Validation of the Contextual Assessment Inventory for problem behavior.(Report)

Problem behavior is a major barrier to successful community integration for people with developmental disabilities. Recently, there has been increased interest in identifying contextual factors involving setting events and discriminative stimuli that impact the display of problem behavior. The authors previously developed the Contextual Assessment Inventory and evaluated it for efficiency, comprehensiveness, comprehensibility, and reliability. This study further evaluated this inventory with respect to convergent and predictive validity. Convergent validity was examined for 17 participants with developmental disabilities through a review of community residence log entries that included a record of the contextual events associated with each episode of problem behavior. Predictive validity was evaluated for a subset of 5 participants through direct observation of contextual events. Results indicated that the inventory had both convergent and predictive validity. Implications for extending contextual assessment and using such information to develop intervention strategies are explored.

Keywords: autism; problem behavior; functional assessment; setting events; antecedent control

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People with developmental disabilities often display severe problem behavior such as aggression, property destruction, and self-injury. These behaviors have been associated with limited community integration, higher rates of institutionalization, social rejection, and lowered self-esteem (e.g., Bruininks, Hill, & Morreau, 1988; Koegel, Koegel, & Dunlap, 1996) and with increased stress in family members, direct care staff, and teachers (Lucyshyn, Dunlap, & Albin, 2002). Therefore, much effort has been expended in assessing and treating such behavior.

Following an extensive meta-analysis of the published literature, we concluded that functional assessment is critical for the design of effective interventions (Carr et al., 1999). Functional assessment has been the primary method of determining the factors that maintain problem behavior, factors that include getting attention from others (Durand, Crimmins, Caulfield, & Taylor, 1989), avoiding or escaping from aversive situations (Carr, Newsom, & Binkoff, 1980), obtaining tangible items (Durand & Crimmins, 1988), avoiding social interaction (Taylor & Carr, 1992), and generating sensory reinforcement (Favell, McGimsey, & Schell, 1982).

Several methods of assessment, including experimental manipulation, direct observation, and interviews/checklists have been employed to help identify the functions of problem behavior (Cart et al., 1994; Desrochers, Hile, & Williams-Moseley, 1997; O'Neill et al., 1997; O'Neill, Homer, Albin, Storey, & Sprague, 1990). However, research suggests that it is not always possible to identify the functions of problem behavior (McGill, 1999), and even when it is possible, problem behavior is typically influenced by context (Kennedy & Meyer, 1996; McGill, 1999; McGill, Teer, Rye, & Hughes, 2003; O'Reilly, 1997). That is, function does not exist in a vacuum; it is embedded in and influenced by specific contexts that involve physical, activity/routine, social, and biological factors. Identifying these contexts may help generate additional opportunities for intervention.

Problem behavior is thought to be associated with two classes of contextual variables: discriminative stimuli and setting events (Carr & Smith, 1995). A discriminative stimulus is an event in whose presence a response is reliably reinforced (Skinner, 1938). Because the stimulus predicts reinforcement, contingent on performance of the response, the response is more likely to be exhibited in the future whenever the discriminative stimulus is presented. A setting event is a variable that momentarily alters ongoing stimulus-response relationships (Bijou & Baer, 1961, 1978; Kantor, 1959). In other words, an individual's response to a particular discriminative stimulus may differ depending on the presence or absence of the setting event. For example, an individual who is ill may frequently display self-injurious behavior when given a difficult task to complete and, yet, when well, successfully complete that same task without displaying self-injurious behavior. For this individual, physical illness is considered a setting event because it alters the association between a discriminative stimulus (task presentation) and a response (self-injury).