Use of the structured descriptive assessment to identify possible functions of challenging behaviour exhibited by adults with brain injury

Abstract

Behaviour modification procedures for challenging behaviour, based on principles of operant learning, benefit from an accurate appraisal of behavioural function. Numerous methods of direct and indirect functional assessment exist, which have relative strengths and weaknesses. In this study, structured descriptive assessments were used to identify the function of challenging behaviour. The application of this hybrid approach has been unexplored in the neurobehavioural literature. The structured descriptive assessments involved the systematic manipulation of antecedent variables (only) that were conducted by typical caregivers in the normal environment. Also, observational software was used to provide a high degree of analytical detail. The methodology was found to be effective in generating hypotheses of behavioural function and also efficient as a clinical research tool. Only just over 2.25 hours of assessment data were collected for each participant, on average, and yet functional relationships emerged in respect of all four participants. The aggression exhibited by two participants was deemed to serve a demand escape function and the challenging behaviours of the other two participants were attributed to an attention gaining function. Future studies should implement additional validity measures by corroborating findings with other (experimental) functional assessment techniques or by implementing treatment programmes based on its results.

Holistic Practice in Traumatic Brain Injury Rehabilitation: Perspectives of Health Practitioners

“…Indeed, teamwork, shared information, individualised goal setting, and participation of the person with brain injury (and their families) were also highlighted by practitioners as necessary to the individual’s recovery. These findings, unique to the perspective of brain injury rehabilitation practitioners, support previous literature investigating the perspective of patients, their families, and children’s school teachers [ 76 , 77 ], observation and intervention studies [ 78 – 80 ], and reviews [ 81 – 83 ].…”

Integrated Behavioral Intervention and Person-Centered Therapy Within Community-Based Treatment of an Adult With Acquired Brain Injury

“…The authors also conducted FBA comprising interviews with care providers, daily recording forms, and antecedent-behavior-consequence measures from direct observations of Natalie in the group home (Rahman et al, 2013). These FBA findings were reviewed by clinicians and presented to care providers for clarification and refinement.…”

“…Clinicians and students are encouraged to conduct FBA before intervening with a person who has ABI (Call et al, 2017; Rahman et al, 2013). In the present case, FBA with Natalie included direct observations and interviews with care providers to isolate the conditions and situations that consistently preceded and followed challenging behaviors.…”

“…Absent such information, practitioners are subject to implementing intervention procedures arbitrarily without clearly identifying behavior-function and forming hypotheses about behavior–environmental relationships. We recommend that clinicians and students consider multiple indirect and descriptive methods when planning and implementing FBA (Iwata et al, 2013; Rahman et al, 2013).…”

Re-Establishing Solid Food Consumption in a Person With Traumatic Brain Injury and Extended Food Avoidance/Restriction Using a Multicomponent Behavioral Intervention

“…The authors conducted a functional behavior assessment (FBA) comprising direct observations of attempts to feed Tammy solid foods, interviews with care providers, and review of food intake recordings during meals (Rahman et al, 2013). The supervising clinician (first author) summarized and presented the FBA findings to care providers for clarification and refinement.…”