ABC Says Attention; the Functional Analysis Says Otherwise
Marcus, 7, is referred for self-injury (open-hand hits to the head, up to 40 per day). A functional behavior assessment interview with his teacher points to attention. ABC recording across three school days yields 22 instances: 15 during independent seatwork while the teacher works with other students, 5 during transitions, 2 during small-group instruction. The BCBA then runs a brief functional analysis with 5-minute sessions, four per condition: alone 0.1 responses per minute, attention 2.3, demand 1.9, play 0.2. Within-condition variability was low. The teacher wants to start an attention-based plan on Monday.
1. Interpret the functional analysis. What function or functions are supported, and why did the ABC data point elsewhere?
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Attention (2.3/min) and demand (1.9/min) both exceed the play control (0.2/min) by roughly tenfold, so the analysis supports multiply maintained self-injury - social-positive (attention) and social-negative (escape from demands).
The ABC data were not wrong so much as incomplete. ABC recording is correlational and samples only contingencies that occur naturally. This teacher rarely presents difficult tasks during independent seatwork, so a demand function had little opportunity to show itself in that context. The 15 instances during independent work are equally consistent with attention deprivation (teacher occupied elsewhere) and with difficult work the student is avoiding.
One caution: the standard demand condition contains adult attention - prompts, praise, and reprimands. The demand elevation cannot be read as pure escape until attention is controlled within that condition.
2. What would you do before committing the plan to an attention-only treatment?
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Separate the two contingencies before selecting reinforcers:
- Run a low-attention demand condition (minimal prompts, no reprimands, brief neutral statement of the task) and compare it with the standard demand condition. If self-injury persists when attention is stripped out, escape is confirmed.
- Alternatively run a demand condition with escape unavailable to see whether responding drops.
- Check that the alone condition was long enough and stripped enough to detect low-rate attention-maintained behavior; 0.1/min is near zero but not obviously a floor for a behavior occurring 40 times a day.
- Verify that the attention condition's attention was actually contingent on self-injury and comparable in quality to what the teacher delivers.
The teacher's Monday deadline is a scheduling preference, not a clinical constraint. Starting the wrong function-based plan risks strengthening the behavior and losing the teacher's confidence.
3. The teacher implements the attention plan as written and self-injury increases during reading groups. What is the most likely account, and what is the corrective?
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The most likely account is that escape from demands is untreated and possibly worsened. Attention-based components (noncontingent attention, extinction of attention-maintained self-injury) do nothing to the demand contingency; if demands are still presented and escape still follows self-injury, that contingency continues to reinforce it. Extinction of an attention function can also produce a temporary extinction burst that the teacher reads as treatment failure.
The corrective is a two-function treatment:
- Functional communication training with two responses - one recruiting attention, one recruiting a break - both reinforced on rich schedules.
- Noncontingent attention to reduce the establishing operation for attention.
- Demand fading, choice, and interspersed easy tasks to reduce the value of escape.
- Programmed schedule thinning, plus treatment-integrity checks, since a teacher managing a reading group will drift.
Collect data on both topographies of the communicative response and on the rate of demands delivered, not just on self-injury.