https://doi.org/10.1177/1534650119872270
Clinical Case Studies
1–12
© The Author(s) 2019
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DOI: 10.1177/1534650119872270
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Original Manuscript
Comparison of Function-Based,
Nonfunction-Based, and Combined
Treatments for Escape-Maintained
Aggression in a Child With
Attention Deficit Hyperactivity
Disorder: A Case Study
David A. Wilder
1
, J. Aaron Bevacqua
2
,
Ansley C. Hodges
1,2
, Hallie Ertel
1,2
, and Nga Luong
1,2
Abstract
In applied behavior analysis, the use of function-based treatments to reduce problem behavior
is well-supported. However, in some cases, function-based treatments alone may not be
as effective as nonfunction-based treatments or function-based treatments with additional,
nonfunction-based components. In this case study, we compared the delivery of preferred
edible items (a nonfunction-based treatment), a break from a task (a function-based treatment),
and an enhanced break, which consisted of a break plus access to a preferred tangible item
(combination of a nonfunction-based and function-based treatment), to treat escape-maintained
aggression exhibited by a young child with attention deficit hyperactivity disorder. Across all three
treatments, reinforcement (i.e., edible, break, or enhanced break) was delivered contingent upon
compliance with instructions and problem behavior resulted in escape. The nonfunction-based
treatment and the combination treatment reduced aggression to zero levels; the function-based
treatment did not. Finally, we allowed the participant to choose which of the three treatments
he preferred to experience; he selected the combination treatment most often.
Keywords
attention deficit hyperactivity disorder, escape-maintained behavior, function-based treatment,
nonfunction-based treatment, compliance
1 Theoretical and Research Basis for Treatment
In applied behavior analysis (ABA), functional behavioral assessment (FBA) is a process used to
identify the operant function of problem behavior. Based upon the outcome of FBA, behavior is
1
Florida Institute of Technology, Melbourne, USA
2
Nemours Children’s Hospital, Orlando, FL, USA
Corresponding Author:
David A. Wilder, School of Behavior Analysis, Florida Institute of Technology, 150 West University Blvd., Melbourne,
FL 32901, USA.
Email: dawilder@fit.edu
872270CCS XX X 10.1177/1534650119872270Clinical Case StudiesWilder et al.
research-article 2019