Factors associated with the Questions About Behavior Function for functional assessment of low and high rate challenging behaviors in adults with intellectual disability.

The team asked caregivers to fill out the Questions About Behavior Function (QABF) for adults with intellectual disability. They looked at two groups: adults who showed the behavior a lot and adults who showed it rarely. The goal was to see if the checklist gave the same results no matter how often the behavior happened.

QABF worked well for aggression items in both groups. It was less steady for self-injury items, especially when the behavior happened rarely. High-rate behaviors overall gave more reliable scores than low-rate ones.

Unwin et al. (2014) also used caregiver checklists for aggression in adults with ID. Their CC-QoLS showed good reliability, matching the strong QABF aggression results here. Eisenmajer et al. (1998) tested the older CCB tool. They described its structure but did not report reliability by behavior type, so the new QABF data extend their work by showing which items you can trust most. Prasher et al. (1995) found solid reliability for the Reiss Screen in institutional care. Their setting differed, yet both studies agree that well-trained raters give stable scores on adult ID checklists.

When you run an FBA for an adult with ID, start with QABF aggression items if that is the concern. For self-injury, collect extra proof: add direct observation or a second rater. If the behavior is rare, plan more sessions before you trust the numbers. This small step keeps your treatment plan built on solid ground.