Review of a Behavioral Assessment Process from Descriptive Assessment to Experimental Analysis: A Summary of 118 Cases

Case Report

Austin J Psychiatry Behav Sci. 2014;1(2): 1010.

Review of a Behavioral Assessment Process from Descriptive Assessment to Experimental Analysis: A Summary of 118 Cases

Marvin Conn, K Mark Derby and T F McLaughlin*

Department of Special Education, Gonzaga University, USA

*Corresponding author: TF McLaughlin, Department of Special Education, Gonzaga University, Spokane, WA 99258-0025, USA

Received: Fabruary 10, 2014; Accepted: March 10, 2014; Published: March 21, 2014


Functional analysis is one of the more robust advances in the assessment and treatment of severe behavior. Using technologies to identify the function of aberrant behavior and adjunctive reinforces to develop treatment packages is crucial to developing interventions designed to reduce aberrant behaviors while increasing alternative replacement responses. Descriptive assessments, preference assessments, reinforce assessments, and experimental functional analyses are tools that have been empirically validated to accomplish this goal. These methods have been shown to be effective in inpatient settings, homes, schools, and outpatient clinics. This study examines the use of these procedures for 118 clients evaluated in either an outpatient clinic and in the natural setting (i.e., schools, homes, and daycares). All procedures were conducted by graduate students enrolled a BCBA approved program for Masters Level practitioners. In addition, all evaluations were supervised by a doctoral level behavior analyst. We present a descriptive summary of the effectiveness of (a) the effectiveness of using the Motivation Assessment Scale at identifying maintaining functions compared to experimental analysis outcomes, (b) the preference assessment to identify reinforcing stimuli, and (c) the effectiveness of treatment packages developed. The efficacy of the outpatient model to serve clients with severe problem behaviors is discussed.

Keywords: Functional behavioral assessment; Preference assessments; University–based clinic; Undergraduate and graduate students; Aberrant behavior.


The advent of functional assessment technology by Iwata, Dorsey, Slifer, Bauman, and Richman [1], may be one of the more robust advances in the assessment and treatment of severe behavior displayed by persons with developmental disabilities [2]. Its’ development has lead to a proactive rather than reactive treatment approach for severe problem behavior [3]. As described by Iwata et al. the procedure itself consists of the systematic replication and withdrawal of analogue conditions until a pattern of responding is shown. Typically, these analogue conditions are designed to evaluate the role of positive, negative, and sensory reinforcement functions. To date, this technology has been shown to be robust across diagnostic groups, behaviors and settings [4–6,1,3,7].

Despite the robust success of both functional analysis and descriptive assessment procedures, most published clinical evaluations have been conducted in extremely controlled environments [7,8,5]. Since its inception, a general concern has been the level of expertise and precision needed to conduct a functional analysis [8]. Initially, there were concerns of not being able to establish control over the environment in outpatient settings similar to the level that can be accomplished in a clinical setting [9–10]. As such, early replications of the procedure focused on its application across settings [8,11]. However, there is strong evidence that these procedures can be used in less clinical settings. For example, Derby et al. [4]. Evaluated 79 cases in an outpatient setting and the utility of the procedures were established. In its simplest form, treatment based on functional analysis results consists of contingencies to increase the learning of alternative behaviors while systematically decreasing problem behaviors targeted for reduction [3].

Studies have shown that the use of functional analysis based treatment in combination with adjunctive reinforces can reduce the time needed to decrease problem behaviors and increase alternative or adaptive behaviors [12]. One method to identify adjunctive reinforces that has been shown to have fidelity within treatment is the forcedchoice hierarchal procedure described by Fisher, Piazza, Bowman, Hagopian, Owens, and Slevin [13]. With this technique, the evaluator presents stimuli in a concurrent operant paradigm that more closely resembles a natural environment when choice options are present.

The purpose of this study is to examine the outcomes of the assessment, functional analysis, and reinforcement assessment procedures [4,7,11], completed at a university based clinic over a ten–year period (1999 – 2009) [14]. During this period, 118 clients were assessed. The data represented are the findings from those cases. Questions to be answered through this study were: For what percentage of clients did the preferred items identified during the preference assessment match the outcomes obtained during the reinforcement assessment? What percentage of clients did the controlling function identified through the indirect assessment [15] (Alter, Conroy, Mancil & Haydon, 2008) match the function identified during the experimental functional analysis? How did the functions identified during this study compare to similar epidemiological studies [1,4]? Lastly, how effective was the developed treatment for the reduction of aberrant behaviors?


The investigation was conducted across three phases. Phase 1 consisted of the initial data gathering and visual inspection of available case files. In phase 2, outcomes of the assessments were compared. The preference assessment (PA) outcomes were compared with the outcomes of the reinforce assessment (RA). The maintaining condition identified through the Motivational Assessment Scale (MAS) [15] was compared against the maintaining condition identified during experimental analysis. During phase 3, we evaluated the treatment effectiveness by comparing the reduction of aberrant behavior observed across functional analysis baseline and treatment sessions.

Participants and settings

Participants were served in a university–based clinic located at Gonzaga University in Spokane Washington [14]. Client’s evaluated through the clinic ranged in age from 2 years to 24 years old. All of the clients were referred for engaging in severe problem behaviors. Problem behaviors ranged from physical and verbal aggression to self–injurious behavior. Clients assessed were previously diagnosed with a multitude of problems including mild to profound intellectual delays, autism, mental illness, physical disabilities, and traumatic brain injury.

Assessments and treatment sessions were conducted in clinic, school, or home settings. The same procedures were used across all settings. Assessments conducted in the clinic setting were completed in a room designed to serve as a integrated preschool and clinic context. The room had items found in typical preschool classrooms (i.e., toys, tables, chairs). The room was equipped with a one–way mirror that permitted unobtrusive observation. Community based assessment and treatment sessions were conducted in locations specific to each client (e.g., school classrooms, homes, or daycare settings).

Assessment and treatment conditions were completed by graduate students enrolled in a BCBA approved Masters in Special Education Functional Analysis program [16]. All cases were supervised by two clinic directors, who were trained behavioral analysts. Evaluations were conducted across varying time periods ranging from 3 weeks to 4 months, which mirrored the universities semester and summer schedule.

General clinic procedures


The assessments completed included a functional assessment interview adopted from O’Niel, Horner, Albin, Sprague, Steney and Newton [12] that included the Motivation Assessment Scale [15]. Direct assessments consisted of preference [13], and reinforce assessments [12] to determine possible tangible items and the relative reinforce strength of across items. Next, a brief functional analysis [1,4,7,11,17] was used to identify maintaining conditions for problem behavior. Lastly, a treatment package was developed based on the outcomes of the both assessments.

Indirect assessment: Prior to being evaluated, the clients’ care provider was asked to complete an informational packet that included the functional assessment interview and the MAS [15]. Definitions and topographies of targeted aberrant behaviors were identified via the assessment questionnaire and a follow–up phone interview. A graduate student clinician conducted a reinforce assessment interview [18] to identify potential adjunctive reinforces (i.e. eight to ten items that could be used during the preference assessment). The interview consisted of questions about items that provide visual, olfactory, edible, auditory, tactile, and social stimuli to the client. A list of items that could serve as a reinforce was created based in this parent report.

Motivation assessment scale: The MAS [15] is a questionnaire that consists of 16 questions. Care providers are instructed to answer how frequently the target behavior is likely to occur in specific situations (e.g., when presented with a difficult task). Questions are specific to one of four functions, escape, attention, tangible, and sensory. Each function has four questions directly pertaining to the function. Respondents answer each question using a Likert scale from 0 to 6 (0 behavior never occurs, 6 behaviors always occurs). Scores for each function were totaled then divided by 4 to obtain a mean score. The scores were rated relative to each other, the highest mean score was then rated as a 1 the lowest mean score was rated as a 4. A 1 rating was considered to be the most likely maintaining function of the behavior. Using this information, clinicians developed a hypothesis about function of the behavior.

Direct assessments

Motivation Assessment Scale Using a forced–choice format [13,19] each item was paired against all other items. The client was verbally prompted (i.e., which one do you want ________ or ________”) to pick between two presented items; thereby, gaining access to that choice item for a brief period of time. The non–selected item was simultaneously removed with the delivery of chosen item to client. Data collectors recorded the item selected for each pairing. Attempts to gain access to both choice items were redirected by the therapist. Forced–choice selections were continued until all items had been paired with each other at least once. If there were any ties (i.e., an item was chosen an equal amount of times) a tie breaker presentation was conducted (i.e., the two items presented until one item was selected).

Preference assessment outcomes were graphed using a bar graph format. To aid in the visual interpretation of the results the item chosen most often (i.e., highly preferred) was placed closest to the abscissa followed by the remaining items in order from most to least selected. When tie–breaker presentations were conducted, the more preferred item chosen was identified by a (*) symbol being placed above that items bar. A typical graph is shown in Figure 1. This client’s preferred items were: balloon, duck, frog, weeble, hat, seal, Nemo, keys, and square. The graph depicts these items from most to least preferred respectively. For this client, tie breaker presentations were conducted for the frog versus weeble and seal versus Nemo choices.