ABSTRACT
We replicated and extended the effects of an assessment and treatment model employed by Hanley et al. (Journal of Applied Behavior Analysis, 47, 16-36, 2014) with one participant receiving home-based services. Following a functional analysis, we taught the participant multiple functional communication responses (FCRs) and to tolerate delays and denials to requested items. The participant learned the FCRs and the delay to reinforcers was increased to 34 min. Results generalized across stimuli, people, settings, and time. Social validity results supported that the behaviors were important, the treatment was acceptable, and the effects were significant.
ABSTRACT
In their 2016 article, "Navigating a Managed Care Peer Review: Guidance for Clinicians Using Applied Behavior Analysis [ABA] in the Treatment of Children on the Autism Spectrum," Papatola and Lustig provide an overview of the managed care process, discuss the medical necessity of ABA, and offer guidance to clinicians on how to navigate the managed care peer review process. Given that the authors are employed by a large international health insurance carrier and conduct peer reviews on behalf of that organization, this response seeks to provide guidance from both the clinical and public policy perspectives that reflect best practices in the field of autism treatment. This response is not written with the intention of providing or replacing legal advice; rather, this paper offers health care providers of ABA an essential understanding of some of the laws that govern and support their efforts to secure medically necessary treatment and the mechanisms in place with which to challenge decisions by managed care organizations, health plans, and health insurance issuers that may be contrary to best practices. Finally, suggestions are offered on how to navigate a peer review to ensure optimal outcomes and, when necessary, to lay the groundwork to overturn a funding source decision that does not reflect best practices or the standard of care in ABA-based autism treatment.
ABSTRACT
We describe a procedure for differentiating among potential precursor responses for use in a functional analysis. Conditional probability analysis of descriptive assessment data identified three potential precursors. Results from the indirect assessment corresponded with those obtained from the descriptive assessment. The top-ranked response identified as a precursor according to the indirect assessment had the strongest relation according to the probability analysis. When contingencies were arranged for the precursor in a functional analysis, the same function was identified as for target behavior, supporting the utility of indirect and descriptive methods to identify precursor behavior empirically.
