Date Approved

5-6-2024

Embargo Period

5-6-2024

Document Type

Dissertation

Degree Name

Doctor of Philosophy (Ph.D.)

Department

Psychology

College

College of Science & Mathematics

Advisor

Christina A. Simmons, Ph.D.

Committee Member 1

Katherine O. Gotham, Ph.D.

Committee Member 2

Jonathan M. Campbell, Ph.D.

Committee Member 3

Wendy F. Aita, Ph.D.

Keywords

Severe behavior, autism, behavioral function, hospital

Subject(s)

Autistic people; Hospital care; Health behavior

Disciplines

Psychology | Social and Behavioral Sciences

Abstract

Hospital patients with autism spectrum disorder (ASD) may engage in various topographies of severe behavior, with higher rates of restraint implemented than for their neurotypical counterparts. Qualitative research suggests that physician knowledge of function-based intervention is limited. Multidisciplinary behavior management teams were developed to decrease restraint across general hospital patients. In Study 1, the research team developed the Knowledge of Behavioral Function (KoBF) survey measure, using an iterative user-centered development process and administered the measure to multidisciplinary physicians and trainees. Results indicated low knowledge of behavioral function, with a mean percent correct of 66.60% on close-ended survey items and 14% correct on open-ended vignette items. Years of experience and discipline were each not significantly associated with knowledge of behavioral function. Despite low function-based knowledge, 91.10% of participants demonstrated adequate knowledge of autism and these scores were not significantly correlated. In Study 2, focus group discussions with behavioral management team members highlighted differences in team purposes, procedures, and training across hospitals. Although participants still described using restraint, they considered alternative strategies to restraint and indicated areas for future training and team improvements. Study findings may inform development of ASD-focused, function-based training to improve hospital standard of care for autistic patients. Keywords: Severe behavior, autism, behavioral function, hospital

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