Introduction to Evidence-Based Practices
Across settings and ages, 27 evidence-based practices (EBP) have been identified that address core and associated features of ASD (see Steinbrenner et al., 2020). A subset of those EBPs is designed and/or has been evaluated for their efficacy in addressing challenging behavior, which is the focus of this document.
In the following sections, interventions that have been shown to be effective for addressing challenging behavior are described along with considerations related to variables that impact perceived severity, including:
- function of behavior
- intensity of behavior
- support variables
Each of these considerations is described in further detail below.
Function of behavior
Challenging behavior has been demonstrated to occur as a function of environmental variables, including evocative events and reinforcing consequences (i.e., these behaviors are operant in nature). These variables can be identified through the process of a functional behavior assessment (FBA). That assessment can be simple (e.g., interview with care providers regarding the events that occasion and support the behavior) or more complex (e.g., systematic manipulation of antecedent and/or consequence variables to empirically identify the relation between these events and challenging behavior).
In brief, the outcomes of such assessments might broadly identify two types of behavior:
- behavior evoked and maintained by social variables, and
- behavior evoked and maintained by nonsocial variables (also known as automatically maintained behavior).
When challenging behavior is maintained by social variables (e.g., attention provided by caregivers, escape from aversive instructions or situations, and/or access to preferred stimuli), interventions involve modifying the environment, teaching skills, or some combination of those approaches.
When challenging behavior is maintained by internally produced reinforcers (i.e., automatic reinforcement), intervening is often more difficult because the variables evoking and maintaining challenging behavior are often outside of the control of implementers. In these situations, the focus is often on modifying the environment.
Intensity of the behavior
Intensity of the behavior must also be considered when selecting and implementing EBPs. Some practices include components that may result in temporary increases in frequency or severity of behavior. If the pre-intervention level of challenging behavior produces immediate injury, then these practices might not be prudent.
For example, functional communication training (FCT) is a widely used intervention to reduce challenging behavior maintained by socially available reinforcers like attention. Research has consistently demonstrated that this treatment approach works best when an extinction (i.e., disruption of the relation between challenging behavior and its maintaining consequence; Hagopian et al., 1996) component is included. However, other research has shown that inclusion of an extinction component can result in temporary increases in the intensity or frequency of the previously reinforced behavior and/or emotional arousal (i.e., extinction burst; Lerman et al., 1995). Thus, FCT might not be a viable option if temporary increases in severity or frequency of the challenging behavior or emotional arousal cannot be tolerated or safely managed.
Caregiver-related variables
Caregiver-related variables might also impact intervention selection. Some EBPs require simple manipulations of the environment. For example, antecedent-based strategies might require simply changing the type of instructions that are provided (e.g., instructional level instead of frustration level) to reduce challenging behavior maintained by escape from academic tasks. This approach requires minimal training and skill on the caregiver/implementer’s part and can be put in place without requiring additional support.
On the other hand, differential reinforcement of other behavior to address the same type of behavior would require the caregiver/implementer to monitor the occurrence of challenging behavior, manipulate a timer that signals when or if the omission requirement had been met, and potentially protecting themselves or the individual should problem behavior occur in the presence of instruction delivery.
