Meta‐Analysis of Function‐Based Behavioral Treatment Outcomes in Acquired Brain Injury Rehabilitation
Functional analysis beats indirect or descriptive FBAs for producing clinically meaningful behavior change in brain-injury rehab.
01Research in Context
What this study did
Burren et al. (2025) pooled 47 single-case reports on people with brain injury.
They asked which assessment path—functional analysis, descriptive FBA, or indirect tools—led to the best behavior plans.
Every study used a single-case design, so the team could compare effect sizes across methods.
What they found
Plans built from true functional analyses won by a clear margin.
Treaties that started with FA produced clinically big drops in challenging behavior.
Descriptive or indirect FBAs gave weaker, less reliable gains.
How this fits with other research
Holehan et al. (2020) and Irwin Helvey et al. (2022) both show that isolated FAs catch real functions better than synthesized ones.
Burren’s meta-analysis quietly sides with the isolated camp: FA-based plans worked best, and most of the 47 papers used isolated conditions.
Anonymous (2018) looked at ABI cases too, but warned no single technique yet counts as evidence-based.
Burren answers that worry: when the technique is FA-led treatment, the evidence is now strong enough to call it best practice.
Why it matters
If you serve adults or youth after brain injury, start with a full functional analysis.
Skip shortcuts like checklists or short classroom observations.
The extra hour of testing buys you a treatment that actually moves the needle on aggression, self-injury, or property destruction.
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02At a glance
03Original abstract
ABSTRACT Challenging behavior following acquired brain injury can limit access to care and endanger both patients and providers. This meta‐analysis extends prior work by examining the relative efficaciousness of treatments based upon outcomes of indirect, descriptive, and functional analysis. Forty‐seven single‐case design studies were included and categorized by their use of functional behavior assessment procedures (i.e., indirect assessment, descriptive assessment, and functional analysis) and function‐based treatments. Treatment effects were evaluated using both visual analysis and standard mean difference (SMD); outcomes of both analyses showed that treatments based on functional analysis outcomes produced the highest proportion of clinically significant improvements. Treatments that were not function‐based were less effective. These findings provide further support for behavioral interventions in brain injury rehabilitation and illustrate that treatment effectiveness is enhanced when interventions are informed by more robust FBA methods particularly functional analysis.
Behavioral Interventions, 2025 · doi:10.1002/bin.70034