The Ecological Validity of Research Studies on Function-Based Interventions in Schools for Children With Autism Spectrum Disorder

Abstract

Our main purpose in this review was to determine the extent to which ecological validity was demonstrated and assessed in single-case experimental design (SCED) studies examining the effectiveness of function-based interventions (FBIs) for children with autism spectrum disorder (ASD) within schools. We reviewed 55 SCED studies published between 1985 and 2019 to identify indicators of ecological validity and the instruments used to assess it. We also conducted an analysis to determine the extent to which implementation procedures were described. Results indicated that approximately half of the assessments and FBIs were conducted by teachers in classrooms. Approximately 50% of the assessments and FBIs were implemented within the context of isolated sessions and required multiple implementers. Ecological validity was assessed in seven of the studies reviewed. A complete description of implementation procedures was provided for approximately half of the assessments and FBIs. Limitations of the present review and future directions for research are discussed.

Keywords

ecological validity function-based interventions autism school

Ecological validity has been defined as the relevance of research outcomes or the extent to which the findings of a research study can be used beyond the context of the study by typical people in everyday settings (Gaylord-Ross, 1979; Ledford et al., 2016; Singer, 2000). It has also been referred to as feasibility of implementation of an intervention (Gast, 2014; Ledford et al., 2016). Some researchers contend that ecological validity is a component of social validity (cf. Machalicek et al., 2007), a construct encompassing the social significance of goals and outcomes and the acceptability of procedures (Wolf, 1978). Other researchers consider that ecological validity, although closely related to social validity, can be evaluated by examining several aspects related to the implementation of an intervention or the extent to which an intervention can be used under natural conditions (Bowen et al., 2009).

Researchers have proposed several indicators of ecological validity. First, the ecological validity of a research study is demonstrated when the intervention is implemented by typical agents (Clark & Dunlap, 2008). For example, a study examining the effects of a behavioral intervention on problem behavior has ecological validity if the teacher rather than the researcher implements the intervention. Second, the implementation of the intervention in a typical setting is also reflective of ecological validity (Singer, 2000; Stichter et al., 2004). In the example described previously, the ecological validity of the study would be enhanced if the behavioral intervention were conducted in a classroom rather than an analogue environment. In addition to the implementer and setting, researchers have proposed other indicators of ecological validity, such as cost, personnel support, continued use of an intervention, and reports of typical agents that it can be used in typical settings as planned (Ledford et al., 2016). For example, interventions that require excessive effort and are rated as impractical by teachers are less likely to be used in schools (Leko, 2014; Reid & Parsons, 2002).

The importance of conducting ecologically valid research studies has been highlighted in the literature over the past 41 years (Gaylord-Ross, 1979; Ledford et al., 2016); however, we located only four studies whose purpose was to determine its current status in applied research. First, Stichter et al. (2004) analyzed the ecological validity of the assessment and antecedent-based interventions for individuals with developmental disabilities and emotional and behavioral disorders. They conducted an analysis of 1,380 studies published between 1980 and 2001 and measured ecological validity by examining the implementer and setting where the interventions were implemented. Findings revealed that the use of teachers in intervention implementation decreased over the years from a mean of 24% between 1980 and 1990 to a mean of 17% between 1990 and 2001. Data also showed that the implementation of assessments and interventions in typical settings decreased from a mean of 42% to a mean of 36% for assessments and from a mean of 23% to a mean of 8% for interventions.

Second, Ledford et al. (2016) analyzed the ecological validity of 54 single-case experimental design (SCED) studies on social skills interventions for young children with ASD. The authors examined several aspects of ecological validity, including the implementer, setting, activities, continued use of intervention, and maintenance of behavior change. Results indicated that half of the studies contained aspects reflective of ecological validity, including typical implementers and typical settings. Moreover, less than 30% of the studies examined the interventions within natural activities and a very limited number of studies reported continued use of the intervention. The authors highlighted the need for (a) research on instruments used to measure ecological validity, (b) more frequent assessment of ecological validity, and (c) systematic reporting guidelines. Third, Machalicek et al. (2007) in their review of SCED studies on school-based behavioral interventions for individuals with ASD noted that teachers were involved to some degree in data collection and intervention in approximately 50% of the studies and that about 80% of the studies were implemented in typical settings. Fourth, Martinez et al. (2016) reviewed 26 SCED studies on school-based behavioral interventions for children with ASD and reported that 85% of the interventions were conducted in typical settings and 46% of the interventions were implemented by teachers.

The significance of ecological validity as a critical aspect of applied research has also been discussed in relation to the adoption and sustained use of empirically-supported interventions (i.e., evidence-based practices [EBPs]) to promote positive student outcomes (Cook et al., 2013; Snodgrass et al., 2018). Despite advances in the identification and dissemination of EBPs in the field of education, there continues to be a lack of adoption and sustained used of EBPs in typical settings (Hess et al., 2008). One factor that may promote the adoption of EBPs in typical settings is the development of ecologically valid interventions (Schalock et al., 2011). Specifically, interventions that (a) are minimally invasive, (b) can be implemented within the existing constrains of financial and human resources, and (c) can be used by typical people in everyday environments are more likely to be adopted (Schalock et al., 2011).

One area of applied research in which ecological validity and the use of EBPs may be especially relevant is the literature on function-based interventions (FBIs) for children with ASD in schools. FBIs are behavioral interventions that consist of two phases: an assessment to identify the antecedents and consequences associated with the problem behavior (i.e., the function) and an assessment-based intervention designed to address the identified function of the behavior. FBIs typically include one or more of the following strategies: (a) antecedent manipulations to prevent problem behavior or evoke socially appropriate behavior, (b) instructional strategies to teach a replacement behavior that has the same function (i.e., functionally equivalent) as the problem behavior, and (c) consequence manipulations to reinforce appropriate behavior and weaken a problem behavior (e.g., Cook et al., 2012; Dunlap & Fox, 2011). The underlying principle of FBIs is that by making environmental arrangements to modify stimuli that occur prior to the behavior (i.e., antecedents) and after the behavior (i.e., consequences) and by teaching replacement behaviors, problem behavior will decrease while socially appropriate behavior will increase (Carr et al., 1999).

Despite empirical evidence documenting the effectiveness of FBIs in reducing problem behavior emitted by children with ASD when implemented by teachers in the classroom (e.g., Severini et al., 2018), their adoption in schools has been somewhat limited (Cook et al., 2012; Odom, 2010). Given the occurrence of problem behavior in children with ASD in schools and the negative effect on their participation in inclusive settings (Fox et al., 2002; Rojahn et al., 2007), it is crucial to analyze the ecological validity of research studies on FBIs and to determine directions for future research on their adoption and sustained use by teachers.

Thus, our purpose in this systematic review was to extend the current literature on the ecological validity of SCED studies on FBIs for children with ASD in schools in several ways. First, we examined the extent to which researchers provide a detailed description of the procedures implemented in a study. A detailed description of procedures is a critical component of research studies both for replication purposes and for adoption of EBPs (Horner et al., 2005; Kazdin, 2011). Considering the limited preservice and in-service training on EBPs (Hsiao & Peterson, 2018; McKenna et al., 2014), teachers may rely on the description of procedures in research studies in addition to other sources, such as free online modules, videos, webinars, or other instructional materials. To our knowledge, no published reviews have analyzed whether procedures are described with enough detail to allow teachers to use them in the classroom.

Second, we extended the evaluation of ecological validity by examining additional aspects other than the setting and implementer. Ecological validity is a complex construct that encompasses myriad factors in addition to the setting and implementer. These factors may include the human and financial resources required to adopt and use the intervention, the time needed to implement the intervention, the type of activity within the context of which the intervention is implemented, and the schedules, responsibilities, and values of teachers who must implement it (Ledford et al., 2016; Mayer et al., 2019). Thus, it is important to consider the factors listed previously when evaluating the ecological validity of applied research studies.

Third, we examined if the authors of the studies reviewed evaluated the ecological validity of the intervention by asking typical people to provide feedback in terms of ease of use, continued use in the future, time, cost, and competing responsibilities that would interfere with its implementation under natural conditions. The importance of evaluating the ecological validity of interventions examined in applied research studies and the need for developing instruments to measure this construct have been highlighted in the literature. For example, Ledford et al. (2016) noted that ecological validity was less frequently measured compared to the acceptability (i.e., social validity) of an intervention. Moreover, researcher-developed surveys were used more often than established instruments to evaluate the social and ecological validity of interventions. Because Ledford et al. (2016) analyzed both the social validity and the ecological validity of interventions it is difficult to determine the extent to which ecological validity alone was measured in the research studies reviewed. Thus, many questions related to the frequency with which ecological validity is assessed and how it is measured remained unanswered and need further evaluation. Our research questions were:

What type of behavioral assessments and FBIs targeting problem behavior in children with ASD are implemented in schools?

To what extent do researchers describe the procedures used to conduct assessments and FBIs targeting problem behavior in children with ASD in schools?

To what extent do studies examining the effects of FBIs targeting problem behavior in children with ASD in schools include aspects reflective of ecological validity?

To what extent and how do researchers evaluate the ecological validity of assessments and FBIs targeting problem behavior in children with ASD in schools?

Method

Search Procedures

Figure 1 displays the article identification, screening, and selection process.

Figure 1.

Flow diagram of identification, screening, and selection process.

Article identification

First, we conducted an electronic search of peer-reviewed articles using several databases: Education Research Information Center (ERIC), Education Research Complete, Psychological Information Database (PsychINFO), and Academic Research Complete. We located articles using the search terms autism OR aut* combined with each of the following keywords or truncated keywords: function-based intervention OR functional-based intervention OR assessment-based intervention; functional communication training OR FCT OR functional equivalence training; differential reinforcement of alternative behavior OR DRA; problem behavior OR disruptive behavior OR challenging behavior; trial-based functional analysis OR TBFA; discrete-trial based functional analysis OR DTFA; functional analysis OR FA; functional behavior assessment OR behavioral assessment OR descriptive assessment. After duplicates were removed, the search resulted in 423 peer-reviewed articles.

Article screening

The first author and a graduate student independently screened the title and the abstract of each of the 423 peer-reviewed articles to exclude those that focused on other aspects of behavioral interventions, such as staff training, program evaluation, validity and reliability of an assessment scale, or description of program implementation. This screening resulted in 344 peer-reviewed articles.

Article selection

The first author and a graduate student independently reviewed the full text of each of the 344 articles and used the following inclusion criteria to determine their eligibility for inclusion in the review. First, the article had to be published in a peer-reviewed journal between 1985 and 2019. We decided to limit our search to these years because the concept of teaching functionally equivalent socially appropriate behaviors to replace problem behaviors was first introduced in 1985 (Carr & Durand, 1985). Second, the authors of the article had to use a SCED to examine a functional relation between the dependent and independent variable. A SCED is an experimental research method used to demonstrate causal relations between an intervention and one or more behaviors by comparing one’s performance across different conditions over time (Kazdin, 2011). We decided to include only studies that implemented a SCED because FBIs used to address problem behavior are likely to be individualized to meet the unique characteristics of a child rather than implemented within the context of a group design.

Third, the authors had to examine an FBI targeting problem behavior. Fourth, the article had to include at least one participant who had a diagnosis of ASD with or without additional disabilities. Fifth, the participant with ASD had to be 12 years old or younger and this participant had to receive the FBI. We selected this age range because we were interested in examining the current status of FBIs to address problem behavior for preschool and elementary-aged children before they transition to adolescence. Implementing effective interventions at an early age has the potential to reduce the frequency and severity of problem behaviors during adolescence and adulthood (Conroy et al., 2005; Webster-Stratton & Hammond, 1997). Sixth, the FBI had to be implemented in a public or private school. Finally, the article had to be published in English. Application of these criteria resulted in 55 articles (see Supplemental Appendix).

We excluded studies that examined the effects of the intervention on certain behaviors, such as feeding disorders, including packing, rumination, or pica because these behaviors usually require more specialized interventions provided by trained professionals and are less likely to be used by teachers. We also conducted an ancestral search of the reference list of the articles that met the inclusion criteria. The ancestral search did not result in additional articles.

Coding Procedures

The first and second authors coded descriptive information from each of the 55 articles to answer the research questions related to the type of behavioral assessments and FBIs targeting problem behavior in children with ASD in schools, the extent to which the researchers described the procedures used to conduct behavioral assessments and FBIs, the aspects illustrative of ecological validity, and the evaluation of ecological validity. We also coded the total number of children enrolled in the study, the total number of children who met the inclusion criteria (i.e., be 12 years old or younger, have a diagnosis of ASD, and receive an FBI), and their age and gender. Coding was conducted separately for each child in the study and each type of assessment and FBI. If a child received multiple interventions, we coded each intervention.

Assessment

We coded the type of assessment used to determine the function of the problem behavior as (a) descriptive functional behavioral assessment (FBA) consisting of indirect methods and direct observation, (b) indirect FBA consisting of rating scales, (c) functional analysis (FA; Iwata et al., 1982, 1994), and (d) discrete trial-based functional analysis (DTFA; e.g., Chezan et al., 2014). An assessment consisting of a systematic collection of information about a problem behavior conducted to develop a hypothesis of the function of problem behavior or test the hypothesis was coded as EBP (National Professional Development Center [NPDC], Steinbrenner et al., 2020; Wong et al., 2014, 2015).

Intervention

First, we coded each FBI targeting problem behavior as an antecedent-based intervention, an instruction-based intervention, a reinforcement-based intervention, extinction, a punishment-based intervention, and “other.” Then, we coded the instructional strategy in each category. Antecedent-based interventions consisted of changes in the physical or social environment (e.g., changing the complexity of a task, providing choices) or provision of reinforcers on a fixed-time schedule (i.e., noncontingent reinforcement) that occurred prior to the problem behavior and were matched to the identified function. Instruction-based interventions consisted of strategies aimed at teaching a socially appropriate replacement behavior (e.g., picture exchange communication systems [PECS], mand training).

Reinforcement-based interventions consisted of the delivery of reinforcers contingent on the emission of the replacement behavior. Examples included differential reinforcement of alternative behavior, differential reinforcement of other behavior, and token systems without response cost. Extinction consisted of minimizing or withholding the delivery of the functional reinforcer contingent on problem behavior. Punishment-based interventions consisted of aversive strategies implemented contingent on problem behavior (e.g., time out, response blocking). Any intervention that did not fall into one of our categories was coded as “other.” We also coded whether an intervention was considered EBP for children with ASD. EBPs are interventions that have been empirically supported in experimental research studies and have been demonstrated to be effective for individuals with ASD (Odom, 2010).

Description of assessment and FBI procedures

We coded the extent to which the authors described the assessment and FBI procedures as complete, incomplete, or no description. We recorded a code of complete when the authors provided a step-by-step description of all the steps required to conduct the assessment or the FBI. We recorded a code of incomplete when the authors provided a partial description of one or multiple steps required to conduct the assessment or the FBI. For example, we coded incomplete if the authors stated that they conducted an FBA consisting of direct and indirect methods without describing one or both methods and how it was implemented. An incomplete description code was assigned when the authors noted that prompting was used to teach a behavior, but they did not specify the type of prompt used or when and how it was delivered. We recorded no description when the authors did not describe the assessment or FBI procedures or stated only the name of the assessment or FBI. For example, an assessment was coded as no description when the authors stated that they conducted an FBA but did not provide a description of the procedures implemented. Similarly, a no description code for an intervention was assigned when the authors stated that the child was prompted to mand but did not describe the steps of how to teach a mand. Within a study, each assessment and FBI were coded separately and could have received different codes (e.g., assessment complete and FBI incomplete or no description).

Setting, type of activity, and implementer

We coded whether the behavioral assessment and FBI were implemented in a typical setting. A typical setting was defined as a location in which children engaged in academic and nonacademic activities throughout the school day. Examples of typical settings included general or special education classrooms, inclusive classrooms, playground, cafeteria, and hallways. Examples of nontypical settings included separate rooms. We coded whether the assessment and FBI were implemented within the context of typical or contrived activities. A typical activity was defined as a naturally occurring activity in which children were involved as part of their daily school routine. Activities specifically scheduled for the purpose of the study were considered contrived. We coded whether the person implementing the assessment and FBI was indigenous to the child’s environment (e.g., teacher). Researchers and graduate students were not considered indigenous.

Schedule of implementation and human resources

We recorded the implementation schedule of the assessment and FBI. We coded the schedule as (a) isolated (e.g., 5-min session per day), (b) distributed (e.g., multiple sessions spread throughout the day), and (c) naturalistic (e.g., at a time when the behavior naturally occurred throughout the day). We also coded the number of individuals needed to implement the assessment and FBI procedures and collect data.

Ecological validity evaluation

We coded whether the authors measured ecological validity by gathering teachers’ perspectives on ease of implementation, the time required to implement the intervention, the feasibility of the intervention in relation to existing resources and competing responsibilities, and whether teachers were planning to continue the intervention after the study ended. We recorded the type of the instrument used by the authors of the studies reviewed to evaluate ecological validity (e.g., established scale) and how they reported results.

Interrater Agreement

We conducted interrater agreement on article screening, article identification, and on descriptive characteristics’ coding. The first author served as the primary coder and a graduate student served as the secondary coder for the article screening and identification. For article screening, an agreement was scored if both the primary coder and the secondary coder scored a study as eligible or not eligible for inclusion in the next phase. For article identification, an agreement was scored if both coders recorded either “yes” or “no” for each of the seven inclusion criteria. For descriptive characteristics’ coding, the second author served as the primary coder and the first author served as the secondary coder. An agreement was scored if both coders recorded the same code for each descriptive characteristic. We calculated point-by-point agreement by dividing the number of agreements by the total number of agreements plus disagreements and multiplying the quotient by 100 (Kazdin, 2011).

We collected interrater agreement for the 30% (126 of 423) of randomly selected articles during article screening, for 29% (100 of 344) of randomly selected articles during article identification, and for 31% (17 of 55) of the articles during descriptive characteristics’ coding. Mean agreement was: 99% for article screening, 98% for article identification, and 97% for descriptive characteristics’ coding. In case of a disagreement, the coders reviewed and discussed the coding until a consensus was reached.

Results

In this review, we analyzed 55 studies published between 1985 and 2019 examining the effects of FBIs on problem behavior displayed by 92 children who met the inclusion criteria (i.e., were 12 years old or younger, had a diagnosis of ASD, and received an FBI). Ten percent (9 of 92) of the children were girls and 83% (76 of 92) of the children were boys. For the remaining 7% (7 of 92) of the children, the gender was not reported. A total of 109 assessments and 225 FBIs were examined in the review. The assessment consisted of descriptive FBAs (n = 34; 31.2%), indirect FBAs (n = 9; 8.3%), FAs (n = 58; 53.2%), and DTFAs (n = 8; 7.3%). Table 1 displays the FBIs and the percentage of cases in which they were implemented. Across studies, the most commonly-implemented antecedent-based interventions were choice (6.7%) and visual supports (4%), the most commonly-implemented instruction-based interventions were functional communication training (14.7%) and prompting (10.2%), and the most commonly-implemented consequence-based interventions were extinction (13.3%) and continuous reinforcement (8%).

Table 1.

Type of Function-Based Interventions and Percentage of Implementation.

Type	Name of intervention	Number (n)	Percentage (N = 225)
Antecedent-based interventions	Modification to task complexity	3	1.3%
	Modification to instructional delivery	1	0.4%
	Modification to instructional pacing	2	0.9%
	Choice within and across activities	15	6.7%
	Visual supports	9	4%
	Environmental modifications	2	0.9%
	Interspersal	2	0.9%
	Demand fading	3	1.3%
	Response satiation	4	1.8%
	Response deprivation	2	0.9%
	Noncontingent reinforcement	4	1.8%
Instruction-based interventions	Prompting	23	10.2%
	PECS	3	1.3%
	Mand training	5	2.2%
	Functional communication training	33	14.7%
	Direct instruction	2	0.9%
	Social stories	2	0.9%
	Modeling	15	6.7%
	Discrete-trial training	1	0.4%
Reinforcement-based interventions	Continuous reinforcement schedule	18	8%
	Intermittent reinforcement schedules	6	2.7%
	Chained schedules of reinforcement	2	0.9%
	Differential reinforcement of other behavior	6	2.7%
	Differential reinforcement of alternative behavior	8	3.5%
	Differential reinforcement	1	0.4%
	Token economy systems	6	2.7%
	Delay to reinforcement	3	1.3%
Extinction	Extinction	30	13.3%
Punishment-based interventions	Positive practice overcorrection	1	0.4%
	Response blocking	3	1.3%
	Response interruption/redirection	3	1.3%
	Response cost	1	0.4%
	Redirection	4	1.8%
Other	Power card strategy	1	0.4%
Other	Scenario-based learning	1	0.4%

Description of Behavioral Assessments and FBI Procedures

Figure 2 displays the extent to which the procedures were described in the reviewed studies. The authors provided a complete description of the procedures for 58.8% (n = 20) of descriptive FBAs, for 44.4% (n = 4) of indirect FBAs, for 60.3% (n = 35) of FAs, and for all DTFAs. The description of procedures was complete for: 76.6% (n = 36) of the antecedent-based interventions, 59.5% (n = 50) of the instruction-based interventions, 76% (n = 38) of the reinforcement-based interventions, 86.7% (n = 26) of extinction, 91.7% (n = 11) of the punishment-based interventions, and for the two FBIs classified as “other.” For the remaining assessments and FBIs, the description of the procedures was incomplete or not provided.

Figure 2.

The number of assessment and intervention strategies for which the authors of the studies reviewed provided a complete, incomplete, or no description of procedures.

Ecological Validity of Behavioral Assessments

Table 2 displays the number and percentage of the different assessments used to identify the function of problem behavior in relation to the setting, type of activity, person conducting the assessment, schedule of implementation, and human resources.

Table 2.

Ecological Validity Indicators of Behavioral Assessments.

Indicator		Descriptive FBA	Indirect FBA	FA	DTFA
Indicator		n (%)	n (%)	n (%)	n (%)
Setting	Typical	25 (73.5)	—	22 (37.9)	8 (100)
	Nontypical	5 (14.7)	—	28 (48.3)	—
	Not reported	4 (11.8)	9 (100)	8 (13.8)	—
Activity	Naturally occurring	28 (82.4)	—	3 (5.2)	8 (100)
	Contrived	1 (2.9)	—	48 (82.7)	—
	Not reported	5 (14.7)	9 (100)	7 (12.7)	—
Implementor	Typical	13 (38.2)	3 (33.3)	11 (19)	8 (100)
	Not typical	17 (50)	3 (33.3)	44 (75.9)	—
	Not reported	4 (11.7)	3 (33.3)	3 (5.1)	—
Schedule	Isolated	16 (47)	—	40 (69)	—
	Distributed	2 (5.9)	—	6 (10.3)	3 (37.5)
	Embedded	7 (20.6)	—	2 (3.4)	5 (62.5)
	Not reported	9 (26.5)	9 (100)	10 (17.3)	—
Resources	One	19 (55.9)	6 (66.7)	12 (20.7)	—
	Multiple	5 (14.7)	—	31 (53.5)	8 (100)
	Not reported	10 (29.4)	3 (33.3)	15 (25.8)	—

Setting, type of activity, and implementer

Data reveal that over 70% of the descriptive FBAs and 100% of the DTFAs were implemented in special or general education classrooms, whereas only 37.9% of the FAs were implemented in typical settings. Data also indicate that 82.4% of the descriptive FBAs and 100% of the DTFAs were conducted within the context of typical activities, while 82.7% of the FAs were implemented during contrived activities. Furthermore, data suggest that 50% of the descriptive FBAs and 75.9% of the FAs were implemented by researchers and 100% of DTFA were conducted by teachers. Ninety-nine percent of the assessments were EBPs.

Schedule of implementation and human resources

Approximately 50% of the descriptive FBAs were implemented during isolated sessions and required one person, whereas more than 60% of the FAs were conducted within the context of isolated sessions and required multiple individuals. These individuals were undergraduate or graduate students who assisted researchers with the data collection or implementation of assessment procedures throughout the study. Additionally, more than 60% of the DTFA were conducted within the context of embedded sessions throughout the day and required multiple individuals.

Evaluation of ecological validity

In three of the studies reviewed, the authors evaluated several aspects related to the ecological validity of the behavioral assessments (Flynn & Lo, 2016; Larkin et al., 2016; Sasso et al., 1992). They used instruments to assess the overall acceptability of the assessment rather than targeting ecological validity alone. However, these instruments contained several items related to ecological validity, including ease of implementation, use in the future, cost, time required to implement the assessments, and disruptions to the class activities. Table 4 displays the aspects and instruments used to evaluate the ecological validity of assessments. Overall acceptability scores were reported in two studies (Flynn & Lo, 2016; Sasso et al., 1992) and in one study the authors made statements about the overall acceptability of the assessments without reporting any data (Larkin et al., 2016).

Ecological Validity of FBIs

Table 3 displays the number and percentage of FBIs in relation to the setting, type of activity, person implementing the FBI, implementation schedule, and human resources.

Table 3.

Ecological Validity Indicators of Function-Based Interventions.

Indicator		ABI	IBI	RBI	Extinction	Punishment	Other
Indicator		n (%)	n (%)	n (%)	n (%)	n (%)	n (%)
Setting	Typical	28 (59.6)	45 (53.6)	35 (70)	18 (60)	5 (41.7)	2 (100)
	Nontypical	12 (25.5)	36 (42.8)	11 (22)	10 (33.3)	5 (41.7)	—
	Not reported	7 (14.9)	3 (3.6)	4 (8)	2 (6.7)	2 (16.6)	—
Activity	Naturally occurring	22 (46.8)	20 (23.8)	35 (70)	20 (66.7)	8 (66.7)	2 (100)
	Contrived	25 (53.2)	62 (73.8)	13 (26)	9 (30)	3 (25)	—
	Not reported	—	2 (2.4)	2 (4)	1 (3.3)	1 (8.3)	—
Implementor	Typical	23 (48.9)	38 (45)	25 (50)	15 (50)	8 (66.7)	2 (100)
	Not typical	24 (51.1)	46 (55)	25 (50)	15 (50)	4 (33.3)	—
	Not reported	—	—	—	—	—	—
Schedule	Isolated	28 (59.6)	46 (54.8)	16 (32)	5 (16.7)	3 (25)	2 (100)
	Distributed	6 (12.8)	15 (17.9)	2 (4)	7 (23.3)	—	—
	Embedded	9 (19.1)	18 (21.4)	30 (60)	16 (53.3)	8 (66.7)	—
	Not reported	4 (8.5)	5 (5.6)	2 (4)	2 (6.7)	1 (8.3)	—
Resources	One	7 (14.9)	17 (20.2)	6 (12)	1 (3.3)	—	—
	Multiple	27 (57.5)	51 (60.7)	28 (56)	18 (60)	6 (50)	2 (100)
	Not reported	13 (27.6)	16 (19)	16 (32)	11 (36.7)	6 (50)	—

Note. ABI = antecedent-based intervention; IBI = instruction-based intervention; RBI = reinforcement-based intervention.

Setting, type of activity, and implementer

Data suggest that more than 50% of the FBI were conducted in special or general education classrooms during typical activities, except for instruction-based interventions, of which over 70% were conducted during contrived activities. Ninety-nine percent of the interventions were EBPs. Furthermore, data indicate that at least 45% of FBI were implemented by teachers. The authors of the studies included in this systematic review did not provide any information on teacher demographic or descriptive data, such as age, grade, gender, race, years of experience, or highest degree of qualification and, thus, we cannot provide a description of the characteristics of the teachers involved in the implementation of the interventions or the influence of their characteristics on the selection and use of EBPs.

Schedule of implementation and human resources

Data show that approximately 55% of FBI were conducted during isolated sessions, except for reinforcement, extinction, and punishment-based procedures which mostly occurred during natural activities. Approximately 55% of the FBIs required multiple individuals for implementation and data collection.

Evaluation of ecological validity

The authors of the studies reviewed used different instruments to assess the ecological validity of the FBIs implemented to address students’ problem behavior. The instruments consisted of published scales (e.g., Teacher Acceptability Rating Form-Revised [TARF-R], Reimers et al., 1992; Teacher Postintervention Acceptability and Importance of Effects [TPAIE], Lane & Beebe-Frankenberger, 2004) or researcher-created surveys (see Table 4). The ecological validity aspects assessed with these instruments were: time, ease of implementation, cost, interference with competing responsibilities, and continued use of the intervention in the future. The Likert scales contained in the instruments mentioned previously consisted of a 5-point scale where 1 indicated disagreement (i.e., strongly disagree) and 5 indicated agreement (i.e., strongly agree) (e.g., TPAIE, researcher-created survey) or a 7-point scale where 1 indicated disagreement (i.e., extremely disagree) and 7 indicated agreement (i.e., extremely agree) (e.g., TARF-R). Overall, lower scores were associated with low levels of ecological validity and higher scores were associated with high levels of ecological validity.

Table 4.

Evaluation of Ecological Validity.

Study		Aldosari (2016)	Blair et al. (2007)	Campbell and Tincani (2011)	Flynn and Lo (2016)	Larkin et al. (2016)	Pennington et al. (2012)	Sasso et al. (1992)
Measure		TARF-R	Created	TARF-R	TPAIE	TARF-R	Not reported	TARF-R
Assessment	Easy to use				X
	Use in the future				X	X
	Time							X
	Cost							X
	Competing responsibilities							X
Intervention	Easy to use		X		X	X	X
	Use in the future			X	X	X	X
	Time	X	X	X
	Cost	X		X
	Competing responsibilities	X		X
Results	Scores reported	X	X	X	X			X
Results	No scores, only statement					X	X

Note. TARF-R = Teacher Acceptability Rating Form-Revised; TPAIE = Teacher Postintervention Acceptability and Importance of Effects.

The time required to implement the intervention was evaluated for 13 of the 225 FBIs (5.8%) and was rated at 4.5 (on a 5-point Likert scale) or 6.8 (on a 7-point Likert scale). Ease of implementation was assessed for 7 of the 225 FBIs (3.1%) and was rated at 4.0 and 4.5 on a 5-point Likert scale. Cost was evaluated for 8 of the 225 FBIs (3.5%) and was rated at 6.8 on a 7-point Likert scale. Interference with competing responsibilities was assessed for eight of the 225 FBIs (3.5%) and was rated at 6.8 on a 7-point Likert scale. Continued use of the intervention in the future was evaluated for five of the 225 FBIs (2.2%) and was rated at a 4.3 (on a 5-point Likert scale) and at 6.8 (on a 7-point Likert scale). In two studies, no scores were reported for the items related to ecological validity (Larkin et al., 2016; Pennington et al., 2012).

Discussion

We had several purposes for conducting this review: (a) to examine the assessments and FBIs implemented in schools for children with ASD, (b) to determine the extent to which the assessment and FBI procedures were described, (c) to analyze whether research studies on FBIs included aspects reflective of ecological validity, and (d) to identify the methods used to assess ecological validity. Findings are consistent with previous literature reviews on behavioral interventions in schools in terms of the type of assessments and FBIs used to address problem behavior in children with ASD. Specifically, results indicate that 99% of the assessments and interventions examined in the studies reviewed were EBPs. Most of the interventions consisted of modifications to antecedents and consequences to prevent problem behavior or to evoke an existing socially appropriate behavior, and instructions to teach a replacement behavior. A limited number of interventions were punishment based or non-EBPs.

Our analysis also revealed several important findings related to the description of the assessment and FBI procedures and the ecological validity of the studies reviewed. One important finding was that the authors of the studies provided a complete description for more than half of the assessment and FBI procedures used to address problem behavior. Although this finding is encouraging because it may play a critical role in the adoption and use of FBIs by teachers, it is noteworthy to mention that an incomplete or no description of procedures was reported for the remaining studies included in this analysis.

The systematic description of procedures in research studies is crucial considering that federal mandates require teachers to use EBPs to improve outcomes for students with ASD (Every Student Succeeds Act [ESSA], 2015; Individuals with Disabilities Education Improvement Act, [IDEIA], 2004). One factor that contributes to the reduced adoption and use of EBPs by teachers is their limited knowledge and training on these practices (Hsiao & Peterson, 2018; Paynter et al., 2017). According to Hsiao et al. (2018), approximately 50% of teachers reported that functional communication training was never explicitly taught during their preservice training or professional development. In the absence of training on EBPs, teachers also may rely on the description of procedures reported in research studies to use EBPs.

Therefore, researchers conducting studies on assessments and FBIs should pay increased attention to the description of procedures to ensure consistency across studies and facilitate the dissemination of information to teachers. One potential approach to ensure consistency, to facilitate the dissemination of the assessments and FBIs examined in research studies, and to assist teachers to access the information consists of including a step-by-step description of all materials, procedures, and data collection sheets in the study’s supplementary materials. Furthermore, future studies should focus on designing reporting guidelines for researchers that target not only aspects related to the methodological rigor of the study, but also aspects informing the dissemination of findings to teachers and to other educational professionals.

Another important finding is the large percent of assessments and FBIs conducted in typical settings by individuals indigenous to the environment. This finding is consistent with previous literature reviews indicating that about half of the assessments and interventions for children with ASD conducted in schools were implemented by teachers in typical settings (Machalicek et al., 2007; Martinez et al., 2016). The use of teachers in the implementation of FBIs has increased over the past 18 years since the publication of Stichter et al. (2004), who found that teachers implemented only 17% of the interventions in the examined studies. The increase in teacher involvement may be due to the scholarly and legislative efforts to promote development of ecologically valid interventions and, thus, their adoption by teachers.

For example, researchers have recommended that FBAs and FAs should be conducted in the natural environment where the behavior occurs and the FBI will be implemented (e.g., Harding et al., 2005; Lang et al., 2010). The assumption beyond this recommendation is that the complexity of variables present in the natural environment cannot always be replicated in an analogue environment and may produce inconclusive assessment results. Although teachers may work collaboratively with other professionals and are not always the sole implementors of assessments, their active involvement in the assessment process has the potential to increase its ecological validity (Hanley et al., 2003). Consequently, it seems relevant to design ecologically valid assessments that can be conducted by teachers and other professionals in typical settings under conditions that evoke the problem behavior (Rispoli et al., 2013; Scott & Kamps, 2007).

Although the involvement of teachers in the implementation of FBIs in research studies has increased in recent years, future research studies should address two aspects related to the ecological validity of FBIs. One aspect is the provision of demographic and descriptive data (e.g., age, race, years of experience, level of education) of the teachers involved in research studies to allow for the examination of individual variables, their influence on the use of FBIs in the classroom, and the conditions under which these interventions are more likely to be adopted by teachers. The other aspect is the involvement of teachers not only in the implementation of FBIs, but also in the selection and evaluation of these interventions.

The gradual increase in teacher use of assessments and FBIs in typical settings is promising but represents only one aspect of ecological validity. Aspects related to the type of activity, the schedule of implementation, and the number of individuals required should also be considered when developing interventions that are ecologically valid. The findings of this review suggest that although more than half of the descriptive FBAs, DTFAs, and FBIs were implemented within the context of typical activities in the classroom, they were conducted during isolated sessions and required multiple individuals to implement the procedures and collect data. Moreover, these individuals were undergraduate or graduate students rather than educational professionals working in schools.

Two aspects related to this finding warrant further discussion. The first aspect is the implementation of assessments and FBIs during a predetermined period within the context of isolated sessions rather than throughout the day when a naturally occurring opportunity for the behavior arises. Implementing an FBI during a limited period or within the context of one session per day may not provide enough opportunities to promote skill acquisition and, thus, lengthen the duration of the intervention. Previous research has demonstrated that children with ASD may need extensive training ranging from hundreds to thousands of trials to learn communicative responses or more complex skills (Carr et al., 1978).

Furthermore, the implementation of research studies within the context of isolated sessions has been mentioned in the literature as one of the factors limiting the ecological validity of research studies (Gaylord-Ross, 1979). Although researchers may opt to implement FBIs within the context of isolated sessions to achieve experimental control and for logistical purposes, future studies should examine new methodologies that would allow researchers both to strengthen the internal validity of a study and to design FBIs that can be used by teachers throughout the day and, thus, promote generalized behavior change.

The second aspect is the involvement of multiple individuals to implement the assessment and FBIs. Limited human resources have been cited in the literature as one of the factors that hinder the adoption and sustained used of EBPs (Hsiao & Peterson, 2018; McKenna et al., 2014). Teachers who have many competing responsibilities are less likely to use interventions that require multiple individuals. In those cases when teachers may adopt such interventions, the implementation fidelity may be compromised and, thus, the effectiveness of the intervention will likely decrease. Therefore, there is a need to explore innovative approaches that would allow researchers to develop FBIs that mirror the complexity of the environmental variables present in a classroom and match the existing human resources available to implement and, thus, increase the ecological validity of the behavioral assessments and FBIs.

Another important finding relates to the measurement of ecological validity. The evaluation of assessments and FBIs appears to be an underresearched aspect in the studies reviewed. Specifically, a few aspects of the ecological validity of the assessments were examined only in three of the 55 studies, whereas several aspects of the ecological validity of FBIs were measured in five of the 55 studies. The two aspects of ecological validity evaluated the most were ease of implementation and use in the future, while the least aspects evaluated consisted of time, interference with competing responsibilities, and cost. Examining multiple aspects of ecological validity, including the ones mentioned previously, would allow researchers to develop an understanding of the extent to which these aspects influence the use of EBPs by teachers and, consequently create conditions to promote the uptake and sustained use of EBPs in schools.

Moreover, findings reveal inconsistencies in the instruments used to evaluate various aspects of ecological validity and in reporting results. Specifically, some researchers reported scores for each item included in the instrument, others reported the overall score, whereas in some cases the authors made a statement without reporting any scores. The limited number of studies assessing ecological validity, the variety of instruments used, and the inconsistencies in reporting results pose challenges to drawing accurate conclusions. These challenges have also been noted in previous reviews of ecological validity (Ledford et al., 2016). Thus, researchers should develop valid measures of ecological validity and advocate for its continuous and consistent evaluation in research studies in an attempt to develop FBIs that are likely to be adopted by teachers in schools and, therefore, minimize the research-to-practice gap.

One critical aspect that has practical implications for teachers working with students with ASD who engage in problem behavior is the frequent use of several assessments and FBIs. Specifically, data revealed that the most frequently used assessments and FBIs in the studies reviewed were: (a) descriptive FBAs and FAs; (b) choice and visual supports (i.e., antecedent-based interventions); (c) functional communication training and prompting (i.e., instruction-based interventions); and (d) extinction and continuous reinforcement (i.e., consequence-based interventions). Myriad and complex factors may explain the frequent use of the above assessments and FBIs in applied research studies, but these explanations are beyond the scope of the current study. Nonetheless, we would like to offer teachers several suggestions to guide their adoption and use of FBIs to address children’s problem behavior in the classroom.

First, an assessment to identify the purpose of problem behavior should be conducted prior to selecting and using FBIs. One potential assessment that can be used by teachers or by a team of educators to determine the function of children’s problem behavior is descriptive FBA. Second, prevention, instruction, and responding are three essential components of FBIs. Specifically, FBIs should contain strategies to (a) prevent problem behavior (e.g., provide choices, modify task complexity); (b) teach new socially appropriate behaviors (e.g., direct instruction) or increase the frequency of existing behaviors; and (c) respond to problem behavior when it occurs (e.g., extinction). Third, FBIs should match the function of the problem behavior. For example, if FBA data show that a child engages in verbal aggression to escape an academic task, then the FBI may consist of modifications to task complexity and length (prevent), modeling to teach asking for assistance (instruction), and reinforcement (if the student asks for assistance) or extinction (if the student engages in verbal aggression). Finally, teachers who are not familiar with assessments and FBIs should seek training or consultation prior to selecting and using interventions in the classroom.

The findings of this review should be interpreted with caution within the context of several limitations. First, we did not use any procedures to determine the effectiveness of the FBIs examined in the studies reviewed. A large body of literature has demonstrated the effectiveness of FBIs to address challenging behavior in children with ASD (e.g., Carr et al., 1999; Reeves et al., 2013) and, thus, we did not consider that an additional analysis of the effectiveness of FBIs would make a significant contribution to the literature. Second, we limited our analysis of ecological validity to peer-reviewed articles and did not include other sources, such as unpublished dissertations. Although these sources may have brought additional information, we limited our analysis to peer-reviewed articles because teachers are more likely to consult articles published in scholarly or practitioner journals rather than unpublished dissertations. Third, we included in our analysis only studies that focused on FBIs for children with ASD. It is possible that findings related to ecological validity may have been different if we considered other populations. Finally, we analyzed only the items reflective of ecological validity included in the social validity surveys used by the authors. Therefore, our analysis may provide only an incomplete overview of how ecological validity is measured in research studies.

In conclusion, the findings of this review suggest an increased trend in the use of teachers in the implementation of assessments and FBIs in schools during naturally occurring activities. Although many researchers provide a complete description of the assessment and intervention procedures, additional attention needs to be allocated to the systematic description of procedures required to implement FBIs. The need to develop new methodologies to reduce the number of individuals required to implement FBIs and to conduct them during naturally occurring opportunities throughout the school day remains a priority in promoting ecologically valid interventions. Reliable and valid measures to evaluate the ecological validity of FBIs implemented in schools should be used consistently across studies to provide a better understanding of how interventions are perceived by teachers and to allow for a more in-depth analysis of findings across multiple studies.

Supplemental Material

Appendix – Supplemental material for The Ecological Validity of Research Studies on Function-Based Interventions in Schools for Children With Autism Spectrum Disorder

Supplemental material, Appendix for The Ecological Validity of Research Studies on Function-Based Interventions in Schools for Children With Autism Spectrum Disorder by Laura C. Chezan, Meka N. McCammon, Erik Drasgow and Katie Wolfe in Behavior Modification

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iDs

Laura C. Chezan

Katie Wolfe

Supplemental Material

Supplemental material for this article is available online.

Author Biographies

Laura C. Chezan is an associate professor of Special Education in the Department of Communication Disorders and Special Education at Old Dominion University. Her areas of interest include autism, communication interventions and behavior support for children with autism, and single-case research methodology.

Meka N. McCammon is a board certified behavior analyst and a doctoral student at the University of South Carolina. Her areas of interest include visual analysis, parent training in the application of behavioral interventions, and behavioral approaches to higher education instruction.

Erik Drasgow is a professor of Special Education at the University of South Carolina. His areas of interest include autism, language intervention, and positive behavior support. He has conducted workshops and given presentations across the country in his areas of expertise and has provided technical assistance for more than 30 years to families, teachers, related practitioners, and paraprofessionals.

Katie Wolfe is an associate professor of Special Education in the Department of Educational Studies at the University of South Carolina. She conducts research on behavioral interventions for children with autism and single-case methodology.

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