Behavioural assessment and functional analysis — branching viva

Stem

The examiner starts with definitions, then adds multi-setting data, a medical red flag, school refusal functions, and a medication request. [1] [2]

Branch 1 — Definitions

Examiner: What is functional assessment of behaviour? [1]

Strong answer: A structured process to define the behaviour, identify antecedents and consequences, and hypothesise what maintains it — attention, escape, tangible access or automatic/sensory consequences — so intervention matches function rather than form alone. Descriptive assessment uses history and ABC data; experimental FA tests conditions under specialist protocols. [1] [2]

Examiner: Why is form not function? [2]

Strong answer: Identical topography can serve different contingencies. Hitting may end a demand (escape) or recruit adult response (attention). Treatment that only suppresses form without a replacement skill often fails. [2]

Branch 2 — Bedside method

Examiner: How do you assess this child in clinic? [10]

Strong answer: Safety first. Operational definition. Multi-informant ABC across home and school. Medical/pain/sleep/medication screen. Communication and sensory context. Function hypothesis. Shared PBS plan and caregiver training. Specialist FA if needed. [1] [2] [5] [10]

Examiner: ABC notes show hits only when tasks start and stop when tasks end. Function? [2]

Strong answer: Escape/avoidance-maintained behaviour is most likely. Plan demand fading, functional communication for break/help, and consistent non-removal of safety while teaching alternatives. [2] [4]

Branch 3 — Medical and school applications

Examiner: Non-verbal child with new self-injury — first moves? [10]

Strong answer: Pain and medical causes until proven otherwise — dental, ENT, abdomen, bones, constipation, seizures, medication adverse effects — while protecting from injury. Then reassess operant function. [10]

Examiner: Apply functional analysis thinking to school refusal. [12]

Strong answer: Kearney profiles: avoid negative affectivity; escape aversive social/evaluative situations; gain attention/proximity; gain tangible reinforcement outside school. Mixed functions common. [12]

Branch 4 — Medication

Examiner: Staff want risperidone increased. Defend your position. [6] [8]

Strong answer: Optimise formulation, medical care and PBS/FCT first. RUPP supports risperidone for serious behavioural problems/irritability in autism after careful use framing, not for every behaviour and not for core autism. Tyrer found antipsychotics not superior to placebo for aggressive CB in adults with ID — caution against automatic escalation culture. If medication is used: named target, monitoring, time limit. [5] [6] [8] [10]

Examiner traps

• Diagnosing from topography alone.
• Skipping pain screen in non-verbal children.
• Claiming experimental FA without specialist process.
• Medication-first answers.
• Forgetting FCT/parent training evidence anchors. [4] [5] [10]