Despite mounting evidence documenting the benefits of access to and participation in inclusive school settings for students with extensive support needs (ESN), most students with ESN spend a majority of the school day in separate settings. Challenging behavior is one of several barriers that may lead to exclusion from inclusive school settings. Although the literature is replete with examples of effective behavioral supports for this student population, less is known about how challenging behavior is addressed in inclusive school settings for students with ESN. We conducted a systematic literature review and found 11 intervention studies focused on addressing challenging behavior across 20 students with ESN. Most interventions resulted in large to very large changes in challenging behavior in a variety of school settings, though the quality of studies varied widely. We present implications for practice related to supporting the behavioral needs of students with ESN in inclusive school settings, including developing contextually fit interventions that are socially valid from the student and educator perspective, and the critical need for additional research in this area.
*AlbertoP.HeflinL. J.AndrewsD. (2002). Use of the timeout ribbon procedure during community-based instruction. Behavior Modification, 26(2), 297–311. https://doi.org/10.1177/0145445502026002008
2.
AmorA. M.HagiwaraM.ShogrenK. A.ThompsonJ. R.VerdugoM. Á.BurkeK. M.AguayoV. (2019). International perspectives and trends in research on inclusive education: A systematic review. International Journal of Inclusive Education, 23(12), 1277–1295. https://doi.org/10.1080/13603116.2018.1445304
3.
AndzikN. R.Cannella-MaloneH. I.SigafoosJ. (2016). Practitioner-implemented functional communication training: A review of the literature. Research and Practice for Persons with Severe Disabilities, 41(2), 79–89. https://doi.org/10.1177/1540796916633874
4.
AndzikN. R.SchaeferJ. M.NicholsR. T.ChungY. C. (2018). National survey describing and quantifying students with communication needs. Developmental Neurorehabilitation, 21(1), 40–47. https://doi.org/10.1080/17518423.2017.1339133
5.
*BlairK.-S. C.LiaupsinC. J.UmbreitJ.KweonG. (2006). Function-based intervention to support the inclusive placements of young children in Korea. Education and Training in Developmental Disabilities, 41(1), 48–57. http://www.jstor.org/stable/23879870
6.
*BlairK.-S. C.UmbreitJ.DunlapG.JungG. (2007). Promoting inclusion and peer participation through assessment-based intervention. Topics in Early Childhood Special Education, 27(3), 134–147. https://doi.org/10.1177/02711214070270030401
7.
BrockM. E.Cannella-MaloneH. I.SeamanR. L.AndzikN. R.SchaeferJ. M.PageE. J.BarczakM. A.DuekerS. A. (2017). Findings across practitioner training studies in special education: A comprehensive review and meta-analysis. Exceptional Children, 84(1), 7–26. https://doi.org/10.1177/0014402917698008
8.
BrockM. E.CarterE. W. (2017). A meta-analysis of educator training to improve implementation of interventions for students with disabilities. Remedial and Special Education, 38(3), 131–144. https://doi.org/10.1177/0741932516653477
9.
CarpenterM. E.SnodgrassM. R.WalkerV. L.PinczynskiM.HarrisR. (in press). Participation of students with IDD in social validity assessment of function-based interventions in school settings: A prevalence review. Journal of Positive Behavior Interventions. https://doi.org/10.1177/10983007251389667
10.
CarterE. W. (2021). Dimensions of belonging for individuals with intellectual and developmental disabilities. In JonesJ. L.GallusK. L. (Eds.), Belonging and resilience in individuals with developmental disabilities (pp. 13–34). Springer. https://doi.org/10.1007/978-3-030-81277-5_2
*ConradiL. A.JamesonJ. M.FischerA. J.FarrellM.EichelbergerC.RyanJ.BowmanJ.Fudge ColemanO.McDonnellJ. (2021). Effects of the Good Behavior Game on students with severe disabilities. Education and Training in Autism and Developmental Disabilities, 56(4), 454–465.
13.
*EllingsonS. A.MiltenbergerR. G.StrickerJ.GalenskyT. L.GarlinghouseM. (2000). Functional assessment and intervention for challenging behaviors in the classroom by general classroom teachers. Journal of Positive Behavior Interventions, 2(2), 85–97. https://doi.org/10.1177/109830070000200202
14.
EmersonE.BlacharJ.EinfeldS.HattonC.RobertsonJ.StancliffeR. J. (2014). Environmental risk factors associated with the persistence of conduct difficulties in children with intellectual disabilities and autistic spectrum disorders. Research in Developmental Disorders, 35(12), 3508–3517. https://doi.org/10.1016/j.ridd.2014.08.039
15.
FlowerA.McKennaJ. W.HaringC. D. (2017). Behavior and classroom management: Are teacher preparation programs really preparing our teachers?Preventing School Failure: Alternative Education for Children and Youth, 61(2), 163–169. https://doi.org/10.1080/1045988X.2016.1231109
16.
GageN. A.CookG. B.ReichowB. (2017). Publication bias in special education meta-analyses. Exceptional Children, 83(4), 428–445. https://doi.org/10.1177/0014402917691016
17.
GageN. A.PicoD. L.EvanovichL. (2022). National trends and school-level predictors of restraint and seclusion for students with disabilities. Exceptionality, 30(1), 1–13. https://doi.org/10.1080/09362835.2020.1727327
18.
GeeK.GonzalezM.CooperC. (2020). Outcomes of inclusive versus separate placements: A matched pairs comparison study. Research and Practice for Persons with Severe Disabilities, 45(4), 223–240. https://doi.org/10.1177/1540796920943469
19.
GiangrecoM. F. (2021). Maslow’s Hammer: Teacher assistant research and inclusive practices at a crossroads. European Journal of Special Needs Education, 36(2), 278–293. https://doi.org/10.1080/08856257.2021.1901377
20.
GohA. E.BambaraL. M. (2012). Individualized positive behavior support in school settings: A meta-analysis. Remedial and Special Education, 33(5), 271–286. https://doi.org/10.1177/0741932510383990
21.
*HallA. M.Neuharth-PritchettS.BelfioreP. J. (1997). Reduction of aggressive behaviors with changes in activity: Linking descriptive and experimental analyses. Education and Training in Mental Retardation and Developmental Disabilities, 32(4), 331–339.
HumeK.SteinbrennerJ. R.OdomS. L.MorinK. L.NowellS. W.TomaszewskiB.SzendreyS.McIntyreN. S.Yücesoy-ÖzkanS.SavageM. N. (2021). Evidence-based practices for children, youth, and young adults with autism: Third generation review. Journal of Autism and Developmental Disorders, 51(11), 4013–4032. https://doi.org/10.1007/s10803-020-04844-2
24.
*HuntP.AlwellM.GoetzL. (1992). The regular class as a communication support group (Report no. 143). Office of Special Education and Rehabilitative Services.
25.
HuntingtonR. N.BadgettN. M.BristolR. M.McIntoshJ.KellyE. M.BravoA.ByunY. H.ParkM. S.GreenyK. (2024). A descriptive assessment of social validity source, timing, and direct consumer inclusion in behavior analytic research. Perspectives on Behavior Science, 47, 691–711. https://doi.org/10.1007/s40614-024-00401-9
26.
Individuals With Disabilities Education Act, 20 U.S.C. § 1400. (2004).
27.
JangJ.DixonD. R.TarboxJ.GranpeeshehD. (2011). Symptom severity and challenging behavior in children with ASD. Research in Autism Spectrum Disorders, 5(3), 1028–1032. https://doi.org/10.1016/j.rasd.2010.11.008
28.
JohnsonH. N.CarpenterM. E. (2022). Including student input as a critical component of functional behavior assessment. Beyond Behavior, 31(3), 175–184. https://doi.org/10.1177/10742956221108365
29.
JohnsonH. N.CarpenterM. E.BoroshA. M.FolkertsR. (2022). Including students with significant support needs in the development of behavior support plans. Inclusive Practices, 1(3), 106–113. https://doi.org/10.1177/27324745221082953
30.
KincaidD.DunlapG.KernL.LaneK. L.BambaraL. M.BrownF.FoxL.KnosterT. P. (2016). Positive behavior support: A proposal for updating and refining the definition. Journal of Positive Behavior Interventions, 18(2), 69–73. https://doi.org/10.1177/1098300715604826
31.
KurthJ. A.HicksT. A.ShogrenK. A.ZagonaA. L.JamesonJ. M.JacksonL.AgranM.RyndakD. (2024). The relationship between severity of disability and segregated placements for students with complex support needs. The Journal of Special Education, 58(4), 208–219. https://doi.org/10.1177/00224669241256126
32.
LaFranceD. L.WeissM. J.KazemiE.GerenserJ.DobresJ. (2019). Multidisciplinary teaming: Enhancing collaboration through increased understanding. Behavior Analysis in Practice, 12(1), 709–726. https://doi.org/10.1007/s40617-019-00331-y
33.
LedfordJ. R.ChazinK. T.LaneJ. D.ZimmermanK. N.BennettP. B.AyresK. A. (2023, May). Single case analysis and review framework (SCARF). http://ebip.vkcsites.org/scarfv2
34.
LedfordJ. R.GastD. L. (2018). Single case research methodology (3rd ed.). Routledge.
35.
LedfordJ. R.LambertJ. M.PustejovskyJ. E.ZimmermanK. N.HollinsN.BartonE. E. (2022). Single-case-design research in special education: Next-generation guidelines and considerations. Exceptional Children, 89(4), 379–396. https://doi.org/10.1177/00144029221137656
36.
*LomanS. L.Strickland-CohenM. K.WalkerV. L. (2018). Promoting the accessibility of SWPBIS for students with severe disabilities. Journal of Positive Behavior Interventions, 20(2), 113–123. https://doi.org/10.1177/1098300717733976
37.
LoryC.GregoriE.HuffS.LeeR.RendonN. (2024). Interventions for challenging behavior of autistic students in general education settings: A systematic literature review. Research in Autism Spectrum, Disorders, 114, 102385. https://doi.org/10.1016/j.rasd.2024.102385
38.
LoryC.MasonR.DavisJ.WangD.KimS.GregoriE.DavidM. (2020). A meta-analysis of challenging behavior interventions for students with developmental disabilities in inclusive school settings. Journal of Autism and Developmental Disorders, 50(4), 1221–1237. https://doi.org/10.1007/s10803-019-04329-x
39.
MasudA. B.WalkerV. L.CarpenterM. E.AndersonA. (2023). Functional communication training in inclusive school settings for students with intellectual and developmental disabilities: A literature review. Journal of Positive Behavior Interventions, 25(4), 239–252. https://doi.org/10.1177/10983007221126530
40.
MazzottiV. L.MorningstarM. E.LombardiA.RaleyS. K.RoweD. A.PoppenM.TestD. W. (2023). Conceptualizing and developing the secondary transition fidelity assessment to support transition programming and practice. Career Development and Transition for Exceptional Individuals, 47(2), 106–118. https://doi.org/10.1177/21651434231163498
41.
*McDonnellJ.Mathot-BucknerC.ThorsonN.FisterS. (2001). Supporting the inclusion of students with moderate and severe disabilities in junior high school general education classes: The effects of classwide peer tutoring, multi-element curriculum, and accommodations. Education and Treatment of Children, 24(2), 141–160. http://www.jstor.org/stable/42899651
42.
McIntoshK.HornerR. H.SugaiG. (2009). Sustainability of systems-level evidence-based practices in schools: Current knowledge and future directions. In SailorW.DunlapG.SugaiG.HornerR. (Eds.), Handbook of positive behavior support (pp. 327–352). Springer. https://doi.org/10.1007/978-0-387-09632-2_14
43.
MonzalveM.HornerR. H. (2021). The impact of the contextual fit enhancement protocol on behavior support plan fidelity and student behavior. Behavioral Disorders, 46(4), 267–278. https://doi.org/10.1177/0198742920953497
44.
MorningstarM. E.KurthJ. A. (2017). Status of inclusive educational placement for students with extensive and pervasive support needs. Inclusion, 5(2), 83–93. https://doi.org/10.1352/2326-6988.5.2.83
45.
ParkerR. I.VannestK. J.DavisJ. L.SauberS. B. (2011). Combining nonoverlap and trend for single-case research: Tau-U. Behavior Therapy, 42(2), 284–299. https://doi.org/10.1016/j.beth.2010.08.006
46.
RobertsJ.SimpsonK. (2016). A review of research into stakeholder perspectives on inclusion of students with autism in mainstream schools. International Journal of Inclusive Education, 20(10), 1084–1096. https://doi.org/10.1080/13603116.2016.1145267
RupparA.KurthJ.BubashS.Lockman TurnerE. (2023). A framework for preparing to teach students with extensive support needs in the 21st century. Teacher Education and Special Education, 46(1), 26–43. https://doi.org/10.1177/08884064211059853
49.
SnellM. E.BradyN.McLeanL.OgletreeB. T.SiegelE.SylvesterL.MineoB.PaulD.RomskiM. A.SevcikR. (2010). Twenty years of communication intervention research with individuals who have severe intellectual and developmental disabilities. American Journal on Intellectual and Developmental Disabilities, 115(5), 364–380. https://doi.org/10.1352/1944-7558-115-5.364
50.
TaubD. A.McCordJ. A.RyndakD. (2017). Opportunities to learn for students with extensive support needs: A context of research-support practices for all in general education classrooms. The Journal of Special Education, 5(3), 127–137. https://doi.org/10.1177/0022466917696263
VannestK. J.NinciJ. (2015). Evaluating intervention effects in single-case research designs. Journal of Counseling & Development, 93(4), 403–411. https://doi.org/10.1002/jcad.12038
53.
VannestK. J.ParkerR. I.GonenO.AdiguezelT. (2016). Single case research: Web-based calculators for SCR analysis (Version 2.0) [Web-based application]. Texas A&M University. https://singlecaseresearch.org
54.
*VascelliL.IacominiS.ArtoniV.BerardoF. (2022). Evaluating the separate and combined effects of enriched environment and punishment for self-injury in school. Behavioral Interventions, 37(2), 239–247. https://doi.org/10.1002/bin.1840
55.
WalkerV. L.ConradiL. A.Strickland-CohenM. K.JohnsonH. N. (2023). School-wide positive behavioral interventions and supports and students with extensive support needs: A scoping review. International Journal of Developmental Disabilities, 69(1), 13–28. https://doi.org/10.1080/20473869.2022.2116232
56.
WalkerV. L.KurthJ.CarpenterM. E.TappM. C.ClausenA.Lockman TurnerE. (2021). Paraeducator-delivered interventions for students with extensive support needs in inclusive school settings: A systematic review. Research and Practice for Persons with Severe Disabilities, 46(4), 278–295. https://doi.org/10.1177/15407969211055127
57.
WalkerV. L.LomanS. L.HaraM.ParkK. L.Strickland-CohenM. K. (2018). Examining the inclusion of students with severe disabilities in school-wide positive behavioral interventions and supports. Research and Practice for Persons with Severe Disabilities, 43(4), 223–238. https://doi.org/10.1177/1540796918779370
58.
WalkerV. L.SnellM. E. (2013). Effects of augmentative and alternative communication on challenging behavior: A meta-analysis. Augmentative & Alternative Communication, 29(2), 117–131. https://doi.org/10.3109/07434618.2013.785020
59.
*WalkerV. L.SnellM. E. (2017). Teaching paraprofessionals to implement function-based interventions. Focus on Autism and Other Developmental Disabilities, 32(2), 114–123. https://doi.org/10.1177/1088357616673561
60.
WestlingD. L. (2015). Evidence-based practices for improving challenging behaviors of students with severe disabilities (Document No. IC-14). University of Florida, Collaboration for Effective Educator, Development, Accountability, and Reform Center. http://ceedar.education.ufl.edu/tools/innovation-configurations/
61.
WiggsN. B.ReddyL. A.BronsteinB.GloverT. A.DudekC. M.AlperinA. (2021). A mixed-methods study of paraprofessionals’ roles, professional development, and needs for training in elementary schools. Psychology in Schools, 58(11), 2239–2254. https://doi.org/10.1002/pits.22589
62.
WolfM. M. (1978). Social validity: The case for subjective measurement or how applied behavior analysis is finding its heart. Journal of Applied Behavior Analysis, 11(2), 203–214. https://doi.org/10.1901/jaba.1978.11-203
63.
ZagonaA. L.KurthJ. A.Lockman TurnerE.PaceJ.ShogrenK.LanseyK.JamesonM.BurnetteK.MansouriM.HicksT.GerasimovaD. (2022). Ecobehavioral analysis of the experiences of students with complex support needs in different classroom types. Research and Practice for Persons with Severe Disabilities, 47(4), 209–228. https://doi.org/10.1177/15407969221126496
64.
ZagonaA. L.KurthJ. A.WalkerV. L.RupparA.LomanS.BubashS. (2024). A mixed-methods quality analysis of behavior intervention plans for Students with extensive support needs. Research and Practice for Persons with Severe Disabilities, 49(4), 262–281. https://doi.org/10.1177/15407969241291485
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
