Essential really to effective behaviour support, “functional assessment” provides the what, why, when, how, and how much of behaviours of concern. In fact, we have read studies that suggest that functional assessments well done improve the likelihood of your choice of support method by as much as 200%.

That is, base your effort on a functional assessment and your intervention is twice as likely to be useful. By useful we mean that behaviour support based on solid assessment and intervention planning seeks to 1. increase safety wherever possible, 2. provide insight and hope, 3. create options and choices, and 4. reduce behaviours of concern and/or change environments and supports that then contribute to changes in behaviours. In many cases these positive outcomes are documented, accepting the fact that every situation is unique and that there are no guarantees.

However, research and professional practice over many years has shown that behaviour support assessments and interventions, and counselling where appropriate, provide significant assistance to clients, families, and staff of support organisations.

Smith et al (2016) looked at the relationship between biological setting events and problem behaviours. This is helpful as research to date has ironically not examined this in empirical studies. They used a three-step multi-method procedure. This provided a detailed and systematic assessment and intervention plan. They used fatigue as a physical/biological setting event and focused on people with autism spectrum disorder and intellectual disability. Other biological setting events may include eating disorders, sleeping disorders, changes to medication time-frames, mental health disorders, etc…

The process they used was to provide a descriptive analysis that identified individuals and their history relevant to the study. This step parallels our practice of gathering and requesting case history information. Without this a comprehensive assessment is far less likely to be achieved.

Then they worked through a “functional analysis of each participant’s problem behavior in relation to two contextual factors: fatigue and task demands.” This stage goes alongside our using functional analysis as a baseline for assessment and intervention planning.

Finally the researchers evaluated and tailored a multi-component intervention package that addressed 1. the biological context (fatigue) and 2. the psychosocial context (task demands). They naturally concluded that when both these were present, behaviours were more likely to happen and at greater frequency and/or intensity.

By implementing a multi-component intervention to address both the biological setting factor and the behaviours of concern they reported a dramatic reduction in problem behaviour across the study. The implications suggested the utility of the three-step procedure for understanding and assisting with other biological setting events that contribute to behaviours of concern.

Source: Christopher E. Smith, Edward G. Carr, Lauren J. Moskowitz, 2016, Fatigue as a biological setting event for severe problem behavior in autism spectrum disorder, Research in Autism Spectrum Disorders, Volume 23, March 2016, Pages 131–144.

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