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Establishing a functional analysis protocol for examining behavioral deficits using social withdrawal as an exemplar

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Title:
Establishing a functional analysis protocol for examining behavioral deficits using social withdrawal as an exemplar
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English
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Walters, Melissa Penaranda
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University of South Florida
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Maintaining variables
Social anxiety
Elementary school students
School refusal
Social interaction
Dissertations, Academic -- Applied Behavior Analysis -- Masters -- USF
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bibliography   ( marcgt )
theses   ( marcgt )
non-fiction   ( marcgt )

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Abstract:
ABSTRACT: The purpose of this study was to establish a functional analysis protocol for examining behavioral deficits, using social withdrawal as an exemplar. A review of the Journal of Applied Behavior Analysis over the past 10 years found that although the current behavior analytic literature contains extensive studies that functionally analyze behavioral excesses, there is a limited amount of studies that analyze deficits. The rationale behind this study was the notion that although behavioral deficits are rarely studied, the fact that the participant is capable of the behavior yet fails to engage in it leads to the idea that certain events are functionally maintaining this failure. The method used involved examining two male students identified as socially withdrawn. The approach for functionally analyzing their behavior(s) was based on the conditions described in Iwata et al. (1982/1994). Specifically this study had the following conditions attention, demand/escape, and unstructured play, otherwise known as the control condition. The procedures of this study were predicated on the hypothesis that behavioral deficits respond to social contingencies in a manner similar to many behavioral excesses. Based on the findings of this study, the deficit collectively referred to as "social withdrawal" was responsive to such contingencies. Specifically, social withdrawal appeared to be maintained by adult attention for both participants.
Thesis:
Thesis (M.A.)--University of South Florida, 2006.
Bibliography:
Includes bibliographical references.
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Mode of access: World Wide Web.
Statement of Responsibility:
by Melissa Penaranda Walters.
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Title from PDF of title page.
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Document formatted into pages; contains 57 pages.

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oclc - 156978194
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Establishing a Functional Analysis Protocol for Examining Behavi oral Deficits using Social Withdrawal as an Exemplar by Melissa Penaranda Walters A thesis submitted in partial fulfillment of the requirements for the degree of Master of Arts in Appl ied Behavior Analysis College of Graduate School University of South Florida Major Professor: Jennifer Austin, Ph.D. Trevor Stokes, Ph.D. Maria dePerczel Goodwin, Ph.D. Date of Approval: June 23, 2006 Keywords: maintaining variable s, social anxiety, elemen tary school students, school refusal, social interaction Copyright 2006, Melissa Penaranda Walters

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Table of Contents List of Tables................................................................................................................. .....ii List of Figures................................................................................................................ ....iii Abstract....................................................................................................................... .......iv Chapter 1 Introduction......................................................................................................... 1 Chapter 2 Method..............................................................................................................1 4 Chapter 3 Results.............................................................................................................. .22 Chapter 4 Discussion.........................................................................................................25 List of References............................................................................................................. .30 Appendices..................................................................................................................... ....32 Appendix A: Comprehensive list of all functional analytic articles reviewed............................................................................................................33 Appendix B: Data Sheet.........................................................................................49 Appendix C: Level of anxiety questionnaire.........................................................50 Appendix D: Teacher Training form.....................................................................51 Appendix E: Teacher “cheat sheets”......................................................................56 i

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List of Tables Table 1 Level of anxiety questionnaire mean scores......................................................24 ii

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List of Figures Figure 1. Functional analytic results for Robert............................................................22 Figure 2. Functional analytic results for Marc...............................................................23 iii

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Establishing a Functional Analysis Protocol for Examining Behavioral Deficits using Social Withdrawal as an Exemplar Melissa Penaranda Walters ABSTRACT The purpose of this study was to estab lish a functional analysis protocol for examining behavioral deficits, using social withdrawal as an exemplar. A review of the Journal of Applied Behavior Analysis ove r the past 10 years found that although the current behavior analytic liter ature contains extensive studies that functionally analyze behavioral excesses, there is a limited amount of studies that an alyze deficits. The rationale behind this study was the notion th at although behavioral deficits are rarely studied, the fact that the partic ipant is capable of the behavi or yet fails to engage in it leads to the idea that certain events are functionally maintaining this failure. The method used involved examining two male students identified as socially withdrawn. The approach for functionally analyzing thei r behavior(s) was based on the conditions described in Iwata et al (1982/1994). Specifically th is study had the following conditions attention demand/escape and unstructured play, otherwise known as the control condition. The procedures of this study were predicated on the hypothesis that behavioral deficits respond to social contingencies in a manner similar to many behavioral excesses. Based on the findings of this study, the deficit collectively referred iv

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to as “social withdrawal” was responsive to such contingencies. Specifically, social withdrawal appeared to be maintained by adult attention for both participants. v

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Chapter One Introduction Functional analysis refers to any of a vari ety of methods used to help identify both the antecedent and consequence environmenta l events that contribute to certain behaviors. By directly obs erving and systematically mani pulating the variables in a person’s environment, the relationship be tween the person’s be havior and their environment often can be determined. Skinne r (1953) described functional analysis as an empirical demonstration of cause and eff ect between environment and behavior. Knowledge of the specific functional relations between behavior and the environment is necessary in determining st rategies for successful behavior change (Cooper, Heron, & Heward, 1987). Accordi ng to Iwata, Kahng, Wallace, & Lindberg (2000), identifying the function of behaviors im proves treatment programs in at least four ways. First, it helps to identify and alte r antecedent conditions that evoke behavior, which may in turn help decrease the freque ncy of behavior. Second, it can determine the reinforcement contingencies operating on beha vior, which may allow one to eliminate or minimize reinforcers and subsequently decrea se behavior. Third, functional analysis helps to identify reinforcers that may be used to establish alternate behaviors. And lastly, functional analysis results help single out relevant reinforcers and/or treatment components. 1

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Conducting a functional assessment or analysis prior to selecting behavior change strategies is considered best practice in a pplied behavior analysis (Miltenberger, 2004). Functional assessment involves indirect data collection strategies (e.g., questionnaires and interviews) or direct observation (e.g., observing and recording the antecedents and consequences) of a behavior, whereas func tional analysis strategies involve the experimental manipulation of the antecedents or consequences to establish a functional relationship. Because functional analyses methodologies are considered the more stringent of the two approaches and therefore yield the most convincing data, these types of investigations tend to be more prevalent in the literature. Within this literature, however, it appears that problems involving be havioral excesses are more likely to be analyzed than problems involving behavior al deficits. Appendix A provides a comprehensive list of all articles reviewed for the present study. This list represents all articles published in the last ten years of the Journal of Applied Behavior Analysis and met the following criteria: (a) publication as an full research article or research report between 1994-2004, (b) presentation of data (in the form of a graph/table) of a functional analysis, and (c) incl usion of at least tw o conditions that invo lved environmental manipulation as a strategy for determ ining behavioral function. Of the 162 articles reviewed, 96% measured behavioral excesse s, 4% measured both behavioral excesses and behavioral deficits, and none of the article s solely measured a behavioral deficit. Some examples of behavioral excesses include self-injurious behavior (SIB) (e.g., Iwata, Dorsey, Slifer, & Bauman, 1982/1994; Mace, Shapiro, & Mace, 1998; Borrero, Vollmer, Wright, Lerman, & Kelley, 2002), aggressi on (e.g., Lalli, Casey, & Kates, 1995; 2

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O’Reilly, 1995; Thompson, Fisher, Paizza, & Kunh, 1998), disruptive behavior (e.g., Hagiopan, Fisher, & Legacy, 1994; Richman, Wacker, Asmus, & Casey, 1998; Jones, Drew, & Weber, 2000), inappropriate langua ge/utterances (e.g., Pace, Ivancic, & Jefferson, 1994; Dixon, Benedict, & Larson, 2001; Lancaster, LeBlanc, Carr, Brenske, Peet, & Culver, 2004)), destructive beha vior (e.g., Bowman, Fisher, Thompson, & Piazza, 1997; Piazza, Bowman, Contrucci, Delia, Adelinis, & Goh, 1999; McComas, Hoch, Paone, & El-Roy, 2000), eye poking (Kennedy & Souza, 1995; Lalli, Livezey, & Kates, 1996), breath holding (Kern, Mauk, Marder, & Mace, 1995; Richman, Lindauer, Crosland, McKerchar, & Morse, 2001), pica (Piazza, Hanley, & Fisher, 1996; Piazza, Fisher, Hanley, LeBlanc, Worsdell, Linda uer, & Keeney, 1998), off-task behavior (Meyer, 1999; Flood, Wilder, Flood, & Masuda, 2002), hand mouthing (Goh, Iwata, Shore, & DeLeon, 1995), inappropriate sexual behavior (Fyffe, Kahng, Fittro, & Russell, 2004), elopement (Piazza, Hanley, Bowman, Ruyter, Lindauer, & Saiontz, 1997), and hair pulling (Rapp, Miltenberger, Galensky, El lingson, & Long, 1999). Of those articles that included analysis of be havioral deficits, targeted behaviors included use of alternative mands (Day, Horn e, & O’Neill, 1994; Peck, Wacker, Berg, & Cooper, 1996; Brown, Wacker, Derby, Peck, Richman, Sasso, Knutson, & Harding, 2000; Winborn, Wacker, Richman, Asmus, & Geier, 2002), appropriate/on-task behavior (Harding, Wacker, Cooper, & Millard, 1994), use of switch activation (Ringdahl, Winborn, Andelman, & Kitsukawa, 2002), and engagement (Moore & Edwards, 2003). Perhaps one reason why studies have focused predominantly on behavioral excesses is that it is more difficult to functiona lly analyze a behavior th at rarely, if ever, 3

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occurs. However, the effectiveness of diffe rential reinforcement of other behavior (DRO) procedures demonstrates convincingly that the absence of behavior can be affected by reinforcement contingencies. Although a “naturally occurring” DRO (i.e., unprogrammed absence of behavior) might be di fficult to analyze, it seems that if the person is capable of performing the behavior, yet isn’t doing so, it would be possible to analyze the environmental variables that suppr ess the occurrence of that behavior. In fact, Iwata et al. (2000) stat e that although low frequency be haviors are usually not seen, effective treatment may require identification of their controlling variables. The authors suggest that these analyses might involve examination of response classes, repeated functional analyses under varying environm ental conditions, or the combination of descriptive and f unctional analyses. Another potential reason for relative paucity of analys es targeting behavioral deficits is that the procedures describe d by Iwata et al. (1982/1994), which are most frequently cited in describing functional analysis procedures, were focused on the analysis of self injurious behavi or (SIB). Using past studies as a framework, the authors focused on creating well defined, analogue conditi ons to directly and repeatedly observe the occurrence of SIB. Furt her, the authors did not imply that the procedures would generalize to other response topographies, a lthough subsequent research has clearly applied the procedures effectively to other aberrant behaviors. However, although these procedures were not initially intended to meas ure deficits, it is interesting to note that over the past 20 years, functional analysis pro cedures have not evolve d to include a wider range of behavior problems, especially with regard to behavioral deficits. If the 4

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procedures have evolved, it is difficult to find evidence of it in the literature. Hanley, Iwata, & McCord (2003) conducted a literat ure review of 277 functional analytic empirical studies from various journals a nd subsequently identified the five most prevalent behavior topographi es targeted in the studies reviewed. Their findings indicated that SIB was targeted most fr equently (64.6% of studies), followed by aggression (40.8%), disruption (19.1%), vocali zations (12.6%), and property destruction (10.5%). The only behavior topography identifi ed by the authors that could be regarded as a behavioral deficit was noncompliance (i.e ., failure to comply), which was examined in a mere 12 studies (or 4.3%). Miltenberger (2004) stated th at a behavioral deficit can be thought of as a failure to engage in a desirable beha vior. The behavior is deem ed desirable because of the positive impact it would have on the person’s lif e in the future; in other words, it is a behavior that would assist the person in acce ssing reinforcers. There are many examples of behaviors whose lack of occurrence negative ly influence the person’s quality of life. Social anxiety is one such example. Social anxiety disorder (SAD), also termed social phobia, is characterized by exce ssive fears of social or performance situations and avoidance of these feared situations. The avoidance and fear are severe enough to interfere with the person’s academic or occ upational functioning, relationships, or social activities ( DSM IV-TR, 2000). It appears that much of the research on SAD has centered on adults, even though many children, particul arly adolescents, also suffer from the disorder (Kashdan & Herbert, 2001). Anxiety disorders are possibly the most common of 5

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childhood and adolescent disorders (Bernstein & Borchardt, 1991), with an estimated prevalence rate of 5 to 15% of the adolescents in the United States (Kashdan & Herbert, 2001). SAD can have significant effects on the emotional, social, and academic functioning of children (Biedel, Turner & Morris, 2000). Re grettably, socially anxious children and adolescents are often overlooked and not referred to treatment by teachers and parents, primarily because they may not recognize the need for professional attention for extreme shyness (Masia, Klein, Storch & Corda, 2001). Kashdan & Herbert (2001) assert that without treatment, SAD follows a chronic, unrel enting course. Adults with SAD have been shown to have significantly lower levels of achievement in work, education, romantic relationships, and subjec tive well being. Masia et al. (2001) point out that the detrimental effects of untreat ed SAD highlight the importance of early detection and intervention. As part of early detectio n, it is essential to understa nd the behaviors associated with SAD. The DSM IV-TR (2000) describes that crying, clinging or staying close to someone familiar, freezing, and inhibited inte raction to the point of mutism, may be observed in children with SAD. They may also appear markedly timid in social settings, refuse to take part in group ac tivities, or stay on the outside of social play times. Social withdrawal is a defining feat ure of the disorder, and although some children might not meet the full diagnostic criteria for SAD, it is reasonable to assume that they might encounter many of the problems associated with the disorder if they become markedly withdrawn from social interactions with adul ts or peers. These deficits might be 6

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particularly likely to occur in school setti ngs, where demands for group interactions with people with whom the child is unfamiliar or un comfortable are common. One factor that makes SAD particularly problematic for childre n is their inability to avoid these social situations (e.g., it is mandatory for them to go to school). Therefore, SAD can cause poor school performance, avoidance of appropriate social activities, or school refusal ( DSM IV-TR 2000). School refusal is a behavior commonly associated with emotional distress, especially anxiety and depression (King & Be rnstein, 2001). Severa l recent publications have suggested the use of functional asse ssment methods (i.e., interview) to help determine the maintaining va riables of school refusal (e.g. Kearney & Silverman, 1990; Chorpita, Albano, Heimberg, & Barlow, 1996; King, Heyne, Tonge, Gullone, & Ollendick, 2001). Kearney & Silverman (1990) evaluated seven child ren and adolescents with difficulties attending school using the School Refusal Assessment Scales (SRAS). The SRAS is a questionnaire designed to identify potential maintaining variables and functional relationships of school refusal beha vior. The specific variables that make up the conditions are fearfulness/ general over-anxiousness, escape from aversive social stimuli, attention-getting or separation anxi ous behavior, and tangible reinforcement (e.g., being able to stay at home and play video games). The SRAS consists of 16 questions, 4 per maintaining condition. Each question is ra ted on a 7-point Lickert-type scale from 0 ( never ) to 6 ( always ). Whenever possible, the SRAS is completed by the child, the parent, and the teacher, with each informant having a separate version of the questionnaire (SRAS-C, SRAS-P, and SRAS-T). In this st udy, all the available SRAS responses of the 7

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children, parents, and teachers were tallie d and the highest mean score of the four categories/conditions was considered to be th e primary maintaining variable of the school refusal. The strength of the remaining condi tions was also factored into the construction of an appropriate treatment plan. Prescriptiv e treatment was assigned in accordance with the hypothesized maintaining variable and incl uded systematic desensitization/relaxation training, modeling and cognitive restructuring, shaping and differential reinforcement of other behavior (DRO), and contingency contr acting. The children, parents, and teachers were also given a series of other self-report measures (questionnaires ) before, during, and after treatment to measure the efficacy of th e SRAS. Results indicated improvement of school attendance in 6 out of the 7 particip ants. The questionnaire and daily ratings results were mixed, though this may have more to do with the fact that not all the questionnaires and ratings were pertinent to each functional category. The results regarding school attendance, preand post treatment ques tionnaire data, and child and parent daily ratings indicated that four motiv ating factors of school refusal behavior could be identified and modified, thus enabling an effective assessment and treatment planning for this behavior. Chorpita et al. (1996) also examined th e efficacy of functional assessment in identifying effective treatments for school refusal. In this study, “prescriptive treatment” was defined as empirically-based interventions differentially applied to specific behavior problems or syndromes as an outcome of functional assessment (Burke & Silverman; 1987). The participant was a 10 year old gi rl who was highly resistant to attending school. At the onset of the study she was clin ically diagnosed with Separation Anxiety 8

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Disorder and Social Phobia based on separate structured, clinical interviews with the parents and child. Each of them also comp leted a version of the SRAS, which suggested that “attention getting/separation anxious” was the primary factor and therefore the principal function of school refusal. A pres criptive treatment plan involving shaping and differential reinforcement was subsequently developed. Results found that problem behaviors such as complaints, anger, ta ntrums, and tears greatly reduced following treatment. The post-treatment diagnostic ev aluations found full remission of Separation Anxiety Disorder and Social Phobia. The authors concluded that in cases of school refusal in children with Separation Anxiety Disorder or Social Phobia, a functional, prescriptive approach specifically targeti ng the refusal behavior may be the most practical strategy. In an effort to expand on previous find ings, King et al. ( 2001) provided a case illustration to support an approach which inco rporates diagnostic interviewing, functional assessment, self-report measures, parent/te acher checklists, and a review of school attendance records. The case involved a 9 y ear old girl who had not attended school for 10 weeks. She and her parents were diagnosti cally interviewed and, based on the results, the child met the criteria for a diagnosis of Separation Anxiety. The child was also given the SRAS and her responses suggested that her behavior served both attention seeking and tangible reinforcement functions. In addi tion to these assessments, the therapist also visited the school and was shown attendance re cords and samples of the student’s work. Her written work and drawings illustrated di fficulties in coping with separation from her mother. Based on these multi-informant clinical assessments, the authors hypothesized 9

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that the school refusal behavior was func tionally related to separation anxiety and a highly reinforcing home environment. Th e intervention program involved graduated school return and parent training in behavior management skills. The program resulted in voluntary school attendance by the student. The authors concluded that the most effective way to handle school refusal is th e collect data from multi-informant sources, (diagnostic interviewing, func tional assessment, self-report measures, parent/teacher checklists and review of school attendance), and develop a functiona lly-based treatment plan based on these findings. These studies (Kearney & Silverman, 1990; Chorpita et al ., 1996; King et al., 2001) provide support for the importance of id entifying maintaining variables prior to selecting treatment options. It is important to note that all the authors claimed to have conducted a functional analysis, although the primary data collection instrument for determining behavioral function was the SRAS. The SRAS, be ing a questionnaire, is by definition an indirect assessment of behavior As such, its usefulness is limited to formulating hypotheses about va riables affecting behavior as opposed to identifying direct cause and effect relati onships between behaviors and the environment. This is significant because in order to provide the most effective treatment, that can produce generalized results, one must make evid ent the effect the behavior has on the environment. The best way to do this is to empirically prove a causal relationship instead of simply providing a hypothesis based on an indirect measure. However, the SRAS appears to be an effective tool in helping to identify the maintaining variables that are to be manipulated and/or observ ed in the functional analysis 10

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Several other studies have shown that th e manipulation of environmental factors can affect children’s abilities to engage in important social inte ractions other than attending school. In an early study, Strain, Shores, and Timm (1977) illustrated the importance of setting events in studying so cial behavior. The study focused on six children with behavioral handicaps who exhibi ted social deficits, defined as seldom engaging in positive interactions with their peer s. As part of the study, some of the peers were instructed to initiate social interactio ns with the children who displayed the social deficits. The authors found that 5 out of the 6 children who were prompted not only responded more, but also initiated more social interactions. The authors also concluded that since one of the childr en did not respond the same as the others, treating social deficits requires individualized assessment and interventions. Chandler, Fowler, & Lubeck (1992) also inve stigated the role of setting events in social interaction, using as pa rticipants seven preschool chil dren enrolled in programs for language delays or at-risk developmental de lays. The students were referred by their teachers because of their social interacti on problems, described as infrequent or aggressive interactions with peers. Four e nvironmental variables that had been identified as strong determinants of preschool children’s pe er interaction (i.e., pr esence of adults in the setting, available toys and materials, p eer groupings, and amount of available space) were manipulated to discern differential effects on social behavior; the primary dependent variables were initiations and respons es. In Study 1, the status of the teacher (presence and behavior), p eer groupings, and materials provided varied across the conditions. In Study 2, the status of the teach er (presence and behavior) and materials 11

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provided varied across conditions, while group compositions and space remained constant. Although combinations of the four settings produced differing rates of social behavior, the most favorable combinati on for encouraging pe er interaction and minimizing teacher-child interaction incl uded teacher absence during the activity, limiting materials, and pairing the child with a socially skilled partner. This study demonstrates the influence of setting events on the social inter actions of young children and provides a framework for analyzing an tecedents that may set the occasion for appropriate behavior. In another analysis, Kennedy (1994) fo cused on three students with severe disabilities who exhibited problem behaviors and social skills deficits. Specifically, the children showed an absence of positive so cial affect, which included smiling, laughing, nodding “yes,” and positive verbalizations. Using a multielement design to analyze antecedent conditions (phase one), the authors illustrated that task demands served as antecedents for problem behavior and social comments correlated with increased levels of positive social affect. These results were then experimentally manipulated with the instructor emitting high rates of social comments and gradually fading in task demands across sessions. The results of this second pha se showed reductions in problem behaviors and high levels of positive social affect for all students, with task demands being increased at or above baseline le vels for two of the students. A third phase replicated the first phase. This study demonstrated th at by manipulating antecedent conditions concerning task demands and social comment s, positive improvements in behavior and increases in social affect were found. 12

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It appears that experimental analyses of social deficits are more likely to focus on the role of antecedent variables in promo ting social interactions. Experimental examination of the role of consequences, out side the evaluation of treatment packages, appears less prevalent. Many studies that ha ve included examination of the function of social deficits have largely focused on indi rect measures (e.g., the SRAS). Moreover, with the exception of school refusal studies, a large percen tage of behavioral studies investigating social skills deficits focus on children with developmental disabilities or severe behavior disorders. This finding is c onsistent within the behavioral literature; in fact, Hanley et al. (2003) found that only 9% of the functional an alytic studies they reviewed examined typical pe rsons without disabilities. The current study seeks to expand upon th e literature by conducting functional analyses to identify the maintaining (i.e., cons equence) variables of social deficits. The effects of consequences on social deficits seem s particularly important especially in light of assessment data indicating that reinforcem ent contingencies may be highly salient in maintaining these behaviors (e.g., King et al., 2001). The purpose of the present study is twofold. First, we will examine the environm ental variables associated with the social interaction deficits of several young typical ly developed children. Second, we will attempt to establish a functional analysis pr otocol for examining behavioral deficits, using social withdrawal as an exemplar. 13

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Chapter Two Method Participants & Settings Two boys in two separate elementary sc hools participated in the study. Robert was in the second grade and was 8 years, 7 months old. Marc was in the third grade and had just turned 9 years old. Marc and Robert were selected for part icipation in the study because their teachers identified them as being less socially ac tive than their peers. Marc also was identified as periodically engaging in crying during social situations and was receiving ongoing therapy from a clinical psyc hologist for social a nxiety. Robert had been selectively mute until the end of the pr evious school year (approximately 10 months prior to the study). Although he was no longer selectively mute at the time of the study, he continued to display ep isodes of selective silence. Neither child was taking any medications and both were reported to be performing at grade-level academically. All tasks used in the study were ones with wh ich the children had shown success throughout the school year. All sessions were conduc ted in the students’ classrooms or on the playground during recess. 14

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Institutional and School District Review Prior to data collection, all experiment al procedures were reviewed by the university’s Institutional Review Board and the school district(s ). The children and their parents signed consent forms prior to bei ng included as participants in the study. Response Definition and Measurement Dependent variables included any socially significant behaviors that appeared to prevent the child from interacting appropria tely with peers or the teacher. These behaviors were individually defined for each boy based on interviews with their teachers. Robert’s target behaviors included shrinki ng (defined as sinking into his seat and cowering), putting his head down and covering it with his hands and or jacket, refusal to answer a question by ignoring th e request, and inaudible speec h. Marc’s target behaviors included covering his face with his hands or ha ir, refusal to answer a question by ignoring the request, inaudible speech, and crying. Each particular target behavior was specifically identified and recorded during the sessions. All targeted behaviors were measured during 10 minute observations using a partial-interval recording procedure (15 second observe, and a 5 second record). Observ ers were cued to reco rd with a cassette recorder with attached ear phone that gives an audible prompt as to when to observe and record. A copy of the data sheet is included in Appendix B. Observer Training Three observers were trained to collect data for the study using instruction and modeling (Appendix B). The observers were gi ven a list of target behaviors for each child, shown how to identify the behaviors (through role play), asked to practice 15

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recording with the auditory cue and data sh eet, and given feedback on their performance by the researcher. Once the observers obtai n a score of 90% re liability with the researcher across three consecutive practice se ssions, they were ready to collect data for the study. All three observers achieved an average of 95% reliability within the first three sessions. Interobserver Agreement Thirty three percent of Robe rt’s sessions and 60% of Ma rc’s sessions were scored by two observers to obtain a measure inter observer agreement (IOA). IOA observations were spaced across the course of the study and were calculated by dividing the number of agreements by the number of agreements plus disagreements, and multiplying by 100. IOA for Robert averaged 98% (range, 92.5% to 100 %). IOA for Marc averaged 98% (range, 92.5% to 100 %). Adjunctive Measures In addition to direct observation data collection, each te acher periodically was asked to complete questionnaires regarding th eir perceptions of thei r student’s level of anxiety throughout the procedures. A copy of the questionnaire is included in Appendix C. Procedures A functional analysis based on Iwata et al. (1982/1994) was used to help identify potential maintaining variables of targeted beha viors. All particip ants were exposed to each of three different conditi ons in a multi-element experimental design. So that contingencies could be assessed as naturalistic ally as possible, teachers were trained to 16

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implement each condition using the procedures described below. For all three conditions, discussions with the teacher were conducted pr ior to establishing experimental protocols to help identify which academic, social and unstructured play assignments were appropriate for each child based on his age, skill level, and classroom routine. Since the teachers were comfortable with alternating between the attention and escape conditions, but less so w ith the unstructured play c ondition, we chose to observe the unstructured play condition during times in which the teacher allowed the children to select preferred activities and did not place demands, such as recess or classroom breaks. The order of presentation for the remain ing conditions (attention and escape) was determined by flipping a coin. Specifically, the attention was desi gnated as “heads” and escape was designated “tails.” The coin wa s flipped by the primary observer prior to each session to determine the order of conditi ons, with the first result (heads or tails) determining the first condition for the session. Each session lasted approximately 10 minutes, with a minimum of 5 minutes betw een sessions. When task demands were required for a condition, those ta sks remained constant across conditions, more specifically if they were in math class a nd required to answer questions about problems on the board, those and or similar problems were required from the participant when called on across the escape and attention conditions alike. Experimental conditions Attention. To provide a context for social in teraction, the teacher directed the child to engage in either an academic task wi th his/her peers or participate in a social activity with his/her peers. Some examples of academic tasks included requiring the 17

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student to read aloud to the cl ass, answer a question that required more than a one word response, or making a making a small presenta tion. This condition also included a social activity in addition to, or in place of, the academic demand. Ex amples of social activities included, but were not limited to, participation in an inte ractive game or requiring the child to discuss a favorite hobby, vacation, or te levision show with the class. Teachers were cued to place academic or social demands on the target child at least every three minutes using a Motivaider timing device. The Motivaider is a discrete electronic device that clips to a belt or waistband and sends a private, pulsating vibr ation. If the child engaged in any of the target behaviors, the teach er was instructed to attend to the student. Attention included coming within two feet of the student and provi ding a redirection to continue the task. The redirection was mainly encouragement to complete engage in the task, such as “Come on, I know you know the answer.” Brief physical contact (e.g., hand on the shoulder) was also included in most redi rections. If the ch ild complied with the request the teacher gave them a short praise such as “Good job,” then moved on to the next student. They would then call on the chil d again about 3 to four minutes later. With the exception of brief praise after complia nce and scheduled commands, teachers were specifically instructed not to attend to the children when they were not engaged in social withdrawal. Academic/Social demand. This condition included similar academic and social activities as the attention c ondition. After placing the de mand, the teacher allowed an appropriate amount of time for the child to initiate the task (i.e., between 5 and 10 seconds). If the child did not initiate a response, the teacher prompted him to do so by 18

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repeating the instruction. If the child engage d in any of the target behaviors after the prompt, the teacher withdrew the assignment and allowed the child to “calm down and take a quick break” for about 3 minutes. The teacher then called on another student and allowed the participant to remain quietly seated at their desk. The teacher kept track of the 3-min break using the Motivaider. Once the time was up, the teacher placed the same demand again If the child failed to initiate a resp onse or engaged in any of the target behaviors, the teacher provided one additional prompt (e.g., “Robert, would you like to give the question one last shot?”). Failure to initiate a response following the last prompt resulted in the teacher calling on another st udent and allowing the withdrawn student to sit quietly for the rest of the session Unstructured play. Most unstructured play sess ions took place during recess on the playground, where no specific task demands were placed on the children. Unlike Iwata et al.’s original protoc ol, we did not include noncontinge nt attention to the target children. This modification was due to the fact that no other students were receiving attention during these times, and the teachers felt it may make the children uncomfortable to be singled out. On a few occasions, th e unstructured play condition was conducted in the classroom. During these times, childre n were allowed to engage in preferred activities during “free time” sessions. Preferre d activities for Marc included coloring and talking quietly with one other classmate. For Robert, preferre d activities included drawing, reading comic books, and coloring. If the child wanted to sit and do nothing, it was acceptable. Participants remained in the classroom, yet were not be required to perform any specific tasks. 19

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Termination criterion If at any point during the attention or escape conditions the child was distressed to the point of crying, the session was terminated. This occurred only once for Marc during an escape condition. Teacher Training The teachers were given a brief overview of the purpose of the study, along with a description of the conditions to be tested. Since the teache rs had the input as to which assignments the students were given, they were already familiar with the stimulus conditions and did not need training to impl ement them. With regard to providing an appropriate consequence (and if appropriate, prompt), teachers were provided with a written outline as to how to implement each session (Appendix D). Next, the researcher conducted role plays with each teacher until the teacher reported feeling comfortable with the task. Each teacher had two role playing se ssions per condition (a total of 4 role plays per teacher). Once the sessions began, the te achers were given a written prompt (i.e. a “cheat sheet”) to remind them of how each condition would best be implemented (Appendix E). Two teachers we re trained to implement Marc ’s sessions because half of his day was spent with one teacher and the other half with another. Procedural integrity The primary researcher was present dur ing each experimental condition and provided reminders to the teachers about how to conduct the conditions. Since the teachers had “cheat sheets” to prompt a ppropriate responding during experimental conditions and were using techniques that were familiar to them (i.e., “get close and 20

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encourage” or “stay back a nd give break”), there were no instances where the teachers did not respond appropriately to the child’s behavior. 21

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Chapter Three Results The results for Robert across the three condi tions are displayed in Figure 1. In the attention condition, Robert engaged in social withdrawal a mean aver age of 9% (range, 0 to 18%). During the escape condition, social withdrawal was displayed a mean average of 4% of the time (range, 0-15%). Robert en gaged in zero social withdrawal during the unstructured play condition. Responding duri ng the attention condition was relatively stable, with the exception of a temporary drop to 0% for two c onsecutive sessions. During the escape condition, the data were ag ain relatively steady w ith the exception of two consecutive data points at the beginning of data collec tion. Data indicated higher overall rates of responding during the attention condition, suggesting the maintaining consequence of the target behavior for Robert was adult attention. 0 10 20 30 40 50 60 70 80 90 100 123456789101112131415161718192021222324252627282930 SessionsPercentage of intervals Attention Escape Unstructured Play Figure 1: Functional analysis results for Robert across the three conditions of attention, escape, and unstructured play. 22

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The results for Marc across the three condi tions are displayed in Figure 2. During the attention condition, Marc socially withdr ew an average of 70% of the observation sessions (range 23 to 100%). He engaged in the target behaviors a mean average of 10% (range 0 to 30%) during the escape condition. He displayed no social withdrawal during the unstructured play condition. Responding during the attention condition was relatively stable. With the exception of a few data point s that fell below 40%, the rest of the data were at or above 98%. The data during the es cape condition also were stable; only one data point fell above 25% and the majority of the data were below 15%. The relative magnitude of responding was clearly differentia ted for Marc, with the highest levels of responding occurring during the at tention condition. These data suggest that the target behavior was maintained by adult attention. 0 10 20 30 40 50 60 70 80 90 100 123456789101112131415161718192021222324252627282930 SessionsPercentage of intervals Attention Escape Unstructured Play Figure 2: Functional analysis results for Marc across the th ree conditions of attention, escape, and unstructured play. 23

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The results for the anxiety questionnaire s are displayed in Table 1. Robert’s teacher completed the questionnaire for one of the ten attention c onditions and three of the ten escape conditions. On a scale of 1-4 (one being relaxed and four being really scared or nervous), Robert’s teacher rated his behavior during the attention condition a mean of 2.0 as to how he felt right now; 2.0 as to how he fe lt during the last activity, and 3.0 as to how he seemed to feel prior to th e last activity. During the escape condition he was reported a mean of 3.0 as to how he wa s feeling right now, 3.0 as to how he felt during the last activity, and 2.6 as to how he seemed to feel prior to the last activity. Marc’s teachers completed the questionnaire fo r four of the ten attention conditions and five of the ten escape conditions. In the atte ntion condition Marc was reported to be at a mean of 3.8 as to how he felt right now; 3.8 as to how he fe lt during the last activity, and 1.3 as to how he seemed to feel prior to th e last activity. During the escape condition he was reported a mean of 1.8 as to how he wa s feeling right now, 1.6 as to how he felt during the last activity, and 1.1 as to how he seemed to feel prior to the last activity. There was no teacher scale given following unstructured play, because the responding during those condi tions was zero. Table 1 Mean Anxiety Scores Across Conditions (teacher provided) ______ Attention Escape Participant Pre During Post Pre During Post Robert 3.0 2.0 2.0 2.6 3.0 3.0 Marc 1.3 3.8 3.8 1.1 1.6 1.8 24

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Chapter Four Discussion The goal of this study was to establish a functional analysis protocol for examining behavioral deficits, using social withdrawal as an exemplar. The procedures of this study were predicated on the hypothesis that behavioral deficits respond to social contingencies in a manner similar to many beha vioral excesses. Based on the findings of this study, the deficit collectively referred to as “social withdrawal” was responsive to such contingencies. Specifically, social wi thdrawal appeared to be maintained by adult attention for both participants. However, th e effects were more noticeable for Marc, who displayed substantially more so cial withdrawal during the atte ntion sessions than in the other conditions. It is interesting to note that neither boy exhibited target behaviors during the unstructured play (mostly recess) condition, wher e the context tended to be purely social. The boys were both active participants in a ny games their peers we re playing, including such activities as kickball, softball, dodge ball, etc. The fact that social interaction was expected, but not mandated, may help to explai n these results. The boys could choose to either participate or not, a nd did not suffer any overt rami fications for choosing not to take part in the games. And when they did pa rticipate, rarely were they the sole focus of the group. Since the activities usually involve d many students, they were only required to be focused on by their peers when it was th eir turn (such as batt ing during softball or 25

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kicking during kickball). One additional explan ation may be that the teachers were fairly removed from the games. Most times the ad ults kept supervision from a considerable distance and only intervened if the student s had confrontations. Since both of the participants’ social withdrawal appeared to be maintained by adult a ttention, the fact that the teachers were not within close proxim ity could explain the absence of social withdrawal behavior. One might also have expected an increas e in social withdrawal when target behaviors produced escape from social dema nds; however, neither participant engaged in consistently high responding during the es cape condition. Although both boys showed some signs of withdrawal during this c ondition, it was minimal. This finding is particularly interesting given that the teach ers for both boys stated on different occasions that they believed the boys’ withdrawal was stimulated by being “put on the spot” either socially or academically. An interesting finding with regard to the anxiety questionnaires is that the teachers’ assessments of the boys’ anxiety levels did not correspond to the observers’ measures of the dependent variables. For ex ample, Robert’s teacher rated his mood to be worse after the escape condition, even though dir ect observations indicated greater social withdrawal during the attention conditions. Such inconsistenc ies may be due to the fact that the teachers were not able to fill out the anxiety questionnaires following every session. Perhaps if they had, the mean anxiet y score would have been more consistent with the observational findings. 26

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Adapting Iwata et al.’s ( 1982/1994) protocol to accomm odate an analysis of potential maintaining variables for behavior de ficits required some modifications to the original procedures. The most notable difference is the fa ct that demands were placed in both the attention and escape conditions (nor mally this solely occurs in the escape condition). The rationale for placing demands in both conditions was to first evoke the behaviors, and then systematically apply th e consequences. Had no demands been placed in the attention condition, the target beha viors probably would not have occurred. Another modification was the omission of prai se during the unstructured play condition. As previously mentioned, this departure from standard functional analysis protocol was based on the teachers’ preferences. Future researchers should discern whether noncontingent attention is a necessary component of control conditions for analyses of social withdrawal. The modified functional analysis used in the current study could be beneficial to future researchers focused on studying social withdrawal. The protocol was effective in helping to identify probable ma intaining variables of social withdrawal, but could be improved on by adding a component of peer atte ntion to see what effects, if any, peers have on the maintenance of social withdrawal One criticism that might be raised toward the current study is that some of the behaviors analyzed were not truly deficits, but rather be havioral excesses that are commonly labeled as a deficit. In othe r words, a child who engages in crying, “shrinking”, and face-covering in the context of social situations might be labeled as socially withdrawn, even though the specific behaviors in which the child engages are 27

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clearly excesses. However, in the current study, the behaviors th at were most often displayed were the “deficit” behaviors (e.g., i gnoring requests) rather than the “excess” behaviors (e.g., crying). Moreover, the beha vioral excesses neve r occurred in the absence of the deficits. From the teachers’ perspectives, failure to comply with social and academic requests was more problematic than the corresponding excesses. This may have been due to the teachers’ frustrations with the constant need for “hand holding” or encouragement to participate in tasks that the participants were academically and socially able to do. The teachers described feeling “dra ined” and at times ready to just give up and not call on the children who participat ed in the study. Although both participants’ teachers were compassionate and wanted to help, they felt frustrated w ith their abilities to do so. Another limitation of the st udy is the number of partic ipants. While this is a common limitation in single-sub ject design studies, it may be especially prevalent with this particular population. In short, is extremely difficult to recruit socially withdrawn students. This may be primarily based on th e fact that students who are withdrawn are labeled “shy” and usually pose few problems fo r teachers. Rather, teachers may tend to focus on the disruptive students in their cl assrooms. Even when equipped with the knowledge of the negative effects that a so cially withdrawn student may suffer, most teachers still have difficulty in identifying such students (Masia et al., 2001). Future researchers may more successfully recruit th ese types of participants by alerting the teachers to the negative consequences a student like this may face in the future, allowing 28

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the teacher time to informally assess students who may be at risk for these problems, then contacting after a brief time to see if they were able to identify such students. In addition to assessing a gr eater number of participan ts, the present study would have been strengthened by selecting participan ts who had been clinically diagnosed as suffering from social anxiety using standa rdized instruments as opposed to teacher reports. This would help to ensure that th e participants’ behaviors were evoked by social anxiety/withdrawal and not by other factors, such as academic deficits (i.e., they could not perform the task as opposed to purposefully refusing to engage in the task). Since this study was based on teacher report, the generality of the findings to clinical populations is somewhat limited. Neverthe less, the participants’ problems were significant enough for their teachers to notice them Consistent with the core dimensions of behavior analysis (Baer, Wolf, & Risle y, 1968), which posit that socially significant behaviors that limit one’s access to reinforcer s are of great importance, these students’ problems at school were significant enough to study regardless of whether they had a particular clinical dia gnostic label or not. Although convincing conclusions about behavior functi on could be reasonably drawn from the results of th is study, it is important to note that no treatments were designed based on the analyses. This was due to the fact that the goal of this particular study was to attempt to modify the Iwata et al. (1982/1994) protocol to assess a different response class. Future researchers should ex amine how functional an alysis results using the protocol of the existing study could be used to design eff ective treatments. 29

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References American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders-Text Revisions (4th Ed.) Washington, D.C: American Psychiatric Association. Baer, D. M., Wolf, M. M., & Risley, T. (1968). Current dimensions of applied behavior analysis. Journal of Applied Behavior Analysis, 1, 91-97. Beidel, D. C., Turner, S. M., & Morgan, T. L. (2000). Behavioral treatment of childhood social phobia. Journal of Consulting and Clinical Psychology, 68, 1072-1080. Bernstein, G. A. & Borchardt, C. M. ( 1991). Anxiety disorders of childhood and adolescence: A critical review. Journal of the American Academy of Child and Adolescent Psychiatry, 30 (4), 519-532. Burke, A. E. & Silverman, W. K. (1987). Th e prescriptive treatment of school refusal. Clinical Psychology Review, 7, 353-362. Chandler, L. K., Fowler, S. A., & Lubeck, R. C. (1992). An analysis of the effects of multiple setting events on the social behavior of preschool children with special needs. Journal of Applied Behavior Analysis, 25, 249-263. Chorpita, B. F., Albano, A. M., Heimber g, R. G., & Barlow, D. H. (1996). A systematic replication of the prescriptive treatment of school refusal behavior in a single subject. Journal of Behavior Therapy & Experimental Psychiatry, 27 (3), 281-290. Cooper, J. O., Heron, T. E., & Heward, W. L. (1987). Applied Behavior Analysis. Columbus, OH: Merrill. Hanley, G. P., Iwata, B. A., & McCord, B. E. (2003). Functional analysis of problem behavior: A review. Journal of Applied Behavior Analysis, 36. 147-185. 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, 197-209. 30

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Iwata, B. A., Kahng, S. W., Wallace, M. D ., & Lindberg, J. S. (2000). The functional analysis model of behavioral assessment. Handbook of Applied Behavior Analysis. Reno, NV: Context Press. Kashdan, T. B. & Herbert, J. D. (2001). Social anxiety disorder in childhood and adolescence: Current status and future directions. Clinical Child and Family Psychology Review, 4 (1), 37-61. Kearney, C. A. & Silverman, W. K. (1990). A preliminary analysis of a functional model of assessment and treatmen t for school refusal behavior. Behavior Modification, 14 (3), 340-366. Kennedy, C. H. (1994). Manipulating anteced ent conditions to alter the stimulus control of problem behavior. Journal of Applied Behavior Analysis, 27, 161-170. King, N. J., Heyne, D., Tonge, B., Guloone, E., & Ollendick, T. H. (2001). School refusal: Categorical diagnoses, functional analysis and treatment planning. Clinical Psychology and Psychotherapy, 8, 352-360. King, N. J. & Bernstein, G. A. (2001). Sc hool refusal in children and adolescents: A review of the past 10 years. Journal of the American Academy of Child and Adolescent Psychiatry, 40 (2), 197-205. Masia, C. L., Klein, R. G., Storch, E. A., & Corda, B. (2001). School-based behavioral treatment for social anxiety disorder in adolescents: Results of a pilot study. Journal of the American Academy of Child and Adolescent Psychiatry, 40 (7), 780-786. Miltenberger, R. G. (2004). Behavior modification: Principles and procedures (3rd Ed.) Belmont, CA: Thomson/Wadsworth Learning. Skinner, B. F. (1953). Science and human behavior. NY:MacMillan. Strain, P. S., Shores, R. E., & Timm, M. A. (1977). Effects of peer social initiations on the behavior of withdrawn preschool children. Journal of Applied Behavior Analysis, 10, 289-298. 31

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Appendices 32

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Appendix A: Comprehensive List of all Functional Analytic Articles Reviewed Adelinis, J. D. & Hagopian, L. P. (1999) The use of symmetrical "do" and "don't" requests to in terrupt ongoing activities. Journal of Applie d Behavior Analysis 32, 519-523. Anderson, C. M. & Long, E. S. (2002). Use of a structured de scriptive assessment methodology to identify variables affecting problem behavior. Journal of Applied Behavior Analysis 35, 137-154. Asmus, J. M., Wacker, D. P., Harding, J. Berg, W. K. Derby, K. M., & Kocis, E. (1999). Evaluation of antecedent stimulus parameters for the treatment of escapemaintained aberrant behavior. Journal of Applied Behavior Analysis 32, 495-513. Asmus, J. M., Ringdahl, J. E., Sellers, J. A., Call, N. A., Andelman, M. S., & Wacker, D. P. (2004). Use of a short-term inpatient model to evaluate aberrant behavior: Outcome data summaries from 1996 to 2001. Journal of Applied Behavior Analysis 37, 283-304. Berg, W. K., Peck, S., Wacker, D. P., Ha rding, J., McComas, J., Richman, D., & Brown, K. (2000). The effects of presession exposure to attention on the results of assessments of attent ion as a reinforcer. Journal of Applied Behavior Analysis 33, 463-477. Borrero, J. C. & Vollmer, T. R. (2002). An application of the matching law to severe problem behavior. Journal of Applied Behavior Analysis 35, 13-27. Borrero, J. C., Vollmer, T. R., & Wright, C. S. (2002). An evaluation of contingency strength and response suppression. Journal of Applied Behavior Analysis 35, 337-347. Borrero, J. C., Vollmer, T. R., Wright, C. S., Lerman, D. C., & Kelley, M. E. (2002). Further evaluation of the role of protective equipment in the functional analysis of self-injurious behavior. Journal of Applied Behavior Analysis 35, 69-72. Bowman, L. G., Fisher, W. W., Thompson, R. H., & Piazza, C. C. (1997). On the relation of mands and the func tion of destructive behavior. Journal of Applied Behavior Analysis 30, 251-265. Brown, K. A., Wacker, D. P., Derby, K. M., Peck, S. M., Richman, D. M., Sasso, G. M., Knutson, C. L., & Harding, J. W. ( 2000). Evaluating the effects of functional communication training in the presence a nd absence of establishing operations. Journal of Applied Behavior Analysis 33, 53-71. 33

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Appendix A (Continued) Buchanan, J. A. & Fisher, J. E. (2002). Functional assessment and noncontingent reinforcement in the treatment of disruptive vocalization in elderly dementia patients. Journal of Applied Behavior Analysis 35, 99-103. Carr, E. G., Yarbrough, S. C., & Langdon, N. A. (1997). Effects of idiosyncratic stimulus variables on func tional analysis outcomes. Journal of Applied Behavior Analysis 30, 673-686. Conners, J., Iwata, B. A., Kahng, S., Hanl ey, G. P., Worsdell, A. S., & Thompson, R. H. (2000). Differential responding in the presence and absence of discriminative stimuli during multielement functional analyses. Journal of Applied Behavior Analysis 33, 299-308. Day, H. M., Horner, R. H., & O'Neill, R. E. (1994). Multiple functions of problem behaviors: Assessment and intervention. Journal of Applied Behavior Analysis 27, 279-289. Deaver, C. M., Miltenberger, R. G., & St ricker, J. M. (2001). Functional analysis and treatment of hair twirling in a young child. Journal of Applied Behavior Analysis 34, 535-538. DeLeon, I. G., Arnold, K. L., Rodrigu ez-Catter, V., & Uy, M. L. (2003). Covariation between bizarre and nonbizarre speech as a f unction of the content of verbal attention. Journal of Applied Behavior Analysis 36, 101-104. Derby, K. M., Hagopian, L., Fisher, W. W., Richman, D., Augustine, M., Fahs, A., & Thompson, R. (2000). Functional anal ysis of aberrant behavior through measurement of separate response topographies. Journal of Applied Behavior Analysis 33, 113-117. Derby, K. M., Wacker, D. P., Berg, W ., DeRaad, A., Ulrich, S., Asmus, J., Harding, J., Prouty, A., Laffey, P., & Stoner, E. A. (1997)The long-term effects of functional communication tr aining in home settings. Journal of Applied Behavior Analysis 30, 507-531. Derby, K. M., Wacker, D. P., Peck, S., Sasso, G., DeRaad, A., Berg, W., Asmus, J., & Ulrich, S. (1994). Functional analysis of separate topographies of aberrant behavior. Journal of Applie d Behavior Analysis 27, 267-278. Dixon, M. R., Benedict, H., & Larson, T. (2001). Functional analysis and treatment of inappropriate verbal behavior. Journal of Applied Behavior Analysis 34, 361-363. 34

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Appendix A (Continued) Durand, V. M. (1999). Functional communica tion training using assistive devices: Recruiting natural communities of reinforcement. Journal of Applied Behavior Analysis 32, 247-267. Ebanks, M. E. & Fisher, W. W. (2003). Altering the timing of academic prompts to treat destructive behavior maintained by escape. Journal of Applied Behavior Analysis 36, 355-359. Ellingson, S. A., Miltenberger, R. G., Stricker, J. M., Garlinghouse, M. A., Roberts, J., Galensky, T. L., & Rapp, J. T. (2000). Analysis and treatment of finger sucking. Journal of Applied Behavior Analysis 33, 41-52. Fischer, S. M., Iwata, B. A., & Mazalesk i, J. L. (1997). Noncontingent delivery of arbitrary reinforcers as treatment for self-injurious behavior. Journal of Applied Behavior Analysis 30, 239-249. Fischer, S. M., Iwata, B. A., & Wors dell, A. S. (1997). Attention as an establishing operation and as reinfo rcement during functional analyses. Journal of Applied Behavior Analysis 30, 335-338. Fisher, W. W., Adelinis, J. D., Thompson, R. H., Worsdell, A. S., & Zarcone, J. R. (1998). Functional analysis and treatment of destructive behavior maintained by termination of "don't" (and symmetrical "do" requests. Journal of Applied Behavior Analysis 31, 339-356. Fisher, W. W., Kuhn, D. E., & Th ompson, R. H. (1998). Establishing discriminative control of responding usi ng functional and alte rnative reinforcers during functional communication training. Journal of Applied Behavior Analysis 31, 543-560. Fisher, W. W., Ninness, H. A., Piazza, C. C., & Owen-DeSchryver, J. S. (1996). On the reinforcing effects of th e content of verbal attention. Journal of Applied Behavior Analysis 29, 235-238. Fisher, W. W., O'Connor, J. T., Kurtz, P. F., DeLeon, I. G., & Gotjen, D. L. (2000). The effects of nonconti ngent delivery of higha nd low-preference stimuli on attention-maintained destructive behavior. Journal of Applied Behavior Analysis 33, 79-83. Fisher, W. W., Piazza, C. C., & Chiang, C. L. (1996). Effects of equal and unequal reinforcer duration during functional analysis. Journal of Applied Behavior Analysis 29, 117-120. 35

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Appendix A (Continued) Fisher, W. W., DeLeon, I. G., Rodri guez-Catter, V., & Keeney K. M. (2004). Enhancing the effects of extinction on attention-maintained behavior through noncontingent delivery of attention or s timuli identified via a competing stimulus assessment. Journal of Applied Behavior Analysis 37, 171-184. Flood, W. A., Wilder, D. A., Flood, A. L ., & Masuda, A. (2002). Peer-mediated reinforcement plus prompting as treatment for off-task behavior in children with attention deficit hype ractivity disorder. Journal of Applied Behavior Analysis 35, 199-204. Frea, W. D. & Hughes, C. (1997). Functi onal analysis and tr eatment of socialcommunicative behavior of adolescent s with developmental disabilities. Journal of Applied Behavior Analysis 30, 701-704. Fyffe, C. E., Kahng, S., Fittro, E., & Russe ll, D. (2004). Functional analysis and treatment of inappropriate sexual behavior. Journal of Applied Behavior Analysis 37, 401-404. Goh, H., Iwata, B. A., & DeLeon, I. G. (2000). Competition between noncontingent and contingent reinforcem ent schedules during response acquisition. Journal of Applied Behavior Analysis 33, 195-205. Goh, H., Iwata, B. A., Shore, B. A., DeLeon, I. G., Lerman, D. C., Ulrich, S. M., & Smith, R. G. (1995). An analysis of th e reinforcing properties of hand mouthing. Journal of Applied Behavior Analysis 28, 269-283. Hagopian, L. P., Fisher, W. W., & Leg acy, S. M. (1994). Schedule effects of noncontingent reinforcement on attention-mainta ined destructive behavior in identical quadruplets. Journal of Applied Behavior Analysis 27, 317-325. Hagopian, L. P., Fisher, W. W., Sullivan, M. T., Acquisto, J., & LeBlanc, L. A. (1998). Effectiveness of functional co mmunication training with and without extinction and punishment: A summary of 21 inpatient cases. Journal of Applied Behavior Analysis 31, 211-235. Hagopian, L. P., Wilson, D. M., & W ilder, D. A. (2001). Assessment and treatment of problem behavior maintained by escape from attention and access to tangible items. Journal of Applied Behavior Analysis 34, 229-232. Hagopian, L. P., Toole, L. M., Long, E. S., Bowman, L. G., & Lieving, G. A. (2004). A comparison of dense-to-lean and fixed-lean schedules of alternative reinforcement and extinction. Journal of Applied Behavior Analysis 37, 323-338. 36

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Appendix A (Continued) Hanley, G. P., Iwata, B. A., & Thomps on, R. H. (2001). Reinforcement schedule thinning following treatment with functional communication training. Journal of Applied Behavior Analysis 34, 17-38. Hanley, G. P., Iwata, B. A., Thompson, R. H., & Lindberg, J. S. (2000). A component analysis of "stereotypy as re inforcement" for alternative behavior. Journal of Applied Behavior Analysis 33, 285-297. Hanley, G. P., Piazza, C. C., & Fisher, W. W. (1997). Noncontingent presentation of attention and alternative stimuli in the treatment of attention-maintained destructive behavior. Journal of Applie d Behavior Analysis 30, 229-237. Hanley, G. P., Piazza, C. C., Fisher, W. W ., Contrucci, S. A., & Maglieri, K. A. (1997). Evaluation of client preference for function-based treatment packages. Journal of Applied Behavior Analysis 30, 459-473. Harding, J. W., Wacker, D. P., Ber g, W. K., Barretto, A., Winborn, L., & Gardner, A. (2001). Analysis of response cl ass hierarchies with attention-maintained problem behaviors. Journal of Applied Behavior Analysis 34, 61-64. Harding, J., Wacker, D. P., Cooper, L. J., Millard, T., & Jensen-Kovalan, P. (1994). Brief hierarchical assessment of potential treatment com ponents with children in an outpatient clinic. Journal of Applied Behavior Analysis 27, 291-300. Horner, R. H., Day, H. M., & Day, J. R. (1997). Using neutralizing routines to reduce problem behaviors. Journal of Applied Behavior Analysis 30, 601-614. 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, 197-209. Iwata, B. A., Pace, G. M., Cowdery, G. E., & Miltenberger, R. G. (1994). What makes extinction work: An analysis of procedural form and function. Journal of Applied Behavior Analysis 27, 131-144. Iwata, B. A., Pace, G. M., Dorsey, M. F., Zarcone, J. R., Vollmer, T. R., Smith, R. G., Rodgers, T. A., Lerman, D. C., Shore, B. A., Mazaleski, J. L., Goh, H.L., Cowdery, G. E., Kalsher, M. J., McCosh, K. C., & Willis, K. D. (1994)The functions of self-injurious behavior: An e xperimental-epidemiological analysis. Journal of Applied Behavior Analysis, 27, 215-240. 37

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Appendix A (Continued) Jones, K. M., Drew, H. A., & Weber, N. L. (2000). Noncontingent peer attention as treatment for disruptive classroom behavior. Journal of Applie d Behavior Analysis 33, 343-346. Kahng, S. & Iwata, B. A. (1998). Play vers us alone conditions as controls during functional analyses of self -injurious escape behavior. Journal of Applied Behavior Analysis 31, 669-672. Kahng, S. & Iwata, B. A. (1999). Correspondence between outcomes of brief and extended functional analyses. Journal of Applied Behavior Analysis 32, 149-159. Kahng, S., Abt, K. A., & Schonbachler, H. E. (2001). Assessment and treatment of low-rate high-intens ity problem behavior. Journal of Applied Behavior Analysis 34, 225-228. Kahng, S., Hendrickson, D. J., & Vu, C. P. (2000). Comparison of single and multiple functional communication training responses for the treatment of problem behavior. Journal of Applie d Behavior Analysis 33, 321-324. Kahng, S., Iwata, B. A., DeLeon, I. G., & Wallace, M. D. (2000). A comparison of procedures for programming noncon tingent reinforcement schedules. Journal of Applied Behavior Analysis 33, 223-231. Kahng, S., Iwata, B. A., DeLeon, I. G., & Worsdell, A. S. (1997). Evaluation of the "control over reinforcement" compone nt in functional co mmunication training. Journal of Applied Behavior Analysis 30, 267-277. Kahng, S., Iwata, B. A., Thompson, R. H ., & Hanley, G. P. (2000). A method for identifying satiation versus extinction effects under nonc ontingent reinforcement schedules. Journal of Applied Behavior Analysis 33, 419-432. Keeney, K. M., Fisher, W. W., Adelinis J. D., & Wilder, D. A. (2000). The effects of response cost in the treatment of aberrant behavior maintained by negative reinforcement. Journal of Applied Behavior Analysis 33, 255-258. Kelley, M. E., Lerman, D. C., & Van Camp, C. M. (2002). The effects of competing reinforcement schedules on th e acquisition of functional communication. Journal of Applied Behavior Analysis 35, 59-63. Kennedy, C. H. & Meyer, K. A. (1996). Sl eep deprivation, allergy symptoms, and negatively reinforced problem behavior. Journal of Applied Behavior Analysis 29, 133-135. 38

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Appendix A (Continued) Kennedy, C. H. & Souza, G. (1995). Func tional analysis and treatment of eye poking. Journal of Applied Behavior Analysis 28, 27-37. Kennedy, C. H., Meyer, K. A., Knowles, T., & Shukla, S. (2000). Analyzing the multiple functions of stereotypical behavior for students with autism: Implications for assessment and treatment. Journal of Applied Behavior Analysis 33, 559-571. Kern, L., Mauk, J. E., Marder, T. J., & Mace, F. C. (1995). Functional analysis and intervention for breath holding. Journal of Applied Behavior Analysis 28, 339340. Kodak, T., Grow, L., & Northup, J. (2004). Functional analysis and treatment of elopement for a child with attent ion deficit hyperac tivity disorder. Journal of Applied Behavior Analysis 37, 229-232. Kuhn, D.E., DeLeon, I.G., Fisher, W.W., & Wilke, A.E. (1999). Clarifying an ambiguous functional analysis with matche d and mismatched extinction procedures. Journal of Applied Behavior Analysis 32, 99-102. Kurtz, P. F., Chin, M. D., Huete, J. M., Tarbox, R. S. F., O'Connor, J. T., Paclawskyj, T. R., & Rush, K. S. (2003). F unctional analysis and treatment of selfinjurious behavior in young ch ildren: A summary of 30 cases. Journal of Applied Behavior Analysis 36, 205-219. Lalli, J. S. & Casey, S. D. (1996). Treatment of multiply controlled problem behavior. Journal of Applie d Behavior Analysis 29, 391-396. Lalli, J. S. & Kates, K. (1998). The eff ect of reinforcer preference on functional analysis outcomes. Journal of Applied Behavior Analysis 31, 79-90. Lalli, J. S., Casey, S., & Kates, K. (1995). Reducing escape behavior and increasing task completion with functi onal communication training, extinction, and response chaining. Journal of Applied Behavior Analysis 28, 261-268. Lalli, J. S., Casey, S. D., & Kates, K. (1997). Noncontingent reinforcement as treatment for severe problem behavi or: Some procedural variations. Journal of Applied Behavior Analysis 30, 127-137. Lalli, J. S., Casey, S., Goh, H., & Merl ino, J. (1994). Treatment of escapemaintained aberrant behavior with es cape extinction and predictable routines. Journal of Applied Behavior Analysis 27, 705-714. 39

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Appendix A (Continued) Lalli, J. S., Livezey, K., & Kates, K. ( 1996). Functional analysis and treatment of eye poking with response blocking. Journal of Applied Behavior Analysis 29, 129132. Lalli, J. S., Mace, F. C., Wohn, T., & Livezy, K. (1995). Identification and modification of a response-class hierarchy. Journal of Applied Behavior Analysis 28, 551-559. Lalli, J. S., Vollmer, T. R., Progar, P. R., Wright, C., Borrero, J., Daniel, D., Barthold, C. H., Tocco, K., & May, W. (1999)Competition between positive and negative reinforcement in the treatment of escape behavior. Journal of Applied Behavior Analysis 32, 285-296. Lancaster, B. M., LeBlanc, L. A., Carr, J. E., Brenske, S, Peet, M. M., & Culver S. J., (2004). Functional analysis and tr eatment of the bizarre speech of dually diagnosed adults. Journal of Applied Behavior Analysis 37, 395-399. Lerman, D. C. Iwata, B. A. Shore, B. A., & DeLeon, I. G. (1997). Effects of intermittent punishment on self-injurious behavior: An evaluation of schedule thinning. Journal of Applie d Behavior Analysis 30, 187-201. Lerman, D. C., Iwata, B. A., Shore, B. A., & Kahng, S. (1996). Responding maintained by intermittent reinforcement: Implications for the use of extinction with problem behavior in clinical settings. Journal of Applied Behavior Analysis 29, 153171. Lerman, D. C., Iwata, B. A., Smith, R. G., Zarcone, J. R., & Vollmer, T. R. (1994). Transfer of behavioral function as a contributing factor in treatment relapse. Journal of Applied Behavior Analysis 27, 357-370. Lerman, D. C., Kelley, M. E., Van Camp, C. M., & Roane, H. S. (1999). Effects of reinforcement magnitude on spontaneous recovery. Journal of Applied Behavior Analysis 32, 197-200. Lerman, D. C., Kelley, M. E., Vorndran, C. M., Kuhn, S. A. C., & LaRue, R. H. Jr. (2002). Reinforcement magnitude a nd responding during treatment with differential reinforcement. Journal of Applied Behavior Analysis 35, 29-48. Lindauer, S. E., Zarcone, J. R., Richma n, D. M., & Schroeder, S. R. (2002). A comparison of multiple reinforcer assessments to identify the function of maladaptive behavior. Journal of Applie d Behavior Analysis 35, 299-303. 40

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Appendix A (Continued) Lindberg, J. S., Iwata, B. A., Ka hng, S., & DeLeon, I. G. (1999). DRO contingencies: An analysis of variable-momentary schedules. Journal of Applied Behavior Analysis 32, 123-136. Lindberg, J. S., Iwata, B. A., Roscoe, E. M., Worsdell, A. S., & Hanley, G. P. (2003). Treatment efficacy of noncontingent reinforcement during brief and extended application. Journal of Applied Behavior Analysis 36, 1-19. Lindberg, J. S., Iwata, B. A., & Kahng, S. (1999). On the relation between object manipulation and stereotypic self-injurious behavior. Journal of Applied Behavior Analysis 32, 51-62. Mace, A. B., Shapiro, E. S., & Mace, F. C. (1998). Effects of warning stimuli for reinforcer withdrawal and task onset on self-injury. Journal of Applied Behavior Analysis 31, 679-682. Magee, S. K. & Ellis, J. (2000). Extin ction effects during the assessment of multiple problem behaviors. Journal of Applied Behavior Analysis 33, 313-316. Magee, S. K. & Ellis, J. (2001). The detrimental effects of physical restraint as a consequence for inappropri ate classroom behavior. Journal of Applied Behavior Analysis 34, 501-504. Mazaleski, J. L., Iwata, B. A., Rodgers, T. A., Vollmer, T. R., & Zarcone, J. R. (1994). Protective equipment as treatment for stereotypic hand mouthing: Sensory extinction or punishment effects? Journal of Applied Behavior Analysis 27, 345-355. McComas, J., Hoch, H., Paone, D., & El -Roy, D. (2000). Escape behavior during academic tasks: A preliminary analysis of idiosyncratic establishing operations. Journal of Applied Behavior Analysis 33, 479-493. McComas, J. J., Thompson, A., & Johnson, L. (2003). The effects of presession attention on problem behavior main tained by different reinforcers. Journal of Applied Behavior Analysis 36, 297-307. McCord, B. E., Iwata, B. A., Galensky, T. L., Ellingson, S. A., & Thomson, R. J. (2001). Functional analysis and treatment of problem behavior evoked by noise. Journal of Applied Behavior Analysis 34, 447-462. McCord, B. E., Thomson, R. J., & Iwata, B. A. (2001). Functional analysis and treatment of selfinjury associated with transitions. Journal of Applied Behavior Analysis 34, 195-210. 41

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Appendix A (Continued) Meyer, K. A. (1999). Functional analysis and treatment of problem behavior exhibited by elemen tary school children. Journal of Applied Behavior Analysis 32, 229-232. Moore, J. W. & Edwards, R. P. (2003). An analysis of aversive stimuli in classroom demand contexts. Journal of Applied Behavior Analysis 36, 339-348. Moore, J. W., Mueller, M. M., Dubard, M ., Roberts, D. S., & Sterling-Turner, H. E. (2002). The influence of therapist a ttention on self-injury during a tangible condition. Journal of Applied Behavior Analysis 35, 283-286. Moore, J. W., Fisher, W. W., & Pe nnington, A. (2004). Systematic application and removal of protective equipment in th e assessment of multiple topographies of self-injury. Journal of Applied Behavior Analysis 37, 73-77. Mueller, M. M., Wilczynski, S. M., Moore, J. W., Fusilier, I., & Trahant, D. (2001). Antecedent manipulations in a tangi ble condition: The effects of stimulus preference on aggression. Journal of Applied Behavior Analysis 34, 237-240. Mueller, M. M., Edwards, R. P., & Trahant, D. (2003). Translating multiple assessment techniques into an interven tion selection model for classrooms. Journal of Applied Behavior Analysis 36, 563-573. Najdowski, A. C., Wallace, M. D., Doney, J. K., & Ghezzi, P. M. (2003). Parental assessment and treatment of food selectivity in natural settings. Journal of Applied Behavior Analysis 36, 383-386. Northup, J., Broussard, C., Jones, K., Ge orge, T., Vollmer, T. R., & Herring, M. (1995). The differential effects of teacher and peer attention on the disruptive classroom behavior of three children w ith a diagnosis of attention deficit hyperactivity disorder. Journal of Applied Behavior Analysis 28, 227-228. Northup, J., Fusilier, I., Swanson, V., Huet e, J., Bruce, T., Freeland, J., Gulley, V., & Edwards, S. (1999). Further analysis of the separate and interactive effects of methylphenidate and common classroom contingencies. Journal of Applied Behavior Analysis 32, 35-50. Northup, J., Wacker, D. P., Berg, W. K., Kelly, L., Sasso, G., & DeRaad, A. (1994). The treatment of severe behavior problems in school settings using a technical assistance model. Journal of Applied Behavior Analysis 27, 33-48. 42

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Appendix A (Continued) Northup, J., Kodak, T., Lee, J., & Coyne, A. (2004). Instructional influences on analogue functional analysis outcomes. Journal of Applied Behavior Analysis 37, 509-512. O'Reilly, M. F. & Carey, Y. (1996). A prelim inary analysis of the effects of prior classroom conditions on performanc e under analogue analysis conditions. Journal of Applied Behavior Analysis 29, 581-584. O'Reilly, M. F. (1995). Functional analysis and treatment of escape-maintained aggression correlated with sleep deprivation. Journal of Applied Behavior Analysis 28, 225-226. O'Reilly, M. F. (1997). Functional analysis of episodic self-injury correlated with recurrent otitis media. Journal of Applie d Behavior Analysis 30, 165-167. O'Reilly, M. F. (1999). Effects of pres ession attention on the frequency of attention-maintained behavior. Journal of Applied Behavior Analysis, 32, 371-374. O'Reilly, M. F., Lacey, C., & Lancioni, G. E. (2000). Assessment of the influence of background noise on escape-maintained probl em behavior and pain behavior in a child with Williams syndrome. Journal of Applied Behavior Analysis 33, 511-514. O'Reilly, M. F., Lancioni, G. E., King, L ., Lally, G., & Dhomhnaill, O. N. (2000). Using brief assessments to evaluate abe rrant behavior maintained by attention. Journal of Applied Behavior Analysis 33, 109-112. Pace, G. M., Ivancic, M. T., & Jefferson, G. (1994). Stimulus fading as treatment for obscenity in a brain-injured adult. Journal of Applied Behavior Analysis 27, 301305. Peck, S. M., Wacker, D. P., Berg, W. K ., Cooper, L. J., Brown, K. A., Richman, D., McComas, J. J., Frischmeyer, P., & Millard, T. (1996). Choice-making treatment of young children's severe behavior problems. Journal of Applied Behavior Analysis 29, 263-290. Perry, A. C. & Fisher, W. W. (2001) Behavioral economic influences on treatments designed to decr ease destructive behavior. Journal of Applied Behavior Analysis 34, 211-215. 43

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Appendix A (Continued) Piazza, C. C., Adelinis, J. D., Hanley, G. P., Goh, H., & Delia, M. D. (2000). An evaluation of the effects of matched stim uli on behaviors maintained by automatic reinforcement. Journal of Applied Behavior Analysis 33, 13-27. Piazza, C. C., Bowman, L. G., Contrucci, S. A., Delia, M. D., Adelinis, J. D., & Goh, H. (1999). An evaluation of the propert ies of attention as reinforcement for destructive and appropriate behavior. Journal of Applied Behavior Analysis 32, 437449. Piazza, C. C., Fisher, W. W., Brown, K. A ., Shore, B. A., Patel, M. R., Katz, R. M., Sevin, B. M., Gulotta, C. S., & Blakel y-Smith, A. (2003). Functional analysis of inappropriate mealtime behaviors. Journal of Applied Behavior Analysis 36, 187204. Piazza, C. C., Fisher, W. W., Hanley, G. P., LeBlanc, L. A., Worsdell, A. S., Lindauer, S. E., & Keeney, K. M. (1998). Treatment of pica through multiple analyses of its reinforcing functions. Journal of Applied Behavior Analysis 31, 165189. Piazza, C. C., Fisher, W. W., Hanley, G. P., Remick, M. L., Contrucci, S. A., & Aitken, T. L. (1997). The use of positive a nd negative reinforcement in the treatment of escape-maintained destructive behavior. Journal of Applied Behavior Analysis 30, 279-298. Piazza, C. C., Hanley, G. P., & Fisher, W. W. (1996). Functional analysis and treatment of cigarette pica. Journal of Applied Behavior Analysis 29, 437-449. Piazza, C. C., Hanley, G. P., Bowman, L. G., Ruyter, J. M., Lindauer, S. E., & Saiontz, D. M. (1997). Functional an alysis and treatment of elopement. Journal of Applied Behavior Analysis 30, 653-672. Piazza, C. C., Moes, D. R., & Fisher, W. W. (1996). Differential reinforcement of alternative behavior and demand fading in the treatment of escape-maintained destructive behavior. Journal of Applie d Behavior Analysis 29, 569-572. Rapp, J. T., Miltenberger, R. G., Galensky, T. L., Ellingson, S. A., & Long, E. S. (1999). A functional analysis of hair pulling. Journal of Applied Behavior Analysis 32, 329-337. Rehfeldt, R. A. & Chambers, M. R. (2003) Functional analysis and treatment of verbal perseverations displayed by an adult with autism. Journal of Applied Behavior Analysis 36, 259-261. 44

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Appendix A (Continued) Richman, D. M., Lindauer, S. E., Crosland, K. A., McKerchar, T. L., & Morse, P. S. (2001). Functional analysis and treat ment of breath holding maintained by nonsocial reinforcement. Journal of Applied Behavior Analysis 34, 531-534. Richman, D. M., Wacker, D. P., & Wi nborn, L. (2001). Response efficiency during functional communication training: E ffects of effort on response allocation. Journal of Applied Behavior Analysis 34, 73-76. Richman, D. M., Wacker, D. P., Asmus, J. M., & Casey, S. D. (1998). Functional analysis and extinction of different be havior problems exhibited by the same individual. Journal of Applied Behavior Analysis 31, 475-478. Richman, D. M., Wacker, D. P., Asmus, J. M., Casey, S. D., & Andelman, M. (1999). Further analysis of problem beha vior in response class hierarchies. Journal of Applied Behavior Analysis 32, 269-283. Ringdahl, J. E. & Sellers, J. A. (2000). The e ffects of different adults as therapists during functional analyses. Journal of Applied Behavior Analysis 33, 247-250. Ringdahl, J. E., Vollmer, T. R., Marcus B. A., & Roane, H. S. (1997). An analogue evaluation of environmental enrich ment: The role of stimulus preference. Journal of Applied Behavior Analysis 30, 203-216. Ringdahl, J. E., Winborn, L. C., Andelma n, M. S., & Kitsukawa, K. (2002). The effects of noncontingently available a lternative stimuli on functional analysis outcomes. Journal of Applied Behavior Analysis 35, 407-410. Romaniuk, C., Miltenberger, R., Conyers, C., Jenner, N., Jurgens, M., & Ringenberg, C. (2002). The influence of activity choice on problem behaviors maintained by escape versus attention. Journal of Applied Behavior Analysis 35, 349-362. Roscoe, E. M., Iwata, B. A., & Goh, H. (1998). A comparison of noncontingent reinforcement and sensory extinction as treatments for self-injurious behavior. Journal of Applied Behavior Analysis 31, 635-646. Shirley, M. J., Iwata, B. A., & Kahng, S. (1999). False-positive maintenance of self-injurious behavior by access to tangible reinforcers. Journal of Applied Behavior Analysis 32, 201-204. 45

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Appendix A (Continued) Shirley, M. J., Iwata, B. A., Kahng, S., M azaleski, J. L., & Lerman, D. C. (1997). Does functional communication training compete with ongoing contingencies of reinforcement? An analysis during response acquisition and maintenance. Journal of Applied Behavior Analysis 30, 93-104. Shore, B. A., Iwata, B. A., Lerman, D. C., & Shirley, M. J. (1994). Assessing and programming generalized behavioral reduction across multiple stimulus parameters. Journal of Applied Behavior Analysis 27, 371-384. Shore, B. A., Iwata, B. A., Vollmer, T. R., Lerman, D. C., & Zarcone, J. R. (1995). Pyramidal staff training in the exte nsion of treatment for severe behavior disorders. Journal of Applie d Behavior Analysis 28, 323-332. Shukla, S. & Albin, R. W. (1996). Effects of extinction alone and extinction plus functional communication training on c ovariation of problem behaviors. Journal of Applied Behavior Analysis 29, 565-568. Smith, R. G. & Churchill, R. M. ( 2002). Identification of environmental determinants of behavior disorders th rough functional analysis of precursor behaviors. Journal of Applied Behavior Analysis 35, 125-136. Smith, R. G., Iwata, B. A., Goh, H., & Shore, B. A. (1995). Analysis of establishing operations for self -injury maintained by escape. Journal of Applied Behavior Analysis 28, 515-535. Tang, J., Kennedy, C. H., Koppekin, A., & Caruso, M. (2002). Functional analysis of stereotypical ear c overing in a child with autism. Journal of Applied Behavior Analysis 35, 95-98. Tarbox, R. S. F., Wallace, M. D., & Williams, L. (2003). Assessment and treatment of elopement: A replication and extension. Journal of Applied Behavior Analysis 36, 239-244. Taylor, J. C. & Romanczyk, R. G. (1994). Generating hypotheses about the function of student problem behavi or by observing teacher behavior. Journal of Applied Behavior Analysis 27, 251-265. Thompson, R. H., Fisher, W. W., Piazza, C. C., & Kuhn, D. E. (1998). The evaluation and treatment of aggression maintained by attention and automatic reinforcement. Journal of Applied Behavior Analysis 31, 103-116. 46

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Appendix A (Continued) Valdovinos, M. G., Roberts, C., & Kenne dy, C. H. (2004). Analogue functional analysis of movements associated with tardive dyskinesia. Journal of Applied Behavior Analysis 37, 391-393. Van Camp, C. M., Lerman, D. C., Kelley, M. E., Roane, H. S., Contrucci, S. A., & Vorndran, C. M. (2000). Further analysis of idiosyncratic antecedent influences during the assessment and trea tment of problem behavior. Journal of Applied Behavior Analysis 33, 207-221. Van Camp, C. M., Lerman, D. C., Kelley, M. E., Contrucci, S. A., & Vorndran, C. M. (2000). Variable-time reinforcement schedules in the treatment of socially maintained problem behavior. Journal of Applied Behavior Analysis 33, 545-557. Vollmer, T. R. & Vorndran, C. M. (1998). Assessment of self-injurious behavior maintained by access to self-restraint materials. Journal of Applied Behavior Analysis 31, 647-650. Vollmer, T. R., Borrero, J. C., Lalli, J. S., & Daniel, D. (1999). Evaluating selfcontrol and impulsivity in children with severe behavior disorders. Journal of Applied Behavior Analysis 32, 451-466. Vollmer, T. R., Marcus, B. A., & LeBlanc, L. (1994). Treatment of self-injury and hand mouthing following inconclusive functional analysis. Journal of Applied Behavior Analysis 27, 331-344. Vollmer, T. R., Marcus, B. A., Ringdah l, J. E., & Roane, H. S. (1995). Progressing from brief assessments to ex tended experimental analyses in the evaluation of aberrant behavior. Journal of Applied Behavior Analysis 28, 561-576. Vollmer, T. R., Marcus, B. A., & Ringdahl, J. E. (1995). Noncontingent escape as treatment for self-injurious behavior maintained by negative reinforcement. Journal of Applied Behavior Analysis 28, 15-26. Vollmer, T. R., Progar, P. R., Lalli, J. S ., Van Camp, C. M., Sierp, B. J., Wright, C. S., Nastasi, J., & Eisenschink, K. J. (1998)Fixed-time schedules attenuate extinction-induced phenomena in the trea tment of severe aberrant behavior. Journal of Applied Behavior Analysis 31, 529-542. Vollmer, T.R., Roane, H.S., Ringdahl, J.E., & Marcus, B.A. (1999). Evaluating treatment challenges with differential reinforcement of alternative behavior. Journal of Applied Behavior Analysis 32, 9-23. 47

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Appendix A (Continued) Wacker, D. P., Harding, J., Cooper, L. J., Derby, K. M., Peck, S., Asmus, J., Berg, W. K., & Brown, K. A. (1996)The effect s of meal schedule and quantity on problematic behavior. Journal of Applie d Behavior Analysis 29, 79-87. Wallace, M. D. & Iwata, B. A. (1999). Effects of session duration on functional analysis outcomes. Journal of Applied Behavior Analysis 32, 175-183. Wallace, M. D. & Knights, D. J. (2003). An evaluation of a brief functional analysis format within a vocational setting. Journal of Applied Behavior Analysis 36, 125-128. Watson, T. S. & Sterling, H. E. (1998). Br ief functional analysis and treatment of a vocal tic. Journal of Applied Behavior Analysis 31, 471-474. Wilder, D. A., Masuda, A., O'Connor, C ., & Baham, M. (2001). Brief functional analysis and treatment of bizarre vocaliz ations in an adult with schizophrenia. Journal of Applied Behavior Analysis 34, 65-68. Winborn, L., Wacker, D. P., Richman, D. M., Asmus, J., & Geier, D. (2002). Assessment of mand selection for func tional communication training packages. Journal of Applied Behavior Analysis 35, 295-298. Worsdell, A. S., Iwata, B. A., Conners, J., Kahng, S., & Thompson, R. H. (2000). Relative influences of establishing operat ions and reinforcement contingencies on selfinjurious behavior during functional analyses. Journal of Applied Behavior Analysis 33, 451-461. Worsdell, A. S., Iwata, B. A., Hanley, G. P., Thompson, R. H., & Kahng, S. (2000). Effects of continuous and intermitte nt reinforcement for problem behavior during functional communication training. Journal of Applied Behavior Analysis 33, 167-179. Zarcone, J. R., Iwata, B. A., Smith, R. G., Mazaleski, J. L., & Lerman, D. C. (1994). Reemergence and extinction of self-i njurious escape behavior during stimulus (instructional) fading. Journal of Applie d Behavior Analysis 27, 307-316. 48

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Appendix B: Data Sheet Participant: ________________________ Observer: _____________________________ Date and Time: ______________________ Condition: ___________________________ Academic/Social Task: ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Target Behavior(s): ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Circle the following during the record phase of each interval: (checkmark) if and when the target behavior(s) occur(s). + (plus sign) if and when the participant demonstrates task engagement/participation O (zero sign) if and when the child is not required to actively participate in a task and/or is doing what he is supposed to do (ex. sitting at desk while another student is called on) *If the target behavior occurs at a ny point during the interval then the should be the only mark circled. The O should only be marked in an interval in which the child is not required to perform any activity a nd is NOT displaying any of the target behaviors. Fifteen second interval 1 2 3 4 1 Student: + O Student: + O Student: + O Student: + O 2 Student: + O Student: + O Student: + O Student: + O 3 Student: + O Student: + O Student: + O Student: + O 4 Student: + O Student: + O Student: + O Student: + O 5 Student: + O Student: + O Student: + O Student: + O 6 Student: + O Student: + O Student: + O Student: + O 7 Student: + O Student: + O Student: + O Student: + O 8 Student: + O Student: + O Student: + O Student: + O 9 Student: + O Student: + O Student: + O Student: + O 10 Student: + O Student: + O Student: + O Student: + O Minutes of Observation 49

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Appendix C: Level of Anxiety Questionnaire Answer the following questions on you believe th e student was feeling on a scale of 1-4: (1=relaxed; 2=okay; 3=a little scared or nervous; 4=rea lly scared or nervous) 1. Right now the student seems to be fee ling: 1 2 3 4 2. During the last activity, the best overall wa y to describe how the student seemed to be feeling is: 1 2 3 4 3. Before I assigned the last activity, the student seemed to be feeling: 1 2 3 4 You may include a description about the way you believe the student felt during the last activity: ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ____________________________________ 50

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Appendix D: Teacher Training This is a brief description as to how each condition should go. If you have any questions along the way, please feel free to ask. Also if there are any situa tions that you believe may work better or are more accura te with this particular stude nt, or the class in general, please discuss it with us and we can make a ny necessary adjustments. We want this study to flow as smoothly as possible for you a nd your students. Please feel free to share any concerns or suggestions with us along the way. Each condition should last a total of 10 minutes; you may use your watch, the classroom clock, or ask for assistance to determine when the 10 minutes are complete. There will be a minimum 5 minute break in between sessions. You will be given an outline as to the order the conditions should take place. You will also be provided a stopwatch that may be used during the conditions. The following describes the 3 different conditions we will be using: Attention condition: This condition will help us determine if the student is withdrawing from tasks or activities as a wa y of gaining your attention. You will direct the child to complete an academic or social task. You will provide verbal instructions and appropriate materials to complete an academic, group assignment in which the child will be given the duty of “group leader.” As the leader, the child will be required to verbally direct the group in the academic task. If the child shows any signs of distress or deliberate refusal to complete the assignment, you should walk over to him/her and direct them to continue the task. You should come within two feet of th e child, and may even provide brief physical contact (i.e., hand on the shoulder) to en courage them to complete 51

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Appendix D (Continued) the task. If they still do not complete the task, you can then walk around the class and check on the other students. If after about 3 minutes the child has not done the task, you should again come close to him/her and provide encouragement to complete the task, you may also provide brief physical contact. Con tinue this process for the remainder of the session. Some alternatives to the academic ta sk may include requiring the student to read aloud to the class, answer a question that requires more th an a one word response, or making a making a small presen tation. If you ask them to read aloud, answer a question, or make a presentation and they refuse or get distressed, you should walk over to them and maybe provide brief physical contact while you ask them again to comply with your request. If they still refuse or get upset, you can direct the question to someone else. Afterwards go back to the student and ask them if they like to give it another try, if again they get upset or refuse, you should walk ove r to them and encourage them one more time. If they still do not comply, then let th em know that they can raise their hand at any point when they feel ready to perform answer /read/or perform the task. Wait for them to raise their hand, or simply allow them to s it quietly until the sessi on is over. This condition may also include a social activity in addition to, or in place of, the academic demand. Examples of social act ivities include, but are not limited to, participation in an interactive game or requiring the child to discuss a favorite hobby, vacation, or television show with the class. The same sequence of providing attention and redirection described above should be implemented. 52

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Appendix D (Continued) The following is a “cheat sheet” of the above instructions: 1. Ask the child to do something (read aloud, give an answer, etc.)-they refuse/get upset 2. Get close, ask them again, encourage them—they refuse/get upset 3. Allow about 3 minutes to pass—go to other students 4. Go back to the original student and make another request—they refuse/get upset 5. One more time get close, ask them again, encourage them—they refuse/get upset 6. Tell them to raise hand when they feel ready to complete task Social/Academic demand condition: This condition will l ook to see if the student’s withdrawn behavior is a way of getti ng out of certain tasks. You will follow the exact procedures describe above except that when the student refuses to complete the assignment, you will give them the directions again, but provide no extra encouragement or attention. You will not need to move clos er to them or place a hand on the shoulder. You will simply give them two chances to follow you directions, if they continue to refuse or get upset you may withdraw the assi gnment and allow the child to “calm down and take a quick break” for about 3 minutes. Th en give your initial request again; if they refuse or get upset, repeat the instructions one final time. If they con tinue to refuse or get upset, redirect the instructions to another student and allow the withdrawn student to sit 53

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Appendix D (Continued) quietly at their desk for the remainder of the condition. If you are doing the group activity you should reassign another member of the group to take over as temporary group leader and allow the part icipant to sit quietly in th e group. Start your timer and allow 3 minutes to pass, once the time is up, ask th e child to again take over as leader. If the child refuses to initiate a response, you w ill prompt him/her one last time. Failure to initiate a response following the last prompt should result in you reassigning the other student to be the leader, and allowing the withdrawn student to sit quietly for the rest of the group task. If at any poi nt the child shows significant distress, he/she should be allowed to leave the group a nd return to his/her desk. The following is a “cheat sheet” of the above instructions: 1. Ask the child to do something (read aloud, give an answer, etc.)-they refuse/get upset. 2. Ask them again—they refuse/get upset 3. Give them a 3 minute “break” (sit quietly) & go to another student 4. Go back to the original student and make another request—they refuse/get upset 5. Ask them one final time—they refuse/get upset 6. Allow them to sit quietly at desk for remainder of session Unstructured play session: This session will involve allowing the student to engage in activities that he or she enjoys while obs erving if their behavior 54

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Appendix D (Continued) differs from the other two conditions. It ma y also allow us to see if the child will initiate any social or academic activitie s while not forced to do so. Pleasing activities may include such things as reading a book, pl aying on the computer, or drawing. Again if you have any questions, or suggesti ons to improve the conditions, please feel free to speak with us throughout the study. 55

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Appendix E: Teacher cheat sheets The following is a “cheat sheet” of what to do in the GET CLOSE & ENCOURAGE phase: 1. Ask the child to do something (read aloud, give an answer, etc.)-they refuse/get upset 2. Get close, ask them again, encourage them —they refuse/get upset 3. Allow about 3 minutes to pass —go to other students 4. Go back to the original st udent and make another request —they refuse/get upset 5. One more time get close, ask them again, encourage them —they refuse/get upset 6. Tell them to raise hand when they feel ready to complete task Every 3-4 minutes (around the time the bu zzer goes off), try and re-direct your attention to the student. **If child gets extremely upset during the condition (meltdown and/or crying), you can simply ignore the buzzer and tell him to raise ha nd when he wants to join the activity. ** 56

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Appendix E (Continued) The following is a “cheat sheet” of what to do in the STAY BACK AND GIVE BREAK phase: 1. Ask the child to do something (read aloud, give an answer, etc.)-they refuse/get upset. 2. Ask them again —they refuse/get upset (TRY TO NOT GET CLOSE and/or GIVE EXTRA ENCOURAGEMENT) 3. Give them a 3 minute “break” (sit quietly) & go to another student 4. Go back to the original st udent and make another request —they refuse/get upset 5. Ask them one final time —they refuse/get upset (*AGAIN TRY TO NOT GET CLOSE and/or GIVE EXTRA ENCOURAGEMENT*) 6. Allow them to sit quietly at desk for remainder of session **Use the timer as a means to visibly check in with student, if engaging in target behavior, simply try to IGNORE him for remainder of session. BUT by all means offer comfort if needed if the child is cr ying OR having a meltdown. Under these circumstances use your own discretion. 57