Parent Support University Week 7

May 13, 2020

AnswersNow Chief Science Officer, Adam Dreyfus, speaks about the topic of Functional Behavior Assessment as a part of the Parent Support University series.

Transcript:

Speaker 1 (00:01):

Hello AnswersNow families. Welcome back. I am Adam Dreyfus. I'm the chief science officer for AnswersNow and you can find out more about us at getanswersnow.com. During this crisis we had been doing these regularly scheduled webinar kind of things about evidence based practices. One of the reasons that we started AnswersNow was to try to get all of this really great expert information that's been out there for decades into the hands of parents. It's a failure on our part as the so called experts to make sure that you parents and caregivers have all the tools that you need. And so what we're doing here is we're walking through all the evidence based ones on a weekly basis. So we've done antecedent based intervention, cognitive behavioral intervention, differential reinforcement, discrete trial training, exercise, and extinction we did last week. 

Speaker 1 (00:48):

This week we're going to be doing one of my favorite topics, F, B, A, functional behavior assessment or functional behavioral assessment. One of the most popular ABA tools out there, applied behavior analysis tools out there and one of the least understood, which is part of the problem. We definitely want to encourage you to go to getanswersnow.com and check us out. You can either sign up to get your own clinician like myself where you can ask questions on a daily basis. You can video chat with or we've got a new feature, one-off videos. So if you don't want to kind of sign up for your own clinician on a month by month basis and you can just sign up for a 15 minute or a 30 minute Q &A and get your questions answered under the one off of a video.

Speaker 1 (01:34):

We are a downloadable app. We're a mobile platform, so you can also go to your App store on your Apple phone or the Android, the Google Play store on your Android phone and download us. We've got communities on there, we've got blogs, we've got all kinds of stuff to talk about. But today we're going to be talking about F B, A, functional behavior assessment. Again, one of the most popular tools in the tool kit. You see it in a lot of public schools, tons of clinics. If you meet with a BCBA and board certified behavior analyst, that's frequently one of the first things they suggest. Oh, let's do an FBA. And the parents go, Ooh, more acronyms. Fantastic. So let's start off with the hard and fast stuff you need to know about an FBA. So an FBA, his whole purpose is to come up with a plan for whatever behavior is being looked at.

Speaker 1 (02:28):

So let's just take a look, right? That happens a lot in schools. It happens, it's big concerned parents, right? They don't want the children to run away a little bit. So the BCBA will come in and say, Oh, we need to do a FBA, a functional behavioral assessment. And what they're trying to do is find out what's the one thing that's driving the behavior. When I do FBA trainings, I always try to reiterate that all of this FBA process, the parent interview, the teacher interview, if you can interview the client or the child the data collection in public schools, that can take six to eight weeks, to look at the data and kind of evaluate it. But really you're just trying to come up with one word, one word, what's the function of the behavior. So that's where the function and functional behavior assessment comes in.

Speaker 1 (03:17):

So there's really, there's only four: attention, escape, demand, like I want something, or automatic, which means they're just doing it because it feels good. It's automatically reinforcing, is the fancy way of saying it. So you just want one of those words because each one will prescribe a different beep a behavior intervention plan. So you have your FBA, your FBA has done, you get one of four words, Oh, it's attention seeking. Oh, it's escape. Oh, it's a, it's a demand or tangible as they sometimes say or it's automatic. They just do it because they like it. So let's take a moment, for example. So we've got Johnny, he's eloping from class and it's very dangerous. He's running out into the street. This is a huge problem. So one of the problems of the FBA procedure is that like in the school division, they might say, well, it's going to take eight weeks.

Speaker 1 (04:11):

Well, do you want to wait eight weeks to address a kid running out in the street? So that's one of the friction points. So what they're looking at is, is Johnny running out in the street for attention? Right. You just, he's lacking in attention as we would say. He's in deprivation for attention, which just is exactly what it sounds like. He's starved for attention and he's found that, Hey, if I run outside and run into the street, man, I get a lot of attention, or it's escape, you know that is a frequent problem in the public schools or in any school, including the schools that I operate, escape. You put something in front of him they don't want to do and they run. There's also demand. So like Johnny may have discovered that when I run out into the street, Adam chases me and then he takes me to the playground afterwards.

Speaker 1 (05:02):

So I get to go on the swings. So I've learned that I can get swings if I run out into the street. Or he just likes to run. He just likes to run, or he likes the sound of the cars, or he likes the sound of the horns, or he likes the feel of the wind on his face. He's not seeking attention. He's not trying to escape from anything. He doesn't have some other thing on the back end of it that he has discovered that is connected to this. Like every time Adam chases me out in the street, he brings me in and gives me a chocolate milk. He just likes the experience. And who knows what element of the experience. But it's internal, right? So always remember that when you're doing an FBA, it is not some, you're not trying to get some elaborate answer.

Speaker 1 (05:43):

You want one of these four things, attention, escape, tangible, automatic. That's the box you're going to check. Be very, very wary of any FBA that comes back with a bunch of these checks. Cause then it's meaningless. It's not meaningless, but it's very difficult to write a plan that if you check multiple boxes that's usually somebody who's not very skilled at what they're doing. So it's a good thing to keep an eye out for. So what comes out after an FBA is completed should be a behavior intervention plan. So that would look something like I would write it up or someone else and they'd say Jack who was running out into the street. It's attention seeking. So here's what we're going to do ahead of the curve. We're going to, we're going to tell Jack he's doing a good job five times an hour.

Speaker 1 (06:40):

And we're going to keep track of that to make sure that it's doing, if he does start to run whoever goes and gets him is not going to talk to them. It's not going to give him anything, is not going to give him very much attention. So what we're going to try to do in that behavior intervention plan is, as we talked about last week, we're going to try to put the elopement on extinction by not reinforcing it, reinforce the behavior that we want, which is him staying in the classroom by giving him lots of attention and have this all drafted up. So FBA behavior intervention plan, boom, stuck together. What to remind you that I am the chief science officer of AnswersNow and you can find out a lot about us at getanswersnow.com. You can check out our free blogs.

Speaker 1 (07:24):

You can check out our communities. These are parent communities where you can ask questions. They're kind of broken out by categories. But the main function is to put a board certified clinician in your pocket so you can sign up and boom you now have the AnswersNow app on your phone and Adam has been assigned to you as your clinician. And whenever you want, you can type in a question or set up a video chat about my kid's behaviors, academic expression, teeth. I got an IEP meeting coming up. What do you think about medication? I'm meeting with my doctor. How do I talk to my doctor about it? Any kind of question you've got around your son or your daughter the clinician should be able to answer. And now we have the fantastic one-off videos. So if you just have a very specific question, like, Oh my God, I got an IEP meeting in two days and I just need to talk to somebody really quick about it.

Speaker 1 (08:11):

Go ahead and sign up. You can sign up for just the one off or there's this behavior. You know,  we're in stay at home orders all the time and now he has started running around in circles and I don't know why he's doing that. Can I talk to somebody about that? Absolutely. So go to getanswersnow.com. Check it out and let's come back to FBA. Again, one of my favorite topics. So as I like to do, I like to get a little historic sometimes. So the reason FBA came about is because we had a tool, we'd still have a tool and it's really, really effective. It's called the functional analysis. It's an F A as opposed to an F B A. I know it gets confusing pretty quickly. What happens with a functional analysis is that a trained clinician will try to turn on the behavior.

Speaker 1 (09:02):

So let's take elopment. So I come into the school and I say, Oh, okay, so Jack's eloping, doesn’t look like he's eloping now. How can we get him to elope? So I remember, I'm trying to find out, is it attention, is it escape, is it demand or is it just he likes the way that it feels running outside? So functional analysis is I would go through all four of those conditions and try to see if I can light switch this on. So for attention I'd be like, all right, nobody paid Jack any attention, nobody paid Jack any attention. And let's see if we reliably can get him running or let's put a ton of demands on Jack. Lot of work on Jack. And let's see if that's it. Has he tried to escape from the work? Or let's find something that we think that he likes and withhold it for a long period of time and see if that triggers him.

Speaker 1 (09:57):

Well, you try and do is see if you can get the behavior to turn almost on and off like a light switch and then you have a very, very high level of confidence that it's one of the four. Automatic is just how many times does he, does, does it more? Does it do it cause it's, you can't turn on something that's just automatically reinforcing cause it's again comes from within. So I'm trying to find one of those four words. Now, do you see the problem with that? Do you see why parents and teachers might think this is not a great idea? So we come in and we say, Hey, we're going to do a functional analysis. I'm going to try to get Jack to run out in the street. And mom goes, Whoa, timeout. This is a really bad idea. Or the teacher says that or it's another behavior, it could be a very dangerous, self-injurious behavior.

Speaker 1 (10:40):

Jack bites himself, Jack bites others, Jack punches people, Jack punches himself. So going to a parent or a school division and saying, Hey, we're going to try to get Jack to bite himself or bite somebody else or punch himself is usually a kind of a nonstarter. So we came up with, we as a field came up with the FBA which is an indirect measure, which means we're not going to try to turn on the behavior that we don't want to see. We're just gonna see if we can talk to enough people and observe him and capture the data and see if we can make a good educated guess, right? A hypothesis. We think that it'sattention or we think that it's escape and here's our behavior plan. Whereas with a functional analysis, you generally know with a very high degree of confidence, like it's totally escape because every time that we deprive him of a attention, he starts to elope after about 35 minutes of no attention you can get.

Speaker 1 (11:34):

It's pretty incredible how you can watch the time charts and see exactly when these behaviors are kickoff in a FA. But again, FA, functional analysis, not a very popular assessment tool for parents and for teachers. And so thus the FBA is not as accurate and can give you false negatives and false positives. It usually takes a little bit longer to kind of get to the root of the problem. But they're very, very commonly used, especially in public schools. Less so in ABA clinics. Cause they're taking enough other data that they generally don't do FBAs. They have enough data that they can test out some of the hypothesis. It's as far as attention and escape without going through the whole FBA process. It's mostly a public school thing.

Speaker 1 (12:25):

But I also want to say the public schools or a lot of folks apparent will escalate their concern about a particular behavior in the school or the clinic or the hospital will say, Oh, let's do an FBA. And this is a little controversial what I'm about to say. I have found many times that that's just a delaying tactic. They're not sure what to do. They know, having dealt with thousands of kids that if you wait a month, sometimes behaviors just go away. Problem with kids on the spectrum and problem with behaviors that are really escalating is they're not going away. And generally speaking, whatever's causing the behaviors to increase is in the environment. And unless you change that you know, you might want to change the teacher behavior, the parent behavior, the way the classroom is set up, there's a million things that you can do to kind of change the context of the behaviors.

Speaker 1 (13:23):

But one thing you definitely is not a good idea is just ignored. It's kind of like, Oh, my brakes are squeaking. You know, brakes squeak. Let me not worry about that. Most of you probably know this, but not everybody does that. Brakes, generally speaking, brakes have a little device on them that when they get worn down to a certain point, a little piece of metal touches them so that they make a squeak so that you go change them. It's the warning sign like, Hey, brakes are pretty low. A behavior escalating is a warning sign that behaviors are going to get worse, probably not just going to get better. Unless you have a really clear idea of what is probably, you know, maybe the kid moved, maybe there was a change in their home environment. Like somebody moved in, somebody moved out, they got a new pet, they lost a pet.

Speaker 1 (14:06):

There's a lot of things that can really set folks off. But if you are doing, if you are engaged in the FBA process recognize that it's going to ask you to probably change some stuff. When you get the behavior intervention plan, it's going to say, mom, this is what you want. We want you to do or or teacher, this is what we need you to do to try to mitigate some of these behaviors. But it's a really good tool. It's a really strong tool. It's great that it is near universally available in the schools and about and if you do have a kid who's in a school and on an IEP and they are behaving in a way that is concerning to you, it's a good thing to request cause it sort of triggers a process.

Speaker 1 (14:44):

You get a lot of different professionals in there. There's usually a psychologist, maybe speech the team comes together and usually participates. So that is FBAs. I highly encourage you to go to the afirm website, A F I R M a website and they've got all these modules on these evidence based practices. And want to thank you very much for watching. Check out, getanswersnow.com or grab your phone. And go ahead and just type in AnswersNow open up your App store and type in dun, dun, time to be hero. Whoops. That's what happens when you chuck your fingers.

Speaker 2 (15:34):

[Inaudible]

Speaker 1 (15:34):

Answers now. Oops.

Speaker 2 (15:41):

[Inaudible]

Speaker 1 (15:42):

And there we are and you just download us and away you go. Thank you again. I'm Adam Dreyfus, chief science officer for AnswersNow, find more about us on getanswersnow.com. And hopefully you're having a terrific day.


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