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The Relationship between Derived Mutually

Entailed Relations and the Function of
Challenging Behavior in Children with Autism:
Co....

Article in Journal of Contextual Behavioral Science · July 2017

DOI: 10.1016/j.jcbs.2017.07.004

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 Journal of Contextual Behavioral Science 6 (2017) 298–307

Contents lists available at ScienceDirect

Journal of Contextual Behavioral Science

journal homepage: www.elsevier.com/locate/jcbs

Empirical research

The relationship between derived mutually entailed relations and the MARK
function of challenging behavior in children with autism: Comparing the
PEAK-E-PA and the QABF
⁎
Jordan Belisle, Caleb R. Stanley, Mark R. Dixon
Southern Illinois University, United States

A R T I C L E I N F O A B S T R A C T

Keywords: The study evaluated the relationship between participants’ abilities to derive mutually entailed relations across
Autism arbitrary stimuli and the function of their challenging behavior as indicated in the Questions About Behavior
Behavior reduction Function (QABF) indirect assessment. Entailed relational abilities were assessed using the Promoting the Emergence
Relational responding of Advanced Knowledge Equivalence Pre-Assessment (Dixon, 2015), and assessments were conducted across 47
PEAK
individuals with autism or a related developmental disability. The results indicated that overall scores generated
by the QABF were significantly lower for participants who could derive mutually entailed and/or combinato-
rially entailed relations (t (44) = 2.468, p < .05), and that in a greater proportion of cases, the QABF failed to
isolate a single behavior function for individuals who could derive either mutually entailed or combinatorially
entailed relations (χ 2 (1, N = 47) = 3.166, p < .05). The ability to derive entailed relations was not predictive
of any specific challenging behavior topography (χ 2 (3, N = 47) = 6.251, p > .05) and was only related to
scores on the Physical subscale of the QABF (t (24) = 3.37, p < .05). The results have implications for the
assessment and treatment of individuals with autism, as well add to the development of a conceptual under-
standing of relational abilities and challenging behavior in this population.

1. Introduction sufficient scientific support (Granpeesheh, Dixon, Tarbox,

The prevalence of autism diagnoses has increased internationally,
with recent prevalence estimates in American countries (the majority of
prevalence data were collected in the United States and Canada) ran-
ging from 11 to 50.5 individuals in 10,000 (median 21.6), with similar
prevalence rates reported in European countries (Elsabbagh et al.,
2012). In the United States and in the UK, societal costs associated with
autism have exceeded several billions annually (Ganz, 2007; Knapp,
Romeo, & Beecham, 2007), and although some individuals with autism
can lead independent and fulfilling lives (Farley et al., 2009), many face
several barriers to achieving autonomy and habilitation. Challenging
behaviors such as physical aggression, self-injury, tantrums, and non-
compliance among other behavior topographies have the potential to
restrict access to appropriate educational services as well as social de-
velopment opportunities (Horner, Diemer, & Brazeau, 1992), gen-
erating a need for scientifically supported assessment and treatment
strategies that can be used to reduce challenging behavior. The prin-
ciples and procedures described in Applied Behavior Analysis (ABA)
comprise one of the only treatment approaches that have garnered
Kaplan, & Wilke, 2009; Reichow, 2012), generating several hundred
treatment strategies that have been published in peer reviewed journals
(Matson, Benavidez, Compton, Paclawskyj, & Baglio, 1996). This
growing body of research has led to the endorsement of ABA procedures
by independent entities such as the US Surgeon General, the New York
State Department of Health, and the National Academy of Sciences, in
application with children and adults with autism.
ABA approaches deviate from others by assessing and treating the
function rather than the topography of challenging behavior (Kinch,
Lewis-Palmer, Hagan-Burke, & Sugai, 2001; Yarbrough & Carr, 2000).
Functional approaches to challenging behavior reduction assert that the
factors that influence the occurrence or non-occurrence of problem
behavior are in the environment, with a specific emphasis placed on
events that reliably precede challenging behavior (i.e., antecedents)
and events that reliably follow challenging behavior (i.e., con-
sequences). Traditionally, a hierarchical functional assessment model is
used to identify the function of challenging behavior, progressing from
interviews or surveys conducted with caregivers, to direct observation
of the challenging behavior in context, and, when necessary,

⁎
Correspondence to: Rehabilitation Institute, Southern Illinois University, Carbondale, IL 62901, United States.
E-mail address: MDixon@siu.edu (M.R. Dixon).

http://dx.doi.org/10.1016/j.jcbs.2017.07.004
Received 12 July 2016; Received in revised form 22 July 2017; Accepted 28 July 2017
2212-1447/ © 2017 Published by Elsevier Inc. on behalf of Association for Contextual Behavioral Science.
J. Belisle et al.
experimental approaches (Paclawskyj, Matson, Rush,
Smalls, & Vollmer, 2001). Once the relevant antecedent and con-
sequence conditions maintaining the occurrence of challenging beha-
vior have been identified, they may then be altered to reduce the
challenging behavior (Hanley, Iwata, & McCord, 2003). Approaches to
problem behavior reduction typically involve (a) identifying or
teaching an appropriate alterative behavior (e.g., a communicative
behavior) that serves the same function as the challenging behavior,
and (b) differentially providing access to the maintaining consequence
contingent upon the appropriate alternative behavior rather than the
challenging behavior. Some common treatment procedures include
functional communication training (FCT; e.g., Carr & Durand, 1985;
Durand & Carr, 1991; Tiger, Hanley, & Bruzek, 2008), differential re-
inforcement of alternative or incompatible behaviors (DRA/DRI; e.g.,
Chowdhury & Benson, 2011; Smith, 1987; Vollmer & Iwata, 1992), and
non-contingent reinforcement strategies (NCR; e.g., Carr et al., 2000;
Carr, Severtson, & Lepper, 2009; Wilder, Normand, & Atwell, 2005).
Such an approach to understanding and treating challenging behaviors
exhibited by individuals with autism, however, may be limited in ap-
plication once individuals begin to acquire meaningful language.
Traditional functional approaches to challenging behavior reduc-
tion are based in a contingency shaped conceptualization of behavior
(Tarbox, Zuckerman, Bishop, Olive, & O'Hora, 2011), where behavior is
brought under contextual control through direct contingencies
(Skinner, 1969). As noted by Skinner (1969), however, immediate or
direct contingencies do not govern a considerable degree of complex
human behavior, rather a considerable degree of complex behavior is
rule-governed. For Skinner (1969), a rule was simply an antecedent sti-
mulus that specified a contingency (e.g., if you do not finish your
homework, then you cannot go outside for recess), seemingly removing
the need for an individual to directly experience contingencies for
control of behavior. As other authors have discussed (Parrot, 1987;
Schlinger, 1990, 1993; Zettle & Hayes, 1982), Skinner's formulation of
rule-governed behavior is problematic in several ways, where ap-
proaches that are based on language development through relational
development (e.g., Sidman & Tailby, 1982; Hayes, Barnes-
Holmes, & Roche, 2001) may provide a better formulation of complex
behavior (Törneke, Luciano, & Valdivia, 2008), as discussed in Rela-
tional Frame Theory (RFT; see Barnes-Holmes, Barnes-Holmes, and
Cullinan (2000), Hayes, Barnes-Holmes, and Roche (2001), O'Hora and
Barnes-Holmes (2004) for a review). RFT posits that the normal de-
velopment of human language centers around the ability of individuals
to entail relations between stimuli that are arbitrarily related (i.e., share
no formally similar properties). For example, the auditory word dog and
the visual stimulus of a dog are no more similar than the auditory word
fish and the visual stimulus of a dog, and yet, given the ability to relate
auditory words to visual stimuli, the vocal word dog comes to stand for
the visual stimulus of a dog relatively early in the lifetime of an English
speaker. The auditory word dog and the visual stimulus of a dog are
described as mutually entailed. Through this process, the function of
the arbitrary auditory stimulus dog is transformed such that individuals
come to interact with the word psychologically as they would the
physical dog. If the individual has a fear response to dogs, perhaps due
to a history of being bitten by a dog, utterance of the word dog or the
thought dog may elicit the same fear response as the presence of an
actual dog, and perhaps even result in the emission of escape behavior
(e.g., changing the conversation subject away from dogs or thinking of
things other than dogs).
Conceptualizations of rule-governed behavior therefore focus on
how rules are verbal events that serve to alter or transform the function
of stimuli in the environment (Parrot, 1987; Schlinger, 1990). For ex-
ample, if a neurotypically developing English-speaking child is pro-
vided the rule “there is going to be a fire alarm tomorrow, so remember
your coat so that you will not be cold”, then the child will be able to
prepare for this event accordingly without needing to experience direct
contingencies for leaving his coat at home. Responding to this rule and
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Journal of Contextual Behavioral Science 6 (2017) 298–307
others therefore, at the very least, necessitates the ability to derive
relations amongst stimuli arbitrarily (Törneke et al., 2008); in the ex-
ample above, relations between fire, alarm, tomorrow, and coat, must
have referents in the environment if they are to affect behavior. Absent
these relations, the rule statement would merely be a collection of ar-
bitrary sounds and may evoke no change in behavior, as may be the
case for a child with a severe form of autism whose coat bringing be-
havior may be under the exclusive control of a history of direct re-
inforcement for putting on a coat before leaving the house for school,
rather than the above-mentioned rule. A child with a milder form of
autism who may lack some of these skills could respond less predictably
to the fire alarm “rule.” For example, if the child ‘understands’ the word
“fire”, but not the words “alarm” and “tomorrow”, it is likely that this
simple rule could evoke both psychological fear responses as well as
challenging behavior that presents as escape maintained in the absence
of the physical stimulus from which the child is attempting to escape
(i.e., fire). For the neurotypical child and the child with a milder form of
autism, both of whom have developed the ability to entail several re-
lations, traditional contingency-based approaches may not adequately
account for the factors influencing appropriate or challenging beha-
viors.
The conceptual assumption that the unique human capacity for
language and rule following (Hayes, 1989) may alter the utility of a
purely contingency-based account is at the core of RFT and emergent
treatment approaches from this theoretical account. Research in the
1980s conducted by Catania and colleagues (Catania,
Shimoff, & Matthews, 1989) provided initial demonstrations that be-
havior, once under the control of rules, shows insensitivity to changes
in reinforcement contingencies. This tendency toward schedule in-
sensitivity is not demonstrated in animal models; however, appears to
emerge in typically developing humans around five-years of age
(Vaughan, 1989; White, 1965). Schedule insensitivity also emerges
corresponding with a salient language development milestone that oc-
curs at around this same age (Lowe, Beasty, & Bentell, 1983; Bentell,
Lowe, & Beasty, 1985). From this, treatment approaches grounded in
conceptual developments in RFT, such as Acceptance and Commitment
Therapy, have moved past a purely contingency-based approach with
typically developing adolescents and adults (Hayes, Luoma, Bond,
Masuda, & Lillis, 2006), focusing instead on rules that participants may
interact with that contribute to psychological suffering (Hayes,
Strosahl, & Wilson, 1999). Given this conceptual assumption, one may
expect that individuals with autism who have begun to develop
meaningful language may also show a relative insensitivity to direct-
acting contingencies. If true, then assessments currently available that
attempt to isolate immediate consequential functions of behavior may
be inadequate in addressing the causes and directing treatment for in-
dividuals with milder forms of autism.
Results reported by Bowman, Fisher, Thompson, and Piazza (1997)
provided a clear demonstration of how language can reduce the ability
for functional assessments to isolate a single function of challenging
behavior. In their study, experimental functional analyses, considered
the gold standard in the functional assessment literature (Hanley,
Iwata, & McCord, 2003), were conducted with 2 participants resulting
in undifferentiated results. By failing to isolate a single function, the
probability of successful treatment stemming from the assessment is
greatly reduced. Informal assessments conducted prior to the functional
analyses, however, suggested that challenging behavior was occasioned
by non-compliance with the participants’ mands, and simply reinfor-
cing participants’ mands when they occurred reduced challenging be-
havior to zero or near-zero rates. By developing an intervention that
accounted for the participants’ verbal behavior, success was achieved
where the tradition experimental analysis approach was not sufficient
in this case. In another study, Adelinis and Hagopian (1999) found that
the topography of instructions provided by caregivers can also evoke
challenging behavior, where “don’t” requests reliably evoked the target
behavior, whereas “do” requests did not. Again, an understanding of
J. Belisle et al.
the factors underlying the challenging behavior would be incomplete
without considering the verbal events and corresponding functions that
are entailed with the verbal events. A substantial number of studies on
the experimental functional analysis of challenging behavior have
yielded either multiple functions or undifferentiated results (Hanley,
Iwata, & McCord, 2003), where language may serve to a) allow the
individual to respond to motivational variables that are contextual ra-
ther than static (e.g., manding), and/or b) temporally distance the be-
havior from the consequences that reinforce its occurrence (e.g., rule-
governed behavior), thus, complicating the analysis. The two studies
outlined above do however demonstrate that, when the functional
properties of language rather than direct-acting contingencies are as-
sessed, a stronger conceptualization of events participating in challen-
ging behavior can be developed. The complexity of the language events
discussed in the above studies, however, were relatively low, and al-
though these basic forms of verbal operant behavior have been the
emphasis of language research in ABA in application with individuals
with autism over the past two decades (Dixon, Small, & Rosales, 2007;
Dymond, O Hora, Whelan, & O Donovan, 2006), recent advances
stemming from accounts consistent with RFT are increasingly sup-
porting the complexity of human language development (Dymond,
May, Munnelly, & Hoon, 2010). As in the example of the fire-alarm rule
presented above, failure to consider these more complex relational
events discussed in RFT will likely lead to an incomplete assessment of
challenging behavior function.
Recently, a comprehensive direct assessment was developed that
allows for an evaluation of individuals’ relational abilities, and may
therefore provide an appropriate measure with which to evaluate how
the development of complex relations may participate in the function of
challenging behavior. The Promoting the Emergence of Advanced
Knowledge Equivalence Pre-Assessment (PEAK-E-PA; Dixon, 2015) pro-
vides a criterion-referenced assessment of an individual's ability to
entail coordinated relations, which are likely the first to develop and
involve relating stimuli in terms of equivalence, or sameness. Although
the terms mutual entailment and combinatorial entailment are used to
describe entailed relations across all frame families more generally, the
special case of coordinated relations allows for use of the terms re-
flexivity, symmetry, transitivity, and equivalence. Symmetry is en-
compassed within mutual entailment, and both transitivity and
equivalence are encompassed within combinatorial entailment. Each of
the four types of relations above (reflexivity, symmetry, transitivity,
and equivalence) are tested in the PEAK-E-PA. Reflexivity is the ability
to respond relationally to stimuli that are identical and, although does
not provide a demonstration of derived arbitrary responding (Hayes
et al., 2001), is a higher-order operant behavior that likely develops
prior to the development of derived relational abilities (Barnes-
Holmes & Barnes-Holmes, 2000). Symmetry involves the bidirectional
relationship between two stimuli, where one direction of the relation is
derived (i.e., occurs without direct reinforcement). For example, if a
participant is taught to match a stimulus A and a stimulus B (A-B), the
participant will be able to match the stimulus B to the stimulus A (B-A).
Transitivity and equivalence involve a derived relationship between
two stimuli based on a directly trained relationship between both sti-
muli and a third stimulus. For example, if a participant is taught to
match a stimulus A to both a stimulus B (A-B) and a stimulus C (A-C),
the participant will be able to match the stimulus B to the stimulus C (B-
C), and vice versa (C-B). By evaluating the relational abilities of parti-
cipants across these four relational skills, the PEAK-E-PA provides tar-
gets for language instruction guided by the Promoting the Emergence of
Advanced Knowledge Equivalence Module (PEAK-E), which has recently
begun to generate empirical support in the peer-reviewed literature in
application with individuals with autism (e.g., Dixon et al., 2017;
Dixon, Belisle, & Stanley, 2017; Dixon, Belisle, Stanley,
Williams, & Daar, 2016).
The purpose of the present study therefore was to allow for a pre-
liminary evaluation of how participants’ abilities to derive entailed
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Journal of Contextual Behavioral Science 6 (2017) 298–307
relations as measured in the PEAK-E-PA influenced functional assess-
ment results. The Questions about Behavior Function (QABF;
Matson & Vollmer, 1995) is a caregiver completed assessment of beha-
vior function that was used as the functional assessment in the present
study. Psychometric evaluations of the QABF suggest that the instru-
ment is a valid and reliable assessment of behavior function that yields
similar results to the experimental functional analysis (Healy,
Brett, & Leader, 2013), and in many cases, leads to effective function-
based intervention strategies (Matson, Bamburg, Cherry, & Paclawskyj,
1999). Three main questions were evaluated in the study. First, we
evaluated how participants’ abilities to entail relations was predictive
of the amount of data generated by the QABF, as well as the success of
the QABF in yielding a single function of challenging behavior. Second,
we evaluated as a control the degree to which the topography of the
challenging behaviors was predictive of the function of the challenging
behaviors identified by the QABF. This question served as a control on
the first evaluation in that significant differences in behavior function
given behavior topography would not be expected; however, we did
expect to find differences in behavior function given the participants’
abilities to entail relations. Finally, we evaluated whether the ability to
entail relations was predictive of any specific challenging behavior to-
pography indicated by the caregivers. This was more of an exploratory
research question, as prior research has not indicated if individuals who
can entail relations are more- or less- likely to emit behaviors of a given
topography. Evaluating the interaction between language development
and challenging behavior adds to a conceptual understanding of the
potential interaction between stimulus relations and maladaptive re-
sponding in a clinically significant population. Prior research has es-
tablished that entailed relations have the potential to transform the
function of events leading to accesses in maladaptive behavior in neu-
rotypical populations (e.g., problem gamblers, see Fletcher and Hayes
(2005) for a review); however, for individuals with disabilities, addi-
tional complexity must be considered in that many individuals may not
be able to entail relations in the first place. In addition to adding to a
conceptual understanding of challenging behavior, the results reported
here may have implications for the treatment of individuals with autism
once they have begun to acquire meaningful language abilities.
2. Methods
2.1. Participants and setting
The participants in the present study included 47 individuals with
autism or another developmental disability (6 females, 41 males) who
attended a specialized school for individuals with autism located in the
Midwestern United States. The academic abilities of the students varied
substantially from one another, however, all the students attended the
specialized school due to on-going academic and/or behavioral chal-
lenges that impeded their ability to participate in the public-school
system. Of the 47 participants, 43 (91.5%) had a diagnosis of autism;
the remaining diagnosed disabilities included Down's Syndrome (N =
2, 4.1%) and intellectual disability (N = 2, 4.1%). Participant ages
ranged from 5 to 19 (M = 13.4, SD = 4.2) years. As part of another
study (Dixon, Belisle, & Stanley, In preparation), IQ scores were ob-
tained using the WISC-IV Short Form assessment (participants over 5
years, 11 months, N = 39, 82.9%) or the WPPSI-III Short Form as-
sessment (participants under 5 years, 11 months, N = 3, 6.4%) for 42 of
the 47 participants (85.71%). Obtained IQ scores ranged from 48 to 132
(M = 58.9, SD = 17.7). For the purposes of the present study, the
PEAK-E-PA was also conducted with each of the participants, which
provides a measure of participants’ relational abilities both with arbi-
trary stimuli and cross modally (Dixon, 2015). Participant scores on the
PEAK-E-PA ranged from 0 to 43 (maximum 48; M = 8; SD = 11), and
together with the obtained IQ scores, suggest that the cognitive func-
tioning of the participants in the study was sufficiently varied to allow
for the analyses conducted in the study.
J. Belisle et al.
All assessments were completed at the school, either in the parti-
cipants’ home classrooms or in a separate room within the school to
minimize distractions. Each home classroom contained desks and chairs
for each student, a large chalk board or white board, several cupboards,
and various instructional and preferred items used in the teaching en-
vironment. Each classroom contained 3–9 other students, a classroom
teacher, and 1–3 paraprofessionals or support staff. The additional
room where several of the assessments took place contained a single
table and two chairs, as well as a single cupboard containing various
instructional and preferred items used for instruction. The PEAK-E-PA
was conducted directly with the participants by trained graduate stu-
dents. A desk and two chairs were positioned where the assessment was
conducted. The experimenter sat directly across from the participant for
the duration of the assessment and a second observer was present for a
subset of the assessments. Each PEAK-E-PA assessment took 5- to 45-
min to complete with each participant. The QABF assessments were
completed indirectly by each participants’ classroom teacher. The
classroom teachers completed the assessments both to ensure that the
assessors were blind to the purpose of the present investigation, as well
as to increase the accuracy of the obtained assessment results due to an
increased familiarity between the assessor and the participants. As a
further consideration, only results reported by assessors who had been
familiar with the participants for at-least 6-months were included in the
analysis. The QABF assessments were completed by the assessors in the
home classroom after the regular school day had concluded, and took
between 10-min and 30-min to complete.
2.2. Materials
2.2.1. PEAK-E pre-assessment (PEAK-E-PA)
The PEAK-E-PA is a 48-item criterion referenced assessment that
provides a measure of participants’ abilities to derive coordinated, or
equivalence, relations (see Hayes et al. (2001), for a review of the
history of these surrogate terms). The assessment is comprised of 4
subtests, each measuring increasingly complex types of relations. The
first subtest, Reflexivity, assesses participants’ abilities to match stimuli
that are identical. The second subtest, Symmetry, assesses participants’
abilities to, when taught to match a sample stimulus to a comparison
stimulus, derive the relation between the comparison stimulus and the
sample stimulus without training. The third and fourth subtests, Tran-
sitivity and Equivalence, assess participants’ abilities to, when taught at
least two relations across three or more stimuli, derive untrained rela-
tions across each of the stimuli without direct training. Transitivity and
Equivalence relations are differentiated in the assessment in that for
transitive relations, the sample stimulus in training remains the sample
stimulus in testing (e.g., train A-B and B-C; test A-C), and for equiva-
lence relations, the sample stimulus in training becomes a comparison
stimulus in testing (e.g., train A-B and B-C; test C-A). This breakdown is
consistent with the structure proposed by Fields and Verhave (1987).
Each of the four subtests consist of 6 skills that are “Basic”, “Inter-
mediate”, or “Advanced” in complexity. For example, 2 of the 6 skills
tested in the Reflexivity subtest are considered “Advanced Reflexivity”,
and 2 of the skills in the Transitivity subtest are considered “Basic
Transitivity”. The PEAK-E-PA can be conducted using either the Long
Form or Short Form assessment arrangement. If the assessment is com-
pleted using the Long Form arrangement, then each of the 6 skills are
tested twice (using a second set of arbitrary stimuli), and one correct
response is equal to a score of 1 in calculating the PEAK-E-PA Total
Score (range, 0–48). If the assessment is completed using the Short
Form arrangement, then each of the 6 skills are tested once, and each
correct response is equal to a score of 2 in calculating the PEAK-E-PA
Total Score (range, 0–48). All PEAK-E-PA assessments used in the
current study utilized the Long Form assessment arrangement to in-
crease confidence in the obtained results.
The relations tested in the PEAK-E-PA evaluate several cross-modal
relations, that include visual, auditory, tactile, gustatory, and olfactory
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Journal of Contextual Behavioral Science 6 (2017) 298–307
Fig. 1. The figure provides exemplars of train and test relations in the PEAK-E-PA. Stimuli
in dashed lines are visual stimuli (arbitrary pictures and text) and stimuli in quotations
are auditory/vocal stimuli (arbitrary words). Colored panels show test relations.
stimuli. Visual stimuli used in the PEAK-E-PA include arbitrary pictures,
arbitrary textual arrangements, and common tangible objects (e.g.,
markers, coins, etc.). Auditory stimuli include arbitrary vocal words
and sounds produced by objects (e.g., notes from a keyboard). Tactile,
gustatory, and olfactory stimuli include common items that are likely to
be available in most settings in which the assessments are conducted
(e.g., vanilla extract, pretzels, vinegar, cotton balls, etc.). Fig. 1 pro-
vides examples from the PEAK-E-PA of how stimuli are arranged in each
of the four subtests. For each skill, an instructional script is read to the
participants verbatim by the assessor, and relations are tested using
either a match-to-sample or sequential presentation arrangement for
most assessment items. In the match-to-sample arrangement, a sample
stimulus A and two comparison stimuli B are provided. The assessor
points to the stimulus A, says “this is the same as this”, and points to the
corresponding stimulus B (e.g., A1-B1). Then, the assessor provides the
B stimulus as the sample stimulus, and two comparison A stimuli, and
says, “Find the same”, while pointing to the sample B stimulus. A cor-
rect response occurs if the participant points to the corresponding A
stimulus (e.g., B1-A1). In the sequential presentation arrangement, the
assessor provides a sample stimulus A followed sequentially by a
comparison stimulus B that is either the same as the sample stimulus
(e.g., A1-B1) or different than the sample stimulus (e.g, A1-B2), and
provides a vocal stimulus indicating whether or not the stimuli were the
same (e.g., “those were the same”, “those were not the same”). The
assessor then provides the B stimulus as the sample stimulus followed
by a comparison A stimulus, and asks, “were those the same?” A re-
sponse was considered correct if the participant's response indicates
that the stimuli were the same given correspondence between the sti-
muli (e.g., B1-A1), or if the response indicated that the stimuli were not
the same given non-correspondence between the stimuli (e.g., B2-A1).
Throughout the assessment, no reinforcement nor feedback was pro-
vided contingent upon a correct response, and in the present study
participants were given 45-s following the presentation of the dis-
criminative stimulus to provide the correct response.
2.2.2. Questions about behavior function (QABF)
The QABF is a 25-item assessment completed by caregivers that
provides an indirect measure of the function of participants’ challen-
ging behavior, focusing specifically on the immediate antecedents and
consequence that may directly influence the occurrence of challenging
behavior. The assessment is designed to be used across a variety of
behavior topographies, as the purpose of the assessment is to identify
the function of the problem behavior independent of the behavior to-
pography. There are 5 subscales in the QABF (5 items per subscale),
each corresponding with a function of challenging behavior. The five
subscales in the QABF are Attention, Escape, Nonsocial, Physical, and
Tangible. The Attention subscale evaluates the degree to which the
J. Belisle et al.
challenging behavior is maintained by access to attention from care-
givers or peers, and the likelihood that the behavior will occur in the
absence of attention. The Escape subscale evaluates the degree to which
the challenging behavior is maintained by escape from a high demand
task or attention from peers and caregivers. The Non-social subscale
evaluates the degree to which the challenging behavior is likely to
occur in the absence of other individuals or is self-stimulatory. The
Physical subscale evaluates the degree to which the challenging beha-
vior is likely to occur when the participant is experiencing aversive
private events (e.g., pain). Finally, the Tangible subscale evaluates the
degree to which the challenging behavior is maintained by access to
preferred items and is likely to occur when preferred items are absent or
taken away. Each item across subscales is scored by the caregiver on a
4-point Likert Scale, where the caregiver rates how often a problem
behavior occurs in the context of the provided item. The values and
associated labels for each scale level are 0 = Never, 1 = Rarely, 2 =
Some, and 3 = Often. The sum of the items in each subscale is then
used to determine the function of the challenging behavior (i.e., the
subscale with the highest value is the function).
2.3. Procedure
Both assessments, PEAK-E-PA and QABF, were conducted across
each of the 47 participants in the study. The PEAK-E-PA was conducted
directly by trained graduate students, who underwent workshop and in-
situ direct training to criterion prior to conducting the assessments.
Based on participant results on the PEAK-E-PA, the participants were
divided into one of two groups. Participants who achieved a score of at
least 2 in any of the Symmetry, Transitivity, or Equivalence subtests
were considered to be in the Mutual Entailment present (ME+) group,
as a demonstration of any of these skills would provide a demonstration
of at-least mutually entailed responding, and a score of 2 is the
minimum score required for at least a demonstration of Basic
Symmetry. If the participants did not achieve a score of 2 or greater in
any of the Symmetry, Transitivity, or Equivalence subtests, they were
considered to be in the Mutual Entailment absent (ME-) group. Prior to
completing the QABF, each teacher was provided a 10- to 15-min ex-
planation of how to complete the assessment. Afterward, they were
asked to identify a challenging behavior that the participant was most
likely to engage in. The challenging behaviors that were identified were
coded by the authors of the present study and subsequently sorted into
4 challenging behavior topographies, including aggression, out-of-seat,
non-compliance, and disruptive vocalizations. Aggression towards self,
staff, and other students were all categorized into the aggression cate-
gory. Out-of-seat behavior included all problem behaviors where the
primary concern was that the participants were out of their seat (e.g.,
out of seat, elopement). Non-compliance occurred when the target be-
havior involved the participant being issued a discriminative stimulus
and not engaging in the “expected” response (e.g., non-compliance, not
listening to the teacher). Finally, disruptive vocalizations included vo-
calizations that were disruptive due to either intensity (e.g., screaming)
or content (e.g., name calling).
2.4. Data analyses
2.4.1. Mutual entailment and behavior function
Several analyses were conducted to evaluate the relationship be-
tween the participants’ abilities to derive relations and the identified
function of their challenging behavior. The first analysis evaluated the
degree to which the items on the QABF were applicable across DRR+
and DRR- participants. The applicability of the assessment items was
determined by finding the sum of each of the subscales to arrive at a
QABF Total Score (range, 0–60). Higher QABF Total Score values in-
dicated that more of the items could be applied to a participant, as the
Likert Scale ranges from Never occurs (0) to Often occurs (3). QABF
Total Score values were believed to provide a measure of how
302
Journal of Contextual Behavioral Science 6 (2017) 298–307
applicable the assessment items were for each participant. The second
analysis evaluated the degree to which the QABF could isolate a single
function for the participants’ challenging behavior. For this analysis, a
single function was identified when the highest subscale score was
greater than the second highest subscale score by 2 or more. For ex-
ample, the QABF identified a single-function if a participant had a score
of 15 in the Attention subscale (highest) and a score of 13 in the
Tangible subscale (second highest). The final analysis evaluated the
degree to which the functions identified in the QABF differed across the
DRR+ and DRR- groups. For example, an escape function may be more
likely to occur for participants who can derive relations compared to
those who cannot, providing a measure of the predictability of behavior
function given the ability to derive relations. For all analyses where
statistically significant results were obtained, a second set of statistical
and effect-size analyses were conducted to determine if the same de-
cisions were reached when the 4 participants with a diagnosis other
than autism were removed from the data. This was done ensure that
conclusions were consistent with an exclusive autism sample.
2.4.2. Behavior topography and behavior function
Another set of analyses evaluated the relationship between the to-
pography of challenging behavior and the corresponding function of
challenging behavior. This was conducted as a sort of control by which
to compare the relationship between derived responding and behavior
function. The first analysis again evaluated the degree to which the
QABF assessment was applicable across each of the four behavior to-
pographies. For example, if significantly higher values were obtained
for participants who demonstrated aggressive behavior compared to
those who demonstrated disruptive vocalizations, this would support
the applicability of the QABF for determining the function of aggressive
behavior, but may not support the applicability of the QABF for de-
termining the function of disruptive vocalizations. The second analysis
was conducted to evaluate the degree to which the QABF could isolate a
single function of each participants’ challenging behavior differentially
across each of the behavior topographies. A final analysis was con-
ducted to determine the degree to which the behavior topography was
predictive of the identified function. For this analysis, the QABF sub-
scale scores were compared for three of the four behavior topographies
(aggression, non-compliance, disruptive vocalizations). Participants
who demonstrated out-of-seat behavior were eliminated from this
analysis due to the small number of participants in this group.
2.4.3. Mutual entailment and behavior topography
A final analysis was conducted to evaluate the degree to which
participants’ abilities to derive relations was predictive of the identified
behavior topography. For this analysis, the proportion of participants in
the ME+ and ME- groups who were identified as engaging in each of
the behavior topographies were compared across the two groups.
2.4.4. Measures of reliability
Measures of reliability were conducted for the direct implementa-
tion and scoring of the PEAK-E-PA as well as the coding of behavior
topographies identified in the QABF. Reliability for the implementation
and scoring of the PEAK-E-PA was evaluated by having a second ob-
server independently record participant responses during the assess-
ment for 42.6% of the assessments. IOA was calculated by dividing the
number of agreements for each skill by the number of agreements and
disagreements for each skill, multiplied by 100. IOA was 91.4%, in-
dicating a high level of agreement across observers. Reliability of
coding the QABF behavior topographies identified by the assessors was
evaluated by having 2 independent raters code the identified behavior
topographies for 53.2% of the assessments. Again, IOA was calculated
by dividing the number of agreements by the number of agreements
and disagreements, multiplied by 100. IOA was 100%, indicating a high
level of agreement across observers.
J. Belisle et al.
80
60
QABF Total Score
40
20
0
E-
E+
M
M
Fig. 2. Scatter-dot plot of participants’ QABF Total Score across ME+ and ME- partici-
pants. Each data point represents a single participant, each bar represents the mean for
each group, and error bars represent a single standard deviation.
3. Results
3.1. Mutual entailment and behavior function
The analyses of participants’ abilities to derive mutually entailed
relations and the results obtained on the QABF assessments are sum-
marized in Figs. 2, 3, and 4. Fig. 2 shows a scatter-dot plot of partici-
pants’ QABF Total Scores across ME+ and ME- participants. Visual
analysis of the data suggests that mean QABF Total Scores for ME+
participants (M = 31.6, SD = 14.1) were lower than mean QABF Total
Scores for ME- participants (M = 41.8, SD = 12.7). QABF Total Scores
for the ME+ group ranged from 0 to 47, and QABF Total Scores for the
ME- group ranged from 11 to 63. Together, the data suggest a large
degree of variability within both groups. Visual analysis of the data also
suggested that both groups had roughly the same number of partici-
pants above and below the group mean, supporting the mean as the
measure of central tendency reported in the present analysis. An un-
paired samples t-test was conducted, and the results suggest that the
difference between the two groups was statistically significant (t (44) =
2.468, p < .05) and resulted in a large effect size (Cohen's d = 0.76).
Fig. 3 shows the proportion of participants for whom a single behavior
function was identified by the QABF across the ME+ (N = 5, 33.3%)
and ME- groups (N = 19, 59.4%). The data suggest that the QABF failed
to produce a single behavior function for most of the participants in the
ME+ group, whereas the QABF was successful in producing a single
behavior function for most of the participants in the ME- group. A chi-
square analysis was conducted to evaluate the degree to which the
proportion of participants for whom the QABF successfully identified
the behavior function significantly deviated from what would be ex-
pected by chance proportion, and the results suggested that the ob-
tained results were statistically significant (χ2 (1, N = 47) = 3.17,
p < .05) and an odds-ratio analysis suggests that participants in the ME-
group were 3.41 times more likely to have a single identified behavior
20
15
Yes
Proportion SIF
No
10
5 single function of the behavior. The results of a chi-square analysis
0
ME+ ME-
Fig. 3. Contingency analysis of the proportion of QABF results that yielded a single
identified function (SIF) across ME+ and ME- participants.
303
Journal of Contextual Behavioral Science 6 (2017) 298–307
function. Fig. 4 shows the function subscale values for both the ME+
and ME- participants. Visual analysis of the obtained results suggests
that, across both groups, the highest mean values were obtained for the
Attention, Escape, and Tangible subscales, and the lowest mean values
were obtained for the Non-Social and Physical subscales. Multiple
pairwise comparisons were conducted across the two groups and across
each of the functional subscales and a Holm-Sidak correction method
was applied to accommodate for multiple comparisons across the data.
The results suggest that the only significant difference between the two
groups occurred for the Physical subscale, where ME+ participants had
significantly lower Physical subscale scores compared to ME- (t (24) =
3.37, p < .05). A medium to large effect was also observed between the
ME+ and the ME- on the Physical subscale of the QABF (Cohen's d =
0.65). All statistically significant analyses were conducted a second
time with the 4 participants who did not have a diagnosis of autism
removed from the analyses, where 3 of the 4 participants were in the
ME- group. The results suggest that there was a statistically significant
difference between the two groups in total QABF scores (t (40) = 2.91,
p < .05) with a large effect size (Cohen's d = 1.38), a significantly
greater proportion of participants in the ME- groups had an single
isolated function of challenging behavior compared to the ME+ group
(X2 (1, N = 43) = 3.86, p < .05) with a similar odds ratio of 3.86, and
there was a significant difference between the two groups in the Phy-
sical subscale of the QABF (t (40) = 2.79, p < .05) with a large effect
size (Cohen's d = 0.97).
Additional analyses were conducted to determine if there was a
relationship between participant characteristics and either derived re-
lational responding or total scores on the QABF to identify any potential
covariates. A Pearson's correlational analysis suggested that there was
no relationship between age and QABF total score (r = −0.05,
p > 0.05), and Point-biserial correlational analyses suggested that there
were no correlations between age and grouping into the ME+ and ME-
groups (r = 0.20, p > .05) or gender and QABF total score (r = −0.09,
p > .05).
3.2. Behavior topography and behavior function
The analyses of participants’ identified problem behavior and the
results obtained on the QABF assessments are summarized in Figs. 5, 6,
and 7. Fig. 5 shows a scatter-dot plot of participant QABF Total Scores
across each of the four behavior topographies. The results suggest that
participants who demonstrated out-of-seat behavior had the highest
mean QABF Total Score, followed by aggression, non-compliance, and
disruptive vocalizations. Again, the data indicate a high degree of
variability within each of the groups. Visual analysis of the data also
suggested that both groups had roughly the same number of partici-
pants above and below the group mean, supporting the mean as an
appropriate measure of central tendency reported in the present ana-
lysis. A one-way ANOVA was conducted to evaluate if the differences
between the four topographies in terms of QABF Total Score was sta-
tistically significant. The results failed to demonstrate a significant
difference between the response topographies (F (3, 42) = 0.29,
p > .05). Fig. 6 shows the proportion of QABF assessments that pro-
duced a single function across the four problem behavior topographies.
For aggression and out-of-seat, a greater proportion of QABF assessment
failed to isolate a single function of the behavior. For non-compliance,
an equal number of QABF assessments were successful in isolating a
single function of the behavior, and for disruptive vocalizations, a
greater proportion of QABF assessments were successful in isolating a
suggest that the differences across the behavior topographies in terms
of the isolation of a single behavior function was not statistically sig-
nificant (χ2 (3, N = 47) = 2.79, p > .05). Fig. 7 shows the function
subscale values across the top 3 identified response topographies (Ag-
gression, non-compliance, and disruptive vocalizations). The results
suggest that the highest scores were obtained in the Escape, and
J. Belisle et al. Journal of Contextual Behavioral Science 6 (2017) 298–307

20 ME+ 20 ME-

QABF Function Score

QABF Function Score

15 15

10 10

5 5

0 0

le

le
pe

pe
n

n
al

al
l

l
io

io
ib

ib
ia

ia
ca

ca
sic

sic
nt

nt
oc

oc
ng

ng
Es

Es
tte

tte
y

y
-S

-S
Ta

Ta
Ph

Ph
A

A
on

on
N

N
Function Function

Fig. 4. Scatter-dot plot of participants’ QABF Score for each function. Each data point represents a single participant, each bar represents the mean for each function, and error bars
represent a single standard deviation.

80 3.3. Mutual entailment and behavior topography

The analysis evaluating the relationship between participants’

60
QABF Total Score

ability to derive mutually entailed relations and their corresponding

response topographies are summarized in Fig. 8. Visual analysis of the
40 data suggested that, for participants who could derive mutually entailed
relations, the most frequent topography of problem behavior were
disruptive vocalizations, whereas the most frequent topography for
20
individuals who could not derive mutually entailed relations was ag-
gression. The least frequent response topographies across both groups
0
was out-of-seat. The results of a chi-square analysis suggest that the
proportional differences across the two groups in terms of the topo-
S

V
gg

graphy of their problem behaviors were not statistically significant (χ 2

O

D
A

Behavior Topography (3, N = 47) = 6.251, p > .05).

Fig. 5. Scatter-dot plot of participants’ QABF Total Score across each identified topo-
graphy of problem behavior. Each data point represents a single participant, each bar
represents the mean for each topography, and error bars represent a single standard 4. Discussion
deviation.
The results of the present study provide preliminary data suggesting
15 that the ability to derive mutually entailed relations can influence
functional assessment results that attempt to discern immediate en-
vironmental variables that cause and maintain challenging behavior.
Yes Since behavior analysts began publishing on ways to reduce challenging
10
Proportion SIF

No behavior exhibited by individuals with autism, treatment approaches

5
0 context surrounding challenging behavior (Hanley, Iwata, & McCord,
Agg OS
Topography
Fig. 6. Contingency analysis of the proportion of QABF results that yielded a single
identified function (SIF) across each of the indicated problem behavior topographies. Yes
and No indicate whether a single function of behavior was identified.
Tangible, subscales for aggression, the Escape subscale for non-com-
pliance, and the Attention subscale for disruptive vocalizations. Mul-
tiple pairwise comparisons were conducted across the three response
topographies and across each of the functional subscales and a Holm-
Sidak correction method was applied to accommodate for multiple
comparisons across the data. The results failed to indicate significant
differences between any of the functional subscales across any of the
response topographies.
have sought to determine the function of challenging behavior and
design treatment package that target behavior function rather than
topography (Hanley, Iwata, & McCord, 2003). At the most rigorous
level, functional assessments are experimental, as in the experimental
functional analysis, and involve directly manipulating the immediate
NC DV 2003). Although other assessment methods have been developed that
attempt to determine behavior function, their validity is often only
considered if the obtained results correspond with those reported ex-
perimentally in the functional analysis (e.g., Healy et al., 2013). An
assumption inherent in the design of the experimental functional ana-
lysis, and therefore in the design of alternative assessments that cor-
relate with the results produced by the experimental functional analysis
(such as the QABF), is that the controlling environmental variables are
temporally immediate. As noted by Skinner (1966), and refined by
contemporary authors (e.g., Schlinger, 1990, 1993; Törneke et al.,
2008), much of complex human behavior is not governed by immediate
contingencies, but instead is likely to be relationally- or rule-governed.
As noted by other authors (Adelinis & Hagopian, 1999; Carr et al.,
2000), language may explain some of the undifferentiated results ob-
tained in functional assessment strategies, and the results of the present
study support this general position.

304
J. Belisle et al. Journal of Contextual Behavioral Science 6 (2017) 298–307

20
20
Agg
15
15 Yes
QABF Function Score

Proportion ME+
No
10
10

5
5

0
0 Aggressioin OS NC DV
Topography

le
pe
n

al
al
io

ib
ca

ic
i
nt

oc

ng
ys
Es
tte

-S

Ta
Ph
A

on

Fig. 8. Contingency analysis of the proportion of participants who demonstrated derived

N

relational responding (ME+) across each of the indicated problem behavior topo-
graphies. Yes and No indicate whether participants could demonstrate mutual entailment.
20
NC
(1997) and Adelinis and Hagopian (1999), functional assessments that
QABF Function Score

15 have accounted for verbal phenomenon (i.e., manding and the delivery
of instructions, respectively) have also led to successful treatment ap-
proaches. It is therefore not the case that behavior analysts should
10
abandon function-based approaches to reducing challenging behavior
for participants with the ability to entail verbal relations; to the con-
5 trary, we should continue to expand our understanding of functional
control to include greater complexity, accounting for the abilities of
many individuals with- and without-autism to entail relations and to
0 develop meaningful language.
If the ability to derive relations influences the degree to which
le
pe
n

al
l
io

ib
ia
ca

ic
nt

oc

ng
ys
Es

immediate consequences maintain challenging behavior, this may have

tte

-S

Ta
Ph
A

on
N

several implications for a conceptual understanding of RFT in the

context of populations with diminished language abilities. That, once
20 DV relational learning develops, then advances in RFT must be considered
and addressed in approaches to reducing challenging behavior for in-
dividuals who can derive relations. The dense literature base estab-
15
QABF FunctionScore

lished from RFT may be considered in this context, offering perhaps

greater treatment options than a simple consideration of immediate
consequential functions alone. One treatment technology that has
10
emerged from RFT is Acceptance and Commitment Therapy (ACT;
Hayes et al., 1999), which attempts to alter the function of verbal sti-
5
muli to reduce psychological suffering. Applications of ACT with typi-
cally developing individuals with a myriad of challenges, such as de-
pression anxiety, have demonstrated the utility of this approach (Hayes
0 et al., 2006). Although current research is scarce evaluating applica-
tions of ACT or ACT-consistent approaches with individuals with milder
le
pe
n

al
al
io

ib
ca

forms of autism, the data presented here suggest that such an approach
ic
ci
nt

ng
ys
o
Es
tte

-S

Ta
Ph
A

may be needed once individuals are able to entail relations and when
on
N

Function immediate consequential events alone cannot be isolated in the en-

vironment. Of course, further research will be needed to evaluate the
Fig. 7. Scatter-dot plot of participants’ QABF Score for each function, for each identified
efficacy of ACT-based approaches with this population before any
problem behavior topography (Aggression, top; Non-compliance, middle; Disruptive-vo-
calizations, bottom). Each data point represents a single participant, each bar represents conclusions can be ascertained. In addition to utilizing conceptual ad-
the mean for each function, and error bars represent a single standard deviation. vancements in RFT to better understand challenging behavior exhibited
by individuals with autism, the results reported here may also make a
reticulated contribution to conceptual developments in RFT. The ability
In the present study, participants who could derive mutually en-
to entail relations emerges at a relatively young age in typically de-
tailed relations in the PEAK-E-PA had significantly lower overall scores
veloping participants, which presents a barrier to understanding how
on the QABF, and for only 5 of the 15 participants who could demon-
this development interacts with challenging behavior. Participants with
strate mutual entailment was the QABF able to isolate a single function
autism, however, provide a sample with considerable variability in
of behavior, compared to 19 out of 32 who were unable to derive
language deficits and development. The results reported here, sug-
mutually entailed relations. In other words, participants who could not
gesting that isolating a single consequential function of challenging
demonstrate entailed relations were 3.41 times more likely to have a
behavior is less likely once individuals can entail relations, adds to a
single identified function for their challenging behavior. The results did
growing body of literature supporting the conceptual assumption in
not suggest that behavior topography was related to behavior function,
RFT that rule-governed behavior is insensitive to changing con-
nor that entailed responding was related to behavior topography, sug-
tingencies and may therefore require a fundamentally different ap-
gesting that the ability to derive mutually entailed relations may relate
proach (Hayes et al., 2001; Hayes, Strosahl, & Wilson, 1999).
to challenging behavior through its function and, therefore, remains
Due to the preliminary nature of the current study, there are several
consistent with a functional account. As demonstrated by Bowman et al.

305
J. Belisle et al.
limitations that should be addressed in future research on the interac-
tion between derived responding and the function of challenging be-
havior. A first limitation was that the sample in the study was relatively
small, and therefore may not adequately represent the entire population
of individuals with autism who engage in challenging behavior. A
greater number of participants would have also allowed for a more
robust analysis of how not only the ability to derive entailed relations
influences functional assessment results, but also how the complexity of
entailed relations (e.g., mutually entailed compared to combinatorially
entailed) differentially influences functional assessment results. Despite
the small sample in the current study, medium to large effect sizes were
found and statistically significant outcomes were observed. A second
limitation was that the challenging behaviors were selected by the
classroom teacher retrospectively at the time that they were completing
the QABF assessment. Although it is likely that the teachers could recall
the most appropriate behavior topography for which to assess the
corresponding function, data were not collected on the actual challen-
ging behaviors to ensure that they were the most frequently occurring,
nor were efforts made to ensure that the behaviors selected would be
the most socially valid targets for behavior reduction strategies (i.e.,
whether changes in the indicated behaviors would lead to the greatest
increases in life quality for the participants). A third limitation was that
there were fewer participants in the ME+ group relative to the ME-
group. Inclusion in the study necessitated that the participants engaged
in challenging behavior of sufficient rate or intensity such that they
would benefit from behavior reduction strategies, and as has been
noted by prior authors, such behaviors are less likely to be exhibited by
individuals with milder forms of autism, reducing the size of the ME+
sample. This limitation corresponds with the first, however, and should
be addressed in future research utilizing a greater sample. A fourth
limitation was that, although significant differences were observed
between the groups in terms of the ability for the QABF to isolate a
single behavior function, different results may have been obtained if a
different criterion was selected for determining the success of the QABF
in isolating the function (e.g., a score of at least 3 points in one subscale
greater than the other subscales, rather than 2). A final limitation was
that efforts were not made to control for the severity of other symptoms
associated with an autism diagnosis. It is likely that individuals who
experience deficits in language development (i.e., participants in the
ME- group) also experience greater deficits in other areas of cognitive
and social function that undoubtedly contribute to the occurrence of
challenging behavior. At the current time, it is unclear whether in-
structional strategies that improve language skills in this population
lead to corresponding improvements of other areas of functioning, and
therefore influence the appropriateness of current functional assess-
ment strategies.
Despite the limitations in the present study, the obtained results do
add to a growing body of literature on relational responding, as well as
best-practice in the assessment and treatment of challenging behaviors
exhibited by individuals with autism. Future research may expand on
the results of the present study by evaluating how relational abilities
influence the results obtained in experimental functional analyses. Not
only is the experimental functional analysis perhaps the most rigorous
method for assessing the function of challenging behavior, but as noted
by Bowman et al. and Adelinis and Hagopian, functional analyses can
also be modified to accommodate for several complexities, perhaps
including the development of language. The use of the QABF as a ret-
rospective analysis of challenging behavior is only a step toward un-
derstanding the interaction between relational responding and chal-
lenging behavior. Another avenue for future research may be to
evaluate how entailed relations other than those of sameness, or
equivalence, influence the results obtained across functional assessment
methods. Although coordinated relations were the only relational types
evaluated in the present study, individuals can relate stimuli in several
ways (e.g., greater-than and less-than, before and later) contributing to
the development of language. Such an analysis may be possible as
306
Journal of Contextual Behavioral Science 6 (2017) 298–307
psychometrically validated assessments of relational abilities such as
the PEAK-E-PA are developed and applied with individuals with autism.
In summary, ABA interventions have demonstrated effectiveness in
reducing the challenging behaviors exhibited by individuals with
autism. A core assumption in RFT, however, holds that the effectiveness
of contingency-based strategies may be limited once individuals begin
to develop meaningful language. The results of the present study pro-
vide a preliminary demonstration of how the ability to derive mutually
entailed relations may influence the conclusions provided by functional
assessments, leading to undifferentiated results, and therefore pro-
viding little utility in the treatment of complex forms of challenging
behavior. As our understanding of the complexity of language in-
creases, so too should the complexity of our function-based assessment
and corresponding treatment of challenging behaviors exhibited by
individuals with autism. Such a conceptual analysis can only serve to
increase the scope of ABA treatments for individuals with autism and
other developmental disabilities.
4.1. Compliance with ethical standards
4.1.1. Ethical approval
All procedures performed in this study were in accordance with the
ethical standards of the institutional and/or national research com-
mittee and with the 1964 Helsinki declaration and its later amendments
or comparable ethical standards.
Informed consent was obtained from all individual participants in-
cluded in the study.
Disclosure
Last author receives small royalties from sales of the PEAK curri-
culum
References
Adelinis, J. D., & Hagopian, L. P. (1999). The use of symmetrical “do” and “don't” requests
to interrupt ongoing activities. Journal of Applied Behavior Analysis, 32, 519–523.
http://dx.doi.org/10.1901/jaba.1999.32-519.
Barnes-Holmes, D., & Barnes-Holmes, Y. (2000). Explaining complex behavior: Two
perspectives on the concept of generalized operant classes. The Psychological Record,
50, 251–265.
Barnes-Holmes, D., Barnes-Holmes, Y., & Cullinan, V. (2000). Relational frame theory and
skinner's verbal behavior: A possible synthesis. The Behavior Analyst, 23, 69–75.
Bentall, R. P., Lowe, C. F., & Beasty, A. (1985). The role of verbal behavior in human
learning: II Developmental differences. Journal of the Experimental Analysis of
Behavior, 43, 165–181. http://dx.doi.org/10.1901/jeab.1985.43-165.
Bowman, L. G., Fisher, W. W., Thompson, R. H., & Piazza, C. C. (1997). On the relation of
mands and the function of destructive behavior. Journal of Applied Behavior Analysis,
30, 251–265. http://dx.doi.org/10.1901/jaba.1997.30-251.
Carr, E. G., & Durand, V. M. (1985). Reducing behavior problems through functional
communication training. Journal of Applied Behavior Analysis, 18, 111–126. http://dx.
doi.org/10.1901/jaba.1985.18-111.
Carr, J. E., Coriaty, S., Wilder, D. A., Gaunt, B. T., Dozier, C. L., Britton, L. N., & Reed, C. L.
(2000). A review of “noncontingent” reinforcement as treatment for the aberrant
behavior of individuals with developmental disabilities. Research in Developmental
Disabilities, 21, 377–391. http://dx.doi.org/10.1016/S0891-4222(00)00050-0.
Carr, J. E., Severtson, J. M., & Lepper, T. L. (2009). Noncontingent reinforcement is an
empirically supported treatment for problem behavior exhibited by individuals with
developmental disabilities. Research in Developmental Disabilities, 30, 44–57. http://
dx.doi.org/10.1016/j.ridd.2008.03.002.
Catania, A. C., Shimoff, E., & Matthews, B. A. (1989). An experimental analysis of rule-
governed behavior. In S. C. Hayes (Ed.), Rule-governed behavior (pp. 119–150). Reno,
NV: Context Press.
Chowdhury, M., & Benson, B. A. (2011). Use of differential reinforcement to reduce be-
havior problems in adults with intellectual disabilities: A methodological review.
Research in Developmental Disabilities, 32, 383–394. http://dx.doi.org/10.1016/j.ridd.
2010.11.015.
Dixon, M. R. (2015). PEAK relational training system: equivalence module. Carbondale, IL:
Shawnee Scientific Press.
Dixon, M. R., Belisle, J., & Stanley, C. R. (Under Review). Derived relational responding
and intelligence: Assessing the relationship between the PEAK-E Pre-Assessment and
IQ with individuals with disabilities.
Dixon, M. R., Belisle, J., Stanley, C. R., Speelman, R. C., Rowsey, K. E., Kime, D., & Daar,
J. H. (2017). Establishing derived variable categorical responding in children with
disabilities using the PEAK-E curriculum. Journal of Applied Behavior Analysis, 50,
J. Belisle et al.
134–145.
Dixon, M. R., Belisle, J., Stanley, C. R., Williams, L. A., & Daar, J. H. (2017). Derived
equivalence relations of geometry skills in students with autism: An application of the
PEAK-E curriculum. Analysis of Verbal Behavior, 32(32), 38–45.
Dixon, M. R., Small, S. L., & Rosales, R. (2007). Extended analysis of empirical citations
with Skinner's Verbal Behavior: 1984–2004. Behavior Analyst, 30, 197–209.
Durand, V. M., & Carr, E. G. (1991). Functional communication training to reduce
challenging behavior: Maintenance and application in new settings. Journal of Applied
Behavior Analysis, 24, 251–264. http://dx.doi.org/10.1901/jaba.1991.24-251.
Dymond, S., May, R. J., Munnelly, A., & Hoon, A. E. (2010). Evaluating the evidence base
for relational frame theory: A citation analysis. Behavior Analyst, 33, 97–117.
Dymond, S., O Hora, D., Whelan, R., & O Donovan, A. (2006). Citation analysis of
Skinner's verbal behavior: 1984–2004. Behavior Analyst, 29, 75–88.
Elsabbagh, M., Divan, G., Koh, Y. J., Kim, Y. S., Kauchali, S., Marcín, C., & Yasamy, M. T.
(2012). Global prevalence of autism and other pervasive developmental disorders.
Autism Research, 5, 160–179. http://dx.doi.org/10.1002/aur.239.
Farley, M. A., McMahon, W. M., Fombonne, E., Jenson, W. R., Miller, J., Gardner, M., &
Coon, H. (2009). Twenty‐year outcome for individuals with autism and average or
near‐average cognitive abilities. Autism Research, 2, 109–118. http://dx.doi.org/10.
1002/aur.69.
Fields, L., & Verhave, T. (1987). The structure of equivalence classes. Journal of the
Experimental Analysis of Behavior, 48, 317–332. http://dx.doi.org/10.1901/jeab.
1987.48-317.
Fletcher, L., & Hayes, S. C. (2005). Relational frame theory, acceptance and commitment
therapy, and a functional analytic definition of mindfulness. Journal of Rational-
Emotive and Cognitive-Behavior Therapy, 23, 315–336. http://dx.doi.org/10.1007/
s10942-005-0017-7.
Ganz, M. L. (2007). The lifetime distribution of the incremental societal costs of autism.
Archives of Pediatrics & Adolescent Medicine, 161, 343–349. http://dx.doi.org/10.
1001/archpedi.161.4.343.
Granpeesheh, D., Dixon, D. R., Tarbox, J., Kaplan, A. M., & Wilke, A. E. (2009). The
effects of age and treatment intensity on behavioral intervention outcomes for chil-
dren with autism spectrum disorders. Research in Autism Spectrum Disorders, 3,
1014–1022.
Hanley, G. P., Iwata, B. A., & McCord, B. E. (2003). Functional analysis of problem be-
havior: A review. Journal of Applied Behavior Analysis, 36, 147–185. http://dx.doi.
org/10.1901/jaba.2003.36-147.
Hayes, S. C. (1989). Nonhumans have not yet shown stimulus equivalence. Journal of the
Experimental Analysis of Behavior, 51, 385–392. http://dx.doi.org/10.1901/jeab.
1989.51-385.
Hayes, S. C., Barnes-Holmes, D., & Roche, B. (2001). Relational Frame Theory: A post-
Skinnerian account of human language and cognition. New York, NY: Plenum Press.
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and
commitment therapy: Model, processes and outcomes. Behaviour Research and
Therapy, 44, 1–25. http://dx.doi.org/10.1016/j.brat.2005.06.006.
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy:
An experiential approach to behavior change. New York, NT: Guilford Press.
Healy, O., Brett, D., & Leader, G. (2013). A comparison of experimental functional ana-
lysis and the Questions About Behavioral Function (QABF) in the assessment of
challenging behavior of individuals with autism. Research in Autism Spectrum
Disorders, 7, 66–81. http://dx.doi.org/10.1016/j.rasd.2012.05.006.
Horner, R. H., Diemer, S. M., & Brazeau, K. C. (1992). Educational support for students
with severe problem behaviors in Oregon: A descriptive analysis from the 1987–1988
school year. Research and Practice for Persons with Severe Disabilities, 17, 154–169.
http://dx.doi.org/10.1177/154079699201700304.
Kinch, C., Lewis-Palmer, T., Hagan-Burke, S., & Sugai, G. (2001). A comparison of teacher
and student functional behavior assessment interview information from low-risk and
high-risk classrooms. Education and Treatment of Children, 24, 480–494.
Knapp, M., Romeo, R., & Beecham, J. (2007). The economic consequences of autism in the
UK. London, UK: Foundation for People with Learning Disabilities.
Lowe, C. F., Beasty, A., & Bentall, R. P. (1983). The role of verbal behavior in human
learning: Infant performance on fixed‐interval schedules. Journal of the Experimental
Analysis of Behavior, 39, 157–164. http://dx.doi.org/10.1901/jeab.1983.39-157.
307
View publication stats
Journal of Contextual Behavioral Science 6 (2017) 298–307
Matson, J. L., Bamburg, J. W., Cherry, K. E., & Paclawskyj, T. R. (1999). A validity study
on the questions about behavioral function (QABF) scale: Predicting treatment suc-
cess for self-injury, aggression, and stereotypies. Research in Developmental Disabilities,
20, 163–175. http://dx.doi.org/10.1016/S0891-4222(98)00039-0.
Matson, J. L., Benavidez, D. A., Compton, L. S., Paclawskyj, T., & Baglio, C. (1996).
Behavioral treatment of autistic persons: A review of research from 1980 to the
present. Research in developmental disabilities, 17, 433–465. http://dx.doi.org/10.
1016/S0891-4222(96)00030-3.
Matson, J. L., & Vollmer, T. R. (1995). User's guide: Questions about behavioral function
(QABF). Baton Rouge, LA: Scientific Publishers.
O'Hora, D., & Barnes-Holmes, D. (2004). Instructional control: Developing a relational
frame analysis. International Journal of Psychology & Psychological Therapy, 4,
263–284.
Paclawskyj, T., Matson, J., Rush, K., Smalls, Y., & Vollmer, T. R. (2001). Assessment of the
convergent validity of the Questions About Behavioral Function scale with analogue
functional analysis and the Motivation Assessment Scale. Journal of Intellectual
Disability Research, 45, 484–494. http://dx.doi.org/10.1046/j.1365-2788.2001.
00364.x.
Parrot, L. (1987). Rule governed behavior: An implicit analysis of reference. In S. Modgil,
& C. Modgil (Eds.), BF Skinner, consensus and controversy (pp. 265–276). Philadelphia,
PA: Falmer Press.
Reichow, B. (2012). Overview of meta-analyses on early intensive behavioral intervention
for young children with autism spectrum disorders. Journal of Autism and
Developmental Disorders, 42, 512–520. http://dx.doi.org/10.1007/s10803-011-
1218-9.
Schlinger, H. D. (1990). A reply to behavior analysts writing about rules and rule-gov-
erned behavior. The Analysis of Verbal Behavior, 8, 77–82.
Schlinger, H. D. (1993). Separating discriminative and function-altering effects of verbal
stimuli. The Behavior Analyst, 16, 9–23.
Sidman, M., & Tailby, W. (1982). Conditional discrimination vs. matching to sample: An
expansion of the testing paradigm. Journal of the Experimental Analysis of Behavior, 37,
5–22. http://dx.doi.org/10.1901/jeab.1982.37-5.
Smith, M. D. (1987). Treatment of pica in an adult disabled by autism by differential
reinforcement of incompatible behavior. Journal of Behavior Therapy and Experimental
Psychiatry, 18, 285–288. http://dx.doi.org/10.1016/0005-7916(87)90012-7.
Skinner, B. F. (1969). Contingencies of reinforcement: A theoretical analysis. New York, NY:
Appleton-Century-Crofts.
Tarbox, J., Zuckerman, C. K., Bishop, M. R., Olive, M. L., & O'Hora, D. P. (2011). Rule-
governed behavior: Teaching a preliminary repertoire of rule-following to children
with autism. The Analysis of Verbal Behavior, 27, 125–139.
Tiger, J. H., Hanley, G. P., & Bruzek, J. (2008). Functional communication training: A
review and practical guide. Behavior Analysis in Practice, 1, 16–23.
Törneke, N., Luciano, C., & Valdivia, S. (2008). Rule-governed behavior and psycholo-
gical problems. International Journal of Psychology and Psychological Therapy, 8,
141–156.
Vaughan, M. (1989). Rule-governed behavior in behavior analysis: A theoretical and
experimental history. In S. C. Hayes (Ed.), Rule-governed behavior (pp. 119–150).
Reno, NV: Context Press.
Vollmer, T. R., & Iwata, B. A. (1992). Differential reinforcement as treatment for behavior
disorders: Procedural and functional variations. Research in Developmental Disabilities,
13, 393–417. http://dx.doi.org/10.1016/0891-4222(92)90013-V.
White, S. H. (1965). Evidence for a hierarchical arrangement of learning processes. In L.
P. Lipsitt, & C. C. Spiker (Eds.), Advances in child development and behavior. New York,
NY: Academic Press.
Wilder, D. A., Normand, M., & Atwell, J. (2005). Noncontingent reinforcement as treat-
ment for food refusal and associated self-injury. Journal of Applied Behavior Analysis,
38, 549–553. http://dx.doi.org/10.1901/jaba.2005.132-04.
Yarbrough, S. C., & Carr, E. G. (2000). Some relationships between informant assessment
and functional analysis of problem behavior. American Journal on Mental Retardation,
105, 130–151.
Zettle, R., & Hayes, S. C. (1982). Rule-governed behavior: A potential theoretical fra-
mework for cognitive behavioral therapy. Advances in Cognitive-Behavioral Research
and Therapy, 1, 73–117.