Functional Assessment Report Case Study Samples

Section 1

Hypothesis
Luther seems to want attention for himself. When he is walking down the hallways, he likes talking to other people, but his attention span to those he is talking to is easily broken as he moves around. It is also evident that he wants to attract the attention of the staff nurses as he looks at them before walking out of the door. Therefore, it is evident that he wants them to keep on paying attention to him rather than go about their duties. Once they go for him, he takes around five minutes before he decides to concentrate on something else. However, this does not last for long as he goes out again (Cooper, Heron & Heward, 2007). The hypothesis for this situation is, therefore, a lack of attention from the nurses prompts him to do something that he has identified to make them run to him. When he goes out to the court yard, no one follows him and he opts to do something that always attracts their attention.

Functional analysis conditions

The functional analysis conditions that will be applied in the case of Luther include the attention condition where he will be given attention throughout the day. In this case, the staff will ensure that a Luther is with a person every time of the day where he will be given the attention he may need. If the frequency of walking out of the door decreases, then it will be evident that he walks out of the door to seek the attention of the staff nurses. The other functional condition will be escape condition where a staff nurse will not run after him when he walks out of the door. However, he or she will only watch him to ensure he does not hurt himself. This will help determine what really drives him to walk out of the door (Miltenberger, n.d.).
The two conditions will help in testing whether the hypothesis is correct. In this case, if the frequency of walking out of the door increases during the attention condition, it will be evident that he does it to get the attention of the nurses. In the second condition, it will help determine whether he want to occupy himself with a different activity when he is lonely and has no one paying attention to him (Cooper, Heron & Heward, 2007).

Intervention procedure

Luther is an old man who was used to being in charge of his life and having a busy day where he engaged in different activities in his farm. Therefore, being in an enclosed environment where his movement is limited is not conducive for him. Therefore, it is important that pivotal response training is initiated. Training him in pivotal response skills on a particular area will help initiate a change in behavior in the other aspects of his life. In this case, the main area he will be trained on is response to multiple cues. In this case, a routine will be developed where he will be given different cues to help him understand when he can go out and when he has to stay within building. Wants attention, and the staff can help him know that at particular times during the day, someone will come and talk with him. Other initiatives may include giving him a walk round the building at certain times of the day. As a result, he will know that it is not acceptable for him to walk out of the door as he wishes, but that someone will come to him and walk or talk to him.

Section 2

Some of the risks that may arise from the intervention include self-injury when he is left to walk outside by himself during the functional conditioning stage of his assessment. There is a risk that he may slide on the floor or hurt himself by taking a sharp object outside the premise. The other risk that may arise is the health risk that will arise when he walks out in the cold or when it is raining (Cooper, Heron & Heward, 2007). He may catch a cold or pneumonia.
During the intervention stage, some of the risks that can arise include his lack of corporation that may prompt him to be walking out of the door in order to seek attention. In this case, the nurse may be presuming that he is occupying himself with other activities as he waits for someone to walk or talk to him. It is also possible that he may hurt himself or refuse to come back inside when he is taken for a walk outside the building. In this case, there is also the possibility that he might take the occasional walks to be something he can do by himself, and he may decide to take a walk by himself. This possesses the risk that he might forget his way back to the building. The strategies that can be applied to promote generalization may include re-teaching and practice to ensure that the learnt skills remain in the daily habits of the individual. The other strategy will be instructing the staff and Luther to ensure that they stick to the strategies to help ensure that he adapts to his new environment.

Section 3

Summary of the case and interview
The case of Luther is an important review of an adult used to having control over his life and his actions. However, in the nursing facility, his movement is limited, making him fell that he is not free to move around. The attention given to him by the nurses is also limited yet he feels that they are the ones in control (Iwata et al., 2004). Therefore, he has found a way to ensure that there is someone giving him attention by walking out of the door. Luther is an old man who was used to being in charge of his life and having a busy day where he engaged in different activities in his farm. Therefore, being in an enclosed environment where his movement is limited is not conducive for him. Therefore, it is important that pivotal response training is initiated. Training him in pivotal response skills on a particular area will help initiate a change in behavior in the other aspects of his life. In this case, the main area he will be trained on is response to multiple cues. In this case, a routine will be developed where he will be given different cues to help him understand when he can go out and when he has to stay within building. Wants attention, and the staff can help him know that at particular times during the day, someone will come and talk with him. Other initiatives may include giving him a walk round the building at certain times of the day. As a result, he will know that it is not acceptable for him to walk out of the door as he wishes, but that someone will come to him and walk or talk to him (Miltenberger, n.d.).

Summary of the ABC data

In the case of Luther, there are various factors that can be taken into consideration in order to understand his behavior. Through the ABC procedure applied in the case study, it is evident that the antecedents include walking by the hallways, leaving the door when alone, has a preferred door for leaving and usually has talks to someone when he has a chance. In this case, it is evident that Luther is seeking attention from those around him, and when he feels that no one is watching he goes out of the door knowing well that he will attract the attention of a nursing staff (O'Neill, 2007). The behavioral treatment that can be applied in this case may include functional communication training where he learns to tell the nurses what he feels and probably why he has a need to keep going outside. It is also important that he is trained in generalization functions where he will be busy as he was a farmer and always had something to do and not only talk on an occasional basis. From the interview it is evident that every time he walks out of the door, there is someone who follows him and brings him back. Therefore it makes him attract the attention he needs. The hypothesis drawn from the ABC procedure is that he is seeking for attention and wants to be kept busy. He keeps walking out of the door when he feels that someone is not paying attention to him.

References

Cooper, J., Heron, T., & Heward, W. (2007). Applied Behaviour Analysis. Chapter 28,
"Generalization and Maintenance of Behavior Change," pages 614–655.
Iwata, B. et al (2004). The functions of self-injurious behavior: An experimental-
epidemiological analysis. Journal of Applied Behaviour Analysis, 27, 215-240.
Miltenberger (n.d.) Chapter 19, "Promoting Generalization," pages 379–398.
O'Neill, R. et al. (2007). Functional Assessment and Programme Development for Problem
Behaviour: A Practical Handbook. Pacific Grove, CA. Brooks/Cole Publishing Company