Accuracy of caregiver identification of demands for children with escape-maintained challenging behavior.

Background: Although stimulus preference assessments are widely used to identify reinforcers and to inform positive reinforcement conditions in a functional analysis (FA), direct assessments of potential negative reinforcers are not as commonly employed. Demands are often selected from caregiver report alone.
Aims: The purpose of the current study is to (a) replicate the Demand Assessment for Individuals with Severe Disabilities (DAISD) indirect assessment interview for caregivers to identify demands that may evoke challenging behavior; (b), compare the correspondence of the DAISD in relation to an established direct assessment, the demand latency assessment (DLA); and (c) evaluate if the demands that caregivers identify as the most aversive are more likely to evoke challenging behavior and identify an escape function in an FA than those demands caregivers identify as least aversive and replicate validation of the DLA.
Methods and Procedures: This study evaluated caregiver accuracy at identifying demands most likely to evoke escape-maintained challenging behavior for four children with developmental disabilities. Caregiver-informed aversiveness hierarchies from the DAISD were compared to child-informed aversiveness hierarchies from the DLA. Functional analyses included separate escape conditions with DAISD and DLA most and least aversive demands.
Outcomes and Results: Although all caregivers identified at least eight demands, caregivers' accuracy with demand aversiveness was variable as indicated by (a) a false negative FA outcome for one of four participants with the caregiver-nominated most aversive demand; (b) higher rates of challenging behavior with the caregiver-nominated least aversive demand than most aversive for three of four participants; and (c) lack of a strong positive rank order correlation between caregiver- and child-hierarchies for all participants (range, -0.76 to .48). Compliance was not a strong predictive variable of challenging behavior with either assessment.
Conclusions and Implications: Results indicate that the DAISD interview is useful at identifying multiple demands presented in the natural environment, but should be followed up with direct assessment to determine demand aversiveness rather than used for caregivers to rank demand aversiveness.
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