Behavioural assessment and functional analysis

Overview & Definition

A childcare worker says a five-year-old “just snaps.” A school email asks for “something for aggression.” A parent wants a tablet increased because shower time is a war. Your job is not to name a villain. Your job is to run a behavioural assessment that finds what the behaviour does for the child, what medical or communication problem sits underneath, and what support will change the contingency rather than only the volume of the noise. [1] [10] [11]

Challenging behaviour is a description of impact — intensity, frequency or duration that risks safety or seriously limits ordinary life — not a DSM diagnosis by itself. Psychiatric disorders may coexist and need their own criteria. Emerson’s total-population work framed challenging behaviour as a common service-level problem in intellectual disability, not a rare curiosity. [9]

Functional assessment asks: under what conditions does this behaviour occur, and what consequence keeps it going? Experimental functional analysis (FA) tests those hypotheses under controlled conditions, classically associated with Iwata’s work on self-injury. Decades of FA research show that most identified functions are social (attention, escape, tangible), with a meaningful automatic/sensory subset. [1] [2] [3]

This leaf owns assessment method and formulation. Condition-specific treatment depth lives on linked pages for tantrums, oppositional behaviour, school refusal, ASD, ADHD and intellectual disability. Cross-link them. Do not hide a second disorder textbook here. [10] [14]

[1] [4] [5] [17]

References18Show ledgerHide ledger

1. [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. [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
3. [3]Melanson IJ, Fahmie TA Functional analysis of problem behavior: A 40-year review. Journal of applied behavior analysis, 2023.PMID 36892835
4. [4]Ghaemmaghami M, Hanley GP, Jessel J Functional communication training: From efficacy to effectiveness. Journal of applied behavior analysis, 2021.PMID 32929757
5. [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. [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
7. [7]Owen R, Sikich L, Marcus RN, et al. Aripiprazole in the treatment of irritability in children and adolescents with autistic disorder. Pediatrics, 2009.PMID 19948625
8. [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
9. [9]Emerson E, Kiernan C, Alborz A, et al. The prevalence of challenging behaviors: a total population study. Research in developmental disabilities, 2001.PMID 11263632
10. [10]Hyman SL, Levy SE, Myers SM Identification, Evaluation, and Management of Children With Autism Spectrum Disorder. Pediatrics, 2020.PMID 31843864
11. [11]Gleason MM, Goldson E, Yogman MW; Council on Early Childhood; Committee on Psychosocial Aspects of Child and Family Health; Section on Developmental and Behavioral Pediatrics Addressing Early Childhood Emotional and Behavioral Problems. Pediatrics, 2016.PMID 27940734
12. [12]Kearney CA, Albano AM The functional profiles of school refusal behavior. Diagnostic aspects. Behavior modification, 2004.PMID 14710711
13. [13]Fung LK, Mahajan R, Nozzolillo A, et al. Pharmacologic Treatment of Severe Irritability and Problem Behaviors in Autism: A Systematic Review and Meta-analysis. Pediatrics, 2016.PMID 26908468
14. [14]Volkmar F, Siegel M, Woodbury-Smith M, King B, McCracken J, State M; American Academy of Child and Adolescent Psychiatry (AACAP) Committee on Quality Issues (CQI) Practice parameter for the assessment and treatment of children and adolescents with autism spectrum disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 2014.PMID 24472258
15. [15]Deb S, Kwok H, Bertelli M, et al. International guide to prescribing psychotropic medication for the management of problem behaviours in adults with intellectual disabilities. World psychiatry, 2009.PMID 19812757
16. [16]Sheehan R, Hassiotis A Reduction or discontinuation of antipsychotics for challenging behaviour in adults with intellectual disability: a systematic review. The lancet. Psychiatry, 2017.PMID 27838214
17. [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
18. [18]Garner AS, Shonkoff JP Early childhood adversity, toxic stress, and the role of the pediatrician: translating developmental science into lifelong health. Pediatrics, 2012.PMID 22201148