Tarbox, Wallace, & Williams, 2003). Seven FAs used two adjoining spaces: either two clinic rooms (Call, Pabico, Findley, & Valentino, 2011;Lehardy et al, 2013) or one room divided into two (Perrin et al, 2008). Two FAs were conducted outside: one at a kickball field (Stevenson, Ghezzi, & Valenton, 2015) and one in a subject's neighborhood (Kodak, Grow, & Northup, 2004).…”