Does a pre-intervention functional assessment increase intervention effectiveness? A meta-analysis of within-subject interrupted time-series studies. (July 2016)

• Record Type: Journal Article
• Authors: Hurl, Kylee; Wightman, Jade; Haynes, Stephen N.; Virues-Ortega, Javier
• Is Part Of: Clinical psychology review. Volume 47(2016)
• Page Start: 71
• Page End: 84
• Publication Date: 2016-07
• Subjects: Functional assessment -- Functional behavioral assessment -- Functional analysis -- Behavioral assessment -- FBA-based -- Intervention -- Meta-analysis -- Problem behavior; Clinical psychology -- Periodicals; Psychology, Pathological -- Periodicals; Psychotherapy -- Periodicals; Psychology, Clinical -- Periodicals; Electronic journals; 616.89
• DOI: 10.1016/j.cpr.2016.05.003
• Languages: English
• ISSNs: 0272-7358

Abstract

Abstract: This study examined the relative effectiveness of interventions based on a pre-intervention functional behavioral assessment (FBA), compared to interventions not based on a pre-intervention FBA. We examined 19 studies that included a direct comparison between the effects of FBA- and non-FBA-based interventions with the same participants. A random effects meta-analysis of effect sizes indicated that FBA-based interventions were associated with large reductions in problem behaviors when using non-FBA-based interventions as a reference intervention (Effect size = 0.85, 95% CI [0.42, 1.27], p < 0.001). In addition, non-FBA based interventions had no effect on problem behavior when compared to no intervention (0.06, 95% CI [− 0.21, 0.33], p = 0.664). Interestingly, both FBA-based and non-FBA-based interventions had significant effects on appropriate behavior relative to no intervention, albeit the overall effect size was much larger for FBA-based interventions (FBA-based: 1.27, 95% CI [0.89, 1.66], p < 0.001 vs. non-FBA-based: 0.35, 95% CI [0.14, 0.56], p = 0.001). In spite of the evidence in favor of FBA-based interventions, the limited number of comparative studies with high methodological standards underlines the need for further comparisons of FBA-based versus non-FBA-based interventions. Highlights: FBA-based interventions had a large reductive effect upon problem behavior. Non-FBA based interventions had no effect on problem behavior. FBA-based and non-FBA-based interventions increased appropriate behavior. The effect of FBA-based interventions on appropriate behavior was four times larger. Experimental functional analyses were associated with larger intervention effects. Non-experimental approaches to functional assessment were not more time-effective than a functional analysis.