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Results

#1. During an initial record review, a BCBA notes that a client historically engaged in head-hitting, which was determined to be associated with migraines. Recently, the client, who is currently with an RBT, has started to slap their head. Given the client’s medical history and the emergence of this new, topographically similar behavior, what is the first and most critical action the BCBA should take?

Immediately conduct a functional analysis on the head-slapping behavior to determine its function.

Consult with the previous BCBA on the case to gather more detailed information about the client’s past SIB and migraines.

Refer the client for a medical evaluation to rule out or address potential physiological causes for the new head-slapping.

Implement a differential reinforcement of other behavior (DRO) procedure to reduce the head-slapping.

When a client exhibits a challenging behavior especially selfinjurious behavior SIB and there is a known or suspected medical history that could be related like migraines in this case the first and most critical step is to rule out or address any potential medical or physiological causes Behavior analysts have an ethical responsibility to prioritize client welfare and should always recommend a medical consultation when theres a possibility that behavior is influenced by medical factors Conducting a functional analysis or implementing an intervention like DRO would be premature and potentially unethical if the behavior is primarily driven by pain or a medical condition While consulting with a previous BCBA can provide valuable historical context it does not substitute for a current medical evaluation when a new potentially medicallyrelated behavior emerges

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