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WHAT IS THE UTILITY OF A FUNCTION-BASED DIAGNOSTIC CLASSIFICATION SYSTEM?

WHAT IS THE UTILITY OF A FUNCTION-BASED DIAGNOSTIC CLASSIFICATION SYSTEM?

For people naive to behavior-analytic formulations, it may appear that one simply identifies a consequence for a selected target behavior. The selected consequence should be capable of ameliorating the level of the target behavior problem when applied as a contingency. Therefore, the only technical skill needed is to pinpoint the referred problem in observable terms and follow it with an effective consequence. For example, if a referred client is disruptive in an enclave-work environment, first one defines the disruptive behavior in observable terms. Then the professional identifies a consequence to follow the target behavior and specifies the treatment contingency. If this contingency does not work, the professional would select another consequence and design another behavioral treatment contingency.

GOT CONTEXT DATA?

I was involved in a case consultation years ago where a student who was attending a nonpublic school for emotionally disturbed children was being discussed at an interdisciplinary team meeting. Both school and mental health professionals were in attendance at this meeting. Although no actual behavioral assessment data were reported on specific target behaviors, the school and residential staff indicated that his behavior had worsened. They ascribed it to a litany of possible reasons. The reasons ranged from wrong diagnosis (e.g., “I don’t believe he is schizophrenic. I think he is bipolar!”) to blaming his dysfunctional family and his home visits. About 45 minutes went by without any pertinent discussion about specific target behaviors in the classroom. As the meeting was winding down, one of the teachers asked, “OK, what do we do when he acts up?” Somebody volunteered what appeared to be a solution, “Let’s use time-out.” Why was time- out being recommended? Was it important to comprehend that he was from a dysfunctional family, according to some experts? Are students who come from dysfunctional families best treated with time-out? Was it because time-out works best with manic-depressive children (but not, apparently, schizophrenia)? Nothing in the prior discussion had any relation to discussing the behavioral reasons for this proposed treatment. Nor was the rate of target behaviors presented. What was also missing was an analysis of the context under which these target behaviors occur. Further assessment of the contextual nature of the behavioral problems was required.

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