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照顾者识别有逃避维持的挑战性行为的儿童需求的准确性。

Accuracy of caregiver identification of demands for children with escape-maintained challenging behavior.

机构信息

Rowan University, United States.

Rowan University, United States.

出版信息

Res Dev Disabil. 2021 Dec;119:104083. doi: 10.1016/j.ridd.2021.104083. Epub 2021 Sep 22.

Abstract

BACKGROUND

Although stimulus preference assessments are widely used to identify reinforcers and to inform positive reinforcement conditions in a functional analysis (FA), direct assessments of potential negative reinforcers are not as commonly employed. Demands are often selected from caregiver report alone.

AIMS

The purpose of the current study is to (a) replicate the Demand Assessment for Individuals with Severe Disabilities (DAISD) indirect assessment interview for caregivers to identify demands that may evoke challenging behavior; (b), compare the correspondence of the DAISD in relation to an established direct assessment, the demand latency assessment (DLA); and (c) evaluate if the demands that caregivers identify as the most aversive are more likely to evoke challenging behavior and identify an escape function in an FA than those demands caregivers identify as least aversive and replicate validation of the DLA.

METHODS AND PROCEDURES

This study evaluated caregiver accuracy at identifying demands most likely to evoke escape-maintained challenging behavior for four children with developmental disabilities. Caregiver-informed aversiveness hierarchies from the DAISD were compared to child-informed aversiveness hierarchies from the DLA. Functional analyses included separate escape conditions with DAISD and DLA most and least aversive demands.

OUTCOMES AND RESULTS

Although all caregivers identified at least eight demands, caregivers' accuracy with demand aversiveness was variable as indicated by (a) a false negative FA outcome for one of four participants with the caregiver-nominated most aversive demand; (b) higher rates of challenging behavior with the caregiver-nominated least aversive demand than most aversive for three of four participants; and (c) lack of a strong positive rank order correlation between caregiver- and child-hierarchies for all participants (range, -0.76 to .48). Compliance was not a strong predictive variable of challenging behavior with either assessment.

CONCLUSIONS AND IMPLICATIONS

Results indicate that the DAISD interview is useful at identifying multiple demands presented in the natural environment, but should be followed up with direct assessment to determine demand aversiveness rather than used for caregivers to rank demand aversiveness.

摘要

背景

尽管刺激偏好评估被广泛用于识别强化物,并为功能分析(FA)中的正强化条件提供信息,但对潜在负强化物的直接评估并不常见。需求通常仅根据照顾者的报告进行选择。

目的

本研究的目的是:(a)复制用于识别可能引发挑战性行为的需求的严重残疾个体需求评估(DAISD)间接评估访谈;(b)比较 DAISD 与既定直接评估需求潜伏期评估(DLA)的一致性;(c)评估照顾者识别为最厌恶的需求是否比照顾者识别为最不厌恶的需求更有可能引发挑战性行为,并在 FA 中识别逃避功能,并复制 DLA 的验证。

方法和程序

本研究评估了 4 名发育障碍儿童的照顾者识别最有可能引发逃避维持挑战性行为的需求的准确性。将 DAISD 中的照顾者告知的厌恶度等级与 DLA 中的儿童告知的厌恶度等级进行比较。功能分析包括使用 DAISD 和 DLA 最和最不厌恶的需求进行单独的逃避条件。

结果

尽管所有照顾者都确定了至少 8 个需求,但照顾者对需求厌恶度的准确性存在差异,表现在:(a)对于 4 名参与者中的 1 名,照顾者提名的最厌恶需求的 FA 结果为假阴性;(b)对于 4 名参与者中的 3 名,与最厌恶需求相比,照顾者提名的最不厌恶需求引发挑战性行为的比率更高;(c)对于所有参与者,照顾者和儿童等级之间缺乏强烈的正秩相关(范围,-0.76 至.48)。两种评估方法均表明,合规性不是预测挑战性行为的强有力变量。

结论和意义

结果表明,DAISD 访谈有助于识别自然环境中呈现的多种需求,但应跟进直接评估以确定需求厌恶度,而不是让照顾者对需求厌恶度进行排名。

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