Paeds Cases · growth-development-and-behaviour
Behavioural assessment OSCE — function formulation and family counselling
OSCE on multi-setting behavioural assessment, function hypothesis, PBS/FCT counselling and medication thresholds.
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Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
Station A is history and formulation with a parent of a child with aggression at demand. Station B is counselling staff request for antipsychotic escalation and agreeing a PBS plan.
Station objectives
- Operationalise target behaviour and collect ABC-pattern history. [1] [2]
- Screen medical, communication and safety drivers. [10]
- State a function hypothesis and matched PBS/FCT steps. [4] [5]
- Counsel against medication-first escalation with evidence anchors. [6] [8]
- Close the loop with multi-agency ownership. [17]
References8ShowHide
- [1]Iwata BA, Dorsey MF, Slifer KJ, Bauman KE, Richman GS Toward a functional analysis of self-injury. Journal of applied behavior analysis, 1994.PMID 8063622
- [2]Beavers GA, Iwata BA, Lerman DC Thirty years of research on the functional analysis of problem behavior. Journal of applied behavior analysis, 2013.PMID 24114081
- [4]Ghaemmaghami M, Hanley GP, Jessel J Functional communication training: From efficacy to effectiveness. Journal of applied behavior analysis, 2021.PMID 32929757
- [5]Bearss K, Johnson C, Smith T, et al. Effect of parent training vs parent education on behavioral problems in children with autism spectrum disorder: a randomized clinical trial. JAMA, 2015.PMID 25898050
- [6]McCracken JT, McGough J, Shah B, et al. Risperidone in children with autism and serious behavioral problems. The New England journal of medicine, 2002.PMID 12151468
- [8]Tyrer P, Oliver-Africano PC, Ahmed Z, et al. Risperidone, haloperidol, and placebo in the treatment of aggressive challenging behaviour in patients with intellectual disability: a randomised controlled trial. Lancet, 2008.PMID 18177776
- [10]Hyman SL, Levy SE, Myers SM Identification, Evaluation, and Management of Children With Autism Spectrum Disorder. Pediatrics, 2020.PMID 31843864
- [17]Council on Children with Disabilities and Medical Home Implementation Project Advisory Committee Patient- and family-centered care coordination: a framework for integrating care for children and youth across multiple systems. Pediatrics, 2014.PMID 24777209