JOURNAL OF APPLIED BEHAVIOR ANALYSIS 1997, 30, 653–672 NUMBER 4 (WINTER 1997)
FUNCTIONAL ANALYSIS AND TREATMENT OF ELOPEMENT
CATHLEEN C. PIAZZA, GREGORY P. HANLEY, LYNN G. BOWMAN, JOHN M. RUYTER, STEVEN E. LINDAUER, AND DEBORAH M. SAIONTZ
KENNEDY KRIEGER INSTITUTE AND
JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE
Elopement is a dangerous behavior because children who run away may encounter life- threatening situations (e.g., traffic). We conducted functional analyses of the elopement of 3 children who had been diagnosed with developmental disabilities. The results iden- tified a maintaining reinforcer for the elopement of 1 child, but the data were difficult to interpret for 2 of the children. Subsequent reinforcer assessments were used to help to clarify the reinforcers for elopement for these 2 children. Results of the functional analyses and reinforcer assessments then were used to develop successful treatments to reduce elopement. The findings are discussed in terms of (a) the application of functional analysis methodology to elopement, (b) the use of reinforcer assessments to identify potential reinforcers when standard functional analyses are undifferentiated, and (c) the utility of assessment-based treatments for elopement.
DESCRIPTORS: elopement, developmental disabilities, functional analysis, rein- forcer assessments, concurrent operants
Elopement is typically defined as repeated attempts to leave designated areas without permission or supervision (Bodfish, 1992). Elopement may interfere with instructional activities and hinder skill acquisition in classroom settings (Chambers, Sanok, & Striefel, 1980), as well as expose an individ- ual to dangerous situations (e.g., traffic). Ac- cording to Garner (1991), individuals who elope often are placed in more restrictive set- tings to maintain their safety.
Jacobson (1982) estimated the prevalence of elopement to be 4.9% in a population of over 30,000 individuals receiving develop- mental disabilities services. Despite this rel- atively high prevalence of elopement among persons with developmental disabilities, there is a paucity of research on the assess-
This investigation was supported in part by Grant MCJ249149-02 from the Maternal and Child Health Service of the U.S. Department of Health and Human Services. We thank Rachel Thompson for her helpful comments on this manuscript.
Requests for reprints should be sent to Cathleen C. Piazza, Neurobehavioral Unit, The Kennedy Krieger Institute, 707 N. Broadway, Baltimore, Maryland 21205.
ment and treatment of this behavior prob- lem. In most studies on elopement, individ- uals were treated with multiple interventions such as reinforcement for the absence of elopement, time-out for elopement, and graduated levels systems in which the indi- vidual gained access to less restrictive envi- ronments and greater access to reinforcers contingent upon the absence of elopement (Chambers et al., 1980; Garner, 1991).
Garner (1991) treated the elopement of 1 child with profound mental retardation who resided in a group home. The treatment pro- gram involved increased amounts of freedom of movement within the group home (i.e., from restricting him to rooms without exits in the home to allowing him unrestricted access to all areas in the home) contingent on the absence of elopement, and included response interruption (teaching the partici- pant to respond to the command ‘‘stop’’ when he began to run away), time-out fol- lowing episodes of elopement, and reinforce- ment for appropriate communication to leave the group home. A similar program
654 CATHLEEN C. PIAZZA et al.
was described by Chambers et al. (1980) for an individual who was described as ‘‘ungov- ernable.’’ Treatment was implemented with- in a self-contained classroom and consisted of time-out contingent upon elopement and a levels program in which the participant gained increasing access to classroom activi- ties and movement within the classroom contingent upon the absence of elopement. These studies are limited in that functional control of the treatment was not demon- strated, and each study involved only 1 par- ticipant.
The standard of practice for reducing de- structive behavior is to prescribe treatments based on the results of behavioral assess- ments. For example, Iwata, Dorsey, Slifer, Bauman, and Richman (1982/1994) showed that the consequences that maintain self-in- jurious behavior (SIB) could be identified using functional analysis. Vollmer, Iwata, Zarcone, Smith, and Mazaleski (1993) showed that the results of functional analyses could be used to prescribe treatments to re- duce SIB. The functional analysis method- ology was developed originally for the as- sessment of SIB but has been modified to assess and treat a variety of behavior prob- lems such as aggression (Fisher et al., 1993; Piazza et al., 1997), pica (Piazza, Hanley, & Fisher, 1996), tantrums (Carr & Newsom, 1985), and psychotic speech (Fisher, Piazza, & Page, 1989; Mace & Lalli, 1991). In cases in which results of a functional analysis are equivocal or suggest that behavior is main- tained independent of the social environ- ment (i.e., maintained by automatic rein- forcement), results of reinforcer assessments have been used to prescribe treatments (Fish- er et al., 1994; Steege, Wacker, Berg, Cig- rand, & Cooper, 1989). These same strate- gies could be applied to the assessment and treatment of elopement.
In the current investigation, we modified the functional analysis method to assess the elopement of 3 children with developmental
disabilities. Subsequent reinforcer assess- ments were used to identify reinforcers for 2 of the children. The results of the functional analyses and reinforcer assessments then were used to develop treatments to reduce elopement. The treatments were altered (e.g., schedules of reinforcement were thinned) to make them more practical for caregivers and were extended from analogue conditions to more natural settings (e.g., the community).
This is a three-experiment study with data for each participant presented individually in each experiment. First, a functional analysis of elopement was conducted with each par- ticipant. If the results of the functional anal- ysis were unclear, reinforcer assessments were conducted. The results of these behavioral assessments then were integrated into treat- ment packages.
Three individuals were admitted to an in- patient unit specializing in the assessment and treatment of destructive behavior. All 3 participants were admitted primarily for the assessment and treatment of elopement, and they also engaged in aggressive and disrup- tive behaviors. Owen was a 10-year-old boy who had been diagnosed with moderate mental retardation, autism, attention deficit hyperactivity disorder (ADHD), and a sei- zure disorder. Owen could follow one-step instructions and communicated through ges- tures. Owen’s caregivers reported that he would commonly elope from rooms and then engage in dangerous behaviors such as touching electrical cords and climbing on furniture and windowsills.
Ray was an 11-year-old boy who had been diagnosed with severe mental retardation, autism, bipolar disorder, and ADHD. Ray was independent with his daily living skills,