Use of a paired-stimulus demand analysis to evaluate demands for inclusion in functional analyses

Clinicians regularly use both indirect and direct assessments to identify preferred stimuli to include in control conditions and positive reinforcement test conditions in a functional analysis (FA). However, clinicians often rely on indirect assessment alone (e.g., caregiver report) to identify aversive stimuli to include in negative reinforcement test conditions. In this study, we evaluate a paired-stimulus demand analysis and validate assessment results via FA. Results indicate that, for all 4 participants, the demands selected least often evoked higher rates of destructive behavior than more frequently selected demands. We identified an escape function for all 4 participants in the escape-least selected (LS) condition (true positive finding) and for only 1 participant in the escape-most selected (MS) condition (false negative finding for 3 of 4 participants). These results support the utility of empirically deriving stimuli for inclusion in the negative reinforcement test condition of an FA to decrease the likelihood of false negative findings.