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A Systematic Review of Functional Analyses Trainings Victor Ramirez, Ellie Kazemi, and Vahe Esmaeili
California State University, Northridge CalABA February 11th, 2017
Introduction • Functional analysis methodology is
o The most valid method of determining the underlying cause of problem behavior (Hanley, Iwata, & McCord, 2003)
o Considered best practice for identifying function of problem behavior (Beaver, Iwata, & Lerman, 2013)
o Evidenced to produce better treatment outcomes (Campbell, 2003)
• Skills required to complete a functional analysis o Designing o Implementing o Collecting data o Graphing o Interpreting results o Dealing with undifferentiated results o Selecting function-based intervention
• Some expertise is required
Purpose Conducted a systematic review to determine what we currently know about training individuals
to use functional analysis methodology
Method • Search Criteria
o Search engine: PsycINFO o Search date: April 28, 2016 o Peer reviewed o English o Keywords o functional analys* o train* OR teach* o staff* OR teacher* OR parent* OR caregiv* OR practitioner* OR student
• A total of 395 articles
• Inclusion criteria o Trained participants to utilize any functional analysis component skill
§ (e.g., designing, graphing, selecting function-based interventions)
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• Out of 395 articles: o 31 articles
• Two independent reviewers
o Reviewed all 395 articles o 100% agreement on 31 articles to include
• Data Collection o Categorized:
§ Characteristics of participants § Functional analysis component skills trained § Number of participants who met mastery § Average training time per participant
• (Package training time) + (Average session time) • Interobserver agreement
o Reviewed 39% of articles o 95% agreement on information categorized (range of 85%-100%)
Results
• FA Component Skills Trained
• Participant Characteristics
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• Method of FA Taught
• Conditions trained & median trials to criterion
• Training Method (n = 131 participants)
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• Training Format (n = 131 participants)
• Average Training Time per Participants
Conclusions o Implementation can be trained in a short period of timeo Individuals can learn implementation without prior knowledge of FAso Many different individuals have been taught how to implement FAs successfullyo Behavioral skills training has been established as an effective training method for
functional analysiso Group training may be as effective as individual training
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Future Research o Continue research in training all other FA component skills o Researchers should report training time o Training: Design of a functional analysis o Training of all functional analysis component skills together
Selected References
Beavers, G. A., Iwata, B. A., & Lerman, D. C. (2013). Thirty years of research on the functional
analysis of problem behavior. Journal of Applied Behavior Analysis, 46, 1-21. Campbell, J. M. (2003). Efficacy of behavioral interventions for reducing problem behavior in
persons with autism: a quantitative synthesis of single-subject research. Research in Developmental Disabilities, 24(2), 120-138.
Hanley, G. P., Iwata, B. A., & McCord, B. E. (2003). Functional analysis of problem behavior: A review. Journal of Applied Behavior Analysis, 36, 147-185.
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Using Simulation-based Training and eLearning to Teach Students How to Conduct Functional Analyses
Michael Aragon, Ellie Kazemi, Victor Ramirez, & Vahe Esmaeili California State University, Northridge CalABA Symposium February 11, 2017
Introduction
• Many Functional Analysis training packages focus on implementation (Ramirez et al., 2016)
• Training requires a lot of time and the use of expert trainers (Ramirez et al., 2016) • The use of technology
o Reduced cost & resources § eLearning § Robot simulating a client with problem behavior
Purpose
• Examine the effectiveness of a Standard FA training using o Instructional eLearning modules and o Simulations using a humanoid robot on implementation, data collection,
graphing, interpretation, and problem solving skills.
Participants & Settings • Total of 7 graduate students (2 men, 5 women)
o Enrolled in an advanced research methods class o Prior coursework on assessment and treatment of problem behavior
• eLearning Modules o Accessible in any setting with a computer via a Google Drive link
• Simulation-based Training o Observation rooms with one-way mirrors on the university campus
Response Measurement • Knowledge of component skills measured by multiple choice and fill-in tests:
o Data Collection o Interpretation o Problem Solving o Graphing
• Pre-post test design o 20 items total (5 per component skill) o Calculated percentage correct on tests
Intervention: e-Learning Modules
• Five-part eLearning module on FA methods o Average time to completion was 6 hours o Components targeted knowledge test content
1. Implementation (Iwata et al., 1994) 2. Data Collection 3. Graphing
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4. Interpretation (Roane et al., 2013) 5. Problem solving (Chok et al., 2012)
Results of completing the modules
Pe
rce
nta
ge
of
Co
rre
ct
Re
sp
on
se
s
D a ta C o lle c tio n G ra p h in g In te rp re ta tio n P ro b le m S o lv in g T o ta l T e s t S c o re0
2 0
4 0
6 0
8 0
1 0 0
P re -T es t
P os t-T es t
Implementation Skills • Performance monitoring tool (adapted from Ward-Horner & Sturmey, 2012)
o Overall percentage correct o Mastery criteria: one session > 90%
• Trial-by-trial IOA o 90% agreement (range of 80%-100%)
Intervention
• Standard FA condition properties o Participants informed of:
§ Results of preference assessment results § Demand: Clap hands
o 2-min. conditions across a humanoid robot § Fixed order: Attention, play, & demand
• Total training time (M=25 min; Mdn= 18 min)
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Implementation Results
Summary
Limitations • eLearning
o Participants were graduate students o Improvements to weaker module components
• Test Development o Knowledge tests not counterbalanced to assess difficulty o Post-test results did not include implementation knowledge test (screening) o Test sections were too short (each section should be 10 questions)
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Implications • eLearning modules together with simulation-based training may be a great alternative to
teach FA methodology in a time and cost efficient manner.
Selected References Chok, J. T., Shlesinger, A., Studer, L., & Bird, F. L. (2012). Description of a practitioner training program on functional analysis and treatment development. Behavior Analysis in Practice, 5(2), 25.
Iwata, B.A., Dorsey, M.F., Slifer, K.J., Bauman, K.E., & Richman, G.S. (1994). Toward a functional analysis of self-injury. Journal of Applied Behavior Analysis, 27, 197-209. doi: 10.1901/jaba.1994.27-197 (Reprinted from Analysis and Intervention in Developmental Disabilities, 2, 3-20, 1982) Ramirez, V., Kazemi, E., & Esmaeili, V. (2016). A systematic review of functional analysis
trainings. Unpublished raw data.
Roane, H. S., Fisher, W. W., Kelley, M. E., Mevers, J. L. and Bouxsein, K. J. (2013). Using modified visual-inspection criteria to interpret functional analysis outfomes. Journal of Applied Behavior Analysis, 46, 130–146. doi:10.1002/jaba.13
Ward�Horner, J., & Sturmey, P. (2012). Component analysis of behavior skills training in functional analysis. Behavioral Interventions, 27(2), 75-92.
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Obesity and Healthy Living: Can Antecedent Interventions Alter College Students’ Snack Selections?
Shir Zion and Ellie Kazemi
California State University, Northridge
CalABA February 11, 2017
Introduction
• In the past 20 years, there has been a dramatic increase in obesity in the U.S. (Centers for Disease Control, 2010)
• Two major contributing factors to obesity are (National Institutes of Health, 2012)
o High calorie intake o Low levels of exercise
Background
• Jeffrey, French, Raether, and Baxter (1994) o M = 368 consumers in a university office cafeteria o IV: Increased availability of fruits/veggies in salad bar + additional antecedent
modifications
• Olstad, Goonewardene, McCargar, and Raine (2015) o 17,262 items sold in two community pool kiosks o IV: Increased availability of healthier food/drink + additional antecedent
modifications
Gaps in the Literature A lack of
• college student representation. • research relating to snack selection. • behavioral research.
Purpose Evaluate the effect of
• increasing availability of healthier snacks + adding variety and an advertisement of new healthier snacks on college students’ snack selection.
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Participants and Setting • 31 Graduate Students • Age 22-34 years old • Gender
o 8 males; 23 females • California State University, Northridge classroom • Once a week; 6:00pm-9:45pm
Material Selection Criteria
Healthier Snacks
Calories ≤100
Fat <7g
Less Healthy Snacks
Calories >100
Fat ≥7g
U.S. Department of Health and Human Services & U.S. Department of Agriculture, 2010; Bauersfeld, 2015
Materials
Intervention 1 (Includes Less Healthy + Healthy) Intervention 2 (Includes Les Healthy + Healthy + New Healthier + Advertisement) Less Healthy Salty – Lays Potato Chips Sweet – Chewy Peanut Butter Bars Cheesy – Cheetos
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Healthy Salty - Popchips Sweet – Fiber One Cinnamon Bars Cheesy – Ritz Crackers and Cheese Dip New Healthier Salty – Funyons Sweet – Fiber One Brownie Bars Cheesy – Pretzels and Cheese Dip Advertisement (of new healthier snacks)
Response Measurement
1. Percentage of students who selected healthier snacks per session. 2. The mean of the total percentage of healthier snacks selected per condition. IOA: Mean percentage of agreement between the data collectors across sessions 100% (Intervention 1); 100% (Intervention 2); 98.5% (Control)
Procedures Vocal Scripted Instruction:
• Complete and submit index card • Welcomed to make a snack selection during class break • Red ticket for snack • Blue ticket for water • Bring key tag to every class session • Blind to the purpose of the study
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Intervention 1 vs. Control Intervention 2 vs. Control
Group’s Snack Selection
Group’s Statistical Analyses
0
10
20
30
40
50
60
70
80
90
100
1 2 3 4 5 6 7 8 9 10 11 12 13
Per
cent
age
of S
tude
nts S
elec
ting
Hea
lthie
r Sn
acks
Sessions
Intervention 1
Control
Intervention 2
0 10 20 30 40 50 60 70 80 90
100
Control Intervention 1 Intervention 2
Mea
n of
the
Tota
l Per
cent
age
of
Hea
lthie
r Sn
acks
Sel
ecte
d
Condition
M = 43% M = 50%
M = 80% *
* p < .05
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Intervention 1 vs. Control Intervention 2 vs. Control
Individuals who Always Selected (N=3)
Summary • Increasing availability of healthier snacks alone did not result in significant differences. • Increasing availability of healthier snacks + adding variety + advertising new healthier
snacks did result in significant differences for the group.
Discussion Limitations include
• having access to vending machines, • no consensus, • reactivity, • students sharing food, • students eating before class, and • only using non-perishable snacks in this study.
Future Research
• Extend the current study and add cost as an additional variable. • Isolate the component in Intervention 2
o For example: variety and advertisement
0
10
20
30
40
50
60
70
80
90
100
1 2 3 4 5 6 7 8 9 10 11 12 13
Per
cent
age
of S
tude
nts
Sele
ctin
g H
ealth
ier
Snac
ks
Sessions
Intervention 1
Control
Intervention 2
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Selected References
Frazao E., Stewart H., Hyman J., Carlson A. (2012). Gobbling Up Snacks: Cause of Potential Cure for Childhood Obesity? Retrieved on April 1, 2015. http://www.ers.usda.gov/ amber-waves/2012-december/gobbling-up-snacks-cause-or-potential-cure-for- childhood-obesity.aspx#.Var28s5RHdl
Jeffery, R.W., French, S.A., Raether, C., Baxter, J.E.(1994). An Environmental Intervention to Increase Fruit and Salad Purchases in a Cafeteria. Preventative Medicine, 23, 788-792. DOI:10.1006/pmed.1994.1135
Olstad, D.L., Goonewardene, L.A., McCargar, L.J., Raine, K.D. (2015). If We Offer It, Will Children Buy It? Sales of Healthy Foods Mirrored Their Availability in a Community Sport, Commercial Setting in Alberta, Canada. Childhood Obesity. 11(2), 156-164. DOI: 10.1089/chi.2014.0131
U.S. Department of Health and Human Services & U.S. Department of Agriculture. (2015). Dietary Guidelines for Americans. Retrieved on April 1, 2015, from http:// www.health.gov/dietaryguidelines/2015-dga-timeline.pdf
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Workplace Conflict for Board Certified Behavior Analysts
Chelsea Carter, Ellie Kazemi, Shelby Jones, Christina Melanie Saez
California State University, Northridge
CalABA February 11, 2017
Introduction
Studdert et al. (2003) defined conflict as:
“dispute, disagreement, or difference of opinion related to the management of a patient”, and “involving more than one individual and requiring some decision or action”
Prevalence and Impact of Workplace Conflict
Prevalence of conflict
• Healthcare: 72% (Azoulay et al., 2009) • Education: 83% (Tantleff-Dunn, Dunn, & Gokee, 2002)
Negative impact of conflict
• Accounting o Lowered job satisfaction (Shafer, 2002) o Higher intention to leave (Greenhaus, Parasuraman, & Collins, 2001)
• Education/Special Education o Higher burnout (Schwab & Iwanicki, 1982; Crane & Iwanicki, 1986)
Resources for Resolving Workplace Conflict
Behavior Analysis
• 25 Essential Skills & Strategies for the Professional Behavior Analyst (Bailey & Burch, 2010)
• Recommendations for Detecting and Addressing Barriers to Successful Supervision (Sellers, LeBlanc, & Valentino, 2016)
Social and Educational Psychology
• How to deal with “difficult people” (Conlow & Watsabaugh, 2009; Harvard Business School Press, 2004)
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• Bargaining/Negotiation (Strom-Gottfried, 1998) • Assess & Diagnose (Gerardi, 2003)
Purpose of Our Study
Conduct a survey using a representative sample of Board Certified Behavior Analysts (BCBAs) to establish preliminary information on workplace conflict for BCBAs
Participants
National distribution through BACB Listserv:
• 15,818 BCBAs & BCBA-Ds (09/16/16) o 3,982 (25.2%) opened the email
§ 295 (7.4%) attempted the survey • 209 (5.2%) completed the survey
U.S. Professional Employment Survey: A Preliminary Report (2014) – National distribution by Association of Professional Behavior Analysts (APBA)
• 12,588 BCBAs & BCBA-Ds received invitation o 925 (7.3%) completed the survey
Participant Demographics
Demographic Item Median (SD) Age 35 (9.9) % of Sample (N=209) Gender Female 89%
Degree Designation Behavior Analysis or Applied Behavior Analysis, Psychology with focus in ABA, or Psychology/Clinical Psychology
52%
Years with BCBA credential A little over 1 to 6 years 61%
Years as supervisor in ABA A little over 3 to 6+ years 60%
Number of clients 6-13+ 76%
Settings where services are primarily provided Public School, Home-based, School + Home 66%
Highest Degree Master’s degree 85%
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Procedures
Survey details
• All responses anonymous, no identifying information collected o IRB exempt
• Each question included a “prefer not to state” option • Conflict specific questions included “do not work with this group” option
o 25 Question Items o 25-30 minutes to complete
Our Questionnaire
10 Demographic Questions (Kazemi, Shapiro, & Rylander, 2015)
• How often do you deal with conflict with…? (Studdert, et al. 2003; Breen, Abernethy, Abbott, & Tulsky, 2001; Azoulay et al., 2009)
o 11 different individuals (e.g., teachers) with whom BCBAs may encounter conflict
o Likert scale 0 – 5 (e.g. 0 - Do not work with this group, 5 – Daily) • How often is conflict unresolved with…? (Tantleff-Dunn, Dunn, & Gokee, 2002)
o 11 different individuals with whom BCBAs may encounter conflict o Likert scale 0 – 5 (e.g. 0 - Do not work with this group, 5 – Daily)
Our Questionnaire
Other factors related to Workplace Conflict – 13 Total Items
• 2 items: Turnover (Kazemi, Shapiro, & Rylander, 2015; Shafer, 2002) • 2 items: Job satisfaction (Kazemi, Shapiro, & Rylander, 2015; Shafer, 2002) • 1 item: Lost cases • 2 items: Prior training (Azoulay et al., 2009)
Workload Full-time 84%
Primary Responsibilities Oversee cases & supervise interventionists, supervise the clinical team
56%
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Results
Total Rate of Workplace Conflict
Questions: “How often do you deal with conflict with…”
Type of Degree Related to Workplace Conflict?
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Gender Related to Workplace Conflict?
Years of Experience Related to Workplace Conflict?
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Setting of Service Provision Related to Workplace Conflict?
Primary Job Duties Related to Workplace Conflict?
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ANOVA
Number of Clients Related to Conflict?
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ANOVA
Turnover & Total Rate of Conflict
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Lost Cases
Total Rate of Unresolved Conflict
Questions: “How often is conflict unresolved with…”
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Turnover & Total Rate of Unresolved Conflict
Are Participants Interested in Receiving Conflict Resolution Training?
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Do Participants Feel Conflict Impacts Job Satisfaction?
Conclusions – What Have We Learned About Workplace Conflict?
• Occurs most often with teachers, caregivers, colleagues, and supervisees • Significant group differences related to
o Number of clients o Turnover o Lost cases
• Resolution skills would improve job satisfaction • Interest in receiving formal training
Limitations
• Self-report rather than direct observation • Low response rate
o No second wave of surveys • Snowball sample
o Possibly more applicable for those who find conflict interesting • No definition provided of unresolved conflict • No specific information on prior training obtained
Future Directions
• Look into current models of Conflict Resolution Training
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• Determine the key steps required for effective Conflict Resolution
References
Azoulay E, Timsit JF, Sprung CL, et al. (2009). Prevalence and factors of intensive care unit conflicts: the conflicus study. American Journal of Respiratory and Critical Care Medicine, 180(9). 853-60.
Bailey, J., & Burch, M. (2010). 25 essential skills & strategies for the professional behavior analyst: Expert tips for maximizing consulting effectiveness. New York, NY: Routledge.
Breen, C.M., Abernethy, A.P., Abbott, K.H., & Tulsky, J.A. (2001). Conflict associated with decisions to limit life-sustaining treatment in intensive care units. Journal of General Internal Medicine, 16. 283-289.
Conlow, R., & Watsabaugh, D. (2009). Handling difficult people and situations lead people through adversity. Rochester, N.Y.: Axzo Pres.
Crane, S.J. & Iwanicki, E.F. (1986). Perceived role conflict, role ambiguity, and burnout among special education teachers. RASE, 7. 24-31.
Gerardi, D. (2003). Conflict Management Training for Health Care Professionals. Association for Conflict Resolution Quarterly. http://www.mediate.com/articles/gerardi4.cfm
Greenhaus, J.H., Parasuraman, S., & Collins, K.M. (2001). Career involvement and family involvement as moderators of relationships between work-family conflict and withdrawal from a profession. Journal of Occupational Health Psychology, 6(2). 91-100.
Harvard Business School Press. (2004). Dealing with difficult people. Boston, MA.
Kazemi, E., Shapiro, M.., & Rylander, A. (2015) Predictors of intention to turnover in behavior technicians working with individuals with autism spectrum disorder. Research in Autism Spectrum Disorders, 17. 106-115.
Schwab, R.L. & Iwanicki, E.F. (1982). Perceived role conflict, role ambiguity, and teacher burnout. Educational Administration Quarterly, 18. 60-74.
Sellers, T.P, LeBlanc, L.A., & Valentino, A.L. (2016). Recommendations for detecting and addressing barriers to successful supervision. Behavior Analysis in Practice, 9. 309-319.
Shafer, W.E. (2002). Ethical pressure, organizational-professional conflict, and related work outcomes among management accountants. Journal of Business Ethics, 38. 263-275.
Strom-Gottfried, K. (1998). Applying a Conflict Resolution Framework to Disputes in Managed
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Care. SocialKazemi & Carter (2016) Workshop Notes 7Work, 43, 393-401.
Studdert D.M., Mello M.M., Burns J.P., Puopolo A.L., Galper B.Z., Truog R.D., & Brennan T.A. (2003) Conflict in the care of patients with prolonged stay in the ICU: types, sources, and predictors. Intensive Care Med, 29.1489–1497.
Tantleff-Dunn, S., Dunn, M.E., & Gokee, J.L. (2002). Understanding faculty−student conflict: student perceptions of precipitating events and faculty responses. Teaching of Psychology, 29(3), 197-202.
A Special Thank You To…
The KLab Family
Ellie Kazemi
Shir Zion
Victor Ramirez
Vahe Esmaeili
Diana Perez
Shelby Jones
Michelle Padilla
Grecia Marsillo
Michael Aragon
Lance Dayandayan
Austin Chai
Christina Melanie Saez