Use of the structured descriptive assessment to identify possible functions of challenging behaviour exhibited by adults with brain injury

Abstract

Behaviour modification procedures for challenging behaviour, based on principles of operant learning, benefit from an accurate appraisal of behavioural function. Numerous methods of direct and indirect functional assessment exist, which have relative strengths and weaknesses. In this study, structured descriptive assessments were used to identify the function of challenging behaviour. The application of this hybrid approach has been unexplored in the neurobehavioural literature. The structured descriptive assessments involved the systematic manipulation of antecedent variables (only) that were conducted by typical caregivers in the normal environment. Also, observational software was used to provide a high degree of analytical detail. The methodology was found to be effective in generating hypotheses of behavioural function and also efficient as a clinical research tool. Only just over 2.25 hours of assessment data were collected for each participant, on average, and yet functional relationships emerged in respect of all four participants. The aggression exhibited by two participants was deemed to serve a demand escape function and the challenging behaviours of the other two participants were attributed to an attention gaining function. Future studies should implement additional validity measures by corroborating findings with other (experimental) functional assessment techniques or by implementing treatment programmes based on its results.

Keywords:

• Structured descriptive assessment
• Brain injury
• Functional analysis
• Challenging behaviour
• Descriptive analysis

Acknowledgments

This study was jointly funded by the University of Birmingham, UK, and St. Andrew's Healthcare, Northampton, UK. The role of the second observer was carried out by Mari O'Neill. The following people were protagonists in the study: Aaron O'Rourke, Chris Blundred, Debbie Tickle, Louise Tarr, Mari O'Neill, Matt Husbands and Violeta Hetmaniok.

Notes

*excluding the variable tangible removal in relation to participant 2 (only), which did not occur during any of the sessions attended by the second observer.