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JOURNAL OF APPLIED BEHAVIOR ANALYSIS 1997, 30, 713–716 NUMBER 4 (WINTER 1997)
ASSESSMENT-BASED INTERVENTION FOR
SEVERE BEHAVIOR PROBLEMS IN
A NATURAL FAMILY CONTEXT
BOBBIE J. VAUGHN, SHELLEY CLARKE, AND GLEN DUNLAP
UNIVERSITY OF SOUTH FLORIDA
Functional assessments and assessment-based interventions were conducted with a boy
with disabilities and severe problem behavior in the context of two family routines: using
the bathroom in the family home and dining in a fast-food restaurant. A multiple baseline
design demonstrated the effectiveness of the intervention package as implemented by the
boy’s mother in the two routines. The results provide a systematic replication and extension of behavior-analytic interventions in natural family contexts.
DESCRIPTORS: family support, problem behaviors, functional assessment, assessment-based intervention
Many of the responsibilities of family life
include conducting typical family routines in
the home and community; however, these
routines can be very difficult for families that
include children with disabilities and severe
problem behavior. Recently, behavior-analytic research has produced encouraging findings through its development and evaluation
of assessment-based and contextually appropriate interventions in school and community environments (Carr & Carlson, 1993;
Dunlap, Kern-Dunlap, Clarke, & Robbins,
1991). Such studies have used interview and
observational data to develop multicomponent interventions for resolving serious behavioral challenges. Still, despite its crucial
This research was supported by Field-Initiated Research Grant H133G60119 and Cooperative Agreement H133B2004 from the National Institute on Disability and Rehabilitation Research (U.S. Department
of Education) and by the Louis de la Parte Florida
Mental Health Institute of the University of South
Florida. However, no official endorsement by any supporting agency should be inferred. Appreciation is extended to all members of the participating family, and
to Lilliane Reyes and Arcadia Vera for assistance with
data collection.
Reprint requests may be sent to Glen Dunlap, Division of Applied Research and Educational Support,
Department of Child and Family Studies, Louis de la
Parte Florida Mental Health Institute, University of
South Florida, 13301 Bruce B. Downs Blvd., Tampa,
Florida 33612.
importance for the external validity of behavior-analytic procedures, the application
of assessment-based interventions by typical
care providers (e.g., parents) in naturally occurring situations (e.g., family routines) has
received little attention in the research literature (Lucyshyn, Albin, & Nixon, 1997).
Therefore, this controlled case study was
conducted with the purpose of systematically
replicating and extending the literature on
assessment-based intervention in typical
family contexts.
METHOD
Andrew was an 8-year-old boy with severe
disabilities including agenesis of the corpus
callosum. He and his mother participated in
this study. Although Andrew could speak,
his communication was supported by augmentative pictures and objects or was conveyed through gestures or problem behaviors. Andrew’s mother was a homemaker in
her early 30s who attended a community
college on a part-time basis.
The study was conducted in two contexts
that were selected by Andrew’s mother because they involved typical routines that were
associated with significant behavior problems.
The first context was the bathroom in the
714 BOBBIE J. VAUGHN et al.
home: Andrew was expected to follow his
mother’s request and move from a living area
to the bathroom, turn on the light, urinate
in the toilet, flush, turn off the light, and exit
the bathroom. The second context was a fastfood restaurant: Andrew was expected to exit
the car with his mother and sister, enter the
restaurant, sit and wait with his sister while
his mother ordered the food at the counter,
eat the food, and then leave the restaurant.
Sessions were held two times per week
and were defined by predetermined initiation and termination points that were held
constant throughout the study. All sessions
were videotaped using a hand-held camcorder and scored in continuous 10-s intervals.
Dependent variables included disruptive behavior and engagement. Disruptive behavior
consisted of aggression, property destruction, whining, collapsing on the floor, and
attempting to run away, and was scored if
any instance occurred within an interval. Engagement was defined as following the natural sequence of the routine or specific task
instructions and was scored if Andrew was
on task for at least 70% of the interval, as
determined by observer judgment. It was
possible for both dependent variables to be
scored within a single interval. In addition,
Andrew’s task performance on each step of
the routines was scored from the videotapes
on a 3-point scale that included nonperformance (1), performed with assistance (2), and
performed independently (3). Interobserver
agreement was determined for 48% of sessions. Agreement averaged 93% (range, 59%
to 100%) for occurrences of disruptive behavior and 95% (range, 50% to 100%) for
intervals with engagement. Agreement on
the task routines was 100% for the bathroom and 98% for the restaurant.
The independent variable in this study was
the process of intervention development,
which began with a functional assessment
(O’Neill et al., 1997) that included a detailed
interview with Andrew’s mother and several
observations by the first two authors in the
two routines. The assessment data led to the
development of hypotheses regarding the occurrence of disruptions in the two routines.
Disruptions during toileting appeared to occur because the routine required transition to
a relatively unreinforcing activity, and Andrew seemed to have difficulty following the
sequence independently. In response, the intervention involved a visual portrayal (schedule) of the activity sequence that included a
picture of a preferred toy that was delivered
following successful completion of the toileting routine. Similarly, disruptions during the
restaurant routine were hypothesized to be a
function of inadequate reinforcement during
the periods of waiting (e.g., ordering) and an
inability to participate. The intervention included an adapted menu to facilitate Andrew’s participation in ordering, active encouragement of Andrew’s involvement in
paying for food and securing soft drinks, and
a photograph of a preferred toy (reward) that
was provided during the car ride home. Thus,
although the routines differed along many dimensions, both hypothesis-based intervention packages were comprised of supplementary rewards and visual schedules to facilitate
participatory engagement, implemented in a
multiple baseline across settings.
Andrew’s mother implemented all of the interventions during the sessions, with one of
the authors providing suggestions and encouragement during the first few intervention sessions. All subsequent sessions, including all of
the weekly follow-up sessions, were conducted
independently by Andrew’s mother. A probe
session was conducted during follow-up for
the restaurant routine. In this session, Andrew’s father was present and a restaurant was
selected in which ordering was issued to a
server (rather than ordering at a counter). To
expedite the waiting period, Andrew was provided with drawing materials (a common
practice in many family restaurants). All other
procedures were the same.
FAMILY-CENTERED INTERVENTION 715
Figure 1. Percentage of intervals with disruptive behavior and engagement across the bathroom and restaurant routines. Connected data points represent sessions that occurred approximately two times per week. Disconnected points span a period of at least 1 week. The square data points during follow-up in the restaurant
routine depict a probe session that was conducted in a different restaurant environment.
RESULTS AND
DISCUSSION
Figure 1 depicts a clear demonstration of
the effectiveness of assessment-based intervention packages. The interventions produced rapid and durable reductions in disruptive behavior and corresponding increases
in engagement. The one-session probe (the
square data points) in the family restaurant
also yielded desirable behavior. In terms of
Andrew’s task performances, scores for the
bathroom routine averaged 1.77 during
baseline and increased to scores of 2.8 in
both intervention and follow-up; the restaurant routine yielded average scores of 2.5 in
baseline, 2.9 in intervention, and 3.0 in follow-up.
These results contribute to an emerging literature on assessment-based behavioral intervention in typical settings and routines. In recent years, there have been a number of empirical demonstrations of a functional assessment process that leads to multicomponent
interventions in schools and community environments (e.g., Carr & Carlson, 1993;
Dunlap et al., 1991); however, there have
been very few such investigations in family
contexts, despite the fact that family routines
are arguably the most common and most influential interactions for children with disabilities. The present study contributes a controlled case study with a mother implementing all of the procedures in circumstances that
the family identified as the most problematic.
716 BOBBIE J. VAUGHN et al.
It is important to note that the contexts included a private routine in the home (the
bathroom) as well as a routine in a highly
public setting (the fast-food restaurant). In
both settings, problem behavior decreased
while engagement and independent task completion increased.
It is important to acknowledge that the
study is limited by having only one participating family and only two routines. Further,
despite the presence of several weeks of followup data, the scope of the investigation was
inadequate to claim the important benefit of
long-lasting lifestyle change. Nevertheless,
when combined with the accumulating base
of information on assessment-based family
support (Lucyshyn et al., 1997), the present
data can be viewed as adding encouraging testimony to the efficacy and feasibility of functional, assessment-based, and contextually appropriate interventions.
REFERENCES
Carr, E. G., & Carlson, J. I. (1993). Reduction of
severe behavior problems in the community using
a multicomponent treatment approach. Journal of
Applied Behavior Analysis, 26, 157–172.
Dunlap, G., Kern-Dunlap, L., Clarke, S., & Robbins,
F. R. (1991). Functional assessment, curricular
revision, and severe behavior problems. Journal of
Applied Behavior Analysis, 24, 387–397.
Lucyshyn, J. M., Albin, R. W., & Nixon, C. D.
(1997). Embedding comprehensive behavioral
support in family ecology: An experimental, single-case analysis. Journal of Consulting and Clinical
Psychology, 65, 241–251.
O’Neill, R. E., Horner, R. H., Albin, R. W., Storey,
K., Sprague, J. R., & Newton, J. S. (1997). Functional assessment and program development for problem behavior: A practical handbook. Pacific Grove,
CA: Brooks/Cole.
Received March 31, 1997
Initial editorial decision May 21, 1997
Final acceptance July 23, 1997
Action Editor, Craig H. Kennedy
