JOURNAL OF APPLIED BEHAVIOR ANALYSIS

2013, 46, 4760

NUMBER

1 (SPRING 2013)

FUNCTIONAL ANALYSIS SCREENING FOR PROBLEM BEHAVIOR MAINTAINED BY AUTOMATIC REINFORCEMENT ANGIE C. QUERIM
UNIVERSITY OF NEBRASKA

BRIAN A. IWATA
UNIVERSITY OF FLORIDA

EILEEN M. ROSCOE

AND

KEVIN J. SCHLICHENMEYER

NEW ENGLAND CENTER FOR CHILDREN

AND

JAVIER VIRUS ORTEGA

AND

KYLEE E. HURL

UNIVERSITY OF MANITOBA AND ST. AMANT RESEARCH CENTRE

A common finding in previous research is that problem behavior maintained by automatic reinforcement continues to occur in the alone condition of a functional analysis (FA), whereas behavior maintained by social reinforcement typically is extinguished. Thus, the alone condition may represent an efficient screening procedure when maintenance by automatic reinforcement is suspected. We conducted a series of 5-min alone (or no-interaction) probes for 30 cases of problem behavior and compared initial predictions of maintenance or extinction to outcomes obtained in subsequent FAs. Results indicated that data from the screening procedure accurately predicted that problem behavior was maintained by automatic reinforcement in 21 of 22 cases and by social reinforcement in 7 of 8 cases. Thus, results of the screening accurately predicted the function of problem behavior (social vs. automatic reinforcement) in 28 of 30 cases. Key words: functional analysis, automatic reinforcement, screening

In a typical functional analysis (FA) of problem behavior (Iwata, Dorsey, Slifer, Bauman, & Richman, 1982/1994), an individual is exposed repeatedly to a series of conditions in which antecedent and consequent events are manipulated to determine which events are responsible for behavioral maintenance. The utility of the FA as a basis for intervention has been demonstrated in hundreds of studies; as a result, it is considered to be the standard throughout the field (Hanley, Iwata, & McCord, 2003). Much of the research in the FA literature has consisted of systematic replication and extension across client population, problem behavior, and
Address correspondence to Brian Iwata, Psychology Department, 114 Psychology Building, University of Florida, Gainesville, Florida 32611 (e-mail: iwata@ufl.edu). doi: 10.1002/jaba.26

setting. Other research has focused on methodological refinement or adaptation to accommodate unusual client histories or limiting conditions of assessment. These modifications have included variations in both the content and arrangement of assessment conditions, and the present study focuses on the latter. One limitation in settings such as outpatient clinics is the amount of time available for conducting assessments, and a model developed specifically for use in time-limited situations is the brief functional analysis (BFA). As described by Northup et al. (1991), the BFA consists of single exposures to 5-min assessment conditions, with the addition of one replication (the condition in which behavior occurs most frequently) and a treatment probe if time permits. In a review of data from 79 cases in which the BFA was used, Derby et al. (1992) 47

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ANGIE C. QUERIM et al. sessions interspersed with attention and demand probes. If results were clear after 14 sessions, the FA was terminated; if not, further manipulations were conducted. Of the 64 subjects, 46 (72%) required only the first assessment phase, suggesting that exposure to only the alone or nointeraction sessions may have been sufficient for a large number of individuals. The purpose of this study was to evaluate the utility of brief exposure to alone or nointeraction sessions as a screening procedure for problem behavior maintained by automatic reinforcement. If problem behavior is maintained during this brief assessment, it may be possible to forgo other assessment conditions and proceed directly to intervention. By contrast, if problem behavior is not maintained, further assessment would be warranted. In the present study, we conducted the initial screening and a subsequent FA for all subjects to determine whether (a) rates of problem behavior during screening sessions were predictive of the outcome of an FA and (b) behavior maintained by automatic reinforcement revealed a more consistent pattern of responding during screening sessions relative to behavior that has other (social) functions. Because results of several studies have shown that stereotypy is likely to be maintained by automatic reinforcement (Piazza, Adelinis, Hanley, Goh, & Delia, 2000; Rapp, Miltenberger, Galensky, Ellingson, & Long, 1999; Vollmer, Marcus, & LeBlanc, 1994), stereotypy was the topography examined most often in this study. We included other topographies of problem behavior (aggression, self-injurious behavior [SIB], etc.) as well because these behaviors have been shown to be maintained more often by social reinforcement (Iwata et al., 1994; Marcus, Vollmer, Swanson, Roane, & Ringdahl, 2001). The inclusion of multiple topographies of problem behavior increased the likelihood that screening data would be suggestive of extinction as well as maintenance, allowing us to verify both types of predictions.

reported that the BFA yielded interpretable results in 47% of the cases. Kahng and Iwata (1999) subsequently compared outcomes from brief (single-session) and more typical (repeated measures) FAs for 50 cases and found correspondence in 66% of them. Thus, although the BFA may represent the only option for experimental assessment under some conditions, the greatly reduced number and duration of sessions yield limited samples of behavior. Vollmer, Marcus, Ringdahl, and Roane (1995) proposed a progressive or hierarchical model of assessment in which lengthier components were added as needed. Twenty subjects progressed through four phases of assessment, which was terminated after any phase in which the function of problem behavior was identified. In Phase 1, 8 to 12 sessions of a typical FA were conducted in a multielement design, and data were examined as within-session patterns of responding. In Phase 2, FA sessions continued, and data were examined as overall session means. In Phase 3, additional sessions from only the alone (or no-interaction) condition were conducted. In the final phase, all assessment conditions were repeated but were alternated in a reversal design. With this strategy, Vollmer et al. identified the function of problem behavior in 17 of the 20 cases. Six subjects completed the assessment after Phase 1, four additional subjects after Phase 2, five subjects after Phase 3, and two subjects after Phase 4. It should be noted, however, that the assessment was not especially brief because even Phase 1 entailed 8 to 12 10-min sessions, the typical duration for many FAs. Roscoe, Iwata, and Zhou (2013) described an alternative assessment model for a specific application. They assumed that the target behavior in their study, hand mouthing, was most likely to be maintained by automatic reinforcement, so they arranged FA conditions in a 2:1 ratio of alone or no-interaction versus attention and demand sessions and eliminated the play condition entirely. This resulted in an FA that consisted mostly of alone or no-interaction

FUNCTIONAL ANALYSIS SCREENING METHOD Subjects and Settings Twenty-six individuals who had been referred for assessment of problem behavior (stereotypy, SIB, aggression, or property destruction) participated. One individual engaged in three problem behaviors, and two engaged in two problem behaviors, yielding a total of 30 cases. Table 1 shows demographic information for all subjects. The study was conducted at three sites: two school programs and a residential program, all of which served students with intellectual disabilities, autism, or both. All

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sessions were conducted in small rooms that contained a desk, two chairs, and other materials as needed. Screening sessions lasted 5 min; FA sessions lasted 10 min. All sessions were conducted three to five times per day, 1 to 5 days per week. Response Measurement and Reliability The dependent measure was the occurrence of problem behavior, which was defined on an individual basis (see Table 1). Trained observers recorded data on handheld computers. The data were converted to rate measures (responses per

Table 1 Subject Characteristics

Subject Michele Bri Dan Karl Cor Niki Eric Winn Natalie Dave Jake Nate Sonia Holly Ron Mark Jude Ed Sal Dana Kim Larry Eve Brad Queen Pablo Age 13 19 11 13 36 47 30 13 14 12 14 14 14 16 23 10 12 36 16 14 14 9 17 14 13 23 Diagnosis ASD ASD ASD ASD (ID, spastic quadriplegia ID, cerebral atrophy, microcephaly, deaf, blind ID, left hemiparesis, seizure, retinal detachment ASD ASD ASD ASD ASD ASD ID, SL impaired ID, SL impaired, physical impairment SL impaired, orthopedically impaired ASD, SL impaired ID, spastic deplegia, seizure disorder ASD ASD ID, SL impaired ID, cerebral palsy, hydrocephalus, cortical blindness, seizure disorder ID, speech and language impaired Dandy Walker syndrome, ADHD Other health impaired, SL impaired ID, SL impaired STPY: STPY: STPY: STPY: STPY: STPY: Topography hand wave finger play vocal vocal hand or object in mouth finger play

STPY: hand in mouth STPY: hand wave STPY: vocal STPY: finger tap, spin STPY: hand wave STPY: hand wave STPY: hand wave STPY: rub lips STPY: head twirl STPY: lip rub STPY: finger curl STPY: finger to throat SIB: hit head SIB: Pinch self SIB: bite hand AGG: hit, kick, bite, throw objects at person SIB: hit head PD: rip or throw materials AGG: hit, kick, bite AGG: hit, kick, pull hair, bite, throw objects at person SIB: hit chin AGG: pull hair SIB: hit groin PD: rip or throw materials

Note. ASD autism spectrum disorder; ID intellectual disability; STPY stereotypy; SIB self-injurious behavior; PD property destruction; AGG aggression; SL speech-language.

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ANGIE C. QUERIM et al. 75% or more of trials were designated as highly preferred (HP) and were used in the play condition of the FA; items chosen between 30% to 60% of trials were designated as moderately preferred (MP) and were used in the attention condition of the FA. Sequence Screening consisted of a series of 5-min alone or no-interaction sessions. We selected 5 min based on the typical session duration of a BFA (Northup et al., 1991) and conducted a minimum of three sessions with every subject, with additional sessions as needed to clarify trends in the data. All sessions were conducted in a single block with 2-min breaks between sessions (subjects were taken for brief walks or given bathroom breaks as needed, but no specific protocol was followed during breaks). We then conducted a typical FA (Iwata et al., 1982/1994) that included alone or no-interaction, attention, play, and demand conditions in a fixed-sequence multielement design. Screenings always preceded FAs to eliminate subjects prior exposure to FA contingencies, as would be the case under clinical conditions. Assessment Conditions Alone or no interaction. The purpose of this condition was to determine whether problem behavior was maintained in the absence of any social interaction; if so, it was most likely maintained by automatic reinforcement. The subject was in a room that did not contain any leisure items. In the alone condition, the experimenter was not in the room; in the nointeraction condition (for subjects whose target behavior was aggression), the experimenter was present but did not interact with the subject at any time during the session. Attention. The purpose of this condition was to determine whether problem behavior was maintained by social-positive reinforcement in the form of attention. The subject and experimenter were in the room, and the subject had free

minute) or the percentage of 10-s intervals during which responding occurred. A rate measure was used for behaviors that had a discrete beginning and end (e.g., aggression was recorded every time the subjects hand made contact with the therapists body). An interval measure was used for behaviors with variable durations (e.g., the subject pulled the therapists hair). Observers also recorded therapist behaviors (initiation of social interaction or removal of instructions) to assess procedural consistency. A second observer simultaneously but independently collected data for at least 25% of all sessions. Reliability was calculated by dividing session time into consecutive 10-s intervals and comparing observers records on an interval-by-interval basis. Percentage agreement for frequency measures was calculated by dividing the smaller number of responses by the larger number of responses in each interval and averaging these fractions across the session. Percentage agreement for interval measures was calculated by dividing the number of agreement intervals (on the occurrence or nonoccurrence of behavior) by the total number of intervals in a session. The mean reliability percentage for problem behavior across all subjects was 94% (range, 69% to 100%). (Reliability results for other measures are available from the first author.) Preference Assessment A paired-stimulus preference assessment (Fisher et al., 1992) was conducted to identify items to be included in each subjects FA. Nine leisure items were assessed, and subjects were exposed briefly to all items prior to the assessment. On each assessment trial, the experimenter presented two items and prompted the subject to choose one. A selection was scored when the subject touched one of the two items. The subject was given 10-s access to the selected item while the unselected item was removed, after which the selected item was removed and the next pair was presented. Assessment continued until all possible pairs were presented twice. Items chosen on

FUNCTIONAL ANALYSIS SCREENING access to two MP leisure items. The experimenter began the session by stating that she had work to do, turned away from the subject, and engaged in a solitary activity (e.g., read a magazine). If the subject engaged in problem behavior, the experimenter delivered 3 to 5 s of verbal and physical attention. All nontarget behavior was ignored. Play. This condition served as the control condition. The subject and experimenter were in the room, and the subject had free access to two HP leisure items. The experimenter delivered 3 to 5 s of verbal and physical attention at least every 30 s (or whenever the subject initiated appropriate social interaction) and ignored all instances of problem behavior. Demand. The purpose of this condition was to determine whether problem behavior was maintained by social-negative reinforcement in the form of escape from task demands. The experimenter continuously presented academic tasks using a three-prompt sequence (vocal instruction, model prompt, physical prompt), terminated the trial (ceased instruction, removed

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all materials, and turned away from the subject) for 30 s contingent on problem behavior, and delivered brief praise (3 to 5 s) contingent on the subjects compliance. Data Interpretation At least three and usually eight Board Certified Behavior Analysts examined graphs of screening and FA data graphed separately and reached a consensus regarding (a) the prediction made by the screening assessment and (b) the FA outcome. These judgments were used as the basis for determining the extent to which the predictions made based on the screening assessment matched the FA outcomes (see Figure 1). If problem behavior was maintained for three or more screening sessions, it was predicted to be maintained by automatic reinforcement. If problem behavior also was either highest in the alone or no-interaction condition of the subsequent FA or high in all conditions of the FA, it was determined to be maintained by automatic reinforcement (hit). If data showed a clear downward trend ending in a zero or

Figure 1.

Possible outcomes from the screening assessment and the functional analysis.

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ANGIE C. QUERIM et al. forcement were confirmed by their subsequent FAs. One subject, Sonia, engaged in stereotypy that decreased markedly during her screening assessment, suggesting that her behavior was maintained by social reinforcement. Results of her FA confirmed this prediction: Her highest level of stereotypy was observed in the demand condition. Figure 4 shows results for five subjects who engaged in SIB. Pablos, Larrys, Danas, and Sals SIB was maintained in their screening assessments; their SIB also occurred in all conditions of their FAs, confirming predictions that their SIB was maintained by automatic reinforcement. Kim did not engage in any SIB during her screening assessment; she subsequently engaged in the highest levels of SIB during the demand condition of her FA, confirming the prediction that her SIB was maintained by social reinforcement. Figure 5 shows results for two subjects who engaged in property destruction. Pablo did not engage in any property destruction during his screening assessment and engaged in property destruction exclusively in the demand condition of his FA. Thus, the prediction based on his screening (maintenance by social reinforcement) was confirmed by his FA (maintenance by escape). Eves property destruction showed a different pattern; there were high levels of responding during the screening and during all conditions of her FA, with highest levels in the alone condition. Thus, her screening assessment accurately predicted that property destruction was maintained by automatic reinforcement. Figure 6 shows data for four subjects who engaged in aggression (Brad, Pablo, Kim, and Queen). All subjects engaged in zero or near-zero levels of aggression during the screening, suggesting maintenance by social reinforcement. During the subsequent FAs, Brad and Pablo engaged in the highest levels of aggression during the attention condition, whereas Kim and Queen engaged in the highest levels of aggression during the demand condition, confirming that

near-zero rate of behavior during screening, it was predicted to be maintained by social reinforcement. If problem behavior during the subsequent FA was highest in the attention or demand condition, behavior was determined to be maintained by either attention or escape from demands, respectively (also a hit). Two types of errors could have occurred. If the screening assessment predicted that problem behavior was maintained by automatic reinforcement but was observed to occur at the highest levels in either the attention or demand condition (or at high levels in both conditions) of the FA, it was determined to be maintained by social reinforcement (false alarm). If the screening assessment predicted that problem behavior was maintained by social reinforcement but it occurred at its highest levels in the alone condition or in all conditions of the subsequent FA, it was determined to be maintained by automatic reinforcement (miss). RESULTS Figure 2 shows results for 10 subjects who engaged in stereotypy (Jake, Winn, Natalie, Karl, Jude, Dan, Cor, Niki, Eric, and Ron). All subjects stereotypy was maintained during their screening assessments, suggesting that their behavior was maintained by automatic reinforcement. During the subsequent FAs, Ron continued to engage in stereotypy in the alone condition and also in the demand condition; all other subjects engaged in stereotypy in all conditions, confirming all predictions made by the screening assessment. Figure 3 shows results for seven additional subjects who engaged in stereotypy. Six subjects stereotypy was maintained during the screening assessment (Holly, Ed, Bri, Nate, Dave, and Mark) and occurred at its highest levels during either the alone condition (Holly, Bri, and Dave) or most conditions (Ed, Nate, and Mark) of the FA. Thus, predictions that these six subjects stereotypy was maintained by automatic rein-

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Figure 2.

Percentage of intervals of stereotypy across the screening assessment (SA) and FA conditions.

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Figure 3. Percentage of intervals of stereotypy across the SA and FA conditions.

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Figure 4. Responses per minute or percentage of intervals of SIB across the SA and FA conditions.

their aggression was maintained by social reinforcement (attention for Brad and Pablo, escape for Kim and Queen). Figure 7 shows data for the only two subjects whose screening results were inconsistent with those obtained in the subsequent FAs. Queens SIB decreased during the screening assessment. However, she engaged in the highest levels of SIB during the alone condition of her FA. These data

exemplify a miss, in that the prediction based on her screening data (social reinforcement) was not borne out by her FA data (automatic reinforcement). Micheles stereotypy occurred at high levels during her screening assessment; her FA data showed decreasing trends in all conditions initially but gradual emergence in only the attention condition. These data exemplify a false alarm: Her screening assessment incorrectly

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Figure 5. Responses per minute of property destruction across the SA and FA conditions.

Figure 6.

Responses per minute or percentage of intervals of aggression across the SA and FA conditions.

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Figure 7. Responses per minute of SIB (Queen) and percentage of intervals with stereotypy (Michele) across the SA and FA conditions. Queens data reflect a miss; Micheles data reflect a false alarm (see text).

predicted that behavior was maintained by automatic reinforcement, whereas her FA indicated that behavior was maintained by social reinforcement (attention). Table 2 shows a summary of the results. Overall, the screening assessment accurately predicted that behavior was maintained by either automatic or social reinforcement in 28 of 30 cases. Results of the screening assessment for 17 of the 18 subjects who engaged in stereotypy accurately predicted the function of problem behavior (16 automatic reinforcement, one social reinforcement). Only one error (a false alarm)

occurred: The screening assessment predicted that Micheles stereotypy was maintained by automatic reinforcement, whereas the FA identified attention as the maintaining reinforcer. The screening assessment accurately predicted that SIB was maintained by automatic reinforcement for four of the six subjects who engaged in SIB and that SIB was maintained by social reinforcement for a fifth subject, whose FA identified escape from demands as the source of reinforcement. The sixth subjects (Queens) screening produced a miss: It predicted that her SIB was maintained by social reinforcement, whereas

Table 2 Summary of Results

Topography STPY (n 18) SIB (n 6) PD (n 2) AGG (n 4) Subjects 16 1 1 4 1 1 1 1 2 2 Screening Automatic Social Automatic Automatic Social Social Automatic Social Social Social FA Automatic Escape Attention Automatic Escape Automatic Automatic Escape Attention Escape Result Hit Hit False alarm Hit Hit Miss Hit Hit Hit Hit

Note. STPY stereotypy; SIB self-injurious behavior; PD property destruction; AGG aggression.

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ANGIE C. QUERIM et al. reinforcement, and the mean durations of assessment were 21.5 min and 170 min for the screening and FA, respectively. Thus, the screening was completed in 12.6% of the time it would have taken to complete the full FA. We also examined the occurrence of problem behavior exhibited by these subjects and found that the amount of problem behavior (rates or numbers of intervals) observed during the screening was 29.2% of what was observed during the FAs. The screening was not only quick but also easy to implement, in that it was completed in one continuous time block, and the experimenter either was not present or did not deliver any consequences during any session. In spite of the high degree of correspondence between results of the screening and FA procedures, it is important to emphasize that the screening procedure is not a replacement for a full FA of problem behavior. Data in this study indicated that predictions based on the screening resulted in a 93% correspondence with outcomes of a functional analysis, in other words a 7% loss of accuracy, which is significant in clinical research. Although our data were based on a relatively large sample (30 cases), we estimated a similar loss in accuracy for a much larger population. We examined complete sets of FA data published in the Journal of Applied Behavior Analysis and determined the extent to which rates of problem behavior in the alone or nointeraction condition predicted behavioral function. We selected all articles in which (a) a full FA was conducted, (b) an alone or no-interaction condition was included in the FA, and (c) data were presented in the article. In 108 of 115 published data sets that met these criteria, problem behavior occurred at high rates in the alone or no-interaction condition and was maintained by automatic reinforcement; in all 222 data sets, problem behavior occurred at low rates in the alone or no-interaction condition and was maintained by social reinforcement. Thus, in 330 of 337 data sets, high or low rates of problem behavior during the alone or no-interaction

results of the FA showed that SIB was maintained by automatic reinforcement. Two subjects engaged in property destruction, one maintained by automatic reinforcement and the other by social reinforcement, and the screening assessment accurately predicted both FA outcomes. Finally, the screening assessment accurately predicted that the aggression exhibited by four of four subjects was maintained by social reinforcement. The FA data indicated that two of the four engaged in aggression maintained by attention and that the other two engaged in aggression maintained by escape. DISCUSSION Thirty subjects with varied problem behaviors (predominantly stereotypy) completed a screening assessment that consisted of several exposures to a single 5-min test condition that were conducted in one session. Based on a comparison with subsequent FA outcomes, results of the screening assessment accurately predicted the function of problem behavior (automatic or social reinforcement) in 28 of 30 cases. In all but one case in which results of the FA indicated that problem behavior was maintained by automatic reinforcement (21 of 22), the screening assessment provided an accurate prediction. Given these results, the screening may be most useful for behavior suspected to be maintained by automatic reinforcement: stereotypy and perhaps SIB or property destruction. Because the screening was developed primarily for problem behavior maintained by automatic reinforcement, the extent to which it improved efficiency of assessment in these cases is an important consideration. We calculated screening efficiency for behavior maintained by automatic reinforcement by dividing the total duration of screening for each subject whose behavior was maintained by automatic reinforcement in both assessments (hits) by the total duration of each subjects FA. Twenty-one subjects engaged in problem behavior maintained by automatic

FUNCTIONAL ANALYSIS SCREENING condition of an FA were predictive of behavioral function, for an overall correspondence of 98% and a 2% loss of accuracy. The seven data sets that did not show complete correspondence consisted of cases in which problem behavior that occurred at high rates in the alone or no-interaction condition was maintained by both automatic reinforcement and social reinforcement (multiple control). Maintenance by automatic and social reinforcement would be missed in our screening procedure because it does not contain any test for social reinforcement. Although the screening assessment predicted that problem behavior was socially maintained for all four subjects whose problem behavior was aggression, its use with aggression would not be very helpful because it will not identify which social contingency (positive or negative reinforcement) maintains behavior. Nevertheless, trends observed during the screening suggested that one source of social reinforcement was more likely than another, perhaps making the screening helpful as an preliminary test for problem behavior maintained by social reinforcement. The two subjects whose aggression was attention maintained (Brad and Pablo, Figure 6) exhibited either low or decreasing rates of problem behavior during the screening, which would be expected when problem behavior maintained by attention is exposed to extinction. Thus, a decreasing trend during screening might be followed by a singlefunction test (Iwata & Dozier, 2008) in which the attention and control conditions are alternated to confirm attention-maintained problem behavior. By contrast, the two subjects whose aggression was escape maintained (Kim and Queen) never engaged in problem behavior during screening, which also might be expected because the absence of interaction initiated by a therapist eliminates the motivational basis (establishing operation) for escape. If this pattern of problem behavior is observed during screening, it might be followed by a single-function test for escape-maintained problem behavior. Thus, even for cases in which problem behavior is maintained by social

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reinforcement, the alone screening might represent an overall gain in assessment efficiency by reducing the number of subsequent test conditions. In summary, results obtained from this FA screening assessment are highly promising and suggest that it may be an accurate and practical approximation to a complete FA in clinical situations when (a) the target behavior consists of stereotypy, (b) preliminary evidence suggests that problem behavior may be maintained by automatic reinforcement, and (c) a full FA cannot be conducted due to time limitations. Future research might consider the extent to which anecdotal reports facilitate selection of assessment strategies. For example, although verbal reports by caregivers about specific functions of problem behavior are often unreliable (Kelley, LaRue, Roane, & Gadaire, 2011), they may provide reasonable estimates of the extent to which problem behavior is more or less likely to occur in social contexts; if so, this information may be helpful in determining whether to conduct an alone screening or a more complete assessment. REFERENCES
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Piazza, C. C., Adelinis, J. D., Hanley, G. P., Goh, H. L., & Delia, M. D. (2000). An evaluation of the effects of matched stimuli on behaviors maintained by automatic reinforcement. Journal of Applied Behavior Analysis, 33, 1327. doi: 10.1901/jaba.2000.33-13 Rapp, J. T., Miltenberger, R. G., Galensky, T. L., Ellingson, S. A., & Long, E. S. (1999). A functional analysis of hair pulling. Journal of Applied Behavior Analysis, 32, 329 337. doi: 10.1901/jaba.1999.32-329 Roscoe, E. M., Iwata, B. A., & Zhou, L. (2013). Assessment and treatment of chronic hand mouthing. Journal of Applied Behavior Analysis, 46, 181198 Vollmer, T. R., Marcus, B. A., & LeBlanc, L. (1994). Treatment of self-injury and hand mouthing following inconclusive functional analyses. Journal of Applied Behavior Analysis, 27, 331344. doi: 10.1901/ jaba.1994.27-331 Vollmer, T. R., Marcus, B. A., Ringdahl, J. E., & Roane, H. S. (1995). Progressing from brief assessments to extended experimental analyses in the evaluation of aberrant behavior. Journal of Applied Behavior Analysis, 28, 561576. doi: 10.1901/jaba.1995.28561 Received July 4, 2012 Final acceptance November 27, 2012 Action Editor, Timothy Vollmer

Iwata, B. A., & Dozier, C. L. (2008). Clinical application of functional analysis methodology. Behavior Analysis in Practice, 1, 39. PMid: 22477673 PMCid:2846577. Iwata, B. A., Pace, G. M., Dorsey, M. F., Zarcone, J. R., Vollmer, T. R., Smith, R. G., Willis, K. D. (1994). The functions of self-injurious behavior: An experimental-epidemiological analysis. Journal of Applied Behavior Analysis, 27, 215240. doi: 10.1901/ jaba.1994.27-215 Kahng, S., & Iwata, B. A. (1999). Correspondence between outcomes of brief and extended functional analyses. Journal of Applied Behavior Analysis, 32, 149159. doi: 10.1901/jaba.1999.32-149 Kelley, M. E., LaRue, R. H., Roane, H. S., & Gadaire, D. M. (2011). Indirect behavioral assessments: Interviews and rating scales. In W. W. Fisher, C. C. Piazza, & H. S. Roane (Eds.), Handbook of applied behavior analysis (pp. 182190). New York, NY: Guilford. Marcus, B. A., Vollmer, T. R., Swanson, V., Roane, H. R., & Ringdahl, J. E. (2001). An experimental analysis of aggression. Behavior Modification, 25, 189213. doi: 10.1177/0145445501252002 Northup, J., Wacker, D., Sasso, G., Steege, M., Cigrand, K., Cook, J., & DeRaad, A. (1991). A brief functional analysis of aggressive and alternative behavior in an outclinic setting. Journal of Applied Behavior Analysis, 24, 509522. doi: 10.1901/jaba.1991.24-509