Date Approved


Embargo Period


Document Type


Degree Name

Doctor of Philosophy (Ph.D.)




College of Science & Mathematics


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.


Severe behavior, autism, behavioral function, hospital


Autistic people; Hospital care; Health behavior


Psychology | Social and Behavioral Sciences


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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