(PS7-40) Functions of Behavior as Predictors of Changes in Child Disruptive Behaviors in Parent-Child Interaction Therapy

Abstract Text: Applied behavior analysis treats problem behavior by directly understanding the environmental context and specific functions (i.e., attention, escape, automatic, and tangible) of the target behavior (e.g., Gresham et al., 2001; Jessel et al., 2022). Manualized treatments, such as Parent Child Interaction Therapy (PCIT; Eyberg & Funderburk, 2011), do not label behaviors in terms of their function; however, they inherently address these functions through focus on improving parent-child interactions and teaching parents to respond more effectively to behaviors. Specifically, PCIT may primarily target attention-maintained behavior through parental provision of differential attention, as well as escape-maintained behavior through gradual prevention of escape using a structured time out procedure and shaping of demands (Greco et al., 2001; McNeil et al., 2001). The treatment does not directly address behaviors with automatic or tangible functions, although procedures embedded within protocol (e.g., regular review of Eyberg Child Behavior Inventory [ECBI] data, parent check-in) may support application of treatment strategies to address these types of behaviors. Understanding functional considerations in PCIT could help clinicians best tailor the treatment to children’s individual needs and enhance treatment outcomes. The present study aimed to evaluate if function severity by type differentially predicted changes in disruptive behaviors over the course of completed PCIT treatment. Participants included 51 parent-child dyads engaged in PCIT at an outpatient specialty children’s hospital in the mid-Atlantic region. Mean child age was (M = 57.3 months; SD = 14.39) and included 33 boys and 18 girls. Children were 51% White, 16% Black/African American, 10% Multi-racial, and 24% Unknown. Severity ratings of behavior functions (i.e., 0 to 15, with higher numbers indicating more severity) were obtained using the Questions About Behavior Function measure (QABF; Paclawskyj et al., 2000) and intensity of child disruptive behaviors were measured using the ECBI (Eyberg & Pincus, 1999). Multiple regression analyses were used to test the four behavior functions noted above as independent predictor variables of changes in disruptive behavior over the course of PCIT treatment. Preliminary analyses found that mean function severity scores were 3.9 for automatic, 8.6 for attention, 9 for escape, and 9.54 for tangible. The mean ECBI change score was 52. Preliminary analyses indicated that function of behavior did not predict changes in ECBI score (all p’s > .05). Future analyses will examine the number of treatment sessions to reach treatment goals as a covariate, as well as examine the change in ECBI scores across each phase of PCIT. Preliminary results indicated managing behavior through enhanced parent-child relationships and structured discipline procedures as part of PCIT could adequately address a wide range of behaviors regardless of function. More research is needed to determine whether PCIT or broadly focused behavior treatments should be adapted to address specific functions of behavior.