A Systematic Review of Caregiver-Implemented Functional Analyses

Germansky et al. (2020) pulled every paper where moms, dads, or other caregivers ran a full functional analysis at home. They found 36 studies. The team asked two simple questions: Did the parent-run FA show clear differences in behavior? Did the follow-up treatment work?

Each study had to let the caregiver do the test conditions and the fix. The review did not run new kids; it graded the old work.

Across all 36 papers, parents produced clean FA graphs that showed why the problem behavior happened. After the test, the same parents carried out function-based plans like FCT. Kids' problem behavior dropped and stayed low.

The bad news: most authors forgot to score how well the parent stuck to the script. Without fidelity numbers we cannot tell if success came from the plan or from luck.

Shearn et al. (1997) is inside this review. That single case proved a mom could cut severe behavior in restaurants after she ran her own FA. The new review says that 1997 victory was not a fluke; it is part of a 36-study pattern.

Slanzi et al. (2022) showed a 5-minute no-interaction screen can shorten the whole FA to 70 minutes. That speed trick fits the parent-led model the review endorses, but it came out after the review closed.

Yi et al. (2021) looks like a clash: their telehealth parent coaching had weak fidelity. The review, however, covers in-person training. The low telehealth scores simply warn us that remote coachers need extra fidelity checks, not that parents are unable.

Van der Donck et al. (2023) fixes the Yi problem. Their telehealth package hit 95% fidelity and big child gains, proving distance training can work if you script it tight.

You no longer need to hoard FA hours in clinic. Hand the test to the caregiver, teach them the conditions, and watch the data roll in. Start small: one condition per day, brief 5-minute sessions, clear yes-no data sheets. Record every step on your phone and score fidelity before you leave. If the parent scores above 90%, you just freed your calendar and gave the family a lifelong skill.