The QABF (Questions About Behavior Function) and Sensory Profile help reduce aggressive behavior. Sensory strategies reinforce the behavior they immediately follow (McGinnis et al., 2013). Inclusion of the QABF can prevent sensory-based interventions from accidentally worsening pediatric behavior problems (Welch & Polatjko, 2017; Lydon et al., 2017). Research suggests that combining the QABF, Sensory Profile and a preference assessment significantly reduced aggression in children with Autism (McCall et al., 2016). Despite this evidence some occupational therapists are reluctant to use these behavioral assessments. In this post I will describe how to use the QABF and Sensory Profile to quickly develop strategies to reduce aggression in youth with complex behavior challenges.
The importance of combining the QABF and Sensory Profile was seen in a 15-year old with Anxiety Disorder, Autism Spectrum Disorder, Speech Delays, and Sensory Sensitivity who was slapping staff. Despite receiving behavioral and occupational therapy the slapping was increasing so I did the QABF showed below. The QABF suggested the slapping behavior was being done to receive both attention and escape QABFSP15AttEsc
The Sensory Profile indicated Definite Difference much more than others in: Sensory Sensitivity, Sensory Avoiding, and Overall Behavioral challenges. Research supports that adolescents with a diagnosis of Autism Spectrum and Anxiety Disorder as well as significant sensory sensitivity, tend to be overwhelmed by sound and touch input related to a neurological tendency to not habituate to this stimuli, which is significantly related to aggressive behavior (Green et al., 2016). Because he was in a very noisy setting he was offered noise canceling head phones when he appeared upset by the high noise levels. He was approached very slowly and given the opportunity to stop interactions by being offered a presumed favorite activity and being able to respond “yes” or “no”. Glasses and cell phones appeared to be the target of slapping/swiping, so staff were directed to remove them before approaching him.
By working in conjunction with the speech therapist, psychologist, and teachers the team found more appropriate ways for the child to request attention and request escape. An individualized transdisciplinary plan was developed that significantly improved his behavior FABSTRATFORMNewSevAutSample Working together the team minimized attention for the slapping behavior. Research suggests that combining the Sensory Profile and QABF results in more appropriate intervention. It is time for greater interdisciplinary respect and cooperation.
References:
Dunn, W. Sensory Profile 2: Users Manual. Psych Corporation; 2014.
Green, S. A., Hernandez, L., Bookheimer, S. Y., & Dapretto, M. (2016). Salience network connectivity in autism is related to brain and behavioral markers of sensory overresponsivity. Journal of the American Academy of Child & Adolescent Psychiatry, 55(7), 618-626.
Lydon, H, Healy O, Grey I. Comparison of behavioral intervention and sensory integration therapy on challenging behavior of children with autism. Behav Interv. 2017; 32(4): 297-310.
Matson JL, Vollmer TR. User’s guide: Question About Behavioral Function (QABF). Baton Rouge, LA: Scientific Publishers, 1995.
McCall J, Derby K, McLaughlin, T. The effects of matching sensory profile results to functional preference assessment for the in home treatment of aberrant behaviors in two children with autism spectrum disorders. Int Journ of Eng and Ed. 2016; 5(1): 368-390.
McGinnis AA, Blakely, EQ, Harvey AC, Richards, JB. The behavioral effects of a procedure used by pediatric occupational therapists. Behav Interv. 2013;28(1);
48-57.
Welch CD, Polatajko HJ. The issue is-Applied behavior analysis, autism and occupational therapy: A search for understanding. AJOT , 2017; 70(4); 7004360020p1-7004360020p5.
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