title: Does a pre-intervention functional assessment increase intervention effectiveness? A meta-analysis of within-subject interrupted time-series studies.
abstract: This study examined the relative effectiveness of interventions based on a pre-intervention functional behavioral assessment (FBA), compared to interventions not based on a pre-intervention FBA. We examined 19 studies that included a direct comparison between the effects of FBA- and non-FBA-based interventions with the same participants. A random effects meta-analysis of effect sizes indicated that FBA-based interventions were associated with large reductions in problem behaviors when using non-FBA-based interventions as a reference intervention (Effect size=0.85, 95% CI [0.42, 1.27], p<0.001). In addition, non-FBA based interventions had no effect on problem behavior when compared to no intervention (0.06, 95% CI [-0.21, 0.33], p=0.664). Interestingly, both FBA-based and non-FBA-based interventions had significant effects on appropriate behavior relative to no intervention, albeit the overall effect size was much larger for FBA-based interventions (FBA-based: 1.27, 95% CI [0.89, 1.66], p<0.001 vs. non-FBA-based: 0.35, 95% CI [0.14, 0.56], p=0.001). In spite of the evidence in favor of FBA-based interventions, the limited number of comparative studies with high methodological standards underlines the need for further comparisons of FBA-based versus non-FBA-based interventions.
authors.affiliation: Department of Psychology, 190 Dysart Rd, Winnipeg, MB R3T 2N2, Canada.
authors.forename: Kylee
authors.initials: K
authors.lastname: Hurl
authors.affiliation: Department of Psychology, 190 Dysart Rd, Winnipeg, MB R3T 2N2, Canada.
authors.forename: Jade
authors.initials: J
authors.lastname: Wightman
authors.affiliation: Department of Psychology, University of Hawai'i at Mānoa, 2530 Dole St, Sakamaki Honolulu, HI 96822, United States.
authors.forename: Stephen N
authors.initials: SN
authors.lastname: Haynes
authors.affiliation: School of Psychology, The University of Auckland, 261 Morrin Rd, Private Bag 92019, Auckland 1072, New Zealand. Electronic address: j.virues-ortega@auckland.ac.nz.
authors.forename: Javier
authors.initials: J
authors.lastname: Virues-Ortega
mesh_terms: D000293:Adolescent; D000328:Adult; D001526:Behavioral Symptoms / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D000066553:Problem Behavior; D055815:Young Adult
keywords: Behavioral assessment; FBA-based; Functional analysis; Functional assessment; Functional behavioral assessment; Intervention; Meta-analysis; Problem behavior