Question:  What is the status of the research and literature base on intensive behavioral interventions?

Answer:  The good news is that there is a research based on behavioral interventions, but not without its problems. So what I am going to do is talk a little about what that research base looks like. Within the context of children who are showing problem behaviors in schools, from a perspective of effective explicit-based interventions, the primary method for starting behavior interventions is a function-based assessment and a function-based assessment is a series of steps or tools that a practitioner, a clinician, a school psychologist may implement to try and identify the motivating reasons for a student’s problem behavior. Function-based assessments can take many different forms, but essentially they all include features of identifying the conditions under which problem behavior is likely to occur. From the literature, we know that those reasons tend to fall into two broad categories for accessing positives, attention, tangibles, for escaping negatives, avoiding schoolwork, avoiding social interactions, and for a small percentage of kids there may be some internal motivating biological reasons for engaging in problem behavior. But the intensive behavioral interventions begin with assessment. Once that assessment has been conducted then a hypothesis or a motivation is created about why that child is engaging in those behaviors and the goal of this sort of FBA approach is to identify those motivations and use that information to develop interventions. And so many intensive behavioral interventions for students look at teaching replacement behaviors, so for students who might be engaging in problem behavior to escape difficult academic tasks, the replacement behavior might be requesting assistance. For students who might be avoiding social situations, possibly giving them a safe-zone in the classroom to sort of reassure themselves before they go into a situation. So the ideas are sort of taken and match the assessment to the intervention and for a good part of the population we have done a nice job about that. Where we are still lacking in terms of research and what we need to know more about is how we can apply that same technology to less obvious behaviors like depression, like anxiety, like significant social withdrawal and understanding that if there are environmental or observed motivations for those sorts of internalizing type behaviors, can we take the same assessment procedures or something like them and apply them to children with these types of intensive behavioral needs and create function-based assessments and function-based interventions for that population of students as well? We’re not there yet, I think there is some good work being done in that area but we don’t have the evidence base that we do for more externalizing outgoing behaviors. A second sort of limiting area in terms of intensive behavioral supports comes with those students who show high intensity, but low frequency behaviors, like physical attack or vandalism, those things that don’t occur daily, as motivations are not always clear because we just don’t have enough of examples that seem like kids are doing that. So one way that the field is being pushed is looking at classes of behavior and seeing how students who engage in those intensive low frequency, but high intensity behaviors may be showing other signs that might be related to those sorts of episodes that we can take that information and then begin, build a function-based intervention in understanding what might work for those students. I think the last thing I can talk about sort of the current state of research, is that despite our advances in intervention development for this population, we do still come across the attitude problem, that oftentimes students who engage in intensive problem behavior are children that are rejected by schools, rejected by teachers, rejected by their peers and for some reason the notion is that these students are doing things on purpose and often time shaped in to looking only at the child and not the environment, which is totally counter-intuitive to how we’ve been talking about interventions in general for these populations. So, while we are developing these interventions, educating folks about why students might be doing these things and understanding that identifying motivations is the best way to sort of approach this problem but taking ownership, and taking this ownership and saying I got to tell my students you know if a child is engaged in this sort of problem the first question we should be asking is, why is this child doing this? Am I doing something or is the environment doing something to contribute to this child’s problem behavior? And I think if we can sort of teach that attitude, teach that approach to problem behavior then we will continue to progress in our development of effective interventions for students with these sorts of issues.