A Meta-Analysis of Intervention Research with Problem Behavior: Treatment Validity and Standards of Practice
Title
A Meta-Analysis of Intervention Research with Problem Behavior: Treatment Validity and Standards of Practice
Author
Scotti, J.R., Evans, I.M., Meyer, L.H., & Walker, P.
Source
American Journal on Mental Retardation, 96(3), 233-56.
Year Published
1991
Background
Maladaptive, self-injurious, dangerous or inappropriate behaviors are common among people with developmental disabilities and many different interventions have been developed to treat them over the years. Certain behavior treatment principles for people with developmental disabilities have become generally accepted, such as the use of functional behavioral assessment and teaching generalization of positive behaviors to different settings. Other issues, such as the use of intrusive or aversive behavior interventions on people with developmental disabilities, have been continually debated. This meta-analysis examines whether accepted treatment principles are actually practiced in schools and treatment centers, and whether or not controversial aversive interventions are effective or not.
Research Questions
What types of behavioral interventions are most effective in reducing the problem behaviors of students with developmental disabilities?
Are different intensities of intervention more or less successful depending on the severity of problem behaviors? Findings
- Of the 403 studies in this meta-analysis, only 44 studies met the researchers’ criteria to be considered highly effective.
- Treatments across different levels of intervention from positive reinforcement to aversive stimulation were equally effective.
- However, when severity of behavior was factored into the analysis, the more intensive interventions such as Response Cost (e.g., removal of object, token-economy fine, or restriction from activity), Time-Out, restraint, medication, or aversive stimuli were found to more successfully suppress behavior than lower-level interventions such as reinforcement or task modifications.
Conclusion/Recommendations
This meta-analysis showed that many of the generally accepted treatment principles of behavior intervention are often neglected in practice. Findings from this synthesis include:
- Only 22% of studies did any form of functional behavioral analysis to determine the most appropriate intervention.
- Less than half of the studies did any follow-up activities to see what the long term effects of behavioral intervention had been.
- Only 30% of studies reported attempts to generalize treatments to other relevant settings or situations.
- In 38% of studies researchers reported previous interventions used with the study participants. However, only 22% showed they tried the less intrusive interventions before using more severe interventions.
- Women were more likely than men to be treated with intrusive or aversive interventions. However, several treatment principles were upheld to a degree by this synthesis. Primarily, carrying out the intervention in the setting or situation in which the target behavior usually occurred resulted in improved effectiveness at follow-up, and interventions conducted in integrated setting were more effective than those conducted in segregated settings.
- More research must be done on behavioral interventions for people with developmental disabilities, with better data collected on participant characteristics, use of functional behavioral analysis, previous treatment attempts, intervention setting, baseline and intervention data, effects on collateral behaviors, and follow-up.