Running head: CONSULTATION SUMMARY REPORT: PRAC 1

Consultation Summary Report: Practicum Case

Rachel Epstein

Rider University
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Consultation Report

Name of Client: M.J.

Age: 2.75

Date of Birth: ​1/28/2018

Dates of Evaluation:​ 10/18/2020, 11/8/2020, 12/1/2020

Examiner:​ Rachel Epstein

Consultee: ​Rita Jacquinto

Problem Identification

Behavioral Definition

Ms. Jacquinto has sought consultation for a behavioral issue with one of her students.

The student, M.J., is a 2.75 year old male child with autism. M.J. attends an early intervention

preschool program where he works with teachers and a speech language pathologist to build

play, language, and engagement skills. According to the consultee, who is the speech language

pathologist, he has about 30 spoken words.

The behavior we consulted on was M.J. running away during his 30 minute lesson with

the speech language pathologist. This looked like M.J. walking or running away from his play

area or activity during the lesson when he begins to lose interest or becomes frustrated in the

activity. This typically occurs during the final 20 minutes of the lesson and rarely occurs during

the first 10 minutes. At times he will also cry or yell when he runs away, especially if he has

become frustrated. Examples of this behavior were recorded when the client was presented with

an activity or materials from the therapist and the child walked or ran away without engaging.

This behavior was also recorded if the child was engaging with an activity and then became

frustrated, such as when presented with a different shaped block, and ran away from the activity
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upset. If the client ran away from the activity presented to him by the therapist but moved on

quickly to a new material of his choice and engaged with that, this was considered a

non-example of behavior and was not recorded.

Baseline Data

This graph represents M.J. 's instances of running away during a 30 minute lesson with

the consultee, Ms. Jacquinto. It is a frequency count for each of the six days that baseline data

was collected. Baseline data was collected in each of the lessons that the consultee had with the

child over a three week period. The lowest frequency that the child ran away during the lesson

period was three times. The highest frequency that the child ran away during the lesson period

was five times. The average frequency that the child ran away during the lesson period was 4.2

times over the course of baseline collection. The trend line is flat which indicates that the
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frequency of the problem was stable, not increasing or decreasing during the baseline collection

period. Visually the trend line is flat and stable with low variability over the six days.

Problem Validation

Based on the baseline data the consultee determined that the behavior is occurring at a

higher frequency than she had expected. The level of the behavior is not in line with her

behavioral expectations for M.J. The expectation is that M.J. will run away from the teacher or

therapist fewer times during a 30 minute lesson and spend more time engaged with his teachers

and play materials. Other students in similar situations to M.J. are spending more time engaged

in the lesson and are escaping tasks at a lower frequency.

Problem Analysis

The client has been engaging in this behavior since starting the program with the therapist

in September of 2019. According to the therapist and parents, he also exhibited this behavior

while enrolled in a virtual program from home during the COVID-19 school closure. Based on

the history of the behavior problem, the consultee was determined to collaborate to design an

intervention to decrease the frequency of the behavior. On average, the student ran away from

the lesson 4.2 times over the course of six days of baseline data collection. The consultee felt

that this was a higher frequency of behavior than expected. The consultee’s expectation is that

the client would run away from the lesson fewer times in order to have more opportunities for

quality engagement with the therapist and the lesson materials. She would like to see a

reduction in the frequency of the child running away during the lesson.

During our interviews the consultee provided information on the antecedents,

consequences, environmental, and sequential conditions that impact the behavior. The

antecedents, or events that occur directly before the behavior takes place, were the client losing
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interest in the activity or being presented with an unexpected change and becoming frustrated

with the materials he is interacting with. He will get angry and run away from the activity and

therapist. The consequence, or events that occur directly after the behavior, was the therapist let

him go and ignored the behavior. The typical sequential conditions were the student would

throw himself on the floor and cry if he was upset or angry. He would usually look to the

therapist and try to make eye contact with her after running away, which the therapist would

reciprocate. The therapist would not attempt to physically bring him back to the activity as he

would resist too much and risk getting hurt. She would wait until he calmed down, sometimes

using calming strategies, and then engage with him in a new activity when he was ready, usually

a few minutes later. The function of the client’s behavior was hypothesized to be task avoidance

and attention considering he is escaping the activities he is engaging in and also seeking eye

contact and attention from the therapist after he has run away.

Competing Pathways Chart

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Plan Implementation

Goal Setting

Timeframe Three weeks

Behavior M.J. running away from teacher and activities during 30 minute lesson

Conditions M.J. will engage in a planned movement break midway through the
lesson and reduce the frequency of running away during the lesson time

Criterion Goal Reduce frequency of running away by 15% (Mean of 4.2 instances to 3.5
instances)

Throughout the three weeks of intervention implementation the target problem behavior

to reduce was the frequency of M.J. running away during his lesson with the therapist. A short

term goal set was to reduce the frequency of running away by 15%, or to a mean of 3.5 instances

per lesson over the course of intervention implementation. This was to be achieved by the

therapist providing a planned movement break midway through each lesson where M.J. can run

or walk down the hallway, dance, listen to music and engage in a full body movement activity.

Intervention Plan

The hypothesized functions of this behavior is task escape and attention. The behavior

occurs when the child loses interest or becomes frustrated while doing an activity during his 30

minute lesson with the speech language pathologist. The student walks or runs away from the

activity and the therapist. Immediately after, the teacher will let him go. The child will often

make eye contact with the teacher after he has run away. If he is particularly upset, he will throw

himself on the ground and cry. He will resist if the teacher physically attempts to bring him

back, so they do not do that. Sometime after, he will find a new activity to engage in and the

teacher will join him. To match the escape function of this behavior, we implemented a planned

2-3 minute break halfway through the lesson. The consultee noted that the child typically began
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running away from activities sometime after the first ten minutes of the lesson. The consultee

felt that a break midway through the lesson would be appropriate. This break included a full

body movement activity such as dancing to music or running down the hallway. During the

Problem Identification Interview on 10/18/2020, the consultee noted that the student enjoyed

activities that included music and also loved movement activities, therefore it was hypothesized

that these activities would be reinforcing to the child. This intervention met the student’s

behavior function by building task escape and movement into the lesson, which was proposed to

reduce the child’s frequency of escaping the lessons on his own. The therapist engaged with him

during this break which provided attention to the student, also matching the function of the

behavior.

Measurement Strategy

The consultee continued to collect frequency data on the target behavior in the same way

that was done for baseline collection. The consultee recorded the number of times the client ran

away during lesson period on her clipboard and sent the data to the consultant after six days of

collection. The consultee began collecting intervention data on Wednesday, November 11th.

Evaluation

Treatment Integrity

To measure treatment integrity the consultee was asked to complete a daily treatment

integrity checklist which detailed the components of the intervention plan implementation.

There were three steps to the intervention; providing a 2-3 minute break, involving full body

movement, and playing music for the child. The intervention was implemented over six days of

data collection, therefore there were 18 possible steps. The consultee implemented 16 out of the

18 steps as intended. On two days the child did not want music played and chose to run down
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the hallway instead, so she skipped that step. Treatment integrity was 89%, indicating the

intervention was implemented by the consultee as intended an acceptable percentage of times.

Due to the treatment integrity, the data is considered to be a valid representation of the plan’s

effectiveness.

Data Display & Evaluation

The above graph compares the baseline data to the intervention data collected by the

consultee. During baseline collection, the client ran away during the lesson an average of 4.2

times each lesson over the six days of data collection. During the intervention phase this number

decreased to an average of 3 times per lesson over the six days of intervention data collection.

The lowest amount of times the client ran away was two and the highest amount of times the

client ran away was four. The change in behavior occurred gradually over the three weeks of

intervention implementation as the child ran away 4 times on the first two days of plan

implementation. The intervention trendline is descending and noticeably different than the stable
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baseline trend line. During intervention implementation the level of behavior was reduced from

baseline and the client met and exceeded the goal that had been set during the Problem Analysis

Interview.

Positive Impact

The effect size from baseline to intervention was calculated to be 1.46. This is

considered to be a large effect size and indicates that the intervention had a substantial positive

impact on the client’s problem behavior. The implemented intervention was highly effective in

reducing the frequency of the child running away during the lesson period.

Based on the visual analysis coupled with Cohen’s d (1.46), the decision was made to

terminate the consultative relationship. Ms. Jacquinto was quite pleased with the effect of the

intervention on not only reducing the frequency of M.J. running away during their lesson, but

also the increase in his engagement that she has noticed since implementation. The consultee

decided to maintain the intervention and will continue to provide a planned movement break for

the client in the middle of the lesson where he can run, walk or dance as he pleases. The

consultee will begin to fade parts of the intervention such as playing music during the planned

break and will work on reducing the amount of time of the break. Although the formal

consultation process has ended, the consultant remains available as needed.

Rachel Epstein

School Psychology Graduate Student

12/5/2020