Comprehensive Multisituational Intervention for Problem Behavior in the Community

Abstract

Assessment and intervention approaches for dealing with problem behavior need to be extended so that they can be effectively and comprehensively applied within the community. To meet assessment needs, the authors developed a three-component strategy: description (interview followed by direct observation), categorization (aggregating multiple instances of problem behavior into thematic groups, each characterized by a specific function), and verification (manipulating situational parameters to test the accuracy of the assessment data). To meet intervention needs, the authors employed a five-component, assessment-based, hypothesis-driven strategy consisting of rapport building, functional communication training, tolerance for delay of reinforcement, choice, and embedding. Following intervention, improvements in participants' lifestyle, communication, and problem behavior were noted. The intervention was practical in that parents, teachers, job coaches, and group home staff were able to efficiently implement it without compromising high levels of task engagement. Long-term maintenance of intervention effects (ranging from 1.5 to 2.5 years in duration) was also observed. Finally, 100 group home staff judged the effects to be socially valid in that problem behavior was rated as less severe and less dangerous, and as requiring less restraint following intervention. In light of these results, the authors discuss how future community-based intervention will require additional changes in assessment practices and intervention strategies and a redefinition of successful outcomes to include lifestyle change and life-span perspectives.