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LAURA C. CHEZAN. Intellectual Disability Mental Illness Dual Diagnosis Problem Behavior.

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Presentation on theme: "LAURA C. CHEZAN. Intellectual Disability Mental Illness Dual Diagnosis Problem Behavior."— Presentation transcript:

1 LAURA C. CHEZAN

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3 Intellectual Disability Mental Illness Dual Diagnosis Problem Behavior

4 Approach to Problem Behavior BEHAVIORAL INTERVENTIONS Behavior is influenced by environmental variables 1. Assess to identify function 2. Teach replacement behavior

5 Participants Selection All Participants Functional Assessment Trial-Based Functional Analysis Intervention (FCT) Discrimination Assessment Behavioral Assessment

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7 Meeting with directors Informal observation of potential participants Meeting with staff members Selection of participants

8 ParticipantAgeDiagnosisProblem Behavior Antoine27 moderate ID bipolar-disorder autism SIB repetitive verbal and motor behavior Rick32 profound ID mood disorder SIB physical aggression property destruction Tonya23severe ID psychosis NOS snatching food physical aggression Note: ID = intellectual disability; SIB = self-injurious behavior

9 ParticipantType of Program LocationAssessment & Training Setting Antoine day program ruraldining room, instructional room Rick day program ruraldining room, instructional room, hallway Tonyaworkshopurbanwork areas, dining area

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11 PURPOSE Collect information Background Information Topography of problem behavior Environmental variables Develop Hypotheses

12 INDIRECT METHODS DIRECT METHODS Definitions Hypotheses Temporal Relationships Verify Hypotheses Record Review ABC observations (Bijou, Peterson, & Ault, 1968) Interview (FAI; ONeill et al., 1997)FAI Background information

13 Hypotheses DTFA Test Hypotheses Develop DTFA

14 Attention Automatic Reinforcement Attention Tangible 1 Tangible 2 Attention Tangibles Antoines FA Hypotheses Hypotheses Ricks FA Hypotheses Hypotheses Tonyas FA Hypotheses Hypotheses

15 FA HYPOTHESISHYPOTHESIS ANTECEDENT (No Access to Reinforcer) CONSEQUENCE (Access to Reinforcer) ASSESSMENT ( 2 min) DTFA Components REINFORCEMENT (2 min) Present Antecedent STOP if: (a) problem behavior (b) time elapsed Present Consequence hypothesized to maintain problem behavior +

16 Attention Automatic Reinforcement Attention Tangible 1 Tangible 2 Attention Tangibles Antoine RickTonya

17 Problem BehaviorNo Response TARGET BEHAVIOR Occurrence or non-occurrence of the 2 responses (data sheet)data sheet Latency to first response

18 WHO? researcher, staff member, or behavioral consultant WHEN? naturally-occurring opportunities during typical routines throughout the day HOW? 1-5 trials per day under one or multiple conditions wait min between trials

19 ASSESSMENT (No access to reinforcer) REINFORCEMENT (Access to reinforcer) Problem behavior Few or No Problem behavior

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23 WHO? StaffQuestionnaireEnd of assessment HOW? WHEN? OUTCOME – Information about: Significance of outcomes Appropriateness of procedures Continuation of procedures in the future

24 Easy to conduct (M=3.0) SD (1) SA(4) D (2)A (3) Procedures were clear Interested in learning more (M=3.5) Took a long time (M=1.0) Interfered with other responsibilities (M=1.5)

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26 Clear patterns of behavior for all three participants Applicable to adults with dual diagnosis Few number of trials across conditions Variability in the topography of problem behavior and number of trials with problem behavior

27 Variations in stimulus control Individual motivation Fluctuation in the reinforcing value of certain people, items, or activities

28 Efficient and less intrusive way to determine the function of problem behavior Guide the delivery of reinforcement during intervention and increase tolerance for delayed reinforcement

29 Implemented by staff members Embedded within typical routines Rated by staff members as: Easy to implement No time consuming

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31 DTFA was effective in identifying the function of problem behavior for all three adults

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33 Future research may include: Staff training for implementation of DTFA Replication of findings

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35 Identification of replacement behavior Teaching replacement behavior STEPS

36 Reviewed DTFA results Consulted with staff members Identified a behavior that was easily discriminable and functionally equivalent Defined behavior

37 Constant time delay Differential reinforcement Error correction Protocol Develop Instructional Procedures Provide Instruction and Progress Monitoring Assess Current Level of Performance 8 opportunities Daily routines Behavioral indication Researcher & staff BASELINE Protocol and Data Sheet Protocol Data Sheet INTERVENTION Protocol and Data Sheet ProtocolData Sheet

38 Prompted Response or Problem Behavior Independent Response TARGET BEHAVIOR Occurrence or non-occurrence of the two responses for each opportunity (data sheet)

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42 Identify Example and Non- Example Discrimination Probes and Develop ProtocolProtocol Administer Probes and Collect Data

43 100% across all participants for both example probes and non-example probes

44 WHO? StaffQuestionnaireEnd of study HOW? WHEN? OUTCOME – Information about: Significance of outcomes Appropriateness of procedures Continuation of procedures in the future

45 PB affected QOL (M=3.5) Benefited from learning a new response and it reduces the frequency of PB Willing to continue the intervention (M=3.0) Easy to conduct (M=2.5) Interfered with other responsibilities (M=2.0) SD (1) SA(4) D (2)A (3)

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47 Applicable to adults with dual diagnosis Mental illness may influence the acquisition pattern of some adults with dual diagnosis Effective in producing acquisition of a replacement behavior for all three adults

48 Response competition Variations in stimulus control History of reinforcement

49 Teach in the presence of behavioral indication Increases the likelihood of the precise use of replacement behavior

50 Implemented by staff members Embedded within naturally-occurring opportunities Rated as: Beneficial for participants Relatively easy to implement No time consuming

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52 1. FCT produced acquisition of a functionally equivalent replacement behavior 1. FCT produced discriminated use of the newly acquired replacement behavior

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54 Future research may include Relationship between behavioral indication and generalization of replacement behavior Staff training to identify teaching opportunities Replication of findings

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