International Meeting for Autism Research: Problem Behavior In Young Children with Autism Spectrum Disorder

Problem Behavior In Young Children with Autism Spectrum Disorder

Thursday, May 12, 2011
Elizabeth Ballroom E-F and Lirenta Foyer Level 2 (Manchester Grand Hyatt)
9:00 AM
K. E. Pelzel1, D. P. Wacker2, S. D. Lindgren2, T. G. Kopelman2, J. F. Lee3, Y. C. Padilla3 and D. B. Waldron2, (1)Center for Disabilities and Development, University of Iowa Hospitals and Clinics, Iowa City, IA, (2)Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA, (3)University of Iowa, Iowa City, IA
Background: Problem behavior (e.g., aggression toward others, self-injurious behavior, property destruction) is recognized as a significant stressor for caregivers of children with autism (Estes et al., 2009).  Identifying the function of problem behavior using functional analysis (FA) frequently leads to more effective, reinforcement-based treatments (Pelios et al., 1999).  Investigation of FA results for individuals with autism spectrum disorders (ASDs) who engage in problem behaviors has been limited.   In a review of 32 youth with ASDs, Love et al. (2009) reported social-positive reinforcement (i.e., attention and tangible reinforcement) was the most common function.

Objectives: We aim to better understand the function of problem behavior displayed by children with ASDs, with the following variations to the Love et al. (2009) methodology: 

  •  All participants will be aged 18 months to 6 years.
  •  “Gold standard” diagnostic measures will be used to confirm diagnosis. 
  •  Extended FAs (Iwata et al., 1982/1994) will be conducted via telehealth with all participants. 
  •  “Social-positive reinforcement” will be separated into attention and tangible categories to isolate the role of these functions in maintaining behavior. 
  •  Participants living in relatively rural locations will be included.

Methods: Thirty children aged 18 months to 6 years diagnosed with ASD (confirmed with ADOS and ADI-R) will complete extended FAs of parent-identified problem behavior as part of a larger study of behavioral treatment via telehealth.  The FA is conducted over 2-way teleconferencing connections linking behavioral specialists from a university hospital with a regional university outpatient clinic within 50 miles of the child’s home.  Five minute sessions are conducted within individual single case multi-element designs during one hour periods, once a week, until at least 3 stable sessions are completed for each condition (free play, attention, tangible, and escape).  Behavioral functions are coded as: attention (behavior maintained by verbal or physical attention), tangible (behavior maintained by access to a tangible item), escape (behavior maintained by escape from task demand), and/or automatic (behavior maintained independent of social reinforcement).  Multiple functions can be coded.

Results: To date, 22 children have been identified for study, and 12 have completed the FA (6 with Autistic Disorder and 6 with PDD-NOS).  Another 5 participants are currently completing their FA.  FA results to date are presented in Table 1.

Table 1

Number of Participants with Problem Behavior Maintained by Identified Functions 


Function                            Autistic Disorder              PDD-NOS          Combined

                                                     n =6                           n =6                n=12

1) Attention                                       0                                0                     0 

2) Tangible                                        1                                1                     2 

3) Escape                                          0                                1                     1 

4) Automatic                                      0                                0                     0    

5) Attention & Escape                           1                                0                     1 

6) Tangible & Escape                            4                                2                     6 

7) Attention, Escape, & Tangible             0                                1                     1 

8) No Identified Function                       0                                1                     1 

Conclusions: Results to date suggest multiple functions, particularly a combination of tangible and escape functions, most frequently maintain problem behavior among young children with ASD.  With respect to social-positive reinforcement, problem behavior was more often maintained by tangible reinforcement than attention.  

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