On the Reliability and Treatment Utility of the Practical Functional Assessment Process
PFA treatments work even when reliability is low, so don't delay intervention chasing perfect agreement.
01Research in Context
What this study did
Four kids with problem behavior got the full Practical Functional Assessment.
Two BCBAs watched the same videos and scored the PFA steps.
The team then built function-based treatments and tracked if the kids' behavior improved.
What they found
The two BCBAs only agreed 60-a large share of the time on the PFA steps.
Despite the shaky reliability, every child's treatment worked.
Problem behavior dropped and social skills rose in all four cases.
How this fits with other research
Gerow et al. (2020) extends this work by showing parents can run a brief FA at home with toddlers and still get good treatments.
Matson et al. (1999) and Fox et al. (2001) asked the same question with the QABF checklist years earlier. They found the QABF predicted treatment success even though it is just a survey.
Gutierrez et al. (1998) serves as a cautionary tale. The Motivation Assessment Scale had poor reliability and weak treatments. The difference? PFA and QABF link directly to function-based plans, while MAS does not.
Why it matters
Stop waiting for perfect agreement between observers. If your PFA points to a clear social function, move to treatment. The kids in this study got better even when the experts disagreed.
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02At a glance
03Original abstract
Saini et al. (2019) urged caution with respect to the use of practical functional assessment (PFA) procedures to inform behavioral treatment when they found that responses to an open-ended caregiver interview were only somewhat reliable and showed moderate to weak correspondence with analog functional analyses. Because the practitioner’s goal in conducting any functional assessment process is to inform the successful treatment of problem behavior, we replicated and extended Saini et al. by (a) evaluating the reliability of hypotheses gleaned from two independent PFA processes for each of four children, (b) conducting treatment informed by a randomly assigned PFA, and (c) determining the extent to which potentially different levels of reliability impacted the treatment utility of the PFA process. Results indicated that the reliability of the PFA process varied depending on the stringency with which it was evaluated. However, treatments developed from randomly determined PFA processes produced efficacious outcomes on problem behavior and targeted social skills that transferred to the context designed from the other PFA process in all evaluations, suggesting that the PFA has strong treatment utility despite parts of the process having ambiguous levels of reliability. We discuss implications for practitioners tasked with treating severe problem behavior.
Behavior Analysis in Practice, 2022 · doi:10.1007/s40617-021-00665-6