An Empirical Analysis of the Effects of a Possible Sinus Infection and Weighted Vest on Functional Analysis Outcomes of Self-Injury Exhibited by a Child with Autism

Article excerpt

Abstract

Analogue functional analysis methodology was used to assess potential maintaining contingencies of episodic self-injurious behavior (SIB) of a 4-year-old child diagnosed with autism. Analogue conditions were presented within a multielement design when the child did, and did not exhibit signs of a possible sinus infection, and when the participant, did, or did not, wear a weighted vest. Findings revealed higher occurrences of SIB when a sinus infection was considered to be present vs. absent, and the weighted vest did not affect occurrences of SIB during the functional analysis. SIB was considered to be maintained by some form of automatic reinforcement. Implications for enhancing functional analysis methodology by including measures of biological events such as medical illness are discussed.

KEYWORDS: Functional analysis, self-injurious behavior, autism, sinus infection, weighted vests.

***********

Functional analysis methods have been used to identify both social and nonsocial maintaining variables for various behavior disorders. Behaviors maintained by nonsocial variables have been referred to as being automatically reinforced through sensory stimulation or pain attenuation (Vollmer, 1994). Nonsocial maintaining variables have been shown to maintain behaviors such as pica (Piazza, Hanley, & Fisher, 1996), stereotypy (Hanley, Iwata, Thompson, Lindberg, 2000), and eye poking (Kennedy & Souza, 1995; O'Reilly, 1997). Although nonsocial variables may be relevant to several maladaptive behaviors, the direct manipulation of these nonsocial variables responsible for behavior maintenance may be difficult due to the complexities of separating the influence of stimuli from the response (Iwata, Dorsey, Slifer, Bauman, & Richman 1994; Vollmer, 1994). Some behaviors hypothesized to be maintained by automatic reinforcement have been assessed by directly manipulating various idiosyncratic stimuli that could be controlled and ruling out competing hypotheses (Kennedy & Souza, 1995; Piazza et. al. 1996).

Carr (1994) suggested extending the utility of functional analysis methodology by investigating the effects of nonsocial variables such as physiological or internal states. He referred to these variables as biological events such as physical illness or drug states. These types of biological events have been considered to act as establishing operations for the occurrence of problem behavior (Hanley, Iwata, & McCord, 2003; Kennedy & Meyer, 1996; Pace & Toyer, 2000). Kennedy and Meyer (1996) recommended expanding experimental analyses to extraexperimental events such as allergy symptoms and sleep deprivation, that occur outside functional analyses in order to obtain a better understanding of their impact on response rates and to conceptualize the effects of these events. Hanley et al. (2003) suggested conducting functional analyses with and without the presence of physiological or internal states such as illness or drugs in order to clarify the impact of these conditions on a specific behavior and to identify a more accurate and effective treatment. Carr (1994) recommended including information obtained from more comprehensive descriptive assessments to individualize functional analyses and enhance relevance of outcomes. The value of using descriptive assessment procedures to enhance functional analysis outcomes has not been clearly described in the literature (Iwata et al., 1994), primarily due to a lack of inclusion of descriptive assessment information in studies reporting on the use of functional analysis procedures (Hanley et al., 2003). The current literature suggests both discrepancies between descriptive assessment and functional analyses and synonymous relations (Carr, 1994; Galiatsatos & Graff, 2003).

O'Reilly (1997) determined that self-injury was associated with a biological event (otitis media) by conducting a functional analysis during periods when otitis media was and was not present. …