Abstract
We present a model for assessing the relative effects of environmental and medical treatments within an outpatient setting using brief functional analyses. We use the example of Attention-deficit Hyperactivity Disorder as a way of illustrating this assessment approach. We describe two evaluations in which we assessed the relative effects of Ritalin and various environmental variables on the on task behavior of two children referred to an outpatient diagnostic clinic. In both cases, the primary question by the parents involved the need for Ritalin to improve behavior. Assessment results for one child suggested that Ritalin as well as environmental variables improved his behavior, whereas assessment results for the second child suggested that environmental variables improved behavior regardless of medication usage. The results of these case examples illustrate the potential utility of brief functional analyses within the outpatient setting.
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References
Achenbach, T. M., and Edelbrock, C. S. (1983).Manual for the Child Behavior Checklist and Revised Child Behavior Profile, University Associates in Psychology, Vermont.
American Psychiatric Association (1987)Diagnostic and statistical manual of mental disorders (3rd ed.-revised),Washington D.C.:Author.
Carr, E. G., and Durand, V. M. (1985). Reducing behavioral problems through functional communication training.J. Appl. Behav. Anal. 18: 111–126.
Carr, E. G., Newsom, C. D., and Binkoff, J. A. (1980). Escape as a factor in the aggressive behavior of two retarded children.J. Appl. Behav. Anal. 13:393–409.
Cooper, L. J., Wacker, D. P., Sasso, G. M., Reimers, T. M., and Donn, L. K. (1990). Using parents as therapists to evaluate appropriate behavior of their children: Application to a tertiary diagnostic clinic.J. Appl. Behav. Anal. 23: 285–296.
Cooper, L. J., Wacker, D. P., Thursby, D., Plagmann, L., Harding, J., and Derby, M. (1992). Assessment of the role of task preferences, task demands, and adult attention on child behavior: Application to an outpatient and classroom setting.J. Appl. Behav. Anal. In press.
Derby, K. M., Wacker, D. P., Sasso, G., Steege, M., Northup, J., Cigrand, K., and Asmus, J. (1992). A three-year evaluation of the use of brief functional analysis techniques to assess maladaptive behavior in an outclinic setting.J. Appl. Behav. Anal. 25, 713–721.
Frick, P. J., and Lahey, B. B. (1991). The nature and characteristics of attention-deficit hyperactivity disorder.School Psychol. Rev. 20: 163–173.
Goh, H., Lalli, J. S., Mauk, J. E., Reber, M., and Mace, F. C. (May, 1991).The effects of a pharmacological and a behavioral treatment for handbiting and headbanging. Paper presented at the annual Association for Behavior Analysis, Atlanta, GA.
Goyette, C. H., Conners, C. K., and Ulrich, R. F. (1978). Normative data for the revised Conners parent and teacher rating scales.J. Abnorm. Child Psychol. 6: 221–236.
Iwata, B. A., Dorsey, M. F., Slifer, K. J., Bauman, K. E., and Richman, G. S. (1982). Toward a functional analysis of self-injury.Anal. Interven. Devel. Dis. 2: 3–20.
Iwata, B. A., Pace, G. M., Kalsher, M. J., Cowdery, G. E., and Cataldo, M. F. (1990). Experimental analysis and extinction of self-injurious escape behavior.J. Appl. Behav. Anal. 23: 11–27.
Mace, F. C., Page, T. J., Ivancic, M. T., and O'Brien, S. (1986). Analysis of environmental determinants of aggression and disruption in mentally retarded children.Appl. Res. Ment. Retard. 7: 203–221.
Mace, F. C., and West, B. J. (1986). Analysis of demand conditions associated with reluctant speech.J. Behav. Ther. Exp. Psychiatry 17: 285–294.
Northup, J., Wacker, D., Sasso, G., Steege, M., Cigrand, K., Cook, J., and DeRaad, A., (1991). A brief functional analysis of aggressive and alternative behavior in an outclinic setting.J. Appl. Behav. Anal. 24: 509–522.
Quay, H. C., and Peterson, D. (1983).Manual for the revised behavior problem checklist. The University of Miami, Coral Gables, Florida: Privately Printed.
Reimers, T. M., Wacker, D. P., and Koeppl, G. (1987). Acceptability of behavioral interventions: A review of the literature.School Psychol. Rev. 16: 212–227.
Repp, A. C., Felce, D., and Barton, L. E. (1988). Basing the treatment of stereotypic and self-injurious behavior on hypotheses of their causes.J. Appl. Behav. Anal., 21: 281–289.
Safer, D. J., and Krager, J. M. (1988). A survey of medication treatment for hyperactive/inattentive students.J. Am. Med. Assoc., 260: 2256–2258.
Steege, M. W., Wacker, D. P., Berg, W. K., Cigrand, K. K., and Cooper, L. J. (1989). The use of behavioral assessment to prescribe and evaluate treatments for severely handicapped children.J. Appl. Behav. Anal. 22: 23–33.
Steege, M. W., Wacker, D. P., Cigrand, K. K., Berg, W. K., Novak, C., Reimers, T. M., Sasso, G. M., and DeRaad, A. (1990). Use of negative reinforcement in the treatment of self-injurious behavior.J. Appl. Behav. Anal. 23: 459–467.
Wacker, D., Northup, J., and Cooper, L. (1992). Behavioral assessment In Greydanus & Wolraich (Eds.).Behav. Ped., Springer-Verlag New York, pp. 57–68.
Wacker, D. P., Steege, M. W., Northup, J., Sasso, G., Berg, W., Reimers, T., Cooper, L., Cigrand, K., and Donn, L. (1990). A component analysis of functional communication training across three topographics of severe behavior problemsJ. Appl. Behav. Anal. 23: 417–429.
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Cooper, L.J., Wacker, D.P., Millard, T. et al. Assessing environmental and medication variables in an outpatient setting: A proposed model and preliminary results with ADHD Children. J Dev Phys Disabil 5, 71–85 (1993). https://doi.org/10.1007/BF01046599
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DOI: https://doi.org/10.1007/BF01046599