REVIEW ARTICLE

Training Educational Staff in Functional BehavioralAssessment: A Systematic Review

John McCahill & Olive Healy & Sinéad Lydon &

Devon Ramey

# Springer Science+Business Media New York 2014

Abstract Interventions for challenging behavior are more likely to be effective whenbased on the results of a functional behavioral assessment. Research to date suggeststhat staff members in educational settings may not have the requisite levels of expertiseor support to implement behavioral assessment procedures and design correspondingbehavior support plans. The current review sought to examine the nature and effec-tiveness of Functional Behavioral Assessment (FBA) training described in the litera-ture. Twenty-five studies were examined in relation to type of FBA method used,training procedure, behavioral function and intervention outcome. Training was pro-vided in indirect, observational and experimental functional assessment procedures.Video modeling, lectures, feedback and written protocols were some commonly usedtraining procedures. Interventions derived from results of these assessments were usedin twelve studies to treat problem behavior. Social validity and treatment integrityoutcomes across all studies are reported. The implications of these findings for researchand practice are discussed along with directions for future research.

Keywords Functional behavioral assessment . Functional analysis . Staff training .

Teacher training . Challenging behavior

Challenging behavior can have multiple negative effects by impeding learning and skillacquisition in individuals emitting the behavior, disrupting the environment for otherstudents, and possibly resulting in injury to oneself or others (Division of EarlyChildhood 2007; Emerson 2001). Challenging behavior has also been found to havedetrimental effects on teachers. Hastings and Bham (2003) found that burnout andstress levels were higher among teachers dealing with behavioral problems. Thesenegative effects may be more pronounced in schools staffed by individuals unfamiliar

J Dev Phys DisabilDOI 10.1007/s10882-014-9378-0

J. McCahill : O. Healy (*) : S. LydonTrinity College Dublin, Dublin 2, Irelande-mail: olive.healy@tcd.ie

D. RameyTexas State University, San Marcos, TX, USA

with the technology and strategies of Applied Behavior Analysis. Student expulsion orsuspension has been found to be more common in settings where teachers report highlevels of stress and challenging behavior in their classrooms, and who lack knowledgeof behavioral intervention, or the support of behavioral experts (Gilliam and Shahar2006). Further, research suggests that perceived self-efficacy may be higher amongteachers working in schools in which positive behavior support is widely utilized(Kelm and McIntosh 2012).

The consideration of operant theory and Applied Behavior Analysis in the treatment ofchallenging behavior in the classroom yields benefits for both students and teachers.Operant theory attempts to explain challenging or problem behavior in terms of observableenvironmental events. Identifying the stimuli and settings that evoke problem behavior, andthe variables responsible for its maintenance, enables a practitioner to alter the environmentand to teach functionally equivalent appropriate behaviors which should render the targetbehaivor no longer necessary. The events supporting problem behavior can be identifiedthrough informant methods (Durand and Crimmins 1988), direct observation (Bijou et al.1968) or experimental environmental manipulation typically referred to as functionalanalysis (Iwata et al. 1994). These procedures taken together are known as FunctionalBehavioral Assessment (FBA;Healy andBrett 2014).While functional analysis is typicallyconsidered the “gold standard” (Delfs and Campbell 2010, p. 5) for ascribing function andsubsequently developing function-based interventions, a recent review of the utility of FBAprocedures indicated that treatment efficacy did not differ according to the FBA method-ology used (Delfs and Campbell 2010; Healy et al. 2013). However, the importance ofutilizing some form of FBA is evident; research has consistently demonstrated thatbehavioral interventions derived from prior functional assessment or analysis are moreeffective than non function-based interventions (e.g., Campbell 2003; Devlin et al. 2009;Devlin et al. 2011; Didden et al. 2006; Ingram et al. 2005).

Behavior analysts have successfully applied FBA procedures in controlled conditionssince their development (Hanley et al. 2003). However, transitioning their use to educa-tional and clinical settings has taken place relatively recently (Hanley et al. 2003). This ispartly because of the training and expertise required to conduct these procedures (Iwataet al. 2000; Scott et al. 2005). In recent years, there has been an increased focus onimproving the applicability and dissemination of these procedures. The implementationof FBAby individuals other than behavior analysts is desirable formany reasons. Reducingthe “artificiality” of experimental functional analysis techniques is considered a key aim;research has demonstrated that inaccurate functional analysis results may be less frequentwhen the experimental conditions are implemented by persons familiar with the individualexhibiting the challenging behavior, possibly due to the more naturalistic conditionsinvolved (Huete and Kurtz 2010; Martens et al. 2012). Added to this, the Individuals withDisabilities Education Act (IDEA 2004) requires the application of FBA for children whoare at risk of expulsion due to unmanageable behavioral problems (Yell and Shriner 1998).This law aims to bring school policies into line with best practice in behavioral treatment.

However, research has shown that teachers and other educational staff are typicallyinadequately prepared and often lack the skills necessary to conduct effective FBAs ofchallenging behavior which they encounter (e.g., Couvillon et al. 2009; Mortensonet al. 2008; Pindiprolu et al. 2007; Van Acker et al. 2005). Conroy et al. (1999) notedthat some practitioners have implemented FBA without adequate training, oftenresulting in subjective definitions of target behaviors, aversive procedures used by

J Dev Phys Disabil

default, and a frequent failure to use FBA data in interventions (see also Van Ackeret al. 2005). Mortenson et al. (2008) assessed the ability of 88 teachers to identify thebehavioral function of challenging behaviors described in three vignettes. The resultsindicated that participants struggled to correctly identify the function of the specificbehaviors and to propose appropriate behavioral interventions. Such findings highlightthe need for staff training in FBA methodologies in educational settings. However,obstacles to such training programs have also been identified; some have questionedwhether teachers can efficiently conduct FBA procedures while still attending to theirregular classroom tasks (Scott et al. 2004). Teachers’ ability to implement the func-tional analysis conditions with integrity (Scott et al. 2004) and to accurately assessmultiply controlled behaviors (Witt et al. 2004) has also been called into question.

Such findings have led scholars in the field of FBA to call for an increased focus onstaff training in functional analysis and assessment methodologies in order to promotethe utilization of such procedures as well as subsequent implementation of function-based behavioral interventions for challenging behavior (Iwata and Dozier 2008;Pindiprolu et al. 2007; Van Acker et al. 2005). Previous research has demonstratedthat college students (e.g., Iwata et al. 2000; Trahan and Worsdell 2011), parents (e.g.,Feldman and Werner 2002; Najdowski et al. 2008), and residential care workers (e.g.,Lambert et al. 2013; Phillips and Mudford 2008) can be trained to effectively utilizefunctional assessment or analysis techniques.

According to Van Acker et al. (2005) an adequate FBA and intervention plan requireclearly defined behaviors, multiple sources of information on the behavior and gener-ation of functional hypotheses that lead to the development of Behavior InterventionPlans. Currently, many variations of FBA training exist including: training manuals(Cipani and Schock 2011); instructional videos (LaVigna and Willis 2005) and in-school consultation (Renshaw et al. 2008). Training may comprise instruction inindirect assessment, observational assessments, experimental functional analysis orany combination of the three. Regardless of the training method used, educators mustbe trained in functional behavioral assessment procedures which are acceptable tothem, feasible within their organizational context and usable with a high degree ofprocedural integrity (McKenney et al. 2013). Treatment integrity and social validity aretherefore important dependent variables in many training programs (McKenney et al.2013).

To date there remains a lack of consensus on which FBA methodologies should betaught to educational and clinical staff. Some have suggested that informant (indirect)and descriptive (direct observation) methods are sufficient sources of functional assess-ment data. Such methods involve for example, interviews, behavior rating scales,recording antecedent and consequent environmental variables as well as temporalevents. Others contend that functional analysis provides the most accurate assessmentof behavioral function, because it facilitates a demonstration of a causal relationshipbetween social consequences and challenging behavior (Hanley et al. 2003; Iwata andDozier 2008). Regardless of method employed, effective training in FBA can bedemanding in relation to time and resources (Scott et al. 2005).

The current review sought to critically examine the extant literature on training inFBA training in general educational or clinical settings. Specifically, we aimed toevaluate studies which reported training in the utilization of functional assessmentmethodologies among educational or clinical staff, to assess the efficiency of staff

J Dev Phys Disabil

implementation of FBA methods, to evaluate the effectiveness of reported trainingprocedures, and to determine the social validity of the assessments and interventionsdescribed.

Method

Search Procedures

Comprehensive literature searches were conducted using the following electronicdatabases: EBSCO Academic Search Complete, SCOPUS, PsycINFO, ERIC, andPsychology and Behavioral Sciences Collection. Systematic searches were carriedout by inputting the keywords “training”, “staff”, and “teacher” in combination withthe following keywords: applied behavior analysis, functional behavior* assessment,functional assessment, functional analysis, and positive behavior support. Searcheswere limited by year of publication, excluding papers published prior to 1999; in orderreflect the most recent trends in research.

Inclusion and Exclusion Criteria

Studies were selected for inclusion in this review if they met the following criteria: a)the implementation and description of training in functional assessment or functionalanalysis procedures for school staff; b) participating trainees had no prior experienceusing functional assessment or analysis procedures; c) student participants were all ofschool age (<18 years old); d) use of a single subject research design; e) implementa-tion of the assessment procedures in natural (educational/clinical) settings by trainees;and f) publication in an English language, peer-reviewed journal. Studies that employedbehavioral consultation models, in which researchers collaborated with teachers on aFBA but did not allow the trainee to perform the procedures independently, wereexcluded from this review.

Results

Twenty-five studies met the criteria for inclusion in this review. Table 1 providesinformation on the sample sizes, settings, and participant characteristics across thesestudies.

Participant Characteristics

Trainee staff, where reported, included teachers (n=53); special educationteachers (n=14); classroom staff (n=3); psychology graduates (n=3); classroomassistants (n=3); paraprofessionals (n=2); school principal (n=1); assistantteacher (n=1); reading intervention provider (n=1) and one classroom aide(n=1).

Trainee experience in education was reported in 16 studies and ranged from 0–36 years (m=6.40 years). Educational levels were not reported for all trainees but the

J Dev Phys Disabil

Table1

Dem

ographicandclinicalcharacteristicsforstudentsandtrainees

Student

Trainee

Study

Settings

nDiagnoses

Age

range

Position

nExperience/qualifications

Bessette

andWills(2007)

Elementary

school

1EBD

8Paraprofessional

17years

Bloom

etal.(2013)

Publicpreschool,ASD

Preschool

3DevelopmentalDelay;Autistic

Disorder;Autistic

Disorder

4–5

Teacher

3In

training,w

orking

towards

teachercertification

Christensen

etal.(2012)

Title1Elementary

School

3Neurotypically

developing.A

trisk

duetodisruptiveandoff-

task

behaviours

4thgrade

Teacher

1Bachelor’sdegree

elem

entary

education.

Doggettetal.(2001)

Elementary

school

2Nonereported

6–7

Teachers

21year,B

Adegree.4

years,

Master’s.

Erbas

etal.(2006)

SpecialEducatio

n6

DevelopmentalDisabilities

Not

reported

Teachers

63–14

years

Kodak

etal.2

013

University

basedEIcenter,

elem

entary

school

classroom

5Autism

4–9

Classroom

staff

(Therapists)

3BA

Psychology,u

ndergraduate

trainee

Kunnavatana

etal.2

013

Secondary

special

education,

elem

entary

specialeducation.

5Not

reported

Not

reported

Teachers

41–13

yearsexperience.A

llhad

specialed.licensing

&BAor

M.E

d

Lam

bertetal.(2012)

Specialed.p

reschool

3DevelopmentalDisabilities

3–4

Teacher

1MA.S

pecialEd.,

Laneetal.(2007)

Elementary

schools

2Stud

y1:

ADHD

Stud

y2:

ADHD

&OCD

6–7

Principal,special

educator,g

eneral

educator

8Not

reported

MaagandLarson(2008)

Elementary

school

2EBD;LearningDisability

5thgrade

Teacher

115

years

Machalicek

etal.(2010)

DevelopmentalDisorder&

ASD

SpecialSchool

6Autism

forfive

P’s;onewith

autistic

liketendencies

&expressive

language

delays

5–9

Teacher

64–10

years;Bachelor’sdegree

inspecialed.

J Dev Phys Disabil

Table1

(contin

ued)

Student

Trainee

Study

Settings

nDiagnoses

Age

range

Position

nExperience/qualifications

McK

enneyetal.(2013)

MiddleSchool

3Not

reported

6th–8thgrade

Teacher

31–24

years

Moore

etal.(2002)

Elementary

school

3LearningDisability;No

diagnosisfortwo

participants

5thgrade

Teachers

3“V

erylim

itedexperience”

Moore

andFisher

(2007)

Behaviour

Disorder

TreatmentFacility

3Not

reported

Not

reported

BA

Psychology

Graduates

3BAPsych,1MSc.A

BAstudent

Packenham

etal.(2004)

Elementary

School

2Noform

aldiagnoses

8–9

Teacher

18yearselem

entary

level.

Pence

etal.(2013)

Not

reported

6Not

reported

Not

reported

Trainers:Sp

ecialed.

teachers

61–25

years.Enrolledin

ABA

course,n

otyetcertified,

noFB

Aexperience

priorto

training

Pence

etal.(2013)

Trainingoccurred

inlocal

library

andFB

A’sin

teachers’classes(3

elem

entary,2

middle,1

high

school)

6Not

reported

Not

reported

Trainees:Sp

ecialed.

teachers

61–16

years,specialeducation

teachersenrolledin

ABA

training.T

rained

during

acourse

inbehavioural

assessment,no

FBA

experience

Pooleetal.(2012)

HeadStartClassroom

34Ty

pically

developing

3–5

Teacher,assistant

teacher

23yearscollege,4

yearswork

experience;2years

education,

1year

experience

Renshaw

etal.(2008)

Elementary

school

4Ty

pically

developing

1st–5thgrade

Teachers

40–15

years

Radstaake

etal.2013

Specialized

daycarecentre

3AllP’shadsevere

intellectual

disability,Angelman

Syndrome

6–15

Teachers

3Not

reported

J Dev Phys Disabil

Table1

(contin

ued)

Student

Trainee

Study

Settings

nDiagnoses

Age

range

Position

nExperience/qualifications

Rispolietal.(2013)

PublicSchool

2Autism;Dow

n’sSy

ndrome&

intellectualdisability.

5–15

Teacher,

Paraprofessional

215

year.,working

onM.Ed.;

5year.,working

onMSc.

Counseling

SchumateandWills(2010)

Elementary

school

3None

7–8

Reading

Interventio

nProvider

13years;notqualified.

Skinneretal.(2009)

Elementary

school

1ADHD

1stgrade

Teacher

136

years

Wallace

etal.(2004)

ABAWorkshop

1Not

reported

Not

reported

SpecialE

d.Teacher&

GeneralEducator

1Generalandspecialeducation

certified

Ward-HornerandSturm

ey(2012)

School

2Autistic

disorder

9–10

Teacherassistants

3Highschool

degree;bachelor’s

degree

&enrolledin

Masters

inSp

ecialEducation

Watsonetal.(1999)

SpecialEducatio

n1

Intellectualdisability,dw

arfism

,hypoplastic

thorax

syndrome,

nystagmus,p

olydactly,

psychomotor

retardation

10Sp

ecialEd.

Teacher,

Classroom

aide,

replacem

entteacher

36years;2years;0years.

EBD

EmotionalBehaviorDisturbance,E

IEarly

Interventio

n,ADHD

AttentionDeficitHyperactiv

ity,O

CD

Obsessive

Com

pulsiveDisorder

J Dev Phys Disabil

majority had at least, a BA in a field relevant to education, and had all appropriatelicensing. Only four of the trainees had yet to complete their course of education andten were working on or had completed a Master’s degree in their field. Some traineeshad attended seminars on challenging behavior or were involved in an ABA Master’sprogramme. None of the trainees had any prior experience of Functional Assessment orBehavior Support Planning (see Table 1).

A total of 112 participants received a functional assessment across the 25 studiesreviewed. Ages ranged from three to 15 years (M=7.42 years). Participants presentedwith a range of diagnoses. Two children were diagnosed with Emotional and Behav-ioral Disorder (EBD), five with Autism Spectrum Disorder (ASD), ten children hadunspecified developmental disabilities, one participant was diagnosed with DownSyndrome and one with learning disability. Three participants were each reported withdiagnoses of Attention Deficit Hyperactivity Disorder (ADHD), Intellectual Disabilityand Angelman’s Syndrome. Forty eight typically developing children were includedacross studies reviewed and 24 participants were included without a description of theirdiagnosis (see Table 1).

Table 2 reports targeted behaviors, type of functional assessment or functionalanalysis employed, experimental design, baseline assessments, training methods andduration, post-training assessments, treatment integrity and social validity. Disruptionwas the most commonly assessed behavior reported in ten studies. This was followedby aggression, reported in nine studies, self-injurious behavior in five studies andinappropriate vocalizations/crying/ screaming/verbal outbursts reported in four studies.Each of the following behaviors was reported in two studies: off task, tantrums,arbitrary non-challenging behaviors, inappropriate touching, throwing, out of seat,property damage and non-compliance. Each of the following behaviors was reportedby one study: non completion of work, stereotypy, inappropriate attention seeking, andmouthing (see Table 2).

Trainee Conducted Functional Assessments and Functional Analyses

Multiple variations of functional behavioral assessment methodologies were used in thestudies reviewed. Instruction in the implementation of indirect, direct assessments andexperimental analyses of behavior was provided to trainees across studies. Of the 25studies reviewed, four trained school staff in some variation of indirect and directfunctional behavioral assessment including: Function Based Support (FBS; Renshawet al. 2008); the Functional Assessment Hypothesis Formulation Protocol (Maag andLarson 2004); standard functional behavioral assessment (FBA; Lane et al. 2007) and a“truncated FBA” (Packenham et al. (2004). These studies generally involved using theAntecedent-Behavior-Consequence (ABC) assessment and a protocol that allowed thetrainee to develop functional hypotheses about problem behavior. The trainee subse-quently used these hypotheses to generate a function-based Behavior Support Plan(BSP). The remaining studies (n=21) utilized a variation of analogue functionalanalysis (Iwata et al. 2000) to train school staff in behavioral assessment. Analoguefunctional analysis involved the systematic manipulation of controlled environmentalvariables considered representative of those occurring within the natural environment.None of the studies reviewed involved training staff in all three (indirect, direct andexperimental) levels of FBA (see Table 2).

J Dev Phys Disabil

Table2

Summaryof

functio

nalassessmentandfunctio

nalanalysistraining

procedures

Study

Problem

behavior

FAMethod

Experim

entaldesign

Baselineskill

assessment

Trainingduration

Trainingmethods

Posttraining

assessments

Socialvalidity

Treatmentintegrity

Bessette

and

Wills(2007)

Disruption,

aggression,

property

damage

BFA

AB

20item

quiz

Not

reported

Writtenprotocols,

invivo

coaching.

One

training

unit

percondition

BFA

outcom

eKnowledgeQuiz

re-test

Rated

Acceptable

96.6

%

Bloom

etal.

2013

Aggression,

property

destruction,

tantrums,mouthing

TBFA

MultipleBaseline

AcrossParticipants.

ABABduring

intervention

Nonetaken

45–90min

Presentation,

review

ofprocedures

&data

collectionmethods.

Coachingduring

FA

TBFA

Outcome&

Intervention

results

Not

recorded

96%

Christensen

etal.2

012

Disruption

FBS

Stud

y1:

Multiple

Baselineacross

behaviors

Stud

ies2&

3:ABAB

FBSKnowledge

Test

Approx.

10weeks

Group

work,

independent

reading,

applied

activities,

individual

consultation

FBSKnowledge

Test,com

pletion

ofapplied

activities

Teacherdeveloped

BSP

Highsocial

validity

asratedby

teacherand

students

Study1:

90%

Study2:

94%

Study3:

100%

Doggettetal.

(2001)

Out

ofseat,

inappropriate

attentionseeking

Brief

Functional

Analysis

Multi-ElementDesign

Nonetaken,

noprevious

teacher

experience

Not

reported

Reviewof

descriptive

assessment,

discussion,m

odel

conditions,written

protocol

BFA

outcom

eRated

Acceptable

96%

Erbas

etal.

(2006)

Non

compliance,

throwingobjects,

scream

ing,

outof

seat,tantrum

s

Brief

Functional

Analysis

MultipleProbeacross

Participants

Percentage

correct

interactions

per

BFA

condition

Not

reported

PhaseI:Group

instruction,

video

model,P

hase

II:

individualtraining,

videoreview

QuizafterPh

ase1.

Re-testof

BFA

Implem

entation

accuracy

Positivechanges

inview

points

89.9

%

Kodak

etal.

(2013)

Inappropriate

vocalisations,h

and

tobody

contact,

aggression,

TBFA

Multi-elem

entdesign

Noform

albaseline

Not

reported

Protocol

review

,Q&A

session,

brief

supervised

practice

ofprocedures

TBFA

outcom

eNot

reported

97.5

%,o

nly

availableforone

participant

Kunnavatana

etal.(2013)

Not

reported,arbitrary

behavior

used

inTBFA

Multiplebaseline

across

participants

Accuracygraphing

&analyzing

Presentationon

principles

and

Insitu

TBFA

ofstudent

Not

reported

86%

J Dev Phys Disabil

Table2

(contin

ued)

Study

Problem

behavior

FAMethod

Experim

entaldesign

Baselineskill

assessment

Trainingduration

Trainingmethods

Posttraining

assessments

Socialvalidity

Treatmentintegrity

somecasese.g.,foot

tapping

hypothetical

data,T

BFA

trialson

arbitrary

behaviors

Presentation&

groupwork:

1h.

20min

Follow

upat1–

3months

functions

ofbehavior,fitting

TBFA

trialsinto

classactivities,data

collection/

analysis.

Group

practice,

Q&A.R

oleplays,

feedback

&error

correction.

behavior,

accuracy

ofgraphing

and

analyzingdata

Lam

bertetal.

(2012)

Aggressionand

tantrums

TrialBased

Functional

Analysis

MultipleBaseline

across

Participants

Nonetaken,teacher

hadlim

ited

know

ledgeof

ABA

1h

Writtenprotocols,role

play

andfeedback

Probedcorrect

implem

entation

ofBFA

conditions

(Percentage

correct

interactions

per

condition)

Not

reported

92%

Laneetal.

(2007)

Stud

y1:

disruption

Stud

y2:

inappropriate

touching

Functional

Assessm

ent

Stud

y1:

ABAB

Stud

y2:

multiple

baselineacross

settings

Not

reported

18hinstruction

10–12hon

site

support

Group

instruction,

onsitefollowup

FBAand

intervention

outcom

e

Rated

acceptable

anduseful

bystudent&

teacher

Stud

y1:

100%

Stud

y2:

83–100

%Variedacross

settings

Maagand

Larson

(2008)

Disruption

Functional

Assessm

ent

Hypotheses

Formulation

Protocol

(FAHFP

)

MultipleBaseline

across

Participants

None,no

previous

teacher

experience

5.5h

Twosessions

of1:1

training

inFA

HFP

FAHFP

Outcome

Rated

Favorable

P183

%P2

92.5

%

Machalicek

etal.(2010)

Aggression,

crying,

scream

ing,

SIB,

stereotypy

Brief

Functional

Analysis

MultipleBaseline

across

participants

Percentage

correct

interactions

per

FAcondition

75min

(60–

95min

range)

Performance

feedback

delivered

through

videotele-

conferencing

Percentagecorrect

interactions

per

FAcondition

Procedures

rated

highly

Teachers:97

%Su

pervisor:98

%

J Dev Phys Disabil

Table2

(contin

ued)

Study

Problem

behavior

FAMethod

Experim

entaldesign

Baselineskill

assessment

Trainingduration

Trainingmethods

Posttraining

assessments

Socialvalidity

Treatmentintegrity

McK

enney

etal.(2013)

Frequent,low

intensity

disruptivebehavior

Analogue

Functional

Analysis

Non

concurrent

multiplebaseline

across

participants

ReadFA

protocol&

performed

mock

FAwith

researchers

Not

reported

Presentationon

FA,

quizzes,operational

definitionof

CB&

replacem

ent

behavior,

developm

entof

peer

attention

condition,roleplay

Integrity

ofFA

implem

entation

Rated

Acceptabl;

Skills

describedas

useful

during

school

year

Reportedas

outcom

evariableacross

FAconditions.

Highforall

participants

Moore

etal.

(2002)

Yelling

BFA

Playcondition

excluded

MultipleBaseline

across

Participants

None,no

previous

teacher

experience

1day

PhaseI:Group

instruction,

written

protocolsPh

aseII:

Rehearsal,

Modelling&

Feedback

Verbalquestio

nsaftereach

phase.

Percentagecorrect

interactions

per

BFA

condition

Not

reported

95%

Moore

and

Fisher

(2007)

SIB

BFA

MultipleBaseline

across

Participants

Writtentest.

Percentage

correct

interactions

per

BFA

condition

Not

reported

Lecture

training,

completevideo

modelling,

partial

videomodelling

Percentagecorrect

interactions

per

FAcondition

Not

reported

94%

Packenham

etal.(2004)

Disruption,

offtask

and

noncompletionof

work

“Truncated

FBA”

interview,

function

identification

hypothesis

form

ation,

intervention

planning

Multiplebaseline

across

participants

Nonereported,n

oprevious

teacher

experience

Approx.

2hper

student

(4htotal)

Prom

ptsheetsprovided

guidelines

toaid

FBA

process

Treatmentoutcom

ePo

sitive

responses,

also

reported

asa“little

intrusive”

Penceetal.

(2013)

Not

reported

Analogue

Functional

Analysis

Multiplebaseline

across

participants

Attempted

torole

play

conditions

givenmaterials

andwritten

protocol

Not

reported

Pyramidaltraining.

Traineeslearned

FAskillsfrom

BCBA®sandthen

Nospecificmastery

criteria

Not

reported

Not

reported

J Dev Phys Disabil

Table2

(contin

ued)

Study

Problem

behavior

FAMethod

Experim

entaldesign

Baselineskill

assessment

Trainingduration

Trainingmethods

Posttraining

assessments

Socialvalidity

Treatmentintegrity

taught

skillsto

new

learners.

Trainers:workshop

9monthsbefore

experiment.

Didactic

instruction,

role-

play,feedback.

Coachingandfeed-

back

provided

dur-

ingclassroom

FA.

Refresher

before

expt.B

egan.P

rac-

ticed

feedback

&coaching

skills

Trainees:modeling,

traineeattempted

condition.

Feedback

&role-

play

aserrorcor-

rection.

General-

ized

toclassroom

implem

entation

Percentagesteps

correctper

condition

Not

reported

Reportedas

outcom

evariableinstudy,

high

across

all

conditions.

Pooleetal.

(2012)

Disruptivebehavior

Brief

Functional

Analysis

ABAB&

Multi-

elem

entdesign

Nonetaken

40min

Modeling,

prom

pting,

rehearsal,

performance

feedback

(based

onMoore

etal.2

002)

Percentagesteps

correctper

condition

“Strong

satisfactionw

i-th

procedure”

Room

1:95.1

%Room

2:95.1

%

Radstakke

etal.

(2013)

Aggression,

SIB,

throwingmaterials,

precursorbehaviors

Brief

Functional

Analysis

FA:multi-elem

ent

design

FCT:ABABdesign

None

Not

reported

Meeting,

written

protocolsand

verbalcoaching.

FA/FC

Toutcom

esNot

reported

Not

reported

J Dev Phys Disabil

Table2

(contin

ued)

Study

Problem

behavior

FAMethod

Experim

entaldesign

Baselineskill

assessment

Trainingduration

Trainingmethods

Posttraining

assessments

Socialvalidity

Treatmentintegrity

Researcherpresent

during

FAsessions

Renshaw

etal.

(2008)

Disruption,

offtask

FunctionBased

support

(FBS).(As-

sessment,

BSP

design

&im

plem

enta-

tion

MultipleBaseline

across

Behaviors

(trainingunits)

FBSKnowledge

Test(derived

from

Umbreit

etal.(2007)

12weeks

Group

lectures,

Personalreading,

1:1

consultation

FBSKnowledge

testaftereach

training

unit

FAoutcom

eBSP

Quality

Rated

Highly

Favorable

100%

Rispolietal.

(2013)

Aggression,

scream

ing,

pushingetc.Verbal

outbursts:“N

o”“Stopit”

TrialBased

Functional

Analysis&

Analogue

Functional

Analysis

Com

parisonof

FA&

TBFA

outcom

esNot

reported

Not

reported

Modelling,

roleplay,

correctivefeedback

Fidelity

ofcondition

implem

entation

Not

reported

100%

Schumateand

Wills(2010)

Disruption,

Offtask

Brief

Functional

Analysis

Playcondition

excluded

MultipleBaseline

across

Participants

Nonetaken,

noprevious

teacher

experience

10mins

Lecture

training,

modellingandrole-

play.C

olourcoded

writtenprotocol

BFA

outcom

eRated

Favorable

95%

Skinneretal.

(2009)

Disruptionand

aggression

Brief

Functional

Analysis

ABC

Nonerequired

Approx.

45mins

Twosessions

ofdiscussion

androle

play

25item

testafter

each

session

FAoutcom

e

Rated

Highly

Favorable

92.5

%

Wallace

etal.

(2004)

Headhitting

(moderate

rates)

Brief

Functional

Analysis

MultipleBaseline

across

Participants

Percentage

correct

interactions

per

BFA

condition

3h

Dem

onstrationof

FAconditions.Role-

play

ofFA

condi-

tions.F

eedback

from

researchers

Percentagecorrect

interactions

per

BFA

condition

Generalisation

probes

forone

participant

Not

reported

100%

Ward-Horner

andSturmey

(2012)

Challengingresponses:

Aggression:

hitting

&kicking.

Analogue

functional

analysis

Alternatingtreatm

ents

design

combined

Writteninstructions,

quiz,attempt

toNot

reported

Com

ponent

analysis:

P’sassigned

tolearneach

FA

Percentagecorrect

interactions

per

FAcondition

Participants

preferredthe

moreeffective

99%

(95%-100

%)

J Dev Phys Disabil

Table2

(contin

ued)

Study

Problem

behavior

FAMethod

Experim

entaldesign

Baselineskill

assessment

Trainingduration

Trainingmethods

Posttraining

assessments

Socialvalidity

Treatmentintegrity

Non

-cha

lleng

ing

respon

ses:Chin

tapping,

hand

tapping,

spitting

with

ABCand

ABCDdesigns

perform

mock

FAcondition

through

videomodeling,

rehearsalor

feedback.

Counterbalanced

across

participants

andconditions

Subsequent

conditions

taught

using2of

abovemethods.

Any

condition

belowcriterion

trainedusingall3

methods

Effectivenessof

given

component

reported

methods

ofteaching

FAconditions

Watsonetal.

(1999)

SIB

Brief

Functional

Analysis

AB

Nonetaken,teacher

hadlim

ited

know

ledgeof

ABA

20days

Modelof

BFA

with

client,

Teacherattempted

FAwith

feedback

BFA

outcom

eNot

reported

94%

FBAFu

nctio

nalB

ehavioralA

ssessm

ent,BFA

Brief

Functio

nalA

nalysis,TB

FATrialBased

Functio

nalA

nalysis,ABBaseline-Intervention,

CBchallengingbehavior,SIB

self-injurious

behavior,B

CBA®Board

Certifiedbehavior

Analyst,FCTfunctionalcommunicationtraining,BSP

BehaviorSu

pportPlan,FA

Functio

nalAnalysis,FBSFu

nctionBased

Support

J Dev Phys Disabil

Among studies which trained participants in functional analysis methodologies,Brief Functional Analysis (BFA) was the most popular method used. Twelve studiesused some variation of the BFA procedure with session duration across these studiesranging from 5–10 min. Five studies reported staff training in trial-based FunctionalAnalysis (TBFA) with analogue functional analysis employed in four studies. Onestudy (Rispoli et al. 2013) compared the results of a trial-based to analogue functionalanalysis.

Baseline Assessments

All studies reported that none of the trainees had any experience relevant to behavioralassessment or intervention prior to onset of training. Twelve studies did not implementbaseline measures of trainee knowledge or skill in behavioral assessment (see Table 2).Three studies asked trainees to attempt to implement functional analysis conditionswith participants after reading a written protocol and a role-play of functional analysisconditions as a baseline measure (McKenney et al. 2013; Pence et al. 2013; Ward-Horner and Sturmey 2012). Simulated baselines for these studies returned variableresults across participants and conditions. Low to moderate procedural fidelity wasreported during baseline conditions and until training commenced.

Kunnavatana et al. (2013) asked trainees to implement FA conditions on non-challenging responses as a baseline test. The authors used the percentage of correctinteractions, according to FA protocol, per condition as the dependent variable. Resultsat baseline were variable across all conditions for the participants. A further baselinemeasure included participants’ attempts to graph and analyze hypothetical trial-basedfunctional analysis data. Wallace et al. (2004) also examined baseline percentagecorrect interactions during a Brief Functional Analysis protocol. Participants reviewedthe method section of the Iwata et al. (1994) study prior to conducting the test sessions.During the simulated assessments, none of the three participants scored above 50 %correct.

Three studies (Bessette and Wills 2007; Christensen et al. 2012; Renshawet al. 2008) administered a written test before intervention. Average scores atbaseline were 45 %, 43 % and 61 % respectively. Moore and Fisher (2007)administered both a written test and a probe FA as a baseline condition. Thewritten test ensured all participants had knowledge of the procedures beforeimplementing conditions with participants. Scores on written tests averaged95 % but this was not reflected in the low scores on the FA probe conditionsusing naturalistic baselines.

Two studies (Christensen et al. 2012; Renshaw et al. 2008) reported using the FBSKnowledge Test as their baseline measure. This is a 30 item multiple-choice quizadapted from Umbreit et al. (2007) and contains direct and applied questions onprinciples and procedures of behavior assessment.

Where baseline measures were reported, performance was significantly belowthe mastery criterion. For example, mean probe performance across trainees forErbas et al. (2006) was 5.01 % at baseline and Wallace et al. (2004) found that noparticipant scored above 50 % in any condition prior to training. Ward-Horner andSturmey (2012) also found that no participant in their study scored over 22 %during baseline conditions.

J Dev Phys Disabil

Method and Duration of Training

Fifteen studies reported training duration ranging from ten minutes (Schumate andWills 2010) to 12 weeks (Renshaw et al. 2008). Studies reported in hours lasted a meanduration of 7.81 h and those reported in weeks lasted a mean of 6.19 weeks (seeTable 2). There was some evidence to suggest that studies reporting longer trainingduration resulted in outcomes reporting greater detail on behavioral function, hypoth-esis testing and behavior support evaluation (Christensen et al. 2012; Maag and Larson2004; Renshaw et al. 2008).

Studies reporting shorter training duration were primarily used with functionalanalysis procedures (e.g., Moore et al. 2002) or truncated FBA (Packenham et al.2004). Schumate and Wills (2010) reported the shortest training duration with theirparticipants learning to implement a Brief Functional Analysis protocol following a10 min training session. Duration of training did not affect treatment integrity orintervention success across studies (see Table 3).

Studies utilized the following combination of training methods across individual andgroup instructional sessions: written protocols (e.g., Bessette and Wills 2007; Doggettet al. 2001; Lambert et al. 2012; Moore et al. 2002; Radstakke et al. 2013; Schumateand Wills 2010); personal reading (e.g., Christensen et al. 2012; Renshaw et al. 2008);instructor feedback (e.g., Kunnavatana et al. 2013; Lambert et al. 2012; Moore et al.2002; Pence et al. 2013; Poole et al. 2012; Rispoli et al. 2013; Watson et al. 1999) ;role-play (e.g., Kunnavatana et al. 2013; Lambert et al. 2012; McKenney et al. 2013;Pence et al. 2013; Rispoli et al. 2013; Schumate and Wills 2010; Skinner et al. 2009;Wallace et al. 2004) ; modeling, video modeling and in-vivo coaching (e.g., Mooreet al. 2002; Moore and Fisher 2007; Rispoli et al. 2013; Schumate and Wills 2010; seeTable 2).

The schedule of training across the majority of studies involved the presenta-tion of written protocols, followed by group or individual instruction on therationale for FBA, practice in writing operational definitions and information onthe content of FA conditions. Following lectures/workshops, modeling (video/in vivo) and/ or role-play were delivered (Bessette and Wills 2007; Erbas et al.2006; Lambert et al. 2012; Moore et al. 2002; Skinner et al. 2009; Wallace et al.2004.) Some studies (e.g., Watson et al. 1999) attempted implementation at thispoint or used role-play (Moore et al. 2002; Wallace et al. 2004) to simulate FAconditions.

Feedback and error correction to increase implementation accuracy were frequentlyused following initial training sessions. Feedback took the form of video review (Erbaset al. (2006); direct feedback following implementation (Wallace et al. 2004); feedbackduring practice sessions employing functional analysis conditions (Bessette and Wills2007; Pence et al. 2013; Watson et al. 1999) and video tele-conferencing (Machaliceket al. 2010). Feedback, during or following implementation of FBA procedures, waseffective at increasing proficiency to mastery levels, where modeling or rehearsal wasshown to have less success (Moore and Fisher 2007; Ward-Horner and Sturmey, 2012).When procedural integrity was below mastery levels, Pence et al. (2013) also usedfeedback to correct errors during classroom implementation. For the majority of studiesreviewed the researcher carried out direct observations before the trainee conducted anexperimental analysis to verify hypotheses.

J Dev Phys Disabil

Table3

Summaryof

interventions

derivedfrom

traineeconductedfunctionalassessmentsandfunctio

nalanalyses

Study

Problem

Behavior

Trainee

conducted

Functio

nal

Assessm

ent

Trainee

conducted

FA

BehavioralFu

nctio

nInterventio

nsIm

plem

ented

Outcomeof

Intervention

Bessette

andWills(2007)

Disruption,

aggression,

property

damage

No

Yes

Multip

lycontrolled:

attention&

escape

FCT&

Extinction

Decreased

CBandincreasedon

task

behavior

Christensen

etal.(2012)

Stud

y1:

disruptio

nYes

No

Attentionfrom

peersand

teacher

Socialskillsteaching,F

CT

forhand

raising,

altered

reinforcem

entschedules

Decreasein

disruptiv

ebehavior

post

interventio

n

Stud

y2:

offtask

Yes

No

Escapefrom

academ

ictasks

Tokeneconom

y.To

kens

exchangedforextra

recess

time

Increase

inon

task

behavior

forstudent,

improved

with

greaterfidelityto

procedures

Stud

y3:

offtask

Yes

No

Attentionfrom

teacher

andescape

from

task

demands

Non-contin

gent

teacher

attention,

token

econom

y.To

kens

exchangedforextra

recess

time

Decreasein

problem

behavior

maintainedandreinforcem

ent

schedulereduced

Lam

bertetal.(2012)

Aggressionandtantrums

Not

reported

Yes

P1:attention,

escape,

tangible

P2:escape

P3:attention

FCT&

extin

ction

Increase

inappropriatebehavior

and

reductions

inCBfortwoclients.

Inconclusive

outcom

esforthird

client

Laneetal.(2007)

Stud

y1:

interruptio

nsYes

No

Stud

y1:

teacherattention

&escape

Stud

y1:

Selfmonitoring,

curricular

changes,hand

raisingas

replacem

ent

behavior

Stud

y1:

Decreasein

interruptio

ns,n

oconsistent

pattern

ofhand

raising

(replacementbehavior)post

interventio

n

Stud

y2:

Stud

y2:

attention,

sensorystim

ulation

Stud

y2:

socialskills

teaching,token

econom

yforappropriaterequests

Stud

y2:

decrease

intouching

inspecial

andgeneralclassrooms,increasesin

requestsdidnotgeneralizeto

the

generaled.classroom

J Dev Phys Disabil

Table3

(contin

ued)

Study

Problem

Behavior

Trainee

conducted

Functio

nal

Assessm

ent

Trainee

conducted

FA

BehavioralFu

nctio

nInterventio

nsIm

plem

ented

Outcomeof

Intervention

Maag&

Larson(2008)

Disruption

Yes

No

P1:peer

attention

P2:teacherattention

P1:choice

ofseat

P2:contingent

teacher

praise

Decreased

CBto

zero

Renshaw

etal.(2008)

Disruption,

off-task

Yes

No

P1,P

3,P4

:attention

P1:choice

ofseat,p

raise,

extin

ction

Modestreductions

inCB.C

ollateral

gainsin

non-targetappropriate

behaviors

P2:praise,token

exchange

P2:attention&

escape

P3praise,token

exchange,

getoutof

centre

card

P4praise,token

exchange

Radstakke

etal.(2013)

Aggression,

SIB,

throwingobjects.

Precursors:pushing

materials,touching

person/food

No

Yes

Amy:

escape

from

task

Bob:tangibles

Cody:

escape

from

task

FCTusingPE

CSor

object

exchange

Amy:

Large

effectof

FCT,

(d=−4.5)

Bob:Medium

effectof

FCT,

(d=−0.6)

Cody:Mediumeffectof

FCT,(d=−0.5)

Decreases

inprecursorbehavior

also

show

nformajority

oftopographies

SchumateandWills(2010)

Disruption,

Offtask

No

Yes

Attentionforall

participants

DRO

&DRA

CBto

near

zero

Skinneretal.(2009)

Disruptionand

aggression

No

Yes

Multip

lycontrolled:

Attention&

escape

Fixedtim

eattention&

extin

ction

Decreasingtrendin

CB

Watsonetal.(1999)

SIB

No

Yes

Escape

Escapeextin

ction&

DRA

Generalized

reductions

tonear

zero

across

3staff

FAfunctionalassessm

ent,CBchallengingbehavior,F

CTfunctionalcom

municationtraining,P

ECSPictureExchangeCom

municationSy

stem

,SIB

self-injurious

behavior,D

RO/DRA

differentialreinforcem

entof

other/alternativebehavior

J Dev Phys Disabil

Some idiosyncrasies were present across studies. Schumate and Wills (2010) usedcolor coded written protocols as a prompt for the trainee during Brief FA conditions andused a rapid training procedure (10 min) involving role-play before the trainee con-ducted the FA conditions. Moore and Fisher (2007) compared the relative efficacy ofcomplete and partial video modeling. Participants were exposed to partial videomodeling or complete video modeling counterbalanced across conditions and partici-pants. Complete video modeling was effective in teaching FA conditions to mastery inall but one case, in which feedback was used to correct errors.

Renshaw et al. (2008) conducted a twelve-week training program in FBA proce-dures, behavior support preparation, monitoring and implementation. Training in theuse of the Functional Assessment Hypotheses Formulation Protocol (based on Maagand Larson 2004) was conducted in two phases of individualized instruction. Phase Idelivered lectures on rationale and procedures of FBA and hypothesis generation.Phase II involved a review which dealt with difficulties in data collection and correctdefinitions of antecedents and consequences.

Ward-Horner and Sturmey (2012) conducted a component analysis of BehavioralSkills training. The component analysis was in accordance with outcomes of Mooreet al. (2002, 2007) and Machalicek et al. (2010). Feedback and modeling were the mosteffective components of training, while instruction and rehearsal were partially effec-tive. This finding is consistent with those of other studies in the review, in whichwritten protocols and role-play alone, did not result in trainees reaching mastery (Erbaset al. 2006).

Pence et al. (2013) used pyramidal training in which trainees “passed on” skills to asecond set of learners. Pyramidal training allows skills to permeate through an organi-zation or group of professionals while maintaining good procedural integrity (Kuhnet al. 2003). Pence et al. (2013) used didactic instruction, role-plays and feedback toimpart training in functional analysis to an initial group of educators. Having learnedboth in implementation and skills teaching, the initial group trained a second group ofschool staff. The same techniques of role-play, feedback and instruction were effectivein “passing on” functional analysis competencies to a second generation of trainees.

Post Training Assessments, Treatment Integrity and Social Validity

Twenty four studies evaluated training according to the outcomes of trainee conductedFBA procedures. The outcomes of these procedures included the behavioral functionidentified and the function-based intervention that followed. These data are summa-rized in Table 2. Written tests were used by four studies (Bessette andWills 2007; Erbaset al. 2006; Renshaw et al. 2008; Skinner et al. 2009). The percentage of correctresponses on FA conditions was an outcome measure for 11 studies (see Table 3). Averbal quiz was used by Moore et al. (2002) and evaluations of BSPs produced bytrainees were used by Renshaw et al. (2008).

Treatment integrity was reported for 23 studies across FA conditions and/or inter-vention phases and ranged from 83 %–100 % (m=94.75 %; treatment integrity meanswere available for 23 studies, see Table 2).

Social validity was reported for eight of the twelve studies that evaluated outcomes(see Table 2). In all cases procedures were rated as: “favorable”; “highly favorable”;“acceptable” or “highly acceptable”. Erbas et al. (2006) reported “positive changes in

J Dev Phys Disabil

viewpoints” from participants. Other trainees stated that the FBA skills would be usefulduring the school year (McKenney et al. 2013) and useful with additional students(Schumate and Wills 2010). The only negative opinion expressed was reported byPackenham et al. (2004) whereby the trainee found the procedures “a little intrusive”.

Interventions Based on Trainee Conducted FBAs

Table 3 describes behavioral function, treatment types and outcomes for studies thatreported such data. Twelve studies involved intervening on CB after ascertainingbehavioral function. Of these, six studies utilized functional analysis data and sixinvolved non-experimental data e.g., ABC observations (see Table 3).

Attention was the most commonly identified function of targeted CB. Ten partici-pants’ behaviors were maintained by attention from teachers or peers. Behaviorsmaintained by attention were treated using: Functional Communication Training,(FCT; Christensen et al. 2012; Lambert et al. 2012); contingent teacher praise (Maagand Larson 2004); altered reinforcement schedules and social skills training(Christensen et al. 2012); choice of seat, praise and extinction (Renshaw et al. 2008)and DRO and DRA (Schumate and Wills 2010). Maag and Larson (2008) andSchumate and Wills (2010) reported reductions in problem behavior to zero or nearzero levels. Renshaw et al. (2008) reported modest reductions in problem behavior andgains in on task behavior as a collateral result of intervention.

Multiply controlled CBs were the second most prevalent. Multiply controlledbehaviors were displayed by six participants (Bessette and Wills 2007; Lambert et al.2012; Renshaw et al. 2008; Skinner et al. 2009). Combinations of attention and escapemaintained behavior targets were shown for all but one of these participants (Lane et al.2007). This participant showed behaviors maintained by both social positive reinforce-ment, in the form of attention, and automatic reinforcement. Multiply controlledbehaviors were also treated successfully in the studies reviewed. Treatment packagesincluded interventions such as: praise, token exchange and FCT, (Renshaw et al. 2008);fixed time attention and extinction (Skinner et al. 2009) and FCT and extinction(Bessette and Wills 2007). Skinner et al. (2009) reduced problem behavior from amean rate of 3.58/min at baseline to 0.6/min during the maintenance period. Bessetteand Wills (2010) reduced inappropriate vocalizations from a mean of 40 % of intervalsto 3.9 % and aggression from 7.8 % to 1.3 %. Collateral gains in on-task behaviorswere also reported despite not being targeted for intervention. Renshaw et al. (2008)reported modest decreases in problem behavior. Christensen et al. (2012) used non-contingent attention and a token economy to reduce behaviors controlled by escape andattention. Lane et al. (2007) treated multiply controlled behavior with a combination ofsocial skills training and a token economy. Lambert et al. (2012) reported that two oftheir participants’ problem behaviors were susceptible to multiple sources of reinforce-ment but selected the most differentiated function for intervention.

Escape was the third most prevalent behavioral function, (n=5; Lambert et al. 2012;Radstakke et al. 2013; Watson et al. 1999). Escape maintained behaviors were treatedusing: FCTand extinction (Lambert et al. 2012); FCT alone (Radstakke et al. 2013) andDRA and escape extinction (Watson et al. 1999). These intervention packages werehighly successful in reducing problem behavior. Lambert et al. (2012) reported de-creases in problem behavior to zero levels and increases in alternative behaviors for two

J Dev Phys Disabil

participants. Radstakke et al. (2013) reported large and medium effect sizes for threeparticipants using FCT in the reduction of problem behaviors. The researchers alsonoted a decrease in known precursor behaviors across participants. Watson et al. (1999)used a DRA intervention to decrease SIB from a mean rate of 16 instances per minuteto zero within four sessions and demonstrated generalization across settings.

Discussion

The current review examined the methods and effects of training staff in naturaleducational settings to apply FBA and experimental functional analysis procedures.Intervention outcomes were also examined where reported. One of the key aims of thepresent review was to examine whether onsite training in FBA addressed the concernsraised by previous authors (Scott et al. 2000; Scott et al. 2004; Witt et al. 2004). Theseconcerns were centred on the ability of educators to learn procedures to the requiredskill level, their level of independence from consultants and researchers, and theeffectiveness and efficiency of the assessment procedures in the educational setting.A further issue was the need to reconcile the demands of empiricism and pragmatism.As such, procedures needed to deliver a high level of procedural integrity while limitingdisincentives to the future use of functional assessment by the trainees.

A wide variety of trainees took part in the studies reported. People with a range ofexperience levels and various competencies within the school system were able tomaster the skills in functional behavioral assessment to a high standard. This indicatesthat such skills can be effectively taught to staff members regardless of training levelsor prior experience of applied behavior analysis. Trainees included teachers, classroomaides and school principals, among others suggesting that the methods are within thecompass of many members of the education service. Although relatively small numbersof participants are reported across studies, the outcomes demonstrate that it may bepossible to broaden the utility of behavioral assessment in natural settings.

Participants across studies generally presented with relatively mild symptoms ofchallenging behavior, such as yelling, disruption or off task (e.g., Kodak et al. 2013;McKenney et al. 2013; Moore et al. 2002; Renshaw et al. 2008). More severebehaviors, such as SIB were reported less often (e.g., Machalicek et al. 2010; Mooreand Fisher 2007; Wallace et al. 2004; Watson et al. 1999). The studies reviewed did notindicate whether teachers or staff dealing with more severe problem behavior can betrained with equal effectiveness. No studies examined low rate or episodic challengingbehaviors. The focus on less severe problem behavior may reflect “real world” settingswhereby teachers encounter less severe or dangerous challenging behavior.

In terms of effectiveness, the outcomes of training packages were relatively similar.Treatment integrity across the review was 93.8 %. While not all studies proceeded tointervention, trainees who performed interventions were successful in reducing prob-lem behaviors to near-zero levels in many cases (Maag and Larson 2004; Schumate andWills 2010; Watson et al. 1999). However, Moore and Fisher (2007) and Ward-Hornerand Sturmey (2012) found that some aspects of training were more effective thanothers. In both of these studies lectures and written protocols were found insufficient toachieve mastery, while modeling and feedback were more effective components.Several studies (e.g., Bessette and Wills 2007; Erbas et al. 2006; Lambert et al. 2012;

J Dev Phys Disabil

Machalicek et al. 2010; Moore et al. 2002; Wallace et al. 2004; Watson et al. 1999)found that at least one trainee required performance feedback to reach mastery criteria.Although the training procedure outlined by Schumate and Wills (2010) lasted only tenminutes, the use of modeling and color-coded written protocols may have contributedto the accuracy of the implementation of functional analysis. This suggests that futureresearch could prioritize feedback and modeling over lectures and workshops, espe-cially when time is limited.

No study taught participants to conduct all three levels of functional behavioralassessment. Although the protocols used were successful, it was not demonstrated thatteachers could conduct informant, observational and experimental functional behavioranalysis methods and develop a behavior support plan based on those findings. Studiesthat implemented experimental functional analysis conditions (e.g., Doggett et al. 2001)first used a functional assessment to generate functional hypotheses for problembehavior. However, these functional assessments were conducted by the researchersand not the trainees. Future research should incorporate hypothesis generation into stafftraining in experimental functional analysis to a greater degree. Training in observa-tional and experimental functional assessment techniques was mutually exclusive. Thismeans there is a gap in the current research body because trainees were not providedwith skills to develop functional hypotheses through observation and test them with afunctional analysis.

The majority of studies reviewed did not report follow-up data to assess maintenanceof skills in behavioral assessment with trainees. Periodic retraining may be necessaryand research should aim to find an optimal means of refreshing educators’ knowledgeand skills in functional behavioral assessment. Target behaviors for reduction mayinitially increase in intensity (extinction burst) or may reappear after being absent for atime (spontaneous recovery). Future research should examine protocols to preparetrainees to respond appropriately to these phenomena.

Few studies assessed generalization of skills in functional assessment to newbehaviors, behavioral functions and students. Christensen et al. (2012) trained oneteacher who assessed three different students at staggered stages of the training,demonstrating a level of generalization. Poole et al. (2012) examined generalizationfollowing training whereby a teacher was required to assess behavioral function acrossa whole class, while Packenham et al. (2004) and Schumate and Wills (2010) examinedthe effects of training across small groups of children. Most other studies, however,trained only individual student-teacher dyads, without testing the trainee’s skills withadditional students, behaviors or settings.

A further compounding limitation is that only 12 of 25 studies trained staff members toconduct an intervention linked to their behavioral assessment. Where interventions wereapplied, the trainees selected functionally equivalent interventions based on the results oftheir functional assessment or experimental functional analysis. They subsequently im-plemented these interventions and recorded data on outcomes. All studies that attemptedintervention reported moderate to good success. Despite reports of high performance onmeasures of treatment integrity with functional analysis procedures, more than half of thestudies reviewed did not report teacher led intervention on participant problem behavior.Limitations on measures of training effectiveness with regard to behavior reduction mayimpact a teacher’s preparedness for new situations or students and could conceivablyreduce the acceptability of behavioral interventions for such trainees.

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Only three studies (Packenham et al. 2004; Poole et al. 2012; Skinner et al. 2009)reported maintenance probes where intervention was implemented. While the gainsmade during intervention were maintained at follow-up, information was not availableto draw any conclusions about maintenance of skills taught in the natural environment.Future research should examine maintenance of intervention gains.

Other methodological issues included a lack of baseline measures for trainee skillsprior to training across several studies. Those studies that did report baseline datademonstrated low levels of knowledge and procedural integrity prior to training.However, for research purposes a low skill level at outset should not be taken forgranted, especially as some trainees had a certain level of exposure to behavioralmethods. A further issue includes the limited numbers of probes examining outcomesof training in natural settings.

Future Directions

There is currently little consensus on what FBA procedures are necessary and sufficientfor classroom use on a regular basis. There is also little data on the maintenance of FBAand behavioral interventions in the long term within schools. Scott et al. (2004)recommend that researchers demonstrate the ability of general education teachers toperform experimental functional analyses as part of their regular duties. The studiesreported here have shown that school staff can perform several variants of the proce-dure, including newer protocols such as the trial-based and brief functional analyses.Future research should focus on long-term maintenance of skills and relative efficiencyacross the various modes of functional analysis. Research should also focus ongeneralization across students, behavioral functions and topographies and the type ofrefresher training needed to maintain high fidelity.

The use of behavioral methods in school or clinical settings, may generate a tensionbetween pragmatism and empirical rigor. What is most suitable to the end user is notalways the most desirable from the point of view of efficacy. Scott et al. (2004) pointout that the balance between efficiency and efficacy is a major determinant of aprocedure’s validity within a setting. Efficiency in specific training models could alsobe aided by a parametric analysis of the time required to train staff effectively. Trainingtime in the studies reviewed ranged widely (from 10 min to 12 weeks). Future researchin the area should aim to determine optimal training times in order to maximize timeavailable for intervention (Schumate and Wills 2010). A parametric analysis of trainingduration in the FBA and intervention process could contribute to a rapid training modelsuitable for widespread use in school and clinical settings.

McKenney et al. (2013) argue that it may not be necessary to use experimentalfunctional analysis if other methods produce reliable and useful data, which may guideintervention (see also Healy et al. 2013). Studies that reported training in experimentalfunctional analyses demonstrated that trainees were able to perform various experi-mental functional analyses with high integrity. Trial-based functional analysis offers astrong compromise between effectiveness and efficiency in the classroom and hasseveral advantages over analogue functional analysis. This type of functional analysisis able to operate under natural EO’s present in the classroom, has shown at least 60 %concordance with analogue functional analysis, takes less time to implement and isterminated with fewer incidences of challenging behavior (Lydon et al. 2012). Given

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these advantages and its demonstrated efficiency in the natural setting, trial-basedfunctional analysis could make up a large part of future research on functionalassessment training within educational and clinical settings.

Scott et al. (2004) raised concerns about treatment integrity while conductingFBA in natural settings. The studies reported here found that educators may betrained to conduct functional assessment, including experimental analysis, withhigh treatment integrity and a subset of studies demonstrated implementation ofeffective, function-based interventions. These findings suggest a high degree ofutility within natural settings. However, although positive outcomes of FBAtraining programs were widely reported, there remain some limitations to thecurrent body of research. Future research should focus on developing standardizedmodels of training in assessment and intervention, incorporating all levels ofbehavior assessment and support.

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* indicates studies included in the review

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