功能评估与治疗进展特刊简介。

R. LaRue
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引用次数: 3

摘要

关于功能评估和基于功能的治疗的文献是丰富的。自从Carr(1977)和Iwata Dorsey, Slifer, Bauman & Richard(1982/1994)发表了开创性的文章以来,功能分析领域不仅蓬勃发展,而且彻底改变了评估和治疗过程。功能评估程序已被用于指导各种行为困难的治疗过程,包括攻击、自残行为、破坏、财产破坏、仪式行为、进食障碍、异食癖等。这些文献一直表明,理解为什么会发生具有挑战性的行为比开发有效的干预措施要重要得多。在这项研究之前,对问题行为的治疗通常是随意选择的,不了解原因,最终导致效果较差,非功能干预(Carr & Durand, 1985;Durand & Kishi, 1987;kahnh, Iwata & Lewin, 2002;Repp, Felce & Barton, 1988)。这一文学作品的重要性不容低估。正如我们目前所知,这些文献对临床实践产生了巨大的影响。不仅功能评估和治疗程序被证明有益于表现出问题行为的个人(参见Hanley, Iwata & McCord, 2003和Kahng等人,2002关于该主题的评论),而且从业人员使用这些程序所采用的循证实践模型已经影响了联邦和州关于最佳实践的立法(IDEA, 1997, 2004)。虽然关于功能评估和干预发展的文献已经改变了教育系统的景观,但在将研究转化为实践方面仍然存在差距。尽管这些方法在行为学文献中得到了广泛的支持,但它们在临床应用中往往不一致。其中一些差距与使用经验支持的功能评估程序有关。其他差距与应用环境中的治疗问题有关。本期的《今日行为分析师》将解决与从经验证据到临床实践的翻译相关的文献中的一些空白。关于功能评估程序的实际应用仍然存在一些问题。Delfs和Campbell(2010)的文章对功能评估主题的实证文献进行了独特的定量回顾。作者讨论了不同类型的功能行为评估的有效性,以及确定行为功能和治疗效果是否随诊断而变化的程序的使用。斯洛曼(2010)概述了与使用描述性评估相关的关键问题。虽然研究结果在有效性方面好坏参半,但作者回顾了描述性评估可能最有用的情况。此外,Sloman确定了描述性评估程序的新用途,这可能有助于监测治疗的完整性并提供实施的反馈。在Manente, Maraventano, LaRue Delmolino和Sloan(2010)的论文中,作者回顾了评估和治疗成人自闭症的最佳实践。它们确定了执行功能评估程序的一些独特挑战,并确定了程序上的修改,以促进在实际环境中使用这些程序。Gadaire, Kelley, & DeRosa(2010)解决了目前功能评估和治疗文献中最突出的问题之一。虽然操作性行为的原则适用于跨诊断界限,但大多数行为评估和治疗文献只关注于患有发育性残疾的年轻人群。因此,最佳实践往往只适用于这一人群,而其他人群从我们的科学进步中受益的程度是有限的。...
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Introduction for the special issue on functional assessment and treatment development.
The literature on functional assessment and function-based treatments is robust. Since the seminal articles published by Carr (1977) and Iwata Dorsey, Slifer, Bauman & Richard, (1982/1994), the field of functional analysis not only flourished, but it has revolutionized the assessment and treatment process. Functional assessment procedures have been used to guide the treatment process for a wide range of behavioral difficulties, including, aggression, self-injurious behavior, disruption, property destruction, ritualistic behavior, feeding disorders, pica to name a few. This literature has consistently shown that understanding why challenging behavior occurs is far more important than what it looks like to develop effective interventions. Prior to this research, treatments for problem behavior were often selected arbitrarily, without knowledge of the cause, which ultimately led to less effective, non-function based interventions (Carr & Durand, 1985; Durand & Kishi, 1987; Kahng, Iwata & Lewin, 2002; Repp, Felce & Barton, 1988). The importance of this body of literature cannot be underestimated. The literature has had a tremendous impact on clinical practice as we currently know it. Not only have functional assessment and treatment procedures been shown to benefit individuals exhibiting problem behavior (see Hanley, Iwata & McCord, 2003 and Kahng, et al., 2002 for reviews on the topic), but the model of evidence-based practice employed by practitioners using the procedures has influenced federal and state legislation regarding best practice (IDEA, 1997, 2004). While the literature on functional assessment and intervention development has changed the landscape of the educational system, gaps still remain in the translation of research to practice. Although these procedures have widespread support in the behavioral literature, they are often inconsistently applied in clinical settings. Some of these gaps are related to the use of empirically supported functional assessment procedures. Other gaps are related to treatment issues in applied settings. The current issue of Behavior Analyst Today will address some of these gaps in the literature related to the translation from empirical evidence to clinical practice. There remain questions about the practical application of functional assessment procedures. The article by Delfs and Campbell (2010) provides a unique quantitative review of the empirical literature on the topic of functional assessment. The authors discuss the validity of different types of functional behavioral assessment as well as the use of the procedures to determine if behavioral function and treatment effectiveness varies as a function of diagnosis. Sloman (2010) outlines critical issues as they relate to the use of descriptive assessment. While research findings have been mixed regarding the validity, the author reviews the circumstances under which descriptive assessment may be most useful. In addition, Sloman identifies novel uses of descriptive assessment procedures that may be useful for monitoring treatment integrity and providing feedback on implementation. In the paper by Manente, Maraventano, LaRue Delmolino & Sloan (2010), the authors review best practices in the assessment and treatment of adults with autism. They identify some of the unique challenges to the implementation functional assessment procedures and identify procedural modifications to facilitate their use in applied settings. Gadaire, Kelley, & DeRosa (2010) address one of the most glaring issues in the functional assessment and treatment literature at this time. Although the principles of operant behavior apply across diagnostic boundaries, the majority of behavioral assessment and treatment literature has focused exclusively on younger populations with developmental disabilities. As a result, best practice is often only extended to this population, and the extent to which other populations have benefitted from the advances in our science is limited. …
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