Functional Outcomes

In context of any type of therapy, functional outcomes must be Measurable, Behavioral, Observable and Repeatable. For the purpose of our discussion I’ll define functional as: being able to complete a personally practical, purposeful task or behavior.

Just writing a good measurable behavioral objective is a difficult task for many therapists; however, good measurable behavioral objectives should never be your final goal. Outcomes should be functional, while it may take numerous steps to reach that goal, it should be the end you have in mind and even incrementally you should get there as soon as possible.

A very simple example of a functional outcome would be: "When Joey comes home from school he will make him self a peanut butter and jelly sandwich". This would be an example where Joey has basically mastered this skill and has a need for a snack on arrival home from school. Something better for an emerging skill would be: "When Joey arrives home from school, after removing his coat and back pack and within 10 minutes of entering the house, he will go to the kitchen and remove the bread from the bread basket, 4 out of 5 times for 5 consequtive weeks".

When you think about functional objectives, ask the question, what would a person, or a child in this family, typically do if there wasn’t a disability involved?

For example, a child who lives on a farm may typically have chores out on the farm. Perhaps for an older child this may mean something as simple as some kind of assistive accommodation. Some people might think, well this kid just doesn’t need to be going out around the animals, but today, there is a strong belief (and frankly for many, they have had this strong belief for a very long time) that kids and people in general need to be able to participate in life as fully as possible. This is really what functional outcomes are all about, not just on the farm but in the home and school and wherever a typical child might be found. For the same child on the farm at a younger age, perhaps the outcome would have the child in a little wagon, scooping food from a bucket into the feeder. This sort of outcome provides all kinds of therapeutic opportunities, communicating with mom or dad or an older sibling who are pulling the wagon, working on both fine and possibly gross motor therapeutic needs, building self-efficacy (see letter e.) and subsequently self-esteem and being a part of regular life.
Two things you need to remember about a functional objective. It will almost always be in the natural environment for the child, or adult, and it still must be measurable and behavioral.

For additional information on Natural Learning Environment Practices click here.

Functional Behavioral Assessments or What’s causing the short?

Many years ago, early in my marriage, my wife and I owned a Ford Escort. It was a good car for our very young family. After about a year, we started having electrical problems. We took it back to the shop over and over again. A number of different things were replaced but the problem kept recurring. One day, someone discovered that we kept a spare key in the ash tray. That key was causing the short. As soon as we stopped keeping the spare key in the ash tray, the problem stopped, no more shorts.
Sometimes behavior problems are really that simple, sometimes they are not; however, diagnostics, until you find the problem, are essential. The more experienced I become, the more I believe that good upfront and ongoing assessments, to include functional behavioral assessments are absolutely essential. It is better to spend the time and resources finding the problem and the right solution than to skip this step and spend thousands and tens of thousands of dollars address the wrong problem or using the wrong solution (which of course, is usually not a solution at all).  (A Functional Behavioral Assessment is also called a Functional Analysis of Behavior.)




Additional Resources:
Functional Behavior Assessment (FBA) and Behavior Intervention Plans (BIP)
Functional Behavioral Assessment Generator
Example of a Functional Analysis Assessment Report
FUNCTIONAL ANALYSIS OF PROBLEM BEHAVIOR: A REVIEW
Teaching Children with Autism: Functional Behavior Analysis
Free tools for Functional Behavioral Assessments, as well as other therapy tools.
Functional Behavioral Assessment
multimodal functional behavioral assessment
Functional Behavioral Assessment
An IEP Team's Introduction To Functional Behavioral Assessment And Behavior Intervention Plans (2nd edition)
Functional Behavioral Assessments: What, Why, When, Where, and Who?
Functional Behavioral Assessment