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JOURNAL OF APPLIED BEHAVIOR ANALYSIS 1997, 30, 713–716 NUMBER 4 (WINTER 1997)

ASSESSMENT-BASED INTERVENTION FORSEVERE BEHAVIOR PROBLEMS IN

A NATURAL FAMILY CONTEXT

BOBBIE J. VAUGHN, SHELLEY CLARKE, AND GLEN DUNLAPUNIVERSITY OF SOUTH FLORIDA

Functional assessments and assessment-based interventions were conducted with a boywith disabilities and severe problem behavior in the context of two family routines: usingthe bathroom in the family home and dining in a fast-food restaurant. A multiple baselinedesign demonstrated the effectiveness of the intervention package as implemented by theboy’s mother in the two routines. The results provide a systematic replication and exten-sion of behavior-analytic interventions in natural family contexts.

DESCRIPTORS: family support, problem behaviors, functional assessment, assess-ment-based intervention

Many of the responsibilities of family lifeinclude conducting typical family routines inthe home and community; however, theseroutines can be very difficult for families thatinclude children with disabilities and severeproblem behavior. Recently, behavior-analyt-ic research has produced encouraging find-ings through its development and evaluationof assessment-based and contextually appro-priate interventions in school and commu-nity environments (Carr & Carlson, 1993;Dunlap, Kern-Dunlap, Clarke, & Robbins,1991). Such studies have used interview andobservational data to develop multicompo-nent interventions for resolving serious be-havioral challenges. Still, despite its crucial

This research was supported by Field-Initiated Re-search Grant H133G60119 and Cooperative Agree-ment H133B2004 from the National Institute on Dis-ability and Rehabilitation Research (U.S. Departmentof Education) and by the Louis de la Parte FloridaMental Health Institute of the University of SouthFlorida. However, no official endorsement by any sup-porting agency should be inferred. Appreciation is ex-tended to all members of the participating family, andto Lilliane Reyes and Arcadia Vera for assistance withdata collection.

Reprint requests may be sent to Glen Dunlap, Di-vision of Applied Research and Educational Support,Department of Child and Family Studies, Louis de laParte Florida Mental Health Institute, University ofSouth Florida, 13301 Bruce B. Downs Blvd., Tampa,Florida 33612.

importance for the external validity of be-havior-analytic procedures, the applicationof assessment-based interventions by typicalcare providers (e.g., parents) in naturally oc-curring situations (e.g., family routines) hasreceived little attention in the research lit-erature (Lucyshyn, Albin, & Nixon, 1997).Therefore, this controlled case study wasconducted with the purpose of systematicallyreplicating and extending the literature onassessment-based intervention in typicalfamily contexts.

METHOD

Andrew was an 8-year-old boy with severedisabilities including agenesis of the corpuscallosum. He and his mother participated inthis study. Although Andrew could speak,his communication was supported by aug-mentative pictures and objects or was con-veyed through gestures or problem behav-iors. Andrew’s mother was a homemaker inher early 30s who attended a communitycollege on a part-time basis.

The study was conducted in two contextsthat were selected by Andrew’s mother be-cause they involved typical routines that wereassociated with significant behavior problems.The first context was the bathroom in the

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home: Andrew was expected to follow hismother’s request and move from a living areato the bathroom, turn on the light, urinatein the toilet, flush, turn off the light, and exitthe bathroom. The second context was a fast-food restaurant: Andrew was expected to exitthe car with his mother and sister, enter therestaurant, sit and wait with his sister whilehis mother ordered the food at the counter,eat the food, and then leave the restaurant.

Sessions were held two times per weekand were defined by predetermined initia-tion and termination points that were heldconstant throughout the study. All sessionswere videotaped using a hand-held camcor-der and scored in continuous 10-s intervals.Dependent variables included disruptive be-havior and engagement. Disruptive behaviorconsisted of aggression, property destruc-tion, whining, collapsing on the floor, andattempting to run away, and was scored ifany instance occurred within an interval. En-gagement was defined as following the nat-ural sequence of the routine or specific taskinstructions and was scored if Andrew wason task for at least 70% of the interval, asdetermined by observer judgment. It waspossible for both dependent variables to bescored within a single interval. In addition,Andrew’s task performance on each step ofthe routines was scored from the videotapeson a 3-point scale that included nonperform-ance (1), performed with assistance (2), andperformed independently (3). Interobserveragreement was determined for 48% of ses-sions. Agreement averaged 93% (range, 59%to 100%) for occurrences of disruptive be-havior and 95% (range, 50% to 100%) forintervals with engagement. Agreement onthe task routines was 100% for the bath-room and 98% for the restaurant.

The independent variable in this study wasthe process of intervention development,which began with a functional assessment(O’Neill et al., 1997) that included a detailedinterview with Andrew’s mother and several

observations by the first two authors in thetwo routines. The assessment data led to thedevelopment of hypotheses regarding the oc-currence of disruptions in the two routines.Disruptions during toileting appeared to oc-cur because the routine required transition toa relatively unreinforcing activity, and An-drew seemed to have difficulty following thesequence independently. In response, the in-tervention involved a visual portrayal (sched-ule) of the activity sequence that included apicture of a preferred toy that was deliveredfollowing successful completion of the toilet-ing routine. Similarly, disruptions during therestaurant routine were hypothesized to be afunction of inadequate reinforcement duringthe periods of waiting (e.g., ordering) and aninability to participate. The intervention in-cluded an adapted menu to facilitate An-drew’s participation in ordering, active en-couragement of Andrew’s involvement inpaying for food and securing soft drinks, anda photograph of a preferred toy (reward) thatwas provided during the car ride home. Thus,although the routines differed along many di-mensions, both hypothesis-based interven-tion packages were comprised of supplemen-tary rewards and visual schedules to facilitateparticipatory engagement, implemented in amultiple baseline across settings.

Andrew’s mother implemented all of the in-terventions during the sessions, with one ofthe authors providing suggestions and encour-agement during the first few intervention ses-sions. All subsequent sessions, including all ofthe weekly follow-up sessions, were conductedindependently by Andrew’s mother. A probesession was conducted during follow-up forthe restaurant routine. In this session, An-drew’s father was present and a restaurant wasselected in which ordering was issued to aserver (rather than ordering at a counter). Toexpedite the waiting period, Andrew was pro-vided with drawing materials (a commonpractice in many family restaurants). All otherprocedures were the same.

715FAMILY-CENTERED INTERVENTION

Figure 1. Percentage of intervals with disruptive behavior and engagement across the bathroom and restau-rant routines. Connected data points represent sessions that occurred approximately two times per week. Dis-connected points span a period of at least 1 week. The square data points during follow-up in the restaurantroutine depict a probe session that was conducted in a different restaurant environment.

RESULTS ANDDISCUSSION

Figure 1 depicts a clear demonstration ofthe effectiveness of assessment-based inter-vention packages. The interventions pro-duced rapid and durable reductions in dis-ruptive behavior and corresponding increasesin engagement. The one-session probe (thesquare data points) in the family restaurantalso yielded desirable behavior. In terms ofAndrew’s task performances, scores for thebathroom routine averaged 1.77 duringbaseline and increased to scores of 2.8 inboth intervention and follow-up; the restau-rant routine yielded average scores of 2.5 inbaseline, 2.9 in intervention, and 3.0 in fol-low-up.

These results contribute to an emerging lit-erature on assessment-based behavioral inter-vention in typical settings and routines. In re-cent years, there have been a number of em-pirical demonstrations of a functional assess-ment process that leads to multicomponentinterventions in schools and community en-vironments (e.g., Carr & Carlson, 1993;Dunlap et al., 1991); however, there havebeen very few such investigations in familycontexts, despite the fact that family routinesare arguably the most common and most in-fluential interactions for children with disabil-ities. The present study contributes a con-trolled case study with a mother implement-ing all of the procedures in circumstances thatthe family identified as the most problematic.

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It is important to note that the contexts in-cluded a private routine in the home (thebathroom) as well as a routine in a highlypublic setting (the fast-food restaurant). Inboth settings, problem behavior decreasedwhile engagement and independent task com-pletion increased.

It is important to acknowledge that thestudy is limited by having only one partici-pating family and only two routines. Further,despite the presence of several weeks of follow-up data, the scope of the investigation wasinadequate to claim the important benefit oflong-lasting lifestyle change. Nevertheless,when combined with the accumulating baseof information on assessment-based familysupport (Lucyshyn et al., 1997), the presentdata can be viewed as adding encouraging tes-timony to the efficacy and feasibility of func-tional, assessment-based, and contextually ap-propriate interventions.

REFERENCES

Carr, E. G., & Carlson, J. I. (1993). Reduction ofsevere behavior problems in the community usinga multicomponent treatment approach. Journal ofApplied Behavior Analysis, 26, 157–172.

Dunlap, G., Kern-Dunlap, L., Clarke, S., & Robbins,F. R. (1991). Functional assessment, curricularrevision, and severe behavior problems. Journal ofApplied Behavior Analysis, 24, 387–397.

Lucyshyn, J. M., Albin, R. W., & Nixon, C. D.(1997). Embedding comprehensive behavioralsupport in family ecology: An experimental, sin-gle-case analysis. Journal of Consulting and ClinicalPsycholog y, 65, 241–251.

O’Neill, R. E., Horner, R. H., Albin, R. W., Storey,K., Sprague, J. R., & Newton, J. S. (1997). Func-tional assessment and program development for prob-lem behavior: A practical handbook. Pacific Grove,CA: Brooks/Cole.

Received March 31, 1997Initial editorial decision May 21, 1997Final acceptance July 23, 1997Action Editor, Craig H. Kennedy