Participants were enrolled in a public school program for students diagnosed with a severe emotional and behavior disorder (EBD). Students received instruction in their regular classrooms from their regular teacher. The intervention was administered during times the teachers identified as periods when the most inappropriate behaviors typically occurred.
The study sample consisted of four individual students classified with a severe EBD and an intellectual disability (ID). Eli was 18 and receiving services for both diagnoses. His problem behaviors included leaving the classroom, turning over furniture, and displaying physical aggression toward staff. Mary was 8 and was receiving services for EBD, a moderate ID, cerebral palsy, and a feeding disorder. Her problem behavior was forcefully hitting others. Todd was 17 and receiving services for EBD, a moderate ID, autism, and limited speech. His problem behaviors included screaming, throwing, hitting, crying, yelling, refusing to move, and picking at the skin on his hands.
The study also reported outcomes for an additional student (Tony) with EBD; the response to an author query revealed that inter-assessor agreement data were not collected during his second baseline phase, so the experiment for this student does not meet WWC pilot single-case design standards. As a result, Tony’s experiment is not described in this report or included in the ratings of effectiveness.
Functional behavioral assessment (FBA) procedures for each student included interviews with teachers, followed by direct observations. Based on the results, researchers developed functional communication training interventions that trained students to request a short break for a preferred activity, instead of acting inappropriately. Following the first baseline phase, students were trained to place a break card in their teacher’s hand to ask for a break. They would then receive the break and a reward. If the students did not place the break card in their teacher’s hand or displayed inappropriate behavior within 5 seconds of the start of the session, the teacher physically prompted the students to place the break card in their hand. The students then received a break and a reward. Training ended when the students successfully placed the break card in their teacher’s hand five consecutive times.
After training, the teacher placed the work and the break card on the student’s desk and reminded the student that using the break card (referred to as an “alternative mand behavior” in the original study) would result in receiving a break and a reward. Students were then either rewarded with the activity of their choosing if they used the alternative behavior on which they were trained or penalized for inappropriate behavior by being removed from the task without getting to do a desired activity.
Each student’s reward was based on his/her FBA. Eli’s reward was playing puzzle games or listening to music with his headphones; Mary’s reward was playing with plastic straws and eating pudding; and Todd’s reward was sensory reinforcement including hand games and ear tickling. When the student displayed inappropriate behavior, the student received a 30-second break without a reward. Eli’s second intervention phase included a 30-second delay in which he would receive reinforcement.
The study used a reversal-withdrawal design for all three students. During the baseline/withdrawal condition, students did not have access to their break card, and negative reinforcement was used for inappropriate behavior. This involved removal from a task for a period of 30 seconds.
Support for implementation
Teachers received training from the researchers before the FBA and implementation of the intervention. The training consisted of a review and practice of the procedures until they were performed with 100% accuracy. Researchers were also present during all study phases to provide support to teachers.