Evaluating the Long-Term Efficacy of a Trauma-Informed Approach to Addressing Challenging Behavior in the Home

Abstract

Behavioral interventions for challenging behavior often rely on the results of a functional analysis to identify environmental contributors. Multiple functional analysis formats have been developed to improve qualities of the process such as practicality, efficiency, and safety. More recently, the performance-based, interview-informed synthesized contingency analysis (IISCA) was developed as a functional analysis format that incorporates a trauma-informed framework. The performance-based IISCA (a) introduces evocative events following periods of calm to reduce dangerous escalation, (b) includes moment-to-moment measures of challenging behavior to allow for ongoing visual analysis of data, and (c) maintains measures of positive affect. We conducted this study to evaluate the treatment utility of the performance-based IISCA when it is used to inform a skill-based treatment. The performance-based IISCA was conducted for the challenging behavior of three autistic children before teaching communication, toleration, and cooperation during skill-based treatment in the home setting. Challenging behavior was reduced for all participants across different therapists and across time (1-, 2-, 3-month treatment extension). The results support the extension and longevity of treatment informed by the performance-based IISCA.

Keywords

challenging behavior functional analysis treatment extension trauma-informed care

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