We combined a functional analysis of precursors and problem behavior with subsequent communication training to reduce time spent in restraint. The patient was a man in his 30s with autism and lifelong severe problem behaviors resulting in restraint. The highest frequencies of both problem behavior and precursors were observed in the demand conditions of the functional analysis. However, the precursors were observed across all conditions. Based on these findings, we introduced functional communication training to establish an alternative functional response. He was taught to ask for a break when demands were presented, first in an analog setting and later in natural settings throughout his daily life. This resulted in a significant reduction in problem behavior, and what followed was a significant reduction in the time spent in restraints. The much-reduced level of restraint was maintained in the patient’s natural environment at a 12-month follow-up assessment. Our findings suggest that a functional analysis and functional communication training may be an approach to consider when the ultimate goal is to reduce the time spent in restraint. These findings need to be replicated with a better experimental design.
Petursson, Petur Ingi Eldevik, Sigmund
Behavior Analysis: Research and Practice, 2018