Antecedent Assessment and Intervention: Supporting Children and Adults with Developmental Disabilities in Community Settings (review)

As a clinical psychologist, certified health care provider, diplomate in behavioral psychology and Board Certified Behavior Analyst, James K. Luiselli's career includes active roles in clinical treatment, consultation, research and training. His experience in addressing challenging behaviors presented by children and adults with developmental disabilities, such as self-injury and feeding problems, has led to over 240 publications, including several books. In 1998, Dr. Luiselli and Michael J. Cameron co-edited the book, Antecedent Control: Innovative Approaches to Behavior Support to illuminate the benefits of antecedent-based intervention. Dr. Luiselli edited this second book, Antecedent Assessment and Intervention: Supporting Children and Adults with Developmental Disabilities in Community Settings in response to increased interest in this area, as noted by the special section published in the Journal of Applied Behavior Analysis, 2000 (33), regarding establishing operations and motivation. His goals for this book were threefold. First, the book was to offer a compendium of recent research and intervention with chapters written by authors well-recognized in their specialized field of developmental disabilities. Second, the contributors were to focus on how antecedent assessments and interventions are implemented in natural settings, and finally, he urged his authors to integrate theory, evidenced-based treatment recommendations and to include their views on future implications.

The book is logically organized with an initial presentation of theoretical concepts, followed by chapters on the assessment, design, and implementation of antecedent interventions, and areas for future consideration. A major strength of the book is its incorporation of case examples and visual data displays which illustrate the functional behavior analysis-to-intervention process. Readers new to the field might begin with the Dr. Luiselli's final chapter, "Summary and Future Decisions." Here, the premise of using antecedent interventions to address challenging behaviors, as preferable to negative consequence-based (punishment) strategies, is clearly explained with specific references to the book's previous chapters. The issues surrounding effective intervention implementation are presented in a context of conceptual and practical considerations regarding treatment of persons diagnosed with developmental disabilities.

Returning to the Introduction section in Chapter 1 entitled, "The Evolution of Antecedent-Based Interventions" by David P. Wacker, Wendy K. Berg and Jay W. Harding, the reader receives a history of the roles of establishing operations (EOs) and discriminative stimuli (S^D) in designing applied behavioral interventions. At the end of this chapter, there is an interesting case example combining analyses of antecedent-response and response- consequence interventions for a 4-year-old child with autism to decrease aggression and noncompliance. Using functional behavior analysis (FBA), it was determined that both positive (tangible) and negative (escape) reinforcement maintained problem behavior. Further analyses using a choice assessment (comparing combinations of alone/attention and highly preferred/less preferred conditions) showed that the child's behavior was primarily controlled by access to highly preferred toys. Functional communication training (FCT) was used to teach the child to touch a card for work breaks. Results of time allocation during observation indicated that the child almost always chose to work to obtain his preferred toys and problem behaviors decreased to zero levels, thus highlighting the importance of understanding the contribution of establishing operations (EOs) and S^D (discriminating stimuli or triggers) to problem behavior.

In Chapter 2, "Contribution of Establishing Operation to Antecedent Intervention," by Patrick C. Friman and Renee O. Hawkins, the concept of EOs is discussed in further depth and described as a relative newcomer (in the last 25 years) to the field of applied behavior psychology. The paradigm for early operant conditioning focused on three elements: discriminative stimuli (S^D), responses and contingent consequences. However, changing states outside the three term reinforcement contingency often change the reinforcing value of the same consequence (i.e., access to food and water). The authors explain, "Motivational events are what make people want what they want" (p. 32) and may explain what variables mediate the value of...