Using functionally matched interventions with embedded preferences to reduce transition-related challenging behavior for children with autism spectrum disorders
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Transitioning between activities is a common challenge for individuals with autism spectrum disorder (ASD). While a body of research has examined effective interventions targeting transitions for individuals with ASD, very few studies have assessed the function of behavior relative to the transition. Determining functionally matched interventions is a critical component to successful outcomes, thus research into functionally matched transition interventions is warranted. This study examined the effectiveness of a functionally matched embedded preference intervention for three young children with autism spectrum disorder. Using an ABAB reversal with an embedded multielement design, the function of transition-related challenging behavior was first assessed through a transition functional analysis. The functional analysis included two conditions for every traditional functional analysis condition, meaning there was an activity initiation (transitioning to) and activity termination (transitioning away from) component to each function. Transitions with elevated levels of challenging behavior were then targeted for individualized interventions based on participant preferences and behavioral function. Intervention components varied for each participant but included strategies such as using themed materials (e.g., stickers, bookmarks), using “place savers” when interrupting routines, and using modified instructional materials (e.g., themed worksheets, flashcards). Results for all three participants showed clear functions maintaining transition-related challenging behavior and included 2-3 targeted transitions for each participant. Results indicated the functionally matched interventions were effective for all three participants, with behavior decreasing to zero or near-zero levels during intervention across all conditions. Interventions appeared to be equally effective across functions of behavior. Results generalized to new skills or people for all participants. Behavior maintained at the 1-month follow up across all intervention conditions for two participants. One participant had less consistent maintenance data, however, behavior did reduce to near zero levels again after a second maintenance check with an added component for one condition. Results indicated important implications for the treatment of transition-related challenging behavior for individuals with ASD in both home and school settings. Results were discussed including limitations, implications, and direction for future research.