Abstract
Intensive behavioral intervention units are clinical settings typically housed within a larger university-based or medical campus that exclusively admit clients referred for the assessment and treatment of severe problem behavior. The urgent and complex nature of these cases places exceptional demands on behavior analysts and requires a unique therapeutic approach and clinical structure to provide safe and effective service delivery. The purpose of this chapter is to orient those interested in pursuing a training experience on an intensive behavioral intervention unit by (a) outlining the requisite skills for effective clinical application, (b) discussing the unique structure of service delivery, (c) describing the specialized training and supervision that goes into managing behavioral staff, and (d) reviewing some considerations for successfully navigating regulatory and funding frameworks.
Grants 5R01HD079113, 5R01HD083214, and 1R01HD093734 from The National Institute of Child Health and Human Development provided partial support to Brian D. Greer for this work.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
Notes
- 1.
Presenting detailed information on the assessment and treatment process that occurs on an intensive behavioral intervention unit is well beyond the scope of the present chapter. We refer interested readers to other sources (e.g., Fisher et al. in press; Greer and Fisher 2017, Greer et al. 2018) for detailed reviews of the assessment and treatment process.
References
Allen, K. D., & Warzak, W. J. (2000). The problem of parental nonadherence in clinical behavior analysis: Effective treatment is not enough. Journal of Applied Behavior Analysis, 33(3), 373–391. https://doi.org/10.1901/jaba.2000.3-373.
American Association on Intellectual and Developmental Disabilities (AAIDD). (2010). Intellectual disability: Definition, classification, and systems of supports (11th ed.). Washington, DC: Author.
American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington: Author.
Anderson, L. L., Larson, S. A., Mapel Lentz, S., & Hall-Lande, J. (2019). A systematic review of U.S. studies on the prevalence of intellectual or developmental disabilities since 2000. Intellectual and Developmental Disabilities, 57(5), 421–438. https://doi.org/10.1352/1934-9556-57.5.421.
Baker, B. L., Blacher, J., Crnic, K. A., & Edelbrock, C. (2002). Behavior problems and parenting stress in families of three-year-old children with and without developmental delays. American Journal on Mental Retardation, 107(6), 433–444. https://doi.org/10.1352/0895-8017(2002)107<0433:BPAPSI>2.0.CO;2.
Beavers, G. A., Iwata, B. A., & Lerman, D. C. (2013). Thirty years of research on the functional analysis of problem behavior. Journal of Applied Behavior Analysis, 46, 1–21.
Behavior Analyst Certification Board (BACB). (2014). Professional and ethical compliance code. Littleton: Author.
Behavior Analyst Certification Board (BACB). (2017). BCBA/BCaBA task list (5th ed.). Littleton: Author.
Behavior Analyst Certification Board (BACB). (2019). BCBA/BCaBA experience standards – Monthly system. Littleton: Author.
Briggs, A. M., Fisher, W. W., Greer, B. D., & Kimball, R. T. (2018). Prevalence of resurgence of destructive behavior when thinning reinforcement schedules during functional communication training. Journal of Applied Behavior Analysis, 51(3), 620–633. https://doi.org/10.1002/jaba.472.
Brodhead, M. T., Cox, D. J., & Quigley, S. P. (2018a). Identifying your scope of competence in autism treatment. In J. Tarbox Critical Specialties in Treating Autism and Other Behavioral Challenges (Series Ed.), Practical ethics for effective treatment of autism spectrum disorders (1st ed., pp. 53–66). London: Elsevier.
Brodhead, M. T., Quigley, S. P., & Wilczynski, S. M. (2018b). A call for discussion about scope of competence in behavior analysis. Behavior Analysis in Practice, 11(4), 424–435. https://doi.org/10.1007/s40617-018-00303-8.
Carr, J. E., & Briggs, A. M. (2010). Strategies for making regular contact with the scholarly literature. Behavior Analysis in Practice, 3(2), 13–18. https://doi.org/10.1007/BF03391760.
Cooper, S. A., Smiley, E., Jackson, A., Finlayson, J., Allan, L., Mantry, D., et al. (2009). Adults with intellectual disabilities: Prevalence, incidence and remission of aggressive behavior and related factors. Journal of Intellectual Disability Research, 53(3), 217–232. https://doi.org/10.1111/j.1365-2788.2008.01127.x.
Didden, R., Sturney, P., Sigafoos, J., Lang, M., O’Reilly, M. F., & Lancioni, G. E. (2012). Nature, prevalence, and characteristics of challenging behavior. In J. L. Matson (Ed.), Functional assessment for challenging behaviors (pp. 25–44). New York: Springer.
Doehring, P., Reichow, B., Palka, T., Phillips, C., & Hagopian, L. (2014). Behavioral approaches to managing intense aggression, self-injury, and destruction in children with autism spectrum and related developmental disorders: A descriptive analysis. Child and Adolescent Psychiatry Clinics of North America, 23(1), 25–40. https://doi.org/10.1016/j.chc.2013.08.001.
Dumas, J. E., Wolf, L. C., Fisman, S. N., & Culligan, A. (1991). Parenting stress, child behavior problems, and dysphoria in parents of children with autism, Down syndrome, behavior disorders, and normal development. Exceptionality, 2(2), 97–110. https://doi.org/10.1080/09362839109524770.
Emerson, E., & Einfeld, S. L. (2011). Challenging behavior (3rd ed.). Cambridge: Cambridge University Press.
Emerson, E., Kiernan, C., Alborz, A., Reeves, D., Mason, H., Swarbrick, R., et al. (2001). The prevalence of challenging behaviors: A total population study. Research in Developmental Disabilities, 22(1), 77–93. https://doi.org/10.1016/s0891-4222(00)00061-5.
Fisher, W. W., Rodriguez, N. M., Luczynski, K. C., & Kelley, M. E. (2013). The use of protective equipment in the management of severe behavior disorders. In D. D. Reed, F. D. DiGennaro Reed, & J. K. Luiselli (Eds.), Handbook of crisis intervention for individuals with developmental disabilities (pp. 87–105). New York: Springer.
Fisher, W. W., Greer, B. D., Romani, P. W., Zangrillo, A., & N., & Owen, T. M. (2016). Comparisons of synthesized- and individual-reinforcement contingencies during functional analysis. Journal of Applied Behavior Analysis, 49(3), 596–616. https://doi.org/10.1002/jaba.314.
Fisher, W. W., Greer, B. D., Mitteer, D. R., Fuhrman, A. M., Romani, P. W., & Zangrillo, A. N. (2018). Further evaluation of differential exposure to establishing operations during functional communication training. Journal of Applied Behavior Analysis, 51(2), 360–373. https://doi.org/10.1002/jaba.451.
Fisher, W. W., Greer, B. D., & Bouxsein, K. J. (in press). Developing function-based reinforcement procedures for problem behavior. In W. W. Fisher, C. C. Piazza, & H. S. Roane (Eds.), Handbook of applied behavior analysis (2nd ed., pp. X–Y). New York: Guilford Publishing.
Greer, B. D., & Fisher, W. W. (2017). Treatment of socially reinforced problem behavior. In J. L. Matson (Ed.), Handbook of treatments for autism spectrum disorder (pp. 171–190). New York: Springer.
Greer, B. D., Fisher, W. W., Saini, V., Owen, T. M., & Jones, J. K. (2016). Functional communication training during reinforcement schedule thinning: An analysis of 25 applications. Journal of Applied Behavior Analysis, 49(1), 105–121. https://doi.org/10.1002/jaba.265.
Greer, B. D., Mitteer, D. R., & Fisher, W. W. (2018). A practical approach to functional communication training. In A. C. Sella & D. Ribeiro (Eds.), Behavior analysis applied to Autism Spectrum Disorders (pp. X–Y). Curitiba: Appris. ISBN:978-85-473-1929-8.
Greer, B. D., Mitteer, D. M., Briggs, A. M., Fisher, W. W., & Sodawasser, A. J. (2020). Comparisons of standardized and interview-informed synthesized reinforcement contingencies relative to traditional functional analysis. Journal of Applied Behavior Analysis, 53(1), 82–101. https://doi.org/10.1002/jaba.601.
Hanley, G. P., Iwata, B. A., & McCord, B. E. (2003). Functional analysis of problem behavior: A review. Journal of Applied Behavior Analysis, 36(2), 147–185. https://doi.org/10.1901/jaba.2003.36-147.
Holden, B., & Gitlesen, J. (2006). A total population study of challenging behavior in the county of Hedmark, Normay: Prevalence, and risk markers. Research in Developmental Disabilities, 27(4), 456–465.
Howlin, P., Goode, S., Hutton, J., & Rutter, M. (2004). Adult outcomes for children with autism. The Journal of Child Psychology and Psychiatry, 45(2), 212–229. https://doi.org/10.1111/j.1469-7610.2004.00215.x.
Iwata, B. A., Dorsey, M. F., Slifer, K. J., Bauman, K. E., & Richman, G. S. (1994). Toward a functional analysis of self-injury. Journal of Applied Behavior Analysis, 27(2), 197–209. https://doi.org/10.1901/jaba.1994.27-197. (Reprinted from Analysis and Intervention in Developmental Disabilities, 2(1), 3–20, 1982).
Iwata, B. A., DeLeon, I. G., & Roscoe, E. M. (2013). Reliability and validity of the functional analysis screening tool. Journal of Applied Behavior Analysis, 46(1), 271–284. https://doi.org/10.1002/jaba.31.
Kahng, S., Iwata, B. A., & Lewin, A. B. (2002). Behavioral treatment of self-injury, 1964-2000. American Journal on Mental Retardation, 107(3), 212–221. https://doi.org/10.1352/0895-8017(2002)107<0212:BTOSIT>2.0.CO;2.
Lloyd, B. P., & Kennedy, C. H. (2014). Assessment and treatment of challenging behavior for individuals with intellectual disability: A research review. Journal of Applied Research in Intellectual Disabilities, 27(3), 187–199. https://doi.org/10.1111/jar.12089.
Matson, J. L., Kiely, S. L., & Banburg, J. W. (1997). The effect of stereotypies on adaptive skills as assessed with the DASH-II and vineland Adaptive behavior Scales. Research in Developmental Disabilities, 18(6), 471–476.
McClintock, K., Hall, S., & Oliver, C. (2003). Risk markers associated with challenging behaviours in people with intellectual disabilities: A meta-analytic study. Journal of Intellectual Disability Research, 47(6), 405–416. https://doi.org/10.1046/j.1365-2788.2003.00517.x.
Reed, D. D., Luiselli, J. K., Miller, J. R., & Kaplan, B. A. (2013). Therapeutic restraint and protective holding. In D. D. Reed, F. D. DiGennaro Reed, & J. K. Luiselli (Eds.), Handbook of crisis intervention for individuals with developmental disabilities (pp. 107–120). New York: Springer.
Reilly, H., & Warneke, K. (2008). Father Flanagan of Boys Town: A man of vision. Boys Town: Boys Town Press.
Retzlaff, B. J., Fisher, W. W., Akers, J. S., & Greer, B. D. (2020). A translational evaluation of potential iatrogenic effects of single and combined contingencies during functional analysis. Journal of Applied Behavior Analysis, 53(1), 67–81. https://doi.org/10.1002/jaba.595.
Saini, V., Greer, B. D., Fisher, W. W., Lichtblau, K. R., DeSouza, A. A., & Mitteer, D. R. (2016). Individual and combined effects of noncontingent reinforcement and response blocking on automatically reinforced problem behavior. Journal of Applied Behavior Analysis, 49(3), 693–698. https://doi.org/10.1002/jaba.306.
Sellers, T. P., Valentino, A. L., & LeBlanc, L. A. (2016). Recommended practices for individual supervision of aspiring behavior analysts. Behavior Analysis in Practice, 9(4), 274–286. https://doi.org/10.1007/s40617-016-0110-7.
Taylor, L., Oliver, C., & Murphy, G. (2011). The chronicity of self-injurious behavior: A long-term follow-up of a total population study. Journal of Applied Research in Intellectual Disabilities, 25, 107–117. https://doi.org/10.1111/j.1468-3148.2010.00579.x.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Briggs, A.M., Greer, B.D. (2021). Intensive Behavioral Intervention Units. In: Maragakis, A., Drossel, C., Waltz, T.J. (eds) Applications of Behavior Analysis in Healthcare and Beyond. Springer, Cham. https://doi.org/10.1007/978-3-030-57969-2_7
Download citation
DOI: https://doi.org/10.1007/978-3-030-57969-2_7
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-57968-5
Online ISBN: 978-3-030-57969-2
eBook Packages: Behavioral Science and PsychologyBehavioral Science and Psychology (R0)