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A Functional Approach to Reducing Runaway Behavior and

Stabilizing Placements for Adolescents in Foster Care

Hewitt B. Clark
Kimberly A. Crosland
David Geller
Michael Cripe
Terresa Kenney
Bryon Neff
Glen Dunlap
University of South Florida, Tampa

Teenagers’ running from foster placement is a significant problem in the field of child protection. This article describes
a functional, behavior analytic approach to reducing running away through assessing the motivations for running,
involving the youth in the assessment process, and implementing interventions to enhance the reinforcing value of
placements for adolescents, thereby reducing the probability of running and associated unsafe periods. A case study
illustrates this approach and a study compares 13 adolescents who ran away frequently and received interventions with
a group of matched adolescents who had similar patterns of running but received only services as usual. The percent-
age of days on runaway status showed a significant pre-post reduction for those in the functional group, in contrast to
no statistical change in the comparison group. Potential benefits this approach may have for foster care and child pro-
tection in improving youth safety, permanence, and connections for life are discussed.

Keywords: runaway behavior; functional assessment; applied behavior analysis; behavior analytic interventions;
foster care; placement stability

Estimates on the number of youth who run away or are residential facility, running away can hold serious conse-
evicted by their caregivers each year in the United States quences for young people. They may be exposed to the
range from 575,000 to over 1.6 million (Greene, risk of abusing alcohol and drugs, criminal and sexual vic-
Ringwalt, Kelly, Iachan, & Cohen, 1995; Hammer, timization, sexually transmitted disease, arrest and incar-
Finkelhor, & Sedlak, 2002) and the number of homeless ceration, and/or prostitution (Biehal & Wade, 1999;
and/or runaway youth is increasing (Kipke, Palmer, Courtney et al., 2005; Hyde, 2005). Running away from
LaFrance, & O’Connor, 1997; Thompson, Pollio, foster care settings not only places young people in harm’s
Constantine, Reid, & Nebbitt, 2002). Whether youth are way, but also frequently jeopardizes their current place-
missing from their parents’ home, a foster home or a ment, which often leads to more restrictive placements
and an interruption in learning opportunities at school.
These types of interruptions can hinder youths’ abilities to
Authors’ Note: The authors wish to extend their appreciation to Arun Karpur
build the life skills needed for greater self-sufficiency and
for his assistance with the data analysis; Hans Soder for his assistance in to form the social support network essential for resilience
accessing, analyzing, and interpreting state datasets; Dawn Khalil for her cre- and quality of life (Choca et al., 2004; Christenson, 2002;
ative development of the case example graphic profile; and Amanda Fixsen for Clark & Crosland, in press; Iglehart, 1994).
her editorial assistance on this paper. Correspondence concerning this paper
may be addressed to Hewitt B. “Rusty” Clark, PhD, director, National Center Runaway behavior can contribute to placement insta-
on Youth Transition for Behavioral Health: System Development and Research bility, and placement changes can then contribute to the
Team, Department of Child and Family Studies, Florida Mental Health development of behavior problems in youth who previ-
Institute, University of South Florida, 13301 Bruce B. Downs Boulevard, MHC
2332, Tampa, FL 33612–3807, or via e-mail using clark@fmhi.usf.edu.
ously did not exhibit such problems (Newton, Litrownik,
& Landsverk, 2000). Two or more placement changes
Research on Social Work Practice, Vol. 18 No. 5, September 2008 429-441
DOI: 10.1177/1049731508314265
during the 1st year of out-of-home care was shown to be
© 2008 Sage Publications associated with more subsequent placement changes
429
430 RESEARCH ON SOCIAL WORK PRACTICE

(Webster, Barth, & Needell, 2000). Multiple placement Florida data, girls were more likely to run than were
changes before the age of 14 have been associated with boys. Ninety percent of runners were 12 to 18 years of
later delinquency arrests (Ryan & Testa, 2005) and sub- age, most of these being 14 years old or older. Other fac-
sequent placement instability (Webster et al., 2000). tors associated with higher likelihoods of running were
Some placement disruptions are associated with the histories of placement instability, the presence of men-
externalizing behaviors (e.g., noncompliance, fighting) tal health diagnoses or substance abuse problems, place-
of children and youth (Newton et al., 2000). However, ments in residential facilities, and prior runaway
the majority of placement changes that children and episodes. Some of the factors that were associated with
youth experience are related to features of the foster a lower likelihood of running were living with a relative
home or agency, or system/policy issues such as kinship or living in a setting with a sibling.
placement, sibling consolidations, or the use of tempo- A preliminary evaluation of children in Florida’s fos-
rary emergency shelter placements (Hartnett, Falconnier, ter care system revealed some similar risk and protective
Leathers, & Testa, 1999; Newton et al., 2000). Thus, factors associated with the likelihood of running away
placement changes can contribute to the development (Witherup, Vollmer, Van Camp, & Borrero, 2005). The
of problem behaviors and, in turn, these can contribute primary risk factors included such things as being:
to increased placement disruption and incidents of female, between 13 and 17 years of age, in temporary
running away. custody of the system (e.g., adjudicated dependent, cus-
In Florida, it was estimated on the Florida Department tody to DCF, termination of parental rights petition
of Children and Families (FL DCF) Missing Child filed), and in a group-type placement (e.g., shelter facil-
Tracking System (MCTS) that 2,398 children and youth ity, group home, residential). Some of the protective fac-
were reported missing from out-of-home placements dur- tors were being: male, under 13 years of age, Caucasian,
ing FY 2004-05, and 78% of these children and youth in a more permanent custody status (e.g., termination of
were on runaway status. Youth who ran were between 8 parental rights obtained, long-term custody to relative,
and 18 years old, with the highest incidence of running temporary custody to relative or nonrelative), and in a
occurring for the 16-, 17-, 15-, and 14-year-olds, respec- home-type placement (e.g., foster home nonrelative,
tively. Approximately 60% were female, 39% Caucasian, family shelter home nonrelative, approved relative care-
40% African American, and 14% Hispanic. Most of the giver). These researchers also examined risk factors
youth had one episode (49%) or two episodes (21%) of related to frequent placement changes, and their prelim-
running away during this 1-year period. However, 18% of inary findings suggest that being in settings with more
the youth had four or more episodes of running away dur- than four children or in settings for older youth (ages 12
ing this period. FL DCF defined the term running away to 15 years of age) were associated with a higher risk of
as “A child who has left a relative placement, nonrelative placement disruption.
placement, shelter home, foster home, residential group Based on interviews of youth who run away (Courtney
home, any other placement alternative, or their in-home et al., 2005), some adolescents reported that they were
placement without permission of the caregiver and who is “running to family” in order to: touch base with family
determined to be missing.” A criterion was also set to and friends; find a sense of safety, comfort, connection, or
define children who habitually run away as, “A child who normalcy; or to assist their mothers or siblings.
has run away three or more times” (FL DCF, 2002). The
duration of run episodes was distributed about equally Some recognize that their families of origin are neither
healthy, safe, nor even reciprocally caring environments. But
across the following distributions: 0 to 1 day (26%), 2 to many youth equated being around a biological family with
7 days (27%), 8 to 30 days (24%), and 31 to 365 days or being “normal” and their desire for a “real home” (which fos-
more (23%). ter care was not, in their minds). (Courtney et al., 2005, p. 4)
Although different studies have found different risk
factors associated with running away, some of the com-
mon factors are: history of runs, placement disruptions, A FUNCTIONAL APPROACH
use of substances, and victim of abuse (Thompson,
Zittel-Palamara, & Macao, 2004; Witherup & Lee, In recent years there have been increased efforts to
2007; Yoder, Whitbeck, & Hoyt, 2001). A large-scale extend the perspectives and methods of behavior analy-
study of children running away from out-of-home place- sis to a variety of challenges encountered in child wel-
ments in Illinois provides factors that may be predictive fare and the foster care system. While behavior analysis
of youth and situations associated with running away has been well established for some decades in develop-
from placements (Courtney et al., 2005). Similar to the mental disabilities and other areas, it has taken longer
Clark et al. / FUNCTIONAL APPROACH TO REDUCING RUNAWAY BEHAVIOR 431

for the discipline to be demonstrated in the realm of these studies were that elopement was maintained by pos-
child protection. The Behavior Analysis Services itive reinforcement (e.g., attention, edibles, toy play) and
Program (BASP) represents a major step in this direc- was successfully reduced through interventions such as dif-
tion as it brings the programmatic application of behav- ferential reinforcement of other behaviors, functional com-
ior analysis to a statewide level (Stoutimore, Williams, munication training with social praise, or differential
Neff, & Foster, 2008, this issue). reinforcement of appropriate walking with the caregiver.
A hallmark of behavior analysis is its reliance on data Although these studies examined a topographically
to make decisions regarding appropriate treatments different behavior than running away and conducted a
(Neef & Iwata, 1994), and this characteristic has direct functional analysis (i.e., attention and access to toy
become most evident within the past two decades with play were systematically controlled)—the findings of the
the advent of functional analytic and functional assess- Piazza et al. (1997) and Tarbox et al. (2003) studies hold
ment perspectives (Horner, 1994; Iwata, Dorsey, Slifer, implications for designing interventions with adolescents
Bauman, & Richman, 1994; Repp & Horner, 1999). The who engage in runaway behaviors, even though a more
functional approach of behavior analysis calls for a indirect assessment method would typically be required.
preintervention assessment of environmental conditions An indirect functional assessment would include infor-
that serve to maintain a specified behavior and then uses mation gathering via multiple methods such as focused
assessment information to devise an intervention plan interviews with caregivers, friends, family, and the youth
tailored to meet the circumstances and needs of the indi- themselves (Kern & Dunlap, 1999). The functional assess-
vidual. The term functional assessment refers to the ment process would seek information related to: (a) the
“process of gathering information that can be used to motivations for the adolescent’s running (e.g., what
maximize the effectiveness and efficiency of behavioral the youth was seeking to obtain by running, and/or what
support” (O’Neill et al., 1997, p. 3). Two of the primary the youth was attempting to avoid by leaving the foster
outcomes of a functional assessment are: (a) identifica- care placement); as well as (b) the specific circumstances
tion of the consequences that maintain the target behav- or situations that might have triggered the running
ior, which leads to inferences about the function or episode. This information would then be used to devise
outcome of the behavior for that individual, and (b) iden- an individualized, multicomponent intervention plan
tification of the antecedent conditions (events, situations) focused on reducing the youth’s motivations for running
that help predict when a target behavior is more likely to away and increasing the youth’s motivations for staying
occur and when a target behavior is less likely to occur. in a safe setting.
Few intervention studies have been conducted on run- The purpose of this article is to describe and demon-
away behavior, and the studies that have occurred have not strate the impact of behavior analytic functional assess-
utilized a functional assessment approach to tailor the ments and resulting intervention strategies to address the
intervention to the runner (D’Angelo, 1984; Slesnick, runaway behaviors of youth who met the criteria of FL
2001; Slesnick & Prestopnik, 2005; Thompson, 2002). DCF for habitually running away. The analyses were con-
For example, a study of adolescents who ran away com- ducted in the context of the BASP and are presented in two
pared those who attended at least three family counseling parts. Part I provides a case example to depict the types of
sessions to those who did not participate (Ostensen, 1981). placement and runaway histories youth experience and the
The recidivism of running showed a moderate improve- array of interventions that may be used regarding runaway
ment over a 3-month period for the youth who participated behaviors and placement instability. Part II provides the
in the counseling versus those who did not. However, a results of a pre/post analysis of runaway behaviors and
subgroup of adolescents in foster care who participated in placements of 13 youth in foster care who were referred to
the sessions did not differ from the nonparticipants. the BASP for habitually running away. A matched com-
There is literature suggesting that a runaway-like behav- parison group of children with similar rates of run behav-
ior (i.e., wandering out of a designated area without per- iors who were not served by the BASP during this period
mission) was maintained by escape/avoidance and/or were also included in the analysis to illustrate the contrast
positive reinforcement factors. Piazza et al. (1997) and to services as usual.
Tarbox, Wallace, and Williams (2003) provided analog
studies on elopement with children and adults with mental
retardation, 4 to 39 years old. Both studies provided thor- PART I: CASE EXAMPLE
ough functional analyses of elopement that was defined as
movement away from the caregiver and/or into the next A case example is presented to provide the reader
room, without permission. The general conclusions from with a sense of the types of placement and runaway
432 RESEARCH ON SOCIAL WORK PRACTICE

Figure 1: Katrina’s Placement and Run History From Her Entry into the Foster Care System at About 14 Years 9 Months Old to
Her First Run at About 14 Years 11 Months, Through to The Behavioral Analysis Services Program Intervention Starting at About
17 Years 5 Months (Vertical Broken Line) and Ending With Her Independent Living Experience Shown Through to Her Age of About
19 Years 6 Months.

trajectories of some youth in the foster care system, and of days and was then placed in a new foster home where
to illustrate the types of functional assessments and she stayed for almost 2 months. After this period she ran
interventions used to address runaway behavior. The away for a day and then returned to the foster home for
case example is that of a Hispanic female who was another 18 days, at which time she was transferred to the
placed in the Florida foster care system a few months group shelter again. She immediately ran for a 10-day
prior to her 15th birthday. This girl was the first youth period, returned to the original shelter for a day, ran for
with whom the functional approach described in this another day and was placed at another foster home from
article was used on runaway behaviors by the BASP. The which she ran for another 10-day period. Upon her
data for this case example were obtained from the behav- return, she was placed in the shelter facility where she
ior analyst’s case records as well as two of the FL DCF stayed for 3 months, at which time she was sent to
databases (MCTS and Florida’s Integrated Child Welfare another foster home. Fifteen days later, she was placed
Services Information System [ICWSIS] database). in a third group shelter facility for 16 days, then placed
in another foster home where she remained for over 4.5
Katrina’s Story months. Katrina then returned to the second emergency
group shelter facility where she remained for approxi-
Katrina (a pseudonym) was removed from her home mately 4 months. On Figure 1, the data points between
at the age of 14 years 9 months due to confirmed phys- approximately 560 to 710 days depict her placement of
ical and sexual abuse. Figure 1 depicts the placement roughly 5 months in foster care—which involved sev-
and runaway pattern from Katrina’s first out-of-home eral brief placements in different foster homes—ranging
placement through to her achieving independent living from 6 days to 121 days, followed by a fourth foster
at age 18 years 4 months, where she remained at the home placement. At the age of 16.5 years, Katrina began
time of the writing of this article. However, her road to a series of short and extended periods of running (one
independent living was a very rocky one, as is illustrated for over a month and another for over 2.5 months), with
in Figure 1. The vertical axis lists the types of settings brief returns to the foster home or shelter facility. She
she experienced and the horizontal axis shows the days was then placed in a group home where she remained for
from her removal starting with her placement in an over 3 months before the brief runaway pattern resumed.
emergency group shelter facility. During the 2-year 8-month period from age 14 years
Katrina was moved to her first foster home after 9 months to 17 years 5 months, Katrina experienced
being in the shelter facility about 2 months. After being some 20 plus placement changes and 13 runaways,
in this foster home for 2 days she ran away for a day, some of which were for extended periods. These place-
returned and was placed in a second foster home for 10 ment changes were across nine different foster homes,
days, and was then placed in a second group shelter three different group shelter facilities, and a group
facility. Five days later she ran away again for a couple home. Also, during this period, she was missing from
Clark et al. / FUNCTIONAL APPROACH TO REDUCING RUNAWAY BEHAVIOR 433

the foster care system for over 160 days and had numer- explored, but that the process might take a while. The
ous different caseworkers. On the 7th day of a 16-day behavior analyst assured her that he would take forward
run, Katrina showed up at the caseworker’s office and it her expressed interest in this placement and attempt to
was at that time that a BASP behavior analyst was called represent her wishes during the placement review
in to assist. The behavior analyst was introduced to process. In turn, he told Katrina he would be better able
Katrina as someone who had worked with youth who to advocate for her if she were stable in her current
ran away and was interested in hearing what Katrina had placement. Such an approach may not have addressed a
to say about her situation. However, this meeting was function per se, but it could be said to have acted as a
not sufficient to convince her to return to the group setting event whereby the reinforcing value of remain-
home at this time, rather she resumed her run. Through ing in the current placement was increased.
this initial conversation with Katrina, as well as several Another possible function of Katrina’s behavior was to
subsequent ones upon her return, the behavior analyst escape from settings she found aversive. The behavior
and the caseworker were able to conduct an informal analyst and case manager gleaned information from
functional assessment to determine the variables that Katrina and group home staff that suggested running
were possibly maintaining her running away from away may function as a negative reinforcer (i.e., escape
placements. The process involved asking her a number from aversive situations such as coercive staff interac-
of questions regarding her preferred places, people and tions). Staff reported difficulties interacting with her say-
activities, as well as asking about those that she found ing that she was “loud, disrespectful and excitable.” They
aversive. In particular, questions such as the following complained that when she got upset, she spoke in Spanish
evoked helpful responses from Katrina: “What type of a so that they did not understand what she was saying. Her
home would you like to live in?” “How would you like group home behavior plan indicated that if her behavior
to be treated where you live?” “How is school going for was poor, she would not be allowed to go on weekend
you?” “What would make your living situation more visits, rather her brother and his guardian could come by
workable so you wouldn’t need to run away?” She indi- to see her at the group home. There had also been conflict
cated that a particular home where her brother lived over her desire to have certain, inexpensive food items
would be her most highly preferred placement. She also available to take to school rather than the standard group-
stated that it was important to her that she be afforded home bagged lunch. In the overall picture of her day-to-
the opportunity to seek employment that fit in with her day life there were several indicators that her running
time in school. Katrina also reported some anxiety about away behavior was, in part, maintained by escape from
what would happen to her upon leaving the foster care unpleasant situations in her placement.
system and that she did not believe that her current and Through interviews with Katrina and staff, reviewing
past placements prepared her for independence. Finally, her history in foster care and considering her running away
she expressed distaste for what she viewed as unfair and in light of its possible behavioral functions, several
selective discipline in her current placement. approaches to keeping her safe and stable in a more pre-
Given the information from the initial interview, the ferred placement were brought to light. A placement with
behavior analyst was able to provide some immediate her sibling was explored and she was kept fully informed
feedback as to what Katrina could expect from him in as to the progress of efforts in this direction. The case man-
terms of helping her to get where she could access more ager and behavior analyst met with staff at the group home
preferred people and activities, and experience less in order to address some of the aspects of that placement
exposure to aversive events that might set the stage for that might be motivating Katrina’s running away. As a
her running away. result, some key staff began to explore possible employ-
Results of the interview with Katrina allowed the ment for her while she remained at the group home. The
behavior analyst to formulate hypotheses as to what case manager and behavior analyst explored other place-
maintained her running away behavior and what might ment options in case her first choice was unavailable.
reduce the likelihood of running again. First, Katrina’s Throughout this process, Katrina was kept informed, via
preference for being placed with her brother suggested frequent phone calls and visits, of the progress toward
that remaining in an approved placement could poten- addressing her concerns. She was praised for maintaining
tially be positively reinforced by placement with him. stability in the group home while the process unfolded.
Although the behavior analyst and caseworker were Katrina committed to and did make progress on the level
unable to confirm it, it was thought when she ran she system at the group home following these efforts.
often saw her brother. Katrina was informed that a The behavior analyst and caseworker worked quickly
potential placement with her brother was being to implement as many of these interventions as possible,
434 RESEARCH ON SOCIAL WORK PRACTICE

visiting and communicating with Katrina and the group such as multiple placement changes, living in residential
home staff frequently regarding their progress. In just over group-type placements and having limited acceptable
2 weeks after she had returned to the group home, they options to respond when confronted with aversive condi-
were successful in arranging for Katrina to meet a foster tions. This case example suggests the value of informal
family and, based on her interest, she moved in with the functional assessments and assessment-based interven-
family. This foster parent had experience with older tions that the behavior analysts, caseworkers, and care-
youth and had been trained and certified by the BASP as givers used resulting in a dramatic change in the
a Competency Trained Home in the Essential Tools for placement and runaway trajectories for Katrina. By
Positive Behavior Change (FL DCF, 2005; Stoutimore assessing what Katrina suggested were reasons for her
et al., 2008, this issue). By the week’s end, Katrina and running and what she suggested were her preferences, the
the foster mother had “hit it off” really well. Over time, behavior analyst and caseworker were able to formulate a
Katrina reported that she really felt a part of this family hypothesis of escape and noncontingent reinforcement
and that they cared about her. She stayed in this home factors that may have triggered and/or maintained her
consistently for almost a year (310 days), with the fos- runaway behavior. Based on this, they worked with
ter family and funding agency allowing her to continue Katrina and her caregivers to implement an assessment-
living with them beyond her 18th birthday, when she based intervention that provided her with the most exten-
was emancipated. Of the 12 other foster homes in which sive placement stability, in the most normalized types of
Katina had been placed, this was the first home where at settings that she had experienced since removal from her
least one of the foster parents had been through this home. Katrina also achieved “family” connections that
competency training. may prove to be enduring lifetime supports.
The behavior analyst and caseworker encouraged the
foster parents to be attentive to all of the features of the
intervention as well. Thus, the foster parents made sure PART II: COMPARISON GROUP ANALYSES
Katrina had some time to talk privately with one of them
each day, go on outings, go on visits and outings with This part of the study involved examining the impact
her girlfriend and/or brother; learn how to make her own of the BASP interventions on the percentage of days on
lunch with healthy items and favorite snack items; and runaway status, rate of runs, and rate of placement
do activities that made her feel apart of this family. changes for 13 youth who met the criteria of habitually
After about 6 weeks, Katrina had an opportunity to running away. To provide a basis for understanding
interview for an after-school job. Although she didn’t changes from pre- to postintervention conditions, a
get this one, she did get one soon thereafter. However, comparison group of youth, who met the runaway crite-
none of the after-school jobs she had really interested ria and were matched on several additional factors, was
her until she happened upon an opportunity to provide also examined.
in-home support for an elderly lady. In addition to being The effectiveness of the behavior analytic functional
paid, this job included room and board. This indepen- assessments and intervention strategies were examined
dent living and work arrangement proved to be a good by comparing the changes across conditions for the
mix for Katrina, particularly since the location was not BASP group of children who habitually ran away, in con-
far from her foster family—she was able to maintain her trast to the matched comparison group. The following
supportive relationship. After a 1-year 3-month period, hypothesis is addressed in this part of the study: The
Katrina was still in this independent living situation and behavior analytic functional assessments and individually
was beginning to explore alternative postsecondary train- tailored interventions will result in improvements in the:
ing, community college, and/or other work options. (a) percentage of days on runaway, (b) rate of running
Katrina’s foster mother continued to be actively involved away, and (c) rate of placement change over the pre/
in mentoring and guiding her. postconditions for the BASP group in contrast to that of
the comparison group.

CONCLUSION Methods

Participants
Katrina’s case example illustrates the types and frag-
mented placement histories that foster care youth may Thirteen youth from two metropolitan counties in
experience. Many features of this placement history have Florida who habitually ran away during the period from
been associated with the likelihood of runaway behaviors, late 2002 to 2004 were referred to the BASP. These were
Clark et al. / FUNCTIONAL APPROACH TO REDUCING RUNAWAY BEHAVIOR 435

the first 13 youth that the BASP worked with on runaway (b) annualized rate of running away; and (c) annualized
behavior who had not previously been served by the rate of placement change. For treatment youth, baseline
BASP; were ages 12 to 17 at the time of intervention; and began with their first run episode and ended at the start
had not been incarcerated for extended periods during of the BASP involvement. The postperiod began with
their pre/postperiods (youth were not excluded from this the BASP involvement and was arbitrarily defined as
analysis for detention stays which might range from 1 to 5 lasting 365 days. For comparison youth, baseline began
days, but rather for incarcerations in locked secure facili- with their first run episode and was defined as having
ties with little opportunity for running away). Of these 13 the same duration as the matched treatment youth. (Note
BASP participants, 11 were female, 9 were Caucasian, 2 that a comparison youth could have two or three differ-
were African American, 1 was Hispanic, and 1 was bira- ent baseline durations, if matched with two or three dif-
cial. Katrina, the case example presented in this paper, was ferent treatment youth.) The postperiod consisted of the
not included as one of these 13 because she had been following 365 days, except for four cases where there
involved prior to the time period referenced above. were only between 161 and 349 days of data available
In order to match comparison youth to treatment youth (e.g., a participant left the foster care system).
for the same period and geographic area, data were For each of the dependent variables, three statistical
secured from two state databases maintained by FL DCF: comparisons were conducted. First, a comparison
MCTS and ICWSIS. All comparison youth were matched between the baseline for the BASP group and that of the
to treatment youth by gender and race. Then the three comparison group was made using the two-sample
comparison youth closest in age at first run to each of the Wilcoxon rank–sum test (two-sample test), a nonpara-
treatment youth were selected as their respective matches. metric equivalent of independent sample t test, as the
The overall mean difference in age at first run between all dependent variables did not strictly conform to the normality
treatment youth and their assigned comparison youth was assumptions. The statistical significance for all analyses
0.52 years, with a standard deviation of 0.65. Youth were was tested with α = .05. Second, differences between
not used as matched comparisons if they were not habitual the baseline and postperiod for both groups were
runners (i.e., had run away fewer than three times), had assessed separately using the Wilcoxon matched pairs
ever received services from the BASP, or had experienced signed-rank test, a nonparametric equivalent of a paired
any extended periods of incarceration during the compar- t test. Third, the two-sample Wilcoxon test was used to
ison pre- or postconditions. compare the change from baseline and postperiod for
The decision to use three comparison youth per treat- the BASP group to the pre/postchange found for the
ment youth was made to provide additional statistical comparison group.
power, which is particularly appropriate with a small sam-
Intervention Procedures
ple size (Hennekens, Buring, & Mayrent, 1987). Only three
comparisons were used for each BASP youth because of the Functional assessments. The functional assessments
limited size of the comparison pool and the fact that there is that were conducted by the BASP behavior analysts for
not a significant increase in power beyond a 1:4 match this study suggested that some of the escape/avoidance
(Miettinen, 1969). In several cases the best matches for age factors for runaway behaviors included: restrictions
at first run were comparison youth who had already been imposed by the foster home, group home, or emergency
used as matches for another treatment youth. Thus, the 39 shelter facility; no one seeming to care and feelings of alien-
total matches (3 for each of 13 treatment youth) were made ation/aloneness; mistreatment by caregiver/staff; bullying at
with a total of 26 comparison youth. Seven comparison school or in the neighborhood; gang pressures; and avoid-
youth were best matches to each of 2 different treatment ing/escaping the rules or expectations of the living and/or
youth and 3 comparison youth were best matches for each school settings. Alternatively, or concurrently, running
of 3 different treatment youth. In each case, the comparison away could have been running to access positive rein-
youth’s hypothetical intervention date was set from his or forcers. The functional assessments indicated that some
her date of first run to match the number of baseline days of the runaway behaviors were to access: greater control
for the BASP participant. and autonomy; parents, siblings, or extended family
members; preferred home settings; girlfriend or boyfriend;
Data Sets and Data Analyses
friends; teenage activities and parties; experimentation with
Baseline, or preintervention data, and postinterven- drugs and sex; peer recognition for beating the system; a
tion data were gathered from ICWSIS and MCTS and sense of fun, risk, excitement, normalcy, and freedom; or to
were examined for each youth across the dependent demonstrate that they are adults and “can take care of them-
variables of: (a) percentage of days on runaway status; selves.” Some of the antecedents (or triggers) for runs were
436 RESEARCH ON SOCIAL WORK PRACTICE

factors such as: peers in the setting or other friends


40% Comparison

Mean Percent of Days on Runaway Status


prompting a run; an incident of mistreatment or a situa-
35%
tion that the youth saw as unfair; an opportunity to escape
from a highly monitored or locked facility; avoidance of 30%

a consequence related to problem behaviors at school or 25% BASP

residence; a positive or negative telephone conversation 20%


with a parent or sibling; and a feeling of loneliness or 15%
depression. 10%

5%
Description of the array of individually tailored inter-
ventions. The behavior analysts and caseworkers in this 0%
Baseline Period Postperiod (1-Year)
study used an array of interventions to stabilize the ado- Conditions

lescents’ placements at home, in school, and to meet their


current and longer term needs and wishes. The following Figure 2: The Mean Percent of Days on Runaway Status Shown
features that, singularly or in combination, composed for the Behavioral Analysis Services Program (BASP) Group
(solid dots) and The Matched Comparison Group (Open
most of the 13 interventions that were implemented with Triangles) Across The Baselines and the Postperiods.
the youth and their caregivers and caseworkers were: (a)
informal functional assessments which involved exploring BASP group (solid dots) and comparison group (open
the youth’s interests, preferences, and reasons for running triangles). The BASP group was on runaway 38% of the
away; (b) someone to spend some time each day listening time during baseline decreasing to 18% after the inter-
and talking with the youth in a nonjudgmental fashion; (c) vention. The baseline for the comparison group was
access to family, siblings, and other preferred people 34% of days on runaway status and the postcondition
through safe visitations; (d) enhancing the reinforcing fea- was slightly higher at 38%. The two-sample Wilcoxon
tures of the current living situation through increased test found no statistical difference between the two
access to preferred items and activities, time with special baselines. The signed-rank test indicated a statistically
people, and improved interactions between staff personnel significant decrease in the mean percentage of days on
and the youth; (e) more active communication with rele- runaway status between the baseline and postperiod for
vant school personnel and supports for the youth, for BASP group (p = .05), while the difference was not
example, supervised homework time, tutoring; (f) explor- statistically significant for the matched-comparison
ing and acting on the type of living situation that the youth group. Additionally, the change from baseline to the
might want to have in the short term or long term; and (g) postperiod was significantly larger for the BASP group
for older youth, conducting informal “futures planning” than for the comparison group (two-sample test, p =
regarding possible jobs, postsecondary education, and/or .05). As is evident from the slope of the lines on Figure
independent living situations the youth might be interested 2, the BASP group showed a substantial reduction in the
in. A more detailed description of some of these types of percentage of days on runaway status versus the com-
interventions is outlined on Table 1. parison group that showed an increase.
The youth in both the BASP and the comparison The average annualized number of runaway episodes
groups received services as usual for regular foster care in is shown in Figure 3 for both groups and conditions. The
Florida—with those in the BASP group having additional baseline rate of runaway between the BASP and com-
services provided by a behavior analyst during the inter- parison group was statistically different, with the BASP
vention related to the run behaviors. Services as usual group having an average rate of 12.6 runs per year and
includes but is not limited to: a comprehensive behavioral the comparison group with an average rate of 7.0 runs
health assessment for every child entering into dependent per year. The average rate for the BASP group decreased
care (conducted by a licensed mental health provider); from 12.6 to 3.0, while the comparison group decreased
minimum monthly face-to-face visits by a caseworker, from 7.0 to 3.1 in the postperiod. The decreases in annu-
staffings to address specific needs and recommendations alized rate of runs were statistically significant for both
for services/treatment/therapy/placements; and judicial groups. The difference between the baseline and postpe-
reviews, typically two to three times per year. riod was significantly larger for the BASP group in con-
trast to the matched comparison group.
Results The average annualized number of placement
changes is shown in Figure 4 for both groups and both
Figure 2 shows the mean percentage of days on run- conditions. As with the rate of running away, the rate of
away status for the baseline and postcondition for the placement change is substantially different between the
Clark et al. / FUNCTIONAL APPROACH TO REDUCING RUNAWAY BEHAVIOR 437

TABLE 1: An Array of Intervention Strategies for Consideration

Category Intervention

Preference strategies Introduce more preferred activity equipment and materials (e.g., workout equipment, bicycles), activities
(e.g., video games, sports, music), and extracurricular activities (e.g., attending sporting events
or concerts) to increase the likelihood of youth engagement.
Establish safe visitation arrangements with preferred people (e.g., parents, siblings) to allow the youth
access to these people without having to run to them.
Living arrangements Involve the youth in determining their preferred type of living situation or specific living setting.
Arrange access to a more preferred placement.
Make available an array of “youth-preferred” living situations (e.g., supervised apartments, dorm-type
settings) for older youth.
Incentive arrangements Establish a “behavioral contract” so a youth can earn rewards based on individual target behaviors
such as requesting permission to go places, reporting whereabouts, not running away, or completing
school homework.
Establish allowances for assuming responsibilities around the house.
Create a flexible fund for personnel to use with youth to support the above types of incentives
and activities.
Support older youth in their interests in exploring and getting jobs.
Train and coach personnel Conduct training and consultation with caregivers, caseworkers, resource coordinators, and
supervisors to enhance their ability to provide a more reinforcing approach and environment
for the youth.
Provide training to caseworkers and supervisors on the Positive Parenting Tools to enhance their ability
to interact with youth in ways that will more fully engage the young people.
Improve personnel’s competencies with these transition-age youth by: (a) increasing the rate of positive
social descriptive praise and associated reinforcers, increasing sincere care statements, and
decreasing the rate of coercives; (b) increasing the opportunity for youth to talk about how things are
going (e.g., what’s happening in their daily life, problems or concerns they might have);(c) identifying
youth interests, goals, and dreams; and (d) supporting their pursuit of these (e.g., get an after school
job, opportunity to earn a driver’s license); and (e) providing more engaging activities and activity
materials in their living situations.
Enhance the abilities of caseworkers and their supervisors to be able to: (a) receive contacts from youth
on runaway in inviting and reinforcing ways; (b) conduct informal functional assessments with youth
regarding their reasons for running away; and (c) identify preferences of youth that might provide
information regarding preferred placements and/or other strategies to make it likely that they would be
more engaged and stick around.
Provide guidance to foster care caseworkers and supervisors to enhance their coaching skills for
assisting foster parents, adoptive parents, and natural parents to use improved interactional skills
with young people.

baseline rates, with the BASP group at 29.6 and running patterns with whom the BASP was involved
the comparison group at 15.6 and these differences were suggest that the array of interventions implemented col-
statistically significant. The rate of placement change laboratively by the behavior analysts, caseworkers, and
reduced significantly for the BASP group from baseline caregivers were effective in reducing the percentage of
to post-period (29.6 to 10.1) and for the comparison days and rate of runaway. The percentage of days on
group (15.6 to 8.4). Also, the difference between the runaway for the BASP group decreased from 38% in
baseline and postperiod rate of placement change was baseline to 18% postintervention. For the comparison
significantly larger for the BASP group when compared group, the percentage of days on runaway increased fol-
to the matched comparison group’s change. lowing the hypothetical intervention, possibly placing
them at even more risk of abusing alcohol and drugs,
criminal and sexual victimization, contracting/spreading
DISCUSSION AND APPLICATIONS TO sexually transmitted diseases, arrest and incarceration,
PRACTICE prostitution, and further placement disruptions (Biehal
& Wade, 1999; Courtney, et al., 2005). The annualized
This study provides an illustration of the impact of baseline rate of runaway episodes was statistically dif-
behavior analytic assessments and interventions to ferent between the two groups, with the BASP group
reduce the percentage of days on runaway, frequency being at 12.6 runs and the comparison group at 7.0 runs.
of runaway episodes and to improve the stabilization of Both groups’ rates of runs were reduced during the post-
placement for youth who have a history of running period, with the BASP group reduction being statisti-
away. The findings across the 13 youth with habitual cally significantly larger than that of the comparison
438 RESEARCH ON SOCIAL WORK PRACTICE

runs for extended periods may get more attention from


14
the system even though extended runaways may also
12 put the youth at considerable risk. Another feature of
Mean Number of Runs per Year

BASP
10 the data is a possible interaction effect between the
percentage of days on runaway and the rate of run-
8
away. If youth are on runaway status, they have no
6 opportunity to run again until they return. However,
4 Comparison
this interaction is not fully supported by the data in
that some of the highest rates of runaway occurred dur-
2
ing the periods with the highest proportion of days on
0 runaway (e.g., refer to BASP baselines on Figures 2
Baseline Period Postperiod (1-Year)
Conditions and 3). That is, during the periods in which both
groups had 38% of days on runaway (i.e., BASP base-
Figure 3: The Mean Annualized Rate of Runaways Shown for The line and comparison group postperiod on Figure 2), the
Behavioral Analysis Services Program (BASP) Group (solid dots) and average rates of runaway were highest during BASP
The Matched Comparison Group (Open Triangles) Across the Baselines
and the Postperiods.
baseline and lowest during the comparison group’s
postperiod (Figure 3).
The case example and analyses across the aggregate of
youth provide compelling support for the feasibility and
30 effectiveness of this behavior analytic approach for
Mean Number of Placement Changes per Year

assessing and intervening with youth who have serious


25
BASP histories of runaway behaviors. However, as encouraging
20
as these findings are, neither part of this study involved a
rigorous experimental design. The use of the matched
15 comparison group did provide a quasiexperimental
demonstration that the proportion of days on runaway
10 Comparison
would not have decreased without the intervention. The
5
difference in rate of runaway and placement change were
substantial and statistically significant for the BASP
0 group in contrast to the comparison group, but both
Baseline Period
Conditions
Postperiod (1-Year) groups did show a reduction from the baseline to the post-
period for these two variables.
Figure 4: The Mean Annualized Rate of Placement Change Shown for
The use of archival records for both case examples
The Behavioral Analysis Services Program (BASP) Group (Solid Dots) and group data has advantages and numerous limita-
and The Matched Comparison Group (Open Triangles) Across the tions. Data systems change (e.g., definitions of place-
Baselines and the Postperiods.
ment type) and more attention to the accuracy of data
group. The average annualized rate of placement change entry may vary for different years and under different
across the two groups was also statistically different administrations. However, using the dataset from which
during the baseline periods, with the BASP group show- placement payments (i.e., ICWSIS) were made may
ing a placement change rate almost twice that of the mean that these study findings are more accurate than
comparison group. The functionally determined inter- had a dataset been used for which these contingencies
ventions applied to the BASP group resulted in an almost were not in place. These archival datasets do not include
200% reduction in placement change between the base- information such as the reason for a placement change
line and postperiod and less than a 100% reduction for (e.g., youth behavior, availability of a placement at a
the comparison group. As was the case with the other specific time, system policy changes such as placing
dependent variables, the pre/postplacement change siblings together or matching youth and foster families
rate for the BASP group was greater than that of the based on ethnicity).
comparison group. There continues to be a critical need and rich opportu-
One of the implications of the data across all three nity for future research to provide a stronger examination
of these dependent variables is that certain factors may of the functional relationship between assessment/ inter-
trigger a referral to the BASP by the foster care system vention and runaway behaviors. As was mentioned in this
personnel. A youth who runs or requires a placement section previously, the relationship between youth runaway
change more frequently in comparison to a youth who patterns and the system’s response may not reflect the level
Clark et al. / FUNCTIONAL APPROACH TO REDUCING RUNAWAY BEHAVIOR 439

of risks functioning in a youth’s life. For example, is a The findings from this current study should assist the
youth who runs frequently at greater risk than one who is fields of child welfare, mental health, and juvenile jus-
on a long duration run? Also it is extremely important to tice in examining their practices to prevent and amelio-
better understand how to be proactive and prevent a child rate runaway behaviors. Transformation of these fields
from running the first time, thus possibly avoiding a pattern will require a major paradigm shift, one that if adopted
of unsafe run experiences and placement disruptions. will necessitate changes at the system and policy levels
(Biehal & Wade, 1999; Courtney et al., 2005; de Man, to support personnel in the use of new child friendly and
2000; Miller, Eggertson-Tacon, & Quigg, 1990). effective practices. This, and a focus on assisting
The goal of addressing runaway behavior with children in maintaining and building their connections
youth in out-of-home placements is not only to to lifetime support networks, should greatly improve the
reduce the rate of running away and duration of long-term adjustments and outcomes for our children
unsafe days, but, more importantly to stabilize these and youth.
young people in settings that they would prefer or Some of the evidence-based practices, and other more
with arrangements that make their placements more recent promising practices, might prove to be particularly
livable. For example, one thing that Katrina wanted helpful in serving children and youth more humanely and
while at the group home was to be able to take the effectively. A few of these that are worthy of mention are
snack food Lunchables as one of the items in her described here briefly.
lunch and to have someone to talk with each day. She
also expressed an interest in a home-like setting and 1. Dependency systems should implement evidence-based
efforts were successful in securing this for her. Using programs to effectively serve youth at-risk with
conduct disorders and/or emotional/behavioral distur-
a functional assessment framework while listening to bances. These include programs such as Multidimensional
her wants/needs assisted in guiding the behavior ana- Treatment Foster Care (Shepard & Chamberlain, 2004)
lyst, caseworker, and caregiver in developing effec- and the Teaching-Family Group Home Treatment Model
(Wolf, Kirigin, Fixsen, Blase, & Braukmann, 1995).
tive and appropriate interventions. The strategies 2. A functional assessment method is being researched for
employed provided a dramatic change in the trajec- assisting youth in making informed choices regarding
tory for this young woman and created an opportunity their preferences in living situations (Witherup et al.,
2006).
for the development of social networks that might 3. The Transition to Independence Process (TIP) model is
represent the kind of lifetime support that leads to an evidence-informed practice for working with youth
improved quality of life. and young adults who have emotional/behavioral chal-
lenges (Clark & Davis, 2000; Clark & Foster-Johnson,
1996). The TIP model engages young people in a process
Applications and Considerations for of personal futures planning and coaches them in prepar-
Improving Practice and Policy ing and facilitating their transition toward greater self-
sufficiency and achievement of their short-term and
long-term goals. The TIP model is driven by seven prin-
The term human or social capital has been coined to ciples and associated practice elements. The model has
refer to the complex social mechanisms that parents gar- been shown to improve outcomes across the transition
ner to advance their children’s chances of success domains of employment, education and career training,
living situation, personal effectiveness/wellbeing, and
(Coleman, 1988). Carneiro and Heckman (2003) have community-life functioning (http://tip.fmhi.usf.edu;
suggested that social capital in the form of social skills, Clark, Pschorr, Wells, Curtis, & Tighe, 2004; Karpur,
attitudes, and cognitive abilities learned in childhood Clark, Caproni, & Sterner, 2005).
and adolescence may be variables predictive of success 4. Recognizing that these youth in out-of-home care are in a
mode of discovery just as their peers from families of origin
in school and life. Whereas the majority of typical are, one European program has implemented a cell phone
young people develop social networks that include connection so that young people who “take off” are encour-
family, friends, and other community members who aged to keep in touch. Personnel are trained to receive these
calls in ways that may be reinforcing to the youth; and the
provide guidance and support both financially and staff, to the extent possible, guide the youth to remain safe
socially, many youth living in out-of-home dependency and express to them: that they are missed; statements of car-
systems lack opportunities to develop these types of ing, empathy, or concern; and that they are welcome to call
and return (J. Roethlisberger, personal communication,
social and economic capital (Clark & Crosland, in press; 2004). This same communication link is used at entry to the
Shirk & Stangler, 2004). It would seem that one of the program to help teach young people appropriate behaviors
first steps in minimizing this gap for these foster youth such as requesting permission to go places and reporting
would be to assist them in identifying their preferred liv- their whereabouts.
5. The staff interactions described in the previous item
ing situations and stabilizing them in these settings (e.g., are similar to those used within the TIP model and a
Clark & Davis, 2000; Witherup, Van Camp, Vollmer, & youth interaction tool training that BASP provides to
Prestemon, 2006). foster caseworkers and supervisors (FL DCF, 2004).
440 RESEARCH ON SOCIAL WORK PRACTICE

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