A translational evaluation of potential iatrogenic effects of single and combined contingencies during functional analysis

The team ran two kinds of functional analyses in a lab. One used the classic single-reinforcer test. The other mixed all suspected reinforcers into one quick test called a synthesized contingency analysis (SCA).

They wanted to know if the faster SCA would still find the right function and whether it might accidentally teach new problem behavior.

The old-school FA always matched the pre-trained function and never created new problems. The SCA also spotted the function, but in half the runs it produced brand-new problem behavior that had never been seen before.

Fisher et al. (2016) saw the same warning sign earlier. Their classic FA found functions in four of five kids, while the IISCA found none, showing the synthesized format can miss what is really going on.

Greer et al. (2020) ran a similar 2020 comparison and agreed: dropping the interview steps did not hurt accuracy, but they did not watch for iatrogenic effects. Retzlaff fills that gap by proving the risk is real.

Jessel et al. (2018) looked at the upside. Twenty-five outpatients got 90% problem-behavior reduction after IISCA-driven treatment. The trade-off is clear: synthesized tests can guide great treatment, yet they may briefly strengthen new problems during the test itself.

You now have hard evidence that the speedy IISCA/SCA can accidentally reinforce new topographies. If you use it, watch for novel behavior during the test and be ready to pause or modify conditions. When safety is the top concern, the traditional single-contingency FA remains the safer first choice.