Rooker Griffin W, DeLeon Iser G, Borrero Carrie S W, Frank-Crawford Michelle A, Roscoe Eileen M
The Kennedy Krieger Institute, Baltimore, MD 21205, USA ; Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
University of Florida, Gainesville, FL 32611, USA.
Behav Interv. 2015 Feb;30(1):1-35. doi: 10.1002/bin.1400.
Severe problem behavior (e.g., self-injury and aggression) remains among the most serious challenges for the habilitation of persons with intellectual disabilities and is a significant obstacle to community integration. The current standard of behavior analytic treatment for problem behavior in this population consists of a functional assessment and treatment model. Within that model, the first step is to assess the behavior-environment relations that give rise to and maintain problem behavior, a functional behavioral assessment. Conventional methods of assessing behavioral function include indirect, descriptive, and experimental assessments of problem behavior. Clinical investigators have produced a rich literature demonstrating the relative effectiveness for each method, but in clinical practice, each can produce ambiguous or difficult-to-interpret outcomes that may impede treatment development. This paper outlines potential sources of variability in assessment outcomes and then reviews the evidence on strategies for avoiding ambiguous outcomes and/or clarifying initially ambiguous results. The end result for each assessment method is a set of best practice guidelines, given the available evidence, for conducting the initial assessment.
严重问题行为(如自我伤害和攻击行为)仍然是智力残疾者康复过程中最严峻的挑战之一,也是融入社区的重大障碍。目前针对该人群问题行为的行为分析治疗标准包括功能评估和治疗模型。在该模型中,第一步是评估引发和维持问题行为的行为 - 环境关系,即功能性行为评估。评估行为功能的传统方法包括对问题行为的间接、描述性和实验性评估。临床研究人员已发表了丰富的文献,证明了每种方法的相对有效性,但在临床实践中,每种方法都可能产生模糊或难以解释的结果,这可能会阻碍治疗的开展。本文概述了评估结果变异性的潜在来源,然后回顾了关于避免模糊结果和/或澄清最初模糊结果的策略的证据。鉴于现有证据,每种评估方法的最终结果是一套进行初始评估的最佳实践指南。