Functional analysis and treatment of bizarre speech

Functional Behavioral Assessment-based interventions on adults' delusions, hallucinations and disorganized speech: A single case meta-analysis

The Functional Behavioral Assessment (FBA) approach involves the use of single-case designs (SCD) to study the problem behavior-environment contingencies and conduct interventions that consider this functional relationship. Although this approach has been considered an evidence-based practice (EBP) for the treatment of several psychological problems, no meta-analytic studies of FBA-based interventions on delusions, hallucinations and disorganized speech -commonly operationalized as "atypical vocalizations"- have been carried out. Therefore, the purpose of this study was to review and synthesize the results of FBA-based interventions on adults' atypical vocalizations. We conducted a systematic review and a multi-level meta-analysis of these interventions, using a recently developed effect size estimator for SCD studies (i.e., log response ratio). All the studies that met our eligibility criteria provided evidence supporting the effectiveness of FBA-based interventions on atypical vocalizations, with an overall average effect size of a 72% reduction. Both the publication year and the methodological quality were found to be significant moderators. Despite some methodological limitations, we can conclude that FBA-based interventions are effective to reduce atypical vocalizations. The implications of these results could be of interest for the mental health community.

The functional analysis of problematic verbal behavior

This study describes procedures and outcomes in a functional analysis of problem behavior of 2 public school students. For a 13-year-old honors student, bizarre tacts (labeled as psychotic speech by school staff) were maintained by attention. For a 15-year-old with autism, the functional analysis revealed that perseverative mands for toileting were controlled by attention; mands for edible items were controlled by access to any food item; and mands for nonedible items were maintained by access to the specific item manded. The "problematic" aspects of the verbal behavior differed-the bizarre speech was problematic based on its content, but the perseverative verbalizations resulted in high response cost for classroom staff. Research in the area of problematic verbal behavior is sparse and warrants further attention from behavior analysts who work in public school settings. This research demonstrates the applicability and relevance of functionally analyzing problematic verbal behavior in public school settings.

Effect of training different classes of verbal behavior to decrease aberrant verbal behavior

Inappropriate verbal behavior that is labeled "psychotic" is often described as insensitive to environmental contingencies. The purpose of the current study was to establish different classes of rational or appropriate verbal behavior in a woman with developmental disabilities and evaluate the effects on her psychotic or aberrant vocal verbal behavior. Similar to a previous study (Arntzen, Ro Tonnessen, & Brouwer, 2006), the results of the current study suggested that the procedure helped to establish a repertoire of appropriate functional vocal verbal behavior in the participant. Overall, the results suggested the effectiveness of an intervention based on training various classes of verbal behavior in decreasing aberrant verbal behavior.

The significance and future of functional analysis methodologies

Iwata, Dorsey, Slifer, Bauman, and Richman (1982) presented the first comprehensive and standardized methodology for identifying operant functions of aberrant behavior. This essay discusses the significance functional analysis has had for applied behavior analysis. The methodology has lessened the field's reliance on default technologies and promoted analysis of environment-behavior interactions maintaining target responses as the basis for selecting treatments. It has also contributed to the integration of basic and applied research. Future directions for this research are suggested.

Descriptive functional analysis of behavioral excesses shown by adults with Down syndrome and dementia

OBJECTIVES

The study examined the hypothesis that a functional relationship exists between social environmental events and behavioral excesses in individuals with Down syndrome and dementia.

DESIGN

A case-series design was employed (n = 4) using an direct observation-based descriptive functional assessment procedure.

METHODS

Observations were conducted in the natural environments of four participants over periods ranging from 11 to 15.4 hours. Data were collected on non-verbal and verbal behavioral excesses, appropriate engagement and verbal interaction with others. Social environmental events observed including both staff and peer behavior.

RESULTS

Analysis of co-occurrence for behavioral excesses and social environmental events indicated significant relationships for some behaviours consistent with operant reinforcement processes. Sequential analysis showed that changes in the probability of social contact occurred in the period directly preceding and following verbal behaviors.

CONCLUSIONS

Results support the hypothesis that, consistent with literature for older adults with dementia in the general population, some behavioral excesses were functional in nature and not randomly occurring events. No relationship was found between appropriate engagement and staff contact. Evidence of the functional nature of target behavioral excesses indicates that behavioral interventions have potential for this client group.

Functional analysis and treatment of inappropriate verbal behavior

The present study examined the possible function of inappropriate verbal behavior of an adult man who had been diagnosed with both mental retardation and psychosis. Results of a functional analysis indicated that inappropriate verbal utterances were maintained by attention. An intervention consisting of the differential reinforcement of appropriate verbal behavior effectively reduced the inappropriate behavior.