Assessment & Research

The relationship between functional assessment and treatment selection for aggressive behaviors.

Hile et al. (1993) · Research in developmental disabilities 1993
★ The Verdict

Functional assessment spread quickly, yet intrusive fixes for aggression stayed common—showing data alone does not change practice.

✓ Read this if BCBAs writing or reviewing behavior plans for aggression in schools, clinics, or homes.
✗ Skip if Practitioners who only work with typically developing adults or non-behavioral therapies.

01Research in Context

01

What this study did

The authors looked at every study on aggression from 1979 to 1990. They asked: Are we using functional assessment more now? And are we using fewer harsh treatments?

They found 79 papers on people with intellectual or developmental disabilities. They counted how many used functional assessment and how many used intrusive methods like restraint or punishment.

02

What they found

Functional assessment use jumped from a large share to a large share over the 12 years. But harsh treatments stayed common. Even with better data, teams still picked intrusive options.

In plain words: We got better at finding why aggression happens, yet we kept using tough fixes anyway.

03

How this fits with other research

Contreras et al. (2023) later showed descriptive assessments only match full functional analyses half the time. This explains why some teams may skip the full FA and fall back on old, harsh plans.

SLibero et al. (2016) reviewed autism studies and still found FBA plus FCT as the gold standard two decades later. The gap G et al. spotted—knowing the function yet picking harsh fixes—has shrunk but not vanished.

Lang et al. (2008) added that FA results can differ between clinic and classroom. So even when we do assess, we may mis-match treatment if we test in the wrong place.

04

Why it matters

You now have 30 years of proof: Assessment alone does not stop harsh interventions. You must finish the loop—run the FA in the natural setting, pick function-based treatments like FCT, and train staff to stick with them. Next time you see a plan that leans on restraint or punishment, ask: Did we test the function in the real setting, and did we try reinforcement first?

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Check your last three aggression plans—if any use restraint or punishment without a full FA in the natural setting, schedule that FA and rewrite the plan.

02At a glance

Intervention
not applicable
Design
systematic review
Population
intellectual disability, developmental delay
Finding
not reported

03Original abstract

Functional assessment seeks to elucidate the variables controlling a maladaptive behavior. Based on such an assessment, effective treatments can be designed that focus on replacing that maladaptive behavior with a functionally equivalent adaptive prosocial behavior. This technique has been promoted as an effective means of improving treatments by increasing the focus on skill development and reducing the use of aversive and restrictive procedures. The literature for the behavioral treatment of aggression for persons with mental retardation or developmental delays was examined from 1979 through 1990. During that period the use of functional assessment and skill training increased; however, the increased use of functional assessment did not result in the reduced use of intrusive procedures. Potential reasons for these results are discussed, and a call for an increased emphasis on functional assessment methodology is made.

Research in developmental disabilities, 1993 · doi:10.1016/0891-4222(93)90021-b