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Assessment and Treatment of Problem Behaviors within an Outpatient Clinic

Kristen Kalymon
BCBA ethical codes mandate the use of a functional assessment prior to implementing treatment. Accurately identifying a function and selecting an appropriate treatment are fundamental skills for any practitioner. Students learn the importance of functional behavior assessment and selecting functionally relevant interventions; they are not often taught how to select the best alternative given the limitations of the environment. While experimental functional analyses are the gold standard of assessment methods, most practitioners face barriers to their implementation. Difficulties include low probability for observing problem behaviors with limited time for observation, training requirements to carry out the analysis, and the physical space required. Several studies suggest that using descriptive functional evaluation methods, such as Antecedent-Behavior-Consequence (ABC), are a nice alternative due to their ease of administration and results often closely align with functional analyses. Following functional assessment, practitioners must select appropriate treatments. It can be challenging for practitioners to simultaneously consider all of the relevant client and environmental variables that impact treatment selection. Several groups have created decision-making algorithms for selecting treatments for problem behavior. These algorithms ask practitioners to consider the goals of the intervention, needs of the child, resources needed for implementation, and limitations of the environment by considering questions that will lead to differential treatment selection. This talk will give an overview of the clinical use of descriptive functional assessment and decision-making algorithms used within an outpatient clinic where resources are limited, caregivers are responsible for implementation, and environments are unable to tolerate increased rates of problem behavior.

Presented at the 2021 Michigan Autism Conference

Dr. Kalymon has expertise assessing and treating behavioral concerns displayed by children and adolescents with Autism Spectrum Disorders, as well as other developmental disabilities, through the use of evidence-based parent training and individual psychotherapy. Areas of specialization include behavioral excesses (i.e., tantrums, self-injury, aggression, and noncompliance) as well as behavioral deficits (i.e., increasing sleep, toileting, and coping skills). Dr. Kalymon received her Ph.D. from the University of Wisconsin-Madison, completed an internship and fellowship at the Kennedy Krieger Institute and Johns Hopkins University School of Medicine, and then remained on staff as a supervising psychologist and director of clinical operations prior to transitioning to Michigan.
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