A review of the literature on social work and alternative living environments indicates that youth in foster care are twice as likely to run away from living situations as those of the same age in the general population (Sedlak, Finkelhor, Hammer, & Schultz, 2002). A 2004 multi-state study found that 46% of 17-year-olds in foster care had runaway at least once (Courtney, Terao, & Bost, 2004). Relatedly, studies from Illinois and Los Angeles show that 33–36% of youth in foster care run away more than once (Courtney et al., 2004; Pergamit & Ernst, 2011). For these individuals the behavior of concern is primarily the incidence of running away. Runaway behavior of youth in foster care is associated with high levels of placement disruptions, low educational achievement, exposure to alcohol and drugs, criminal activity, and difficulties in school adjustment and performance (Biehal & Wade, 1999; Courtney et al., 2005; Hyde, 2005). Only a few studies have reported interventions specific to decreasing runaway behavior of youth in foster care (Slesnick, 2001; Slesnick & Prestopnik, 2004; Thompson, Pollio, Constantine, Reid, & Nebbitt, 2002). These studies have developed general intervention approaches to apply to all youth without individualizing the intervention approach to match the unique circumstances related to an individual youth’s behavior. Unfortunately, limited success has been reported specific to youth in foster care related to runaway behavior. To date, Clark et al. (2008) is the only known study to evaluate an individualized functional assessment and intervention process for decreasing runaway behavior of youth in foster care. Consequently, there is a crucial need to extend this research to effectively address this problem behavior through the use of individualized behavior support plans that are developed to reduce runaway incidents. But, in order to have successful behavior support plans, it is necessary to complete the functional behavior assessment (FBA) process to determine the function of runaway behavior.

The FBA process is the corner stone of creating and generating interventions based on the philosophy and principles of applied behavior analysis (Horner, 1994; Iwata, Dorsey, Slifer, Bauman, & Richman, 1994; Repp & Horner, 1999). This process reflects a systematic approach for gathering descriptive information from multiple sources in an effort to determine the function, or purpose, of an individual’s challenging or complex behavior that may interfere with daily routines and quality of life (Sugai, Horner, & Sprague, 1999). The data collected from the FBA assists in the ability to identify when, where, and with whom the problem behavior is occurring, as well as documenting when the problem behavior is absent. The information accumulated culminates in the development of hypothesis statements regarding the function or purpose of behavior. These “best guesses” are generated to guide the development of related intervention strategies directly linked to behavior function (Sugai, Lewis-Palmer, & Hagan-Burke, 2000).

Because challenging behavior is complex, and associated with a broad range of stimulus variables, obtaining and summarizing the information used to develop hypotheses is sometimes a complicated process. One of the more established methods used to collect information for hypothesis development is interviewing. Interviews may be conducted with the target individual, as well as those that know him or her best. The Functional Assessment Interview (FAI; O’Neill et al., 1997) is one example of a structured interview designed to gather information about a behavior and the circumstances under which it does and does not occur. The interview consists of 11 sections that help caregivers/teachers describe the behavior, identify antecedents and consequences, and identify medical conditions. The interview also queries about an individual’s communication skills, successful and unsuccessful teaching strategies and activities, effective reinforcers, interventions previously attempted, and the interviewee’s general perceptions about possible function(s) of behavior.

Over time researchers in the field of applied behavior analysis (ABA) have expanded the content of FBA interviews to reflect particular participants or settings that are targeted for behavioral supports. Applied investigators have contributed to the evolution of the FBA process by developing specialized interviews that gather information directly from particular target individuals, in an effort to gain additional idiosyncratic information on perspectives and opinions regarding problem behavior. The Student Assisted Functional Assessment Interview developed by Kern, Dunlap, Clarke, and Childs (1994) is a useful example of how the target individual, in this case school students who displayed problem behavior, were interviewed to obtain their perceptions about problem behavior in relation to academic activities, as well as asking questions about what students viewed as the circumstances and events that may lead to increases in displayed levels of problem behavior. The target student is also asked open-ended questions that pertain to their individual strengths, interests, and preferences. The outcomes of the information gathered on this interview may then be used in conjunction with other information obtained to assist in the development of hypotheses regarding the function of specific problem behavior.

Reed, Thomas, Sprague, and Horner (1997) expanded the Kern et al. (1994) interview for students and added a separate teacher interview to ascertain the opinion of the educator directly involved with the target school student. Following the completion of student and teacher interviews, the authors investigated and analyzed the agreement between students and teacher responses. Results showed high agreement on the causes and functions of problem behavior with mixed agreement on support plan recommendations. Another information gathering instrument that has been used within the FBA process is the Open Ended Functional Assessment Interview (Hanley, 2012). This interview expanded on the FAI by O’Neill et al. (1997) by introducing all open-ended questions, as opposed to semi-structured yes/no types of questions. The information gleaned from these questions assisted with information gathering as well as formally identifying the conditions for the completion of an analogue functional analysis.

Although these enhanced FBA interviews were geared toward children and adolescents in school and traditional home settings, there is a gap regarding FBA interview tools developed and targeted for other circumstances and living situations youth may be experiencing. Specifically, resources reflected in the functional behavior assessment literature do not address the unique variables associated with alternative living environments and the specific behaviors that may be associated within these types of settings. In a study conducted by Crosland, Joseph, Slattery, Hodges, and Dunlap (2018), a need was identified for determining how to gather information from those involved in foster care in order to gather their perspectives as part of the FBA process regarding the reasons why youth runaway and elope from foster care placements. In an effort to document the functions of running away behavior by youth in foster care, a qualitative investigation involving focus groups was conducted to obtain information as part of the FBA process from foster care personnel in the field. Focus groups involving foster care workers, educational personnel, and youth themselves, were completed to gather information about why running away behavior occurs.

Based on the results and outcomes gleaned from the focus groups, the motivation or function of running behavior was found to fit within two major themes or categories: (1) running “to” something (friends, activities); and/or (2) running “away” from something (aversive placements, etc.). The feedback provided by the foster care personnel was found to be helpful for completing the FBA process in targeting running away behavior, but limited in scope, in that the functions identified were not reflective of the behavior of an individual child or adolescent. In addition, because the opinions of the target child or adolescent were not included, there were limitations to the accuracy of the hypothesis statement about the function of running away behavior, and consequently the effectiveness of the individual intervention strategies developed for reducing specific problem behavior.

Outcomes of the qualitative study completed by Crosland et al. (2018) led to the next steps of developing an idiosyncratic FBA interview specifically targeting the function of running away behavior by youth in alternative living settings. The Functional Assessment Interview for Runaways (FAIR) (See Appendix 1) is a unique assessment tool developed particularly for children and youth who are involved in the foster care system with one or more documented incidents of running away from formal placement settings. The interview tool was developed as part of a federally funded research project through the U.S. Department of Education’s Institute of Education Sciences (Titled: Development of an intervention Model to improve Educational Outcomes of Youth in Foster Care by Decreasing Runaway Behavior, Grant # R324A110180) that focused on addressing runaway behavior of youth in the foster care system. This assessment tool incorporates feedback from multiple focus groups and structured interviews with foster care personnel (supervisors, managers, direct care staff), social workers, behavior analysts, school personnel, and youth. Recommendations from expert consultants with extensive experience in clinical settings were also utilized to make revisions to the FAIR tool. The FAIR consists of a systematic questionnaire for which foster care case workers and other professionals who work with youth assigned to alternative environments can be used to obtain youth perceptions and perspectives regarding the reason(s) why they are running away. The questions developed reflect different categories of the youth’s own living situation. Sections of the interview include questions pertaining to the youth’s current health status, preferences, reasons for running, current placement perspectives, family and social supports, their current and/or previous school setting, normalcy, and activities. The information gathered from the young person provides information not only related to the function of the problem behavior (running away from assigned home placement or facility), but also allows for the development of assessment based intervention strategies linked to the youth’s motivation for running away. The ultimate goal of the assessment process was to determine not only how to reduce the rate of running away and the resulting consequences of that behavior, but more importantly to stabilize youth in foster care in settings that they view as more preferable or with arrangements that make their placements more livable and academic experiences more successful. Given the variety of individuals that might potentially use the tool, the introduction and questions are scripted in laymen’s terms to ensure that essential information from the interview is obtained. Individuals with expertise in interviewing skills may slightly alter how they present the questions and could certainly ask additional questions to further delineate the function of the runaway behavior.

The goals of the FAIR include obtaining additional perspectives from youth to assist in the development of an effective and feasible intervention. The FAIR provides the opportunity to identify the functions that the runaway behavior serves for the youth, this includes the different factors that seem to be contributing to running behavior (e.g., running to be with family and friends, running away from or escaping strict group home rules, and escaping from other peers living in the group home). The knowledge gained from this unique interview may help child welfare personnel to gain a greater understanding of the youth’s interests and needs that evolve from the interview. The outcome information gleaned from the FAIR can aid in determining what interventions might assist in (a) reducing runaway behavior, (b) stabilizing youth’s placement, (c) improving school attendance and progress, and (d) maximizing the youth’s well- being. Interventions must be primarily related to the youth’s specific run functions. However, supplementary support interventions that build on the strengths and resources available to youth may also be identified during the interview and help provide a more comprehensive service support system for youth. Additionally, this interview may not always be a one-time event, but a series of conversations that occur to gather information from the youth and follow up on information the interviewer has learned, including identification of solutions that might reduce subsequent runaway behaviors of the youth.

Administration and Interpretation

Delivery of FAIR Interview

The FAIR interview (Appendix 1) is intended for administration by licensed social workers, behavior analysts, case managers, house managers, or other individuals that may be supporting the youth (e.g., teacher). The process should be conversational and conducted in a non- threatening, neutral, and youth friendly location, to encourage the youth to be relaxed and comfortable with speaking freely. It is recommended that the interview be conducted when the youth is calm, rested, and can focus on the interview, as this will increase the likelihood of obtaining meaningful information and having the youth actively engage in identifying strategies for addressing his/her interests and needs. Ultimately, the FAIR will allow the interviewer to identify those antecedents evoking the behavior and the consequences maintaining the runaway behavior.

Preparation

The FAIR interviewer should prepare for the interview by securing as much information as possible regarding the youth, run patterns, family and natural supports, current activities related to placement, school and other connections. When contacting the youth to arrange the interview, the interviewer should emphasize the possible benefits to the youth and determine a mutually agreed upon time to complete the interview process.

Conducting

The FAIR interviewer should meet with the youth during the agreed upon time and when the youth is calm. A major goal of the interview process is to allow the youth to feel as if they can share their point of view without being judged by the interviewer. This goal is obtained by utilizing open-ended questions and avoiding challenging statements (e.g., “This place is great. Why wouldn’t you like it here?”). Throughout, the interviewer should allow the youth to speak without interrupting. In addition, the interviewer should summarize frequently and make note of information as to not repeat questions the youth may inadvertently have already answered. At the end of the interview the youth will be asked to rate each item that they indicated was a reason for running away. This is accomplished by asking the youth to rate on a Likert type scale from one to five the priority level for each reason identified in the assessment. This provides the interviewer with important information about the potential value of reinforcers the youth is accessing and what to target first during intervention.

Initial Plan

The interviewer should develop an initial plan for youth to last 2–3 days after information is gathered from the FAIR. This might consist of determining the next steps for working toward function based changes and follow-up, basic behavioral contracts, and/or what the youth could expect moving forward. This is an opportunity to demonstrate to the youth the interviewer is committed to finding ways to stabilize placement and is willing to acknowledge and incorporate youth preferences and concerns, and help the youth with addressing the function of runaway behavior.

Developing Behavior Support Plans

Based on the high priorities and function determined from the interview, the interviewer should work with the youth and the placement to develop a plan that meets the function maintaining the youth’s running behavior. The goal here is for the youth to access reinforcers that meet the function by engaging in appropriate behavior instead of inappropriate behavior. For example, if the results from the FAIR indicated that a youth was running away to be with her biological (but previously abusive) mother, perhaps more frequent supervised visits could be scheduled. This intervention could only be selected based on the outcome of the FAIR as another youth might actually find increased visits to be highly aversive. Similarly, if more visits could not be feasibly arranged or direct contact with the parent is not safe, the youth might be allowed access to an alternative form of contact such as increased phone calls or “FaceTime” with the biological parent. Other modifications might be warranted based on the results of the FAIR including allowing youth choices such as what they pack for lunch or what chore they complete. Solutions might also involve modifying policies that exist in many group settings to improve normalcy. A youth may be running away to access friends and activities. Allowing youth the ability to hang out with friends at the mall or movies if they use a sign out log and return by curfew could be helpful in decreasing running for this reason. In some cases more intense services may be needed to help build supportive networks and decrease more challenging behaviors associated with substance abuse and/or mental health diagnoses (Clark et al., 2008).

In the next section, a case study is shared to demonstrate the application and completion of the FAIR and the accompanying Action Plan Intervention. The authors are currently working on a detailed intervention guide that can be used in collaboration with the FAIR as a helpful tool for determining interventions that are function-based, feasible in youth settings, and acceptable to youth.

Anthony’s Case Example

Preparing for the Interview

Before meeting with Anthony, the caseworker, Natasha, obtained basic demographic information such as his full name, age, gender, type of placement he was currently residing in, length of stay, and history of previous runs. Anthony was a 16-year- old male assigned to a therapeutic residential facility. He had been at his current placement for two weeks and had a history of running from his previous placements, resulting in placement disruptions every three months on average. In the previous year, Anthony had resided at five different residential facilities and was in a locked facility on two different occasions. At the time of the interview he was residing in a group facility that had four cottages, one for teen girls, one for teen boys, and two for younger children.

FAIR Sections

Interview Introductions

Natasha welcomed Anthony to the interview room and explained how his interview would be structured, and described the different types of questions (i.e., health, school) that he would be asked. She ended the explanation of the interview by allowing Anthony to determine whether he wished to continue with the interview or preferred to meet at another time. Anthony elected to continue with the interview.

Health

Natasha inquired about his current health status. She asked him whether he needed to see a doctor and how his general health was during the present time. Anthony reported he was in good health and did not need to see a doctor.

Run Experience

Natasha started the interview by talking to Anthony about what he liked most while on his runs. He reported he enjoyed getting to make money while on the run and getting to spend time with his girlfriend (access to social positive reinforcement). Anthony also reported he believed these factors were a big reason for why he ran away from his previous placements. When Natasha asked about what aspects Anthony did not like about being on the run, he initially stopped talking and started to cross his arms and turn away. Natasha explained to Anthony that if he did not feel comfortable talking about what he disliked that they could change the topic to events leading up to him deciding to run. At this time, she transitioned to ask Anthony whether there were any uncomfortable events that occurred right before he decided to run. Her goal was to identify triggers that might upset him and increase the likelihood of him running. He reported that he was tired of staff being rude to him so he left the placement to have some fun and make some money.

Placement

When Natasha asked Anthony to describe things at his placement that he liked or disliked, he immediately stated he disliked how the staff wanted him to be in the cottage by 8 p.m. every night. He reported he enjoyed the weekend activities when he was able to do activities with staff and had the opportunity to hang out with the girls at the other cottages. He also said he enjoyed playing video games but was often not allowed to play them at the cottage because they were restricted when he “got in trouble” or other kids were playing them. Anthony stated he did not always run because of the rules but sometimes it was because he did not like the way staff talked to him. Both of these reasons suggested a function of negative reinforcement (escape from aversive situations). He reported sometimes he felt the staff would talk to him as if he was a little child resulting in him deciding to run from the placement.

Family

Anthony reported he had not seen his parents since he was around 6 years of age and his girlfriend was the closest person to him. He stated he would always run to see her because she was the only person in his life who cared about him and loved him. This response suggested Anthony might be running to obtain positive reinforcement by spending quality time with his girlfriend.

Friends

Natasha asked Anthony to tell her about his friends. He reported he did not really have close friends but would consider the people he makes money for while on the run to be close friends. He then stated that sometimes the people pressure him to do things he does not feel comfortable doing which makes it more difficult to be on the run (the interviewer did not directly question Anthony about this activity but surmised that he might be engaged in illegal activity such as selling drugs). Anthony stated he did not run to see friends but only to make money (positive reinforcement). He did not wish to elaborate on the things his friends made him do that led to feelings of discomfort.

Other Connections

Anthony reported to Natasha he used to be really close to his guidance counselor at his old school. He stated that because he had moved to many different placements in a short amount of time, he was not able to stay in contact with her, but wished he could see her again. When asked whether this was a reason why he runs, he stated that it was not but he truly missed seeing her.

School

He also reported he enjoyed his art classes at school because he wanted to become a tattoo artist. When asked about other classes, he reported he spent most of his time attending an Emotional-Behavior class working on computers. He reported he was on grade level for history and english, but behind in math and science. His wish was to be able to attend history and english with his general education peers. Overall, Anthony reported he did not like attending school because he felt he was too far behind his peers in math and science to catch up and graduate. Though he also reported that he liked to be at school because he had access to computers where he could participate in gaming activities. He stated he did not run because of school related variables but wished he could go back and see his old guidance counselor.

Behavior Support Action Plan

Ratings

Based on the interview it was determined that Anthony ran away from his placement for two main reasons (a) to access money and his girlfriend (positive reinforcement) and (b) escape from the rules and staff at the group home (negative reinforcement). The interviewer then asked Anthony to rate how important each of these two reasons for running were to him. Anthony rated making money and seeing his girlfriend as a high priority and the main reasons for him running from his placement. He reported the negative things about his placement, the rules and staff, as a lower priority even though he does run to escape these on occasion. Because he was not running to see his friends, family, or other connections he stated these were not factors of running. Anthony reported two things he would like to change to reduce the likelihood he would run again. The first was the ability to see his girlfriend on a regular schedule. His second was a legal way to make money so he did not have to be in uncomfortable situations in the future when trying to make money.

Initial Plan for Stabilization

The initial plan agreed upon by Natasha and Anthony included a basic behavior contract that outlined expectations for Anthony to stay at his placement. Given Anthony’s interest in video games this was used as a potential reinforcer in his initial support plan behavior contract while Natasha worked on how Anthony might be able to access money and his girlfriend in appropriate ways. Based on the average frequency of his running, Natasha set an initial individualized goal that Anthony would stay at his current placement for two (2) days to earn the ability to rent video games. In addition, he could select a peer of his choice at the group home to play a video game with, as long as he stayed within facility boundaries. Both parties agreed this plan would be active while Natasha worked to set-up a meeting with his case manager to discuss contingencies that could be developed to allow Anthony to see his girlfriend more often. Natasha reported she would follow-up in two days with an initial update. Because Anthony also expressed a desire to obtain a job, Natasha set a second goal of linking Anthony with a company that helped teens prepare, interview, and obtain jobs. She informed Anthony she would update him at their next meeting about his initial appointment with the company and described how they would help him find a job in one of his interest areas (e.g., arts stores, computer/gaming stores).

Action Plan and Interventions

After the interview was completed and the initial plan was set, Natasha evaluated the information obtained during the interview to ensure function-based interventions could be developed to support long-term stability of Anthony’s placement (i.e., prevent runs). As described earlier, she derived that Anthony was mainly running from his placement to access his girlfriend and earn money. To build on the initial plan for following up with Anthony, Natasha developed a strategy to work with the group home and case manager to establish rules. Natasha and the case manager first developed non- negotiable rules for Anthony to see his girlfriend (e.g., he must attend school) and areas where Anthony could negotiate (e.g., frequency of visits). There was a behavioral contract developed that outlined the two expectations. First, Anthony must remain at his placement for two consecutive days at a time to earn transportation to and from visits with his girlfriend. Secondly, actions were made to continue working with the local employment agency to help Anthony find gainful employment. With the help of the agency, Anthony started applying to jobs at local retail businesses that were of interest to him. Approximately two weeks later Anthony interviewed at a nearby computer store that subsequently hired him and he started working part-time in the evening after school.

Additional Supports

Though Anthony did not report experiences at his placement as the highest priority for running away, the team evaluated the importance of Anthony learning to appropriately communicate his wants and express his needs during situations when he felt he was being criticized. With Anthony’s agreement, Natasha linked him with an adult mentor to focus on social skills development and building relationships. Through this process Anthony could learn to express his wants and needs appropriately during aversive situations. Also, the group home was willing to adjust the curfew to be later on the weekends which pleased Anthony. With regard to school, Natasha contacted Anthony’s guidance counselor from his old school to see if she was available to meet with him. A meeting was arranged with Anthony, his old guidance counselor, his current guidance counselor, and Natasha, so the four could brainstorm how best to support Anthony at school. This led to additional classroom supports and Anthony began attending two classes in the general education setting with the hope that he could eventually be enrolled in all general education classes for the next school year. He also began attending extra tutoring sessions after school to help catch up in several classes. Over the course of the six months since the initial interview, Anthony remained at the same group facility and did not engage in any runaway behavior.

Discussion and Conclusion

Decades of research in applied behavior analysis have demonstrated the importance of linking the function of behavior to specific interventions. The FBA process is a valid evidence-based approach for establishing hypotheses for the function of behavior and building effective intervention plans. Due to the complexity and risk associated with runaway behavior, it is important to systematically evaluate the variables that maintain behavior function in alternative environments. In addition, clinicians should utilize the information from the evaluation to develop a function-based intervention plan grounded in the science of ABA. This article describes the FAIR tool which is an FBA questionnaire developed specifically to target youth in alternative living situations who display runaway behavior. In addition to providing a description and rationale of the FAIR procedures and instructions for conducting the FAIR assessment, a corresponding case example of how to complete the questionnaire and link the findings to function based interventions is presented. Further research should examine the efficacy and feasibility of implementing interventions linked to the results from the FAIR assessment. Short- and long-term outcomes for youth should be evaluated for not only reductions in runaway behavior but also improvements in placement stability, education, employment, and mental well-being.