What Strategies Can Be Employed To Differentiate Between Sensory Seeking Behaviors And Attention Seeking Behaviors In An Individual With Severe Autism And Intellectual Disability, Particularly When The Individual's Primary Mode Of Communication Is Limited To Augmentative And Alternative Communication (AAC) Systems, And How Can A Functional Behavior Assessment (FBA) Be Adapted To Account For These Complexities?

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Differentiating between sensory seeking and attention seeking behaviors in individuals with severe autism and intellectual disability, particularly those using AAC, requires a comprehensive approach. Here's a structured strategy and adapted FBA process:

Strategies for Differentiation

  1. Contextual Observation:

    • Setting: Note if the behavior occurs in solitude (possibly sensory) or in social settings (possibly attention-seeking).
    • Environment: Consider sensory factors like noise or stimulation levels that might trigger sensory seeking.

  2. Behavior Characteristics:

    • Sensory Seeking: Look for repetitive movements (e.g., hand flapping, spinning) or sensory-focused actions.
    • Attention Seeking: Identify behaviors like shouting or acting out, which are typically more disruptive.

  3. Post-Behavior Outcomes:

    • Sensory Seeking: The individual may appear calmer or satisfied post-behavior.
    • Attention Seeking: Behavior may cease upon receiving attention.

  4. AAC Utilization:

    • Use AAC to offer choices between sensory activities and social interactions to gauge preferences.

  5. Intervention Testing:

    • Provide sensory activities to see if behavior decreases, indicating sensory seeking.
    • Use attention strategies (e.g., non-contingent attention) to assess reduction in attention-seeking behavior.

Adapted Functional Behavior Assessment (FBA)

  1. Modified Functional Analysis:

    • Conduct in shorter sessions, adapting conditions (play, attention, sensory) to the individual's tolerance.

  2. Enhanced Observation:

    • Track behavior frequency, preceding events, and outcomes. Rely on caregiver observations due to limited self-reporting.

  3. Caregiver Interviews:

    • Gather insights from those familiar with the individual to identify patterns and potential triggers.

  4. Environmental Analysis:

    • Assess sensory environments and daily routines to understand potential sensory triggers.

  5. AAC Integration:

    • Incorporate AAC into assessments to offer choices and gather feedback, enhancing understanding of preferences.

  6. Intervention Testing:

    • Implement interventions targeting sensory or attention needs to observe behavioral changes.

Conclusion

By systematically analyzing context, behavior types, outcomes, and using AAC, alongside an adapted FBA focusing on observation, caregiver input, and environmental factors, one can effectively differentiate between sensory and attention-seeking behaviors. This approach ensures a tailored understanding and intervention plan for the individual.